Yes, sometimes I fall apart, too. I try to keep an encouraging message when it comes to this blog, because that's who I try to be in general. In truth though, sometimes I fall apart and things aren't awesome. I'm not immune to it anymore than the next person.
Thus I found myself staring at a leaking wafer at 4:30 this morning and sobbing so hard I woke up my husband. I've had leaks before, and I can usually take them in stride. This, however, would be the third wafer I would apply in less than 12 hours and I just couldn't take it anymore. My negative self-talk was downright vicious in that moment. I felt less than human. Who can't control even their most basic bodily functions? How did I think I was going to make it through the next how ever many months until my surgeries are all complete and I don't have to do this anymore? What if something happens and I can't get my j-pouch or....even worse...I get it and it doesn't work out and I have to go back to this? How did I think I was going to get through these progressively longer training runs, and ultimately a half marathon, when I can't even keep a wafer for more than a few hours?
These were the horrible thoughts swirling through my mind as I prepped everything I would need for one more appliance change. The first change (yesterday evening) was a scheduled change out for a new appliance. Everything was unremarkable. My skin looked good, stoma was cooperative, easy peasy. An hour or so later we were out eating dinner and something just didn't feel right. I left for the bathroom sure I would find a leak. Nothing. Still, things just felt strange so I popped open the top of my pouch coupling and then I could see why. The top third of my barrier paste ring was completely inside the pouch. This meant a leak was inevitable, but I felt ok finishing dinner and taking care of things at home. Once home, I took the wafer off and could see that it might have lasted another hour or so, but the seal was quickly being compromised. I was glad I caught it as we were taking the kids to an outdoor movie and would be out of the house for a few hours. I would have ended up with a public restroom change which I've been able to avoid so far. New system in place, I went on about my business. Everything seemed fine with this second change. I guess that's part of the reason I felt so defeated when I woke up at 4:30, went in to empty, and found the leak.
It ultimately turned out that yesterday was the perfect storm culmination of a couple of issues I've been dealing with over the last few weeks. The first is that I've lost about 25 pounds since my stoma was placed. Originally, the location was selected because it was on the "summit" of the "hill" that my lower belly formed. Now that I've lost weight, the size of the belly hill has shrunk and the stoma is no longer perched atop that summit. It is now sort of above it and toward the new place where my skin wants to fold in (still working on shrinking that hill, so yes there is still a fold....just a smaller one!). One thing I've noticed in the last couple of weeks is that the edge of the stiff collar formed by the mechanical coupling of my wafer (the plastic ring the pouch snaps onto) seems to poke beyond the edge of where my belly wants to fold in. I'm thinking that when I move around a lot and get into positions where I'm more "folded up" than usual (like sitting cross legged on the ground at an outdoor movie) that firmer area can't bend with my new curvature and it ends up pulling away a bit. I think this has caused some of my leaks. Another issue is that my digestion has really thickened and slowed down. This is good in some ways because it mean less emptying, lower dehydration risk, etc. It is also bad in some ways because really thick output is hard for the stoma to pass. I seem to be more and more susceptible to partial blockages all the time. This lands me in that situation I've mentioned in the past where output is forced past the stoma and into the "downstream" piece of intestine that forms my loop ileo. Since I'm not hooked up inside, there is nowhere for this stuff to go until it collects a bit and eventually gets squeezed back out through the tiny secondary opening at the base of my stoma. This almost always results in a seal loss because what is coming out is thick and typically has nowhere to go but under the wafer edge. I try to leave a little space at the side where the opening is, but a lot of times the paste ring will swell up and block it off anyway.
Early this morning I was feeling really defeated. At one point I asked my husband if he would be able to get the time off of work if I moved my appointment up and tried to have surgery in early September instead of mid-October. He was supportive, but he seemed to know that wasn't the best thing for me. It would mean giving up another half marathon after I've been training so hard and doing so well. I guess my thinking was that moving up Step 2 would move up Step 3 and get the whole thing over faster. I just wanted to be done. I laid there in bed and thought and thought about things. I don't think I went back to sleep at all. I finally decided I wasn't going to let this set back beat me. I know I need to drink more fluids with my meals and throughout the day to cut back on the thickening issue. I can do that, it's an easy fix. I also went online today and researched some of the other appliances that are out there. I'm still using the same one I came home from the hospital with even though my body has drastically changed. It's no wonder I'm having problems! I requested some samples of a few systems I think might work better and I'll give them a try once they get here. I feel like I'm back on track now and I can manage this. I will move forward according to my timeline. I will train for and run my race. I can do this.