Stinky Poo - A Story & a Solution

Most ostomates will at some time or another, experience "Stinky Poo". When you first have surgery, your gut is completely cleaned out (can you say Go Lytely?). When your new "plumbing" starts any old kind of bacteria can take hold and create all sorts of problems. I'm actually surprised at the lack of discussion on this topic. Your gut is the most important part of your immune system. Getting it "tuned in" is critical to your health and in minimizing "stinky poo".

So first a story: I got my surgery done in Texas at MD Anderson. Had a VERY skilled surgeon do the work and I was now the new owner of a urostomy and a colostomy. About a year before, I had an illestomy, so I was pretty used to the drill. So we're getting on the plane home... I had emptied both bags before getting on the plane (highly recommended). We loaded up and I was seated in row 5A. It was a small jet so I had a window and aisle seat. The other side of the plane had 2 seats. I had really active gas. I was wearing a two piece and it was really starting to balloon. The plane was still on the tarmac, but they were not allowing anyone to get up. Seatbelts fastend and all that jazz. I knew my gut was not yet "balanced" and the gas was pretty smelly. Oh well. Everyone farts, right. As carefully as I could, I was able to "burp" the pouch under my shirt. Immediately the smell enveloped the entire plane. The stench was overpowering and unhuman. Everyone on the plane thought the bathroom must have backed up into the ventilation system. Even my wife, who was a couple rows back, didn't think it was me, because the smell was so strong and to foreign to be human. A guy a couple rows back said "where are the emergency vents!" and got more than a few laughs. I was actually relieved that the suspicion didn't fall on anyone (especially me). After a few minutes the stench dissapated and the plane finally took off. Once we reached altitude, I was able to "burp" in the rear bathroom where they had much better bathroom vents.

So now, a solution:

I really thing getting your gut "balanced" is really important from the smell of your output to your general health. So here's an idea that has worked for me. Remember, I'm not a doctor. I'm just a Dude with an ostomy. So anyway, I've been drinking "DanActive" from Dannon. It's a flavorful yogurt based drink that "help support your immune system" with probiotics. Essentially these are the "good" bacteria that should live in your gut. Each little bottle contains 10 BILLION L.casei Immunitas. I've tried a couple different brands of probiotic pills, but the effect on my gut is most effective with the DanActive drink. My output has become more predictable (more solid) and it's really not nearly smelly as before. Your mileage may vary, but if you want to "balance" your gut, and get less smelly, give it a try.

So, I'm off to Hawaii soon. I'll report on how the Stealth Belt works out "in the field" and once I get back, I might even try out some other products to report on. If there's something you want me to try, let me know in the comments.

Stealth Belt

Hi Kids! Sorry for the long delay between posts. Busy with business and dealing with cancer. Yada, yada, yada. So, to bring you up to speed: Currently my favorite products are (in the colostomy category) the Cymed 81400V (reviewed earlier) and (in the urostomy category) the Hollister 8478. The 8478 has a convex wafer (my stoma is sort of recessed) and is fairly standard "Holliser" stuff with wafer surronded by "cloth" tape. It's pretty secure and I like the clear front so I can see my stoma better during application. It's a one piece. One day I'll get into the one-piece/two piece debate, but, put simply the one-piece has one less place to fail. So that's my current setup. I get 4 days wear out of both most of the time.

Now onto the current news. I recently bought a "Stealth Belt" from StealthBelt.com. The main guy (owner?) is Richard (He's an ostomate too). I ordered online and Richard was kind enough to call the next day to confirm some details and get the credit card info over the phone. The payment process was a little primitive in this day of instant everything Internet, but I appreciated the personal touch. My belt was a custom job because I have both an colostomy and urostomy. I gave him all the measurements (waist size, distance between stomas, products used (to measure hole size) etc. Many of their products have some sort of customization, but the "two hole" jobs require a bit more attention. Richard was great on the phone and let me know that my custom belt would be ready and shipped in about 10 days. Sounds good. About a week later, the seamstress that makes the belt, called to discuss a minor customization to the belt (which I approved). Great service so far! A couple days later the belt arrived.

