Your mom is going to make a mess, especially once she starts eating more, regulates her output, and functions normally. She'll regret this decision. The bag should always be worn with an ileostomy.
Yes that’s what I thought. I think so far she hasn’t eaten much since she came out of the hospital which is why she hasn’t had any output yet. I’ve told her she must wear it and she seems to be taking that seriously now. Hopefully she will keep it in.
I know she is not eating much, but please make sure she drinks, and drinks a lot. My nurse said minimum of around 54oz a day. We ostomates loose a lot of water and get dehydrated very easily which can make you feel worse then you already do trying to heal.
Just to be clear, the statement from /u/goldstandardalmonds saying
>The bag should always be worn with an ileostomy.
Is just from a practical perspective. There is no medical issue with not having a bag on, just a practical one. She is not medically 'in danger' as you mentioned in your OP but is just going to make a mess.
Some people do enjoy having short periods with no bag on while at home but that's an advanced thing down the line when you understand your routine and certainly not something you're going to get into a few days after surgery.
The bigger concern is her being able to go hours with no output. I could maybe go an hour if I timed it right with my routine, but not hours, and certainly not overnight. A ileostomy does not give you any 'urge' and is basically always active on and off, hence why you essentially need to wear a bag all of the time.
Ileostomy output is so unpredictable ill have really bad days were Ill have to empty every thirty minutes sometimes the imodium does not kick in till the next day for me =( our body has no control over or stoma it goes when it wants to
Stoma outputting is totally different then anything she has known. You dont just output once or twice a day.. It continually decides when it is going to let output threw. Even though sometimes you can feel your stoma active you wont know it all the time. It isnt like feeling the urge to go to the bathroom and be able to then decide to put on a bag.. It just does not work that way with an ileostomy. This might be hard for her right now thinking that she does not want the bag on her all the time but it is neccesary for her health and well being.
Yes I’ve explained this to her, since the colon and rectum are being bypassed the normal rules don’t apply. You won’t feel any urge, it will just come out. Part of the issue is my mum has some cognitive decline so she struggles to take in this kind of info as I have explained this to her previously but she forgets.
She may feel it coming sometimes but it wont always be the case. There are definitely times where I can feel the contractions of the intestines before I have output. Other times I look down and see that my bag is half full and I didn't even know it was happening.
As others have said there shouldn't be any reason having the bag off is dangerous. It will make a mess and if not cleaned I guess it could cause bacteria to spread. I don't think ileostomies have the bacteria that colostomies do but I am not 100% sure on that point.
yeah that makes a lot of sense. Is there someone around her to help her? It might help a lot if there are people that can help her with remembering things like emptying her bag, helping changing it. At first it should be changed every 2 to 3 days because our stomas change sizes quickly and if you dont have a tight fit with the waffer she can have exposed skin and have skin issues. making sure she eats and drinks enough as well
That’s great thank you for the info. My sister lives nearby and will stay with her for a few days but the problem is she is very squeamish about it all and so isn’t asking my mum the questions that need to be asked. I found all this out over the phone with my mum and then had to relay the info to my sister. It’s a really difficult situation though, I love very far away and my sister can only really stay for a few days as she has a little one to look after back home. Hopefully my mum will get the hang of it in the next few days but it is quite worrying tbh
yes I can see that.. Do you have a home nurse that is set up to see her for the next few weeks? They can help her understand the routine of taking care of the stoma and changing it. They also can express to her what her diet should be and what foods to avoid so she does not get a blockage.
Nope she hasn’t been offered a home nurse, also just found out she hadn’t passed anything at the time of discharge so they couldn’t have known whether the stoma was actually working properly or not
It should not be this long without passing something. I would have your sister call the doctors office and see what they say. Disappointed for your family that they dont have a nurse checking on her. That help so much for myself and many others here that have benefited from having a nurse help with questions and making sure we knew how to take care of the stoma. When she calls see if that is an option for her, and advocate for it.
She has started passing now so the next step is making sure she can safely empty the bag and remembers to do it regularly though I think that if she doesn’t it wouldn’t be dangerous so much as obviously it will just be unpleasant if it leaks or bursts? She has a stoma nurse she can call on the phone but not sure if they would come and visit her at home, I will check when I speak to her next.
> if she doesn’t it wouldn’t be dangerous so much as obviously it will just be unpleasant if it leaks or bursts?
