Pelican Select Convex Drainable Pouch–Product Review

After attending the recent stoma open day, I received a sample pack from Pelican, of three of these bags. Their representative phoned me the other day to see how I got on with them, but at that stage I hadn’t yet tried them, but promised to do so and let them know how I got on with them.

I told her that I was already using the Coloplast SenSura Convex Light bags and once they bring out the SenSura Mio in the convex, that will be my bag of choice, and I felt I should tell her that up front. She said that was fine, and they appreciate any reviews of their products because such feedback always helps with improvements in the future.

I put on this bag on Thursday so I have now been wearing it for two days, and I must say I am generally very impressed.

The convex flange on this bag is very soft indeed, and the backing sheet on it protecting the sticky surface is thin and flexible, with good measuring guides for cutting the hole to size. It is the easiest bag I have ever cut – really soft and effortless.

The sticky surface, called “Skin Protector,” is quite thick compared with other bags I have tried, and it has a foam back, which is extremely flexible. What impresses me most, apart from ease of application and comfort during wear, is that I have experienced no itching at all. On day 2, wearing the Colopolast bags, I do experience some itching under the glue; it’s not a major problem and isn’t caused by any reaction, and there isn’t any evidence of redness or the skin breaking down when I change the bag, but it is an indication that I will soon need to change the bag. With the Pelican bag, however, it has remained very comfortable and so far there is no itching at all.

The bag itself has an “anatomical” asymmetrical shape which is comfortable to wear, being curved on the outer edge so that it sweeps away free of one’s leg. The capacity of the bag is, I think, somewhat larger than the Coloplast bag. The cover is beautiful – it has firm feel to it which I knew would be unlikely to go fluffy with contact with one’s clothing after a day or two, as I have experienced with one or two sample bags I’ve tried, and this has proved to be the case. I am also very impressed with its opacity. The Coloplast bag, while it does have a flesh-coloured opaque cover on it (which again does not go fluffy), you can see the stoma output through it because it is rather thin, but with the Pelican bag, the cover is thicker, and nothing is visible.

It has a split in the middle, underneath which is the clear bag, and you can view the whole of the bag through this, and not just a “port hole” around the stoma, as with another bag I tried. It is very easy to see exactly where to place the bag over the stoma. (On this photo, you can see the thickness of the flange.)

The opening on the tail more closely resembles the Coloplast bag than any other I have tried, with the triple fold-up, and the winged tabs which are pressed down over the folded tail and held in place with Velcro.

I still like the Coloplast one the best, with its two rigid strips – the one on the underside of the bag is located below the one on the top, which means that when you empty it, there is a “step” that the output goes onto before draining away, and I find this easier to wipe with some folded toilet paper wrapped around the end of the bag, without getting any output on my hands. The Coloplast bag tail opens a lot more easily too, because the rigid strips are slightly stiffer, and you just press the sides together and it pops open. With the Pelican bag, the rigid strips are one directly above the other, and you squeeze the sides together to make a “U” shape:

and then pull on the little tab to open the upper layer towards you, which is a two-step process, and I find it doesn’t always work very well, especially when it is wet, because it tends to stick shut.

I couldn’t show a full demo of opening the bag because it required two hands and I needed one to hold the camera!

There is a very effective “fold up” system after you have closed the tail. As with the Coloplast bag, there is a Velcro dot under the opaque cover.

Once you have closed the tail, you fold it up, and stick the exposed Velcro strip between the two tabs, to the Velcro dot, and this holds the tail in place under the cover.

It folds up higher under the cover than on the Coloplast bag.

This is a good thing, because with the weight of the output, I do find that the Coloplast bag tends to sag at the bottom, and while it is still attached to the Velcro dot, it falls down below the cover and flops outwards.

The Velcro dot on the Pelican bag is also slightly larger, and has much tougher Velcro hooks on it, so is more effective. However, yesterday (1st full day of use) I noticed that the dot had come unstuck from its adhesive and was stuck on the tail, leaving the adhesive behind under the cover, and the cover has stuck firmly to it and is quite immovable, rendering the fold-up system useless; I don’t know if this is a one-off, and that it won’t happen with another bag, which I will have to try and see. Ed. 16th June after trying another bag: It is clear that body warmth softens the adhesive on the Velcro dot, which makes the Velcro dot slide off, exposing the sticky surface on the inside of the cover, which then adheres firmly onto the clear plastic lining of the bag. The two cannot be pulled apart without risking tearing a hole in the plastic bag. This renders the tucking up of the tail impossible because the cover remains stuck to the bag in the centre. This is a design fault which needs to be rectified – they need a different adhesive for the Velcro dot.