First Impression: The material is nice and smooth - sort of bathing suit material but maybe a bit thicker. It's comfortable on the skin. I ordered the "pro" version which has Velcro attachments on the back. It's very adjustable and locks down solid with an extra Velcro patch to "sandwich" in the connection. Very solid hookup that's not going to fail. On the front, there are two pouches that hold my ostomy pouches. The design is made to hold these horizontally. With two "one-piece" pouches, this is a commitment! I applied my pouches horizontally and tried on the Stealth Belt. The entry holes for my pouches were sized the correct distance apart and the pouches fit within the belt just fine. Nice comfortable fit. I have a bit of a "hill" under my colostomy stoma and the belt helped smooth it down just a little bit. (More would have been nicer, but to really do that you'd need thicker material (neoprene?) and a LOT of custom work. After a couple days of use, I can say I like it. I had pretty much changed my wardrobe to only include shirt tail OUT only shirts that were long enough to cover my pouches. Sweaters were good (if they were long enough or Hawaiian shirts (for warm weather). Since a belt around my waist would constrain the pouches I rarely wore any shirts that you tucked in. Now, with the Stealth Belt, I can finally wear regular business shirts! A third of my closet is now usable! There are some things to get used to. Since I'm using a one-piece for both ostomies, draining is a bit more difficult. On the urostomy side, if the bag is pretty full, it makes it hard to "fold" the bag, so getting the nozzle pointed down in the toilet is a little tricky. Not impossible, just a little tricky. It's easier if the bag is only 1/2 full or less. On the colostomy side, if you have solid waste, massaging it toward the spout is a bit trickier sideways than it is straight down (with gravity to help too). Again not impossible, but it is a bit trickier. The upside of feeling more secure and being able to wear tucked in shirts far outweighs the minor inconvenience when draining either pouch (in my humble opinion). If you have a two piece system that can easily "spin" a quarter turn, you wouldn't have any of these issues. So, even though I've only worn the belt two days, I give it a thumbs up (for now). I'm taking a trip soon and will be able to report how the belt does when you go swimming! We'll see...

CYMED 8133F and 81400V

81300F (on left) - One Piece Clear Drainable Pouch with MicroDerm Washer and Gore-Tex Charcoal Filter.

81400V (on right) - 11" One-Piece Opaque Drainable Pouch with Gore-Tex Charcoal Filter and Press 'n Seal Closure

The 81300 and 81400 are both ostomy bags from Cymed.

Both of them use their standard "Micro Skin" wafer/connector. The wafer part (that goes around the stoma) is pretty standard wafer and around that is the Tegaderm-like adhesive. Like all their products, it is VERY form fitting, flexible and secure. Application is pretty straightforward.

One thing I do that makes it a bit easier, is I cut (or tear) a line between the bottom half and the top half. This allows you to first attach the central "wafer". Then take off the "top", then the "bottom" then the two side edges. This is a bit more "controlled" then popping the entire thing on (and hoping you have it positioned perfectly. Once you press it onto the skin, there's no repositioning with this thing.

Although the wafer/connector part is pretty much identical in these devices, the actual bag is quite different. I'm not sure, but I suspect the 81300 uses older technology. First of all, the "spout". In the 81300 it's your basic/plain drainable spout that secures with a clip. Cymed also offers some "twisty"-like closures that (I guess) would be more "form fitting" than a plastic clip, but these just looked way to insecure to me for confident use. Really, using a deluxe bread tie to secure your ostomy bag seems crazy. The clip works just fine. Cleaning is very standard for this type of opening. Make a "cuff", empty the bag, wipe with tissue and re-clip.

In contrast, the 81400 uses a plastis backing on the "spout" that, when folded up (5 times) makes a secure seal to hold in all the goo. There's a velcro-like closure that holds it in place. Works pretty well and you don't have to mess with a clip (that might fall into the drink!). I like to clean the inside of the spout up to the first "fold". This requires making a little "tissue point" to poke into the opening, to wipe the inside. Not the easiest to clean after use (the Coloplast fold-lock system is slicker) but not that big a deal either. I'd give it a 7 out of 10 design-wise.

Another difference is the filter. Unfortunately, the 81300 (left) doesn't work too well. How? For me, there was a slight, but pretty frequent "wiff" of poo. Nothing dramatic. Like a 5% fart, but it was pretty frequent. Just enough to chip away at your confidence. Not a good thing. It DOES have a Gore-Tex outer layer, that means you can shower with the thing. A GREAT feature. Having to put a tape cover on the filter (like with some other systems - Coloplast for one) just seems silly (and I forget half the time).

The filter on the 81400 is (on closer inspection) a completely different design (which is good). This filter doesn't smell at all (yay). It seems a bit slower for gas to escape, but I'll take a slower filter if it's more secure any day. Both filters seem to slow down their filtering if they get wet from the inside (like if you rinse the bag between drainings).

Conclusion: The 81300 has enough problems with it, that I really can't recommend it. The 81400 (using, I'm guessing, more recent/advanced technology) is much better. The Micro-Skin is VERY comfortable, the filter works great, the wear time is reasonable (I get 3 days most of the time), and the system for draining doesn't require a clip. The bag is also very light weight which feels good on the belly (or in your travelling bag). Currently, this is my "go to" ostomy bag and recommended.