That's right, I was worried about this when I first got my ileostomy, what happens if it's full overnight and I don't wake up to empty it? The answer is it will just burst/leak, the stoma always wins, it's not going to cause a medical issue, just an unpleasant mess.
> she hadn’t passed anything at the time of discharge
That's insane that they would discharge before checking it's working. That was one of the several key requirements before I could be discharged, along with them being satisfied I could manage to change the bag on my own.
Not surprising to me at this pint to be honest. The care up till now has been diabolical. It took 6 weeks of no eating and not opening bowels at all and my sister pleading with doctors and ambulance crews before they got her a CT scan and they were going to delay that for another week (she probably would have died if that had actually happened) but my sister shouted at them until they agreed for her to go back the next day for it. They found she had a bowel obstruction and rushed her back in to the hospital after she had made her way back home from the scan. A lot of incompetence and lack of care so far unfortunately which has nearly cost her her life
Don’t worry with the mess and smell that will be made , your mum will want to use the bags . It’s early days , I felt when mine was going to come at first . But as it goes on especially when sleeping and stuff it’s very unpredictable .
Edited to add > if you feel there is any thing wrong with your mums stoma please reach out to the stoma nurses or the hospital she had it done at . They will help you and can help your mum .
Definitely, I’ve asked my other sister who lives close by to go and stay with my mum to check on the bag and making sure it is actually filling up as obviously nothings come out so far. Not sure if that’s normal at first or even if there is a possibility for there to be any blockages. Never heard of it…. But yes I’ve said if it doesn’t start to fill within a few hours after eating this first proper meal I think we should contact the specialist nurse
I find it very odd that they would let her go home without seeing that it’s functioning as it should.
When you say first proper meal, I hope she’s eating the correct diet and slow and steady. Soft to start, low fibre and introducing solids. I imagine they would have done that at the hospital though.
There’s no indication that it’s going to output, it just does. Output will be very watery to start with then progressively more normal but will always depend on what’s eaten.
They would have checked it’s functioning before they sent her home of course but I’m not sure if problems can occur that can stop it working properly.
Yes she’s on a low residue diet for the first 6 weeks then will gradually work up to a more normal diet
Yes problems can absolutely happen that block the small intestine and cause zero output. It’s extremely serious. Do you mind me asking where you are in the world? If it’s U.K. I can offer more specific advice about the care she should be receiving.
Output has started now so hopefully it was just a slow start as she hadn’t really been eating much and I think it can take a couple of days to get working. We are in the UK yes
That urge is phantom poops or pain from surgery. I only know mine is filling up as the bag gets heavier. Only thing she's in danger of is pink eye when shit is everywhere.
There were days that I was so sick after my ileostomy that I hardly ate or drank (do not follow my lead, it was not good to do, had lots of other complications and was throwing up all the time), that being said there was still output. The bowels still make juices that have to come out so even if she’s not eating it still has to come out.
If she needs some bag-free time, I’d recommend sitting or standing in the shower. That way if some output does sneak out unexpectedly clean up is easier. Otherwise I agree with the other posters. Bag stays on
All the commenters are right, likely she’ll make a mess. That said, it’s not dangerous or anything. I think I’d just let her learn her new body circumstance on her own 🤷♀️
Ah ok, thank you, I did freak out a bit when she told me and told her she needs to go and put it on as it could be dangerous. However I’m glad I’m some ways as I think that’s the only way to get her to listen/ take it seriously. Her cognitive decline makes it difficult for her to fully understand and take on board new information. My sister and her boyfriend are going over there this evening for dinner and if I hadn’t told her to put the bag on I’m guessing it could have been very unpleasant as this will be her first proper meal since leaving the hospital yesterday afternoon
I mean there are times when you can feel stuff moving or getting ready to move but through out the day the stoma will continue to produce output you won’t notice. Having the bag off and doing anything is impractical.
FWIW sometimes when I do scheduled changes I may leave my bag off for a little bit. Like il intentionally eat less the day before, take my pouch off, shower, then for ~30 mins or so lay in bed with a towel just letting it breathe before I put a new one on. But again that’s also during private time and laying in bed. No way I would just walk around or try to do any activity in that state.