I am not convinced that the filter on the Pelican bag works very well; it is obviously letting some gas out (and I do produce quite a lot of gas!) because I am getting some smell from the bag. Fortunately it is merely the smell of the excellent OstoMart mint deodorising drops sample that I got at the open day – but I have never smelt anything from any of the other bags I have used. The gas is not dispersing fully, either; I still have to burp this bag to get rid of it. Ed. 16th June: To prevent any smell getting out, I have now covered the filter with one of the circular stickers they provided with the samples.

To be fair, I’ve never been convinced by filters on any of the bags I’ve tried; there is no evidence that any gas has escaped at all – odour or otherwise!

In summary, I must say I am very impressed indeed with this bag; the only drawbacks are the filter and the closure, and the failure of the system to tuck the tail under the cover, but these are minor gripes. The quality of the bag is excellent and once it’s on, you can forget it. I would definitely seriously consider choosing this bag above the Coloplast, but I am anxious to try the new Coloplast convex SenSura Mio as soon as it becomes available, and if it works as well as I am expecting, that will be my No. 1 bag of choice.

Stoma Clinic Appointment

On Thursday 28th May I had my final regular appointment at the stoma clinic – up until now I have been attending fortnightly, and then this last appointment was three weeks on from the previous one. In the early days I was having to ask for emergency appointments in between, because of problems, but now that things have finally settled down and I am using the right bag to suit me, I do not have to attend again for the next three months. I am very pleased to have reached this stage at last, after a lot of teething problems (which I think everybody goes through in the early stages), because it’s good to have them behind me as I start my chemo. The chemo increases the stoma output and makes it a lot more liquid too, and I wouldn’t want to be dealing with this if I was still experiencing leaks and finding stoma management difficult.

At this appointment, the nurse discussed setting up my prescription for me. She told me the supply company would phone me in the next few days, and that she would send my prescription to my GP. After this, when I am beginning to run low on anything, I just have to contact the supply company direct and let them know what I need, and they will get the prescription from my GP, and in due course my parcel will arrive. Easy peasy.

She told me that in order to save the NHS money, my choices may be fairly limited. However, I know many people who are able to get both adhesive remover spray and wipes, and not just a choice of one, so it may be possible to ask for it and see what my GP will allow. If they say I can’t have certain things, so be it.

She has also ordered a couple of pairs of pants for me, and a wrap – I should be able to get more of these in due course – to hold the bag in place more securely and to stop bulged showing as the bag fills. I have found that it flops about a bit in bed, and a wrap will hold it in place. These will be sent from a different company so won’t arrive with my first parcel of supplies.

The nurse put a fresh bag on for me, and said that I had cut the hole too small – if there is no room for movement, one can develop granulomas which can bleed a lot and be a nuisance. However, as she cut it and applied it, the hole looked a lot bigger than what I had cut and I was pretty sure it was too big. She said she would send the template to the company and they would pre-cut my bags for me.

Over the next few hours, my worst fears were realised, and I could feel the itching and pain beginning again, and I knew the hole was too large. I left the bag in place until the following day and when I changed it, I was glad I’d caught it in time – the skin was beginning to redden, but it was not yet broken. I cut a fresh bag to the smaller size, and phoned the nurse to tell her what had happened. I asked that she phone the suppliers and ask them to send my first batch uncut, and I would forward my template to them in due course, and she was absolutely fine with this.

It was a very satisfactory appointment.

Yesterday the company phoned me and we discussed this, and other matters.

A Good Stoma Clinic Appointment

The second of two posts for today.

This afternoon I had another scheduled appointment at the stoma clinic. I had spoken briefly on the phone last Tuesday with one of the specialist colo-rectal nurses about my problems with one of the HCAs and asked that I didn’t see her again, so I was a bit alarmed that she appeared to be on duty at the clinic today. I asked the receptionist who I was due to see, and he told me it was one of the CNS’s (Clinical Nurse Specialists) so I was relieved. The receptionist knew me by name, which was nice – but it does indicate just how much time I am spending in that place!!

While I was waiting, Dr. Johnston, the gastro-enterologist came through, and I had a nice chat with him, and while we were talking, my surgeon, Mr. Pullan, also turned up, wearing his scrubs! We all had a nice chat, and he said how well I was looking after my operation. I told them both about the six months of chemotherapy that I am facing and they both wished me well, and agreed that I have to look on it as a positive thing, making sure that all the cancer is gone for good. Nice to see my two favourite consultants!

My hubby was still parking the car when I was called in for my appointment. I was able to have a more detailed conversation with the nurse about the problems I had experienced with the HCA and she said she was sorry this had happened. I told her that I did not like to complain, but I felt it was important to let her know how things were, in case someone else was also affected, and I also had the opportunity to give her some specific examples. I repeated my request that I did not see that HCA again. I was glad my hubby was not there because this sort of thing makes him very uncomfortable (not that I enjoy it much either!) and he would much rather I left things alone and put up with it, but as I said to him, this is too important, and I need to have confidence in those who are caring for me, and sometimes things need dealing with, however unpleasant it might be at the time; in the long run, the benefits outweigh the temporary discomfiture. I feel very much better for having done it now, anyway, and the nurse was very understanding.

