From Stillwater-Ponca City (OK) Ostomy Outlook May 1998:

Too Much of a Good Thing

by Sharon Williams, RNET; via Northwest Arkansas Mail Pouch

Do you need one and one half hours to change your appliance? Does your stock of ostomy supplies resemble the store front of a local pharmacy? Do you need a "road map" to remember what product goes on first, second, third, etc.? If so, you may be the victim of the "too much of a good thing" syndrome.

Occasionally an individual will come to the Stoma Clinic carrying a large sack containing a vast array of skin care products. He explains "all items are needed in order to apply my pouch." Unfortunately, the reason the individual usually seeks assistance is due to a problem with appliance adhesion, skin breakdown, or inability to afford ostomy products. One particular gentleman who comes to mind was utilizing a special skin cleaner and cream, two types of skin cement, a double-faced tape disc, a paste, AND a popular skin-barrier wafer before the pouch was applied. He had started out with a fairly simple system of ostomy management. However in his quest to achieve what he felt should be a seven-day wearing time with his appliance, he had been adding product after product. Besides the many items he was now using, he had what he described as a "closet full of products at home." After checking his abdomen, it became obvious that what he needed was a product change in the convexity of his appliance and NOT the addition of another product. He also needed a more realistic view of wearing time for his particular situation. Realistically, not everyone may be able to achieve a seven-day, leak-free wearing time. It is much better to anticipate leakage and establish a regular time prior to this. Here are a few hints to remember to help achieve a successful ostomy management system.

Keep it simple. Do not use extra cement, skin-care products, etc., unless absolutely necessary. Sometimes, extra products actually interfere with appliance adhesion or create skin problems. Plain water is still the best cleaning agent for skin around the stoma.

Do not continue to use therapeutic products after the problem has been solved. As an example: Kenalog spray and Mycostatin powder should not be used routinely when changing the appliance. These products are prescribed for particular skin problems. Kenalog is usually recommended for its anti-inflammatory effects and symptomatic relief of the discomfort associated with skin irritation. However, continued and prolonged use of Kenalog after the problem is resolved may lead to "thinning" of the outer layer of skin, thus making it more susceptible to irritations. Mycostatin powder is useful for yeast infection. However, using Mycostatin after the infection clears serves no purpose.

Seek Advice. See your physician or ET Nurse if you find yourself a victim of the syndrome. They can provide assistance in selecting the most appropriate and economical ostomy-management system for your needs.

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Content last revised 1998-05-15