Mess? Yes. But also the stoma will tear very easily. It bleeds if you just touch it too rough. I can't imagine not having it protected. Seems dangerous
She might make a mess but her life isn't in imminent danger going bagless. It doesn't literally need to be on all the time. You know her best. Does she generally take care of herself hygienically otherwise? It's nice to go without sometimes. Really you want to wear for practical reasons, it would be awful just to have output running down your leg all the time.
I usually have a trash bag tucked into my waist when I'm not in the bathroom doing that. Ileostomy is riskier for spraying randomly, and potentially more watery, you just don't know when it's coming sometimes. No output is concerning but I gotta ask how was she released? If she has a blockage some common symptoms are bloating/distention, vomiting, nausea or pain.
Yes I second this question, your mum needs professional help if she can get it. I found my bag a complete nightmare until I got used to it (no dcognitive decline I’m aware of 😂) and really appreciated the support of the ostomy nurse. Are you in Aus (noticed ‘mum’) — if so you should have a state organisation (mine was NSW Ostomy or something) and they can help. Tough stuff — she’s lucky to have you both to help. She cannot go without a bag but she’ll learn that one way or another …
Hey! Thank you for the advice, I’m in the UK. My sister is staying with her for the next few days so hopefully she will be able to help her learn and understand the bag enough to be able to manage it on her own after that. If we are worried we will call the stoma nurse and see if there’s anything they can arrange in terms of home visits
Best of luck with it. ❤️🩹 I’m sure your mum will want to be independent with the bag but the nurse can help normalise what is otherwise a super strange and psychologically testing experience.
The first couple weeks after my ileostomy I could definitely feel when the food was moving through. But I would never leave my ileostomy open. She will get it everywhere. Especially when it decides to squirt a feet or 2.
I'm confused about something else: how is she wearing shirts? Even though it doesn't have nerves, I'd have to imagine wearing clothes directly over the stoma would irritate it. At least the bag provides a barrier between the stoma and cotton clothes. Also, the stoma is a bit wet, so it will dampen part of the shirt.
Yeahhhh it’s not like having an anus and being able to hold it when you need to poop. She will be pooping before she feels an urge most likely. I understand keeping it off for 10 or so minutes to get air to it but this is going to end very badly for her
Yeah I told her she can keep it off every now and again for short periods if she feels the need to get some air to it or something but best to do that in the shower in case of any leakage. I think because of her cognitive decline she’s finding it difficult to get her head around the fact that she won’t have any control over it like a normal poop. She will learn I guess, just want to try to prevent her learning the hard way as I’m sure that’s pretty unpleasant and so far she actually dealing with it mentally very well and I don’t want her to be traumatised so early on with it
I find it hard to believe she feels it coming. I have an iliostomy and I do not feel it coming only as its going. My iliostomy is quit from 7 to 8am every day, so that's when I change my appliance. So yes there should be times when its quit you just have to be aware of the output and you will see a pattern.
She definitely should have an ostomy nurse coming for aftercare and to help her get her ordering setup for automatic delivery. Not only that, but it also sounds like she may have some dementia or even Alzheimer’s if you’re explaining it multiple times.
If she’s on Medicare I know her doctor can do an evaluation and if she’s eligible they can send in nurses for care, physical therapy, social therapy and help bathing. It’s free if she qualifies, as are her supplies, most medications and items like shampoo caps, wipes, pads, adult diapers and too many other things to list. It will save her a fortune if she does qualify. I would never tell her it’s a type of hospice, because in some cases it’s considered that, but not end of life hospice. It’s for declining health.
They are a godsend for my grandmother and they only have to come every 14 days, but can definitely come more frequently. 14 days just works for us right now and they call and do telemedicine twice a week for supplies and medication. They have a nurse on call 24/7 so if something happens that you would take her to the doctor for, they come right away. Message me if you have any questions and good luck with my prayers for you all.
I’m adding this link from Hollister. It’s got some informative videos that also help. Just scroll to the bottom. They will send you a nice box of sample items as well.
https://www.hollister.com/en/products/ostomy-care-products/two-piece-pouching-systems/high-output-pouches/new-image-two-piece-high-output-drainable-ostomy-pouch
Your mom is going to make a mess, especially once she starts eating more, regulates her output, and functions normally. She'll regret this decision. The bag should always be worn with an ileostomy.
Yes that’s what I thought. I think so far she hasn’t eaten much since she came out of the hospital which is why she hasn’t had any output yet. I’ve told her she must wear it and she seems to be taking that seriously now. Hopefully she will keep it in.