I've been using some Coloplast products lately and just got some Hollister stuff the other day, so look here soon for more reviews. Hope this helps!!

The Ostomy Dude

Cymed Uostomy Pouch

CYMED 86325
One-Piece Odor-Proof Urostomy Pouch with Anti-Reflux Desing and Comfort Backing

Review by me

Disclaimer: All this stuff is just one dude's opinion. Your mileage may vary. My ostomies could be very different than yours. For education purposes only.

Cymed? Why would you start reviewing products by Cymed? Well, I heard that they have somewhat unique features and they try to appeal to the more "active" guy/gal (and I like to be active as much as the next dude). Currently Cymed is my "go to" product and I thought it would be as good a place as any to begin my series of ostomy/urostomy reviews.

First the good stuff: All of the Cymed products have a VERY thin adhesive backing. If it's not made of tegaderm, it's something very close. Once applied this stuff sticks to you like a second skin (the Cymed folks call it "micro-skin"). I have not tried all the brands yet, but this is the most comfortable appliance I have ever worn. Sometimes I forget I'm wearing it. Really.

The application of the device is slightly more tricky than a "normal" appliance, but once you get used to it, it's really no big deal. For the urostomy pouches, I think they have 3 flavors of wafer/barrier. Thick, thin & no wafer (just the straight "tegaderm-stuff".

Now the not so good news: My stoma is pretty much flush with my skin. I tried the thick & thin wafer versions and the wafer pretty much disolved in two days! This is madness! So where the wafer used to be, there's now a round little pocket that is perfectly suited for collecting a nice little pool of urine around my stoma. Maybe my urine is specially destructive to wafers, but I don't think so. Fortunately, even with the wafer completely gone, the "tape" still holds up pretty well. Also, since it is clear, you can see if any "bubbles" of urine are marching to the sides and take evasive action. So, this version (photos here) is the one without a wafer at all. The adhesive/thin barrier gets stuck directly to the skin. For me, this one worked the best of all.

Another gripe I have is the nozzle cap. It's a "cap" (not a "plug") and has a tendency to collect a couple drops of urine. So you pop the sucker off and, zing, a drop or two goes flying on your shirt. Granted, with practice, you might figure out a way to avoid this, but geez, why make it hard. Also, the cap is connected by a loose ring that swivels freely around the nozzle. So, it's pretty much a necessaty to manually hold the thing away from the nozzle while you're emptying the bag. If you let go (say to keep your shirt from falling into the stream), the cap will slip right into the stream making more of a mess. Again, with practice, not too hard to master, but they could have done better here. The "plug" on the Colonoplast bag is way, way better (although they have some issues too - review coming soon).

The backing is a light plastic mesh that is reasonably comfortable and it dries pretty quickly after taking a shower. (I'll do another post about backings and why they are more trouble than they are worth - later too...).

Wear time? I've been able to get 3 solid days from them unless I "stress" the bag (waiting too long between emptying). This device REALLY excels at "active-wear". I have worn it rock climbing, swimming laps, biking & yoga and it didn't fail. Wow.

Conclusion: So even with it's faults, the Cymed bag is worth a try, especially if you're into staying active (and shouldn't we all be?).

I am an ostomate

On August 21st, 2009, I underwent a 13 hour surgery to remove a cancer tumor that had embedded itself next to my bladder and prostate. To get the cancer out with margins, they removed my bladder, my prostate, and my rectum. I now have a permanent ostomy at the end of my colon (still have about 50 percent of my large intestine) and I also have a permanent urostomy (with an ileal conduit). You can read some of my cancer history here. This blog is not about my cancer. It's about living with an ostomy and urostomy. I've found that there are gaps in the information available to ostomy patients in choosing the right products. Oftentimes, they simply keep using the brand that they started with in the hospital. I'm going to attempt to try out a number of products and hopefully be a resource to folks (like you?) who are looking for more information about what really works and what you can expect in using specific products. I hope to have ostomy "reviews" for Hollister, Cymed, ConvaTec, Coloplast and others. Maybe even some fringe suppliers that have unique products. Please comment if you have info to add. All this is just my opinion and your mileage may vary. FYI, my ostomy stoma is a "football" shape about 1.25 by 1.5 inches and protrudes about 3/4 of an inch. My urostomy stoma is also a bit oblong and is about an inch by 1.25 inches. They seem to be getting a bit rounder as they heal up, so changing sizes is part of my routine. I hope this helps someone out there...