I then told her about the problems I’d had over the past few days. She took the bag off and said I still needed a convex bag. I told her how much I would like to go back to a flat one, because I so much liked the Coloplast SenSura Mio which is not yet available in the convex version, and she said that some people are able to use a flat bag again eventually, because after a period of time using the convex bag, the stoma gets pushed forward more, but it doesn’t happen with everybody. I said I didn’t mind, as long as I could have a decent convex bag, and I would certainly want to use the SenSura Mio convex if and when it was available.

She had another HCA helping her, who was also lovely and not at all like the other one! She made several trips to the cupboard for supplies for me, and the first convex bag they produced (can’t remember the name) I rejected almost at once, because the tail was horrible and it was a fiddle to undo, and like the OakMed one, it only had one rigid plastic strip so I could see myself getting output all over my hands again. The nurse suggested the Coloplast SenSura Convex Light bag – this is the convex version of my original bag, and I jumped at that one.

The tail is identical, and I really like this. It has the two rigid plastic strips, and when you press their edges together, the bag springs open beautifully, and I like the Velcro fastening wings too. This bag has a good viewing window, with the outer cover being divided so that you can lift it, and the top half of the bag under the cover is transparent. This is better than the Salts bag which was only transparent over the stoma itself. Another thing I like about the SenSura bags (flat and convex) is the fact that the edge of the flange is transparent, so you can see if a leak is advancing towards the edge, and deal with it in time.

The convexity is softer, and less pronounced than on my previous bags, and this is a good compromise between the rather hard and rigid deeper convex flanges and the flat bag.

One slight disadvantage is the paucity of measuring rings on the flange, which makes cutting it to size a bit more difficult, but the nurse gave me the backing sheet from the bag she put on me, to use as a template. She cut the hole circular, not worrying about the slight bulge on one side of Kermit, and said that it shouldn’t be too tight a fit, or the stoma might develop granulomas (small nodules which form as a result of friction from the bag) and these can bleed a lot. She cut the bag to around 28 mm.

I told her I was running out of some of my supplies, so in addition to supplying me with plenty of the new bags, she gave me a new pack of Conti wipes (these are the dry wipes that you can use either dry, or with water, and they are larger than a lot of the wipes supplied by the manufacturers of stoma care products, and you can cut them in half and get double the amount!), and plenty of barrier wipes (which the previous HCA had considered unnecessary!!).

I haven’t tried these Pelican barrier wipes, but my first adhesive remover spray was by Pelican and I liked that very much.

Finally, she gave me some more banana flanges to replace the few OstoMart ones I had left. I said I didn’t like those much because they made my skin itch (there are some small red spots where they had been) and she said she didn’t like them much either – a lot of patients had experienced skin irritation from them because they are far too sticky (even with adhesive remover spray they are very hard to remove) and do not allow the skin to breathe. She produced some by Salts instead.

These are thinner and more flexible, and although they look rather opaque when you first apply them, with the warmth of your body they become more transparent and adhere better than initially. They contain aloe vera and are a lot more skin-friendly than the OstoMart ones. Eventually I would like to get the Trio silicone ones through my supplier because these are a dream to use, but the nurse said they don’t deal much with Trio, because they only do accessories and the GPs are apparently pressing them to cut down on prescribing too many accessories. (The other HCA was just dismissive of Trio products and said, “We can’t stock everything…” and “I saw them at a trade fair and wasn’t impressed…”)

These banana flanges have backing papers on both sides. You remove the first one and apply the banana flange as normal, and then remove the top backing sheet, exposing a wafer-thin transparent strip which flexes with your skin and is breathable. I love these!

When the nurse removed my bag, she used plenty of adhesive remover spray without my having to ask her, and she peeled it off slowly and gradually, and I felt quite relaxed about it. She had no problem using barrier wipes either, but said the powder should only be used if the skin irritation was so bad that the surface of the skin was broken and moist, because otherwise the powder would not stick.

She said that we should now be thinking about getting a prescription set up for me, so that I can start receiving supplies via a home delivery service. I quite agreed, but said that things were still constantly changing, which was getting pretty boring! She said there was no point in setting up a prescription if the next week it had to be changed again! She has made another appointment to come in three weeks’ time, which will be on the same day as my follow-up appointment with Mr. Pullan, my surgeon, and hopefully by then, things will finally have settled down.

She warned me that the chemotherapy might affect the stoma – not necessarily its size or shape, but quite likely the output, which can increase in quantity and become much more liquid. She said I may need loperamide (Immodium) to help with this, but I said if I could correct the problem with jelly babies, that was preferable! (How I wish jelly babies