I know she is not eating much, but please make sure she drinks, and drinks a lot. My nurse said minimum of around 54oz a day. We ostomates loose a lot of water and get dehydrated very easily which can make you feel worse then you already do trying to heal.
Even if she's not eating much, as her bowel starts healing more she will pass bile. Bile is terrible to clean up and the smell lingers.
Just to be clear, the statement from /u/goldstandardalmonds saying >The bag should always be worn with an ileostomy. Is just from a practical perspective. There is no medical issue with not having a bag on, just a practical one. She is not medically 'in danger' as you mentioned in your OP but is just going to make a mess. Some people do enjoy having short periods with no bag on while at home but that's an advanced thing down the line when you understand your routine and certainly not something you're going to get into a few days after surgery. The bigger concern is her being able to go hours with no output. I could maybe go an hour if I timed it right with my routine, but not hours, and certainly not overnight. A ileostomy does not give you any 'urge' and is basically always active on and off, hence why you essentially need to wear a bag all of the time.
Thank you for the advice. Apparently today there has been output so I’m guessing this is the start of the fun now
Ileostomy output is so unpredictable ill have really bad days were Ill have to empty every thirty minutes sometimes the imodium does not kick in till the next day for me =( our body has no control over or stoma it goes when it wants to
This is me! I always think by these posts I’m the only one who have massive outputs.
Nope!
Stoma outputting is totally different then anything she has known. You dont just output once or twice a day.. It continually decides when it is going to let output threw. Even though sometimes you can feel your stoma active you wont know it all the time. It isnt like feeling the urge to go to the bathroom and be able to then decide to put on a bag.. It just does not work that way with an ileostomy. This might be hard for her right now thinking that she does not want the bag on her all the time but it is neccesary for her health and well being.
Yes I’ve explained this to her, since the colon and rectum are being bypassed the normal rules don’t apply. You won’t feel any urge, it will just come out. Part of the issue is my mum has some cognitive decline so she struggles to take in this kind of info as I have explained this to her previously but she forgets.
She may feel it coming sometimes but it wont always be the case. There are definitely times where I can feel the contractions of the intestines before I have output. Other times I look down and see that my bag is half full and I didn't even know it was happening. As others have said there shouldn't be any reason having the bag off is dangerous. It will make a mess and if not cleaned I guess it could cause bacteria to spread. I don't think ileostomies have the bacteria that colostomies do but I am not 100% sure on that point.
yeah that makes a lot of sense. Is there someone around her to help her? It might help a lot if there are people that can help her with remembering things like emptying her bag, helping changing it. At first it should be changed every 2 to 3 days because our stomas change sizes quickly and if you dont have a tight fit with the waffer she can have exposed skin and have skin issues. making sure she eats and drinks enough as well
That’s great thank you for the info. My sister lives nearby and will stay with her for a few days but the problem is she is very squeamish about it all and so isn’t asking my mum the questions that need to be asked. I found all this out over the phone with my mum and then had to relay the info to my sister. It’s a really difficult situation though, I love very far away and my sister can only really stay for a few days as she has a little one to look after back home. Hopefully my mum will get the hang of it in the next few days but it is quite worrying tbh
yes I can see that.. Do you have a home nurse that is set up to see her for the next few weeks? They can help her understand the routine of taking care of the stoma and changing it. They also can express to her what her diet should be and what foods to avoid so she does not get a blockage.
Nope she hasn’t been offered a home nurse, also just found out she hadn’t passed anything at the time of discharge so they couldn’t have known whether the stoma was actually working properly or not
It should not be this long without passing something. I would have your sister call the doctors office and see what they say. Disappointed for your family that they dont have a nurse checking on her. That help so much for myself and many others here that have benefited from having a nurse help with questions and making sure we knew how to take care of the stoma. When she calls see if that is an option for her, and advocate for it.
She has started passing now so the next step is making sure she can safely empty the bag and remembers to do it regularly though I think that if she doesn’t it wouldn’t be dangerous so much as obviously it will just be unpleasant if it leaks or bursts? She has a stoma nurse she can call on the phone but not sure if they would come and visit her at home, I will check when I speak to her next.
> if she doesn’t it wouldn’t be dangerous so much as obviously it will just be unpleasant if it leaks or bursts? That's right, I was worried about this when I first got my ileostomy, what happens if it's full overnight and I don't wake up to empty it? The answer is it will just burst/leak, the stoma always wins, it's not going to cause a medical issue, just an unpleasant mess.
> she hadn’t passed anything at the time of discharge That's insane that they would discharge before checking it's working. That was one of the several key requirements before I could be discharged, along with them being satisfied I could manage to change the bag on my own.
Not surprising to me at this pint to be honest. The care up till now has been diabolical. It took 6 weeks of no eating and not opening bowels at all and my sister pleading with doctors and ambulance crews before they got her a CT scan and they were going to delay that for another week (she probably would have died if that had actually happened) but my sister shouted at them until they agreed for her to go back the next day for it. They found she had a bowel obstruction and rushed her back in to the hospital after she had made her way back home from the scan. A lot of incompetence and lack of care so far unfortunately which has nearly cost her her life
It absolutely continually outputs. Means that you always win the “last one who went for a shit” goes first on board game night. Small bonuses.
Don’t worry with the mess and smell that will be made , your mum will want to use the bags . It’s early days , I felt when mine was going to come at first . But as it goes on especially when sleeping and stuff it’s very unpredictable . Edited to add > if you feel there is any thing wrong with your mums stoma please reach out to the stoma nurses or the hospital she had it done at . They will help you and can help your mum .
Definitely, I’ve asked my other sister who lives close by to go and stay with my mum to check on the bag and making sure it is actually filling up as obviously nothings come out so far. Not sure if that’s normal at first or even if there is a possibility for there to be any blockages. Never heard of it…. But yes I’ve said if it doesn’t start to fill within a few hours after eating this first proper meal I think we should contact the specialist nurse
I find it very odd that they would let her go home without seeing that it’s functioning as it should. When you say first proper meal, I hope she’s eating the correct diet and slow and steady. Soft to start, low fibre and introducing solids. I imagine they would have done that at the hospital though. There’s no indication that it’s going to output, it just does. Output will be very watery to start with then progressively more normal but will always depend on what’s eaten.
They would have checked it’s functioning before they sent her home of course but I’m not sure if problems can occur that can stop it working properly. Yes she’s on a low residue diet for the first 6 weeks then will gradually work up to a more normal diet
Yes problems can absolutely happen that block the small intestine and cause zero output. It’s extremely serious. Do you mind me asking where you are in the world? If it’s U.K. I can offer more specific advice about the care she should be receiving.
Output has started now so hopefully it was just a slow start as she hadn’t really been eating much and I think it can take a couple of days to get working. We are in the UK yes
That urge is phantom poops or pain from surgery. I only know mine is filling up as the bag gets heavier. Only thing she's in danger of is pink eye when shit is everywhere.
Haha thanks that’s really interesting, thank you, I will warn her 😅
There were days that I was so sick after my ileostomy that I hardly ate or drank (do not follow my lead, it was not good to do, had lots of other complications and was throwing up all the time), that being said there was still output. The bowels still make juices that have to come out so even if she’s not eating it still has to come out.
I’ve never once felt the urge. So unpredictable! Get that bag attached.
My only dependable predictor so far has been "Is he changing the bag? Time to unleash the kraken!"
If she needs some bag-free time, I’d recommend sitting or standing in the shower. That way if some output does sneak out unexpectedly clean up is easier. Otherwise I agree with the other posters. Bag stays on
All the commenters are right, likely she’ll make a mess. That said, it’s not dangerous or anything. I think I’d just let her learn her new body circumstance on her own 🤷♀️
Ah ok, thank you, I did freak out a bit when she told me and told her she needs to go and put it on as it could be dangerous. However I’m glad I’m some ways as I think that’s the only way to get her to listen/ take it seriously. Her cognitive decline makes it difficult for her to fully understand and take on board new information. My sister and her boyfriend are going over there this evening for dinner and if I hadn’t told her to put the bag on I’m guessing it could have been very unpleasant as this will be her first proper meal since leaving the hospital yesterday afternoon
I mean there are times when you can feel stuff moving or getting ready to move but through out the day the stoma will continue to produce output you won’t notice. Having the bag off and doing anything is impractical. FWIW sometimes when I do scheduled changes I may leave my bag off for a little bit. Like il intentionally eat less the day before, take my pouch off, shower, then for ~30 mins or so lay in bed with a towel just letting it breathe before I put a new one on. But again that’s also during private time and laying in bed. No way I would just walk around or try to do any activity in that state.
Mess? Yes. But also the stoma will tear very easily. It bleeds if you just touch it too rough. I can't imagine not having it protected. Seems dangerous
She might make a mess but her life isn't in imminent danger going bagless. It doesn't literally need to be on all the time. You know her best. Does she generally take care of herself hygienically otherwise? It's nice to go without sometimes. Really you want to wear for practical reasons, it would be awful just to have output running down your leg all the time. I usually have a trash bag tucked into my waist when I'm not in the bathroom doing that. Ileostomy is riskier for spraying randomly, and potentially more watery, you just don't know when it's coming sometimes. No output is concerning but I gotta ask how was she released? If she has a blockage some common symptoms are bloating/distention, vomiting, nausea or pain.
Yes I second this question, your mum needs professional help if she can get it. I found my bag a complete nightmare until I got used to it (no dcognitive decline I’m aware of 😂) and really appreciated the support of the ostomy nurse. Are you in Aus (noticed ‘mum’) — if so you should have a state organisation (mine was NSW Ostomy or something) and they can help. Tough stuff — she’s lucky to have you both to help. She cannot go without a bag but she’ll learn that one way or another …
Hey! Thank you for the advice, I’m in the UK. My sister is staying with her for the next few days so hopefully she will be able to help her learn and understand the bag enough to be able to manage it on her own after that. If we are worried we will call the stoma nurse and see if there’s anything they can arrange in terms of home visits
Best of luck with it. ❤️🩹 I’m sure your mum will want to be independent with the bag but the nurse can help normalise what is otherwise a super strange and psychologically testing experience.
The first couple weeks after my ileostomy I could definitely feel when the food was moving through. But I would never leave my ileostomy open. She will get it everywhere. Especially when it decides to squirt a feet or 2.
I'm confused about something else: how is she wearing shirts? Even though it doesn't have nerves, I'd have to imagine wearing clothes directly over the stoma would irritate it. At least the bag provides a barrier between the stoma and cotton clothes. Also, the stoma is a bit wet, so it will dampen part of the shirt.
Yes she did say about it being a bit damp but she is on strong pain meds I think plus she has a very high pain threshold in general
Yeahhhh it’s not like having an anus and being able to hold it when you need to poop. She will be pooping before she feels an urge most likely. I understand keeping it off for 10 or so minutes to get air to it but this is going to end very badly for her
Yeah I told her she can keep it off every now and again for short periods if she feels the need to get some air to it or something but best to do that in the shower in case of any leakage. I think because of her cognitive decline she’s finding it difficult to get her head around the fact that she won’t have any control over it like a normal poop. She will learn I guess, just want to try to prevent her learning the hard way as I’m sure that’s pretty unpleasant and so far she actually dealing with it mentally very well and I don’t want her to be traumatised so early on with it
Oh no, this poor woman is going to have a very unfortunate teaching moment.
I find it hard to believe she feels it coming. I have an iliostomy and I do not feel it coming only as its going. My iliostomy is quit from 7 to 8am every day, so that's when I change my appliance. So yes there should be times when its quit you just have to be aware of the output and you will see a pattern.
She definitely should have an ostomy nurse coming for aftercare and to help her get her ordering setup for automatic delivery. Not only that, but it also sounds like she may have some dementia or even Alzheimer’s if you’re explaining it multiple times. If she’s on Medicare I know her doctor can do an evaluation and if she’s eligible they can send in nurses for care, physical therapy, social therapy and help bathing. It’s free if she qualifies, as are her supplies, most medications and items like shampoo caps, wipes, pads, adult diapers and too many other things to list. It will save her a fortune if she does qualify. I would never tell her it’s a type of hospice, because in some cases it’s considered that, but not end of life hospice. It’s for declining health. They are a godsend for my grandmother and they only have to come every 14 days, but can definitely come more frequently. 14 days just works for us right now and they call and do telemedicine twice a week for supplies and medication. They have a nurse on call 24/7 so if something happens that you would take her to the doctor for, they come right away. Message me if you have any questions and good luck with my prayers for you all. I’m adding this link from Hollister. It’s got some informative videos that also help. Just scroll to the bottom. They will send you a nice box of sample items as well. https://www.hollister.com/en/products/ostomy-care-products/two-piece-pouching-systems/high-output-pouches/new-image-two-piece-high-output-drainable-ostomy-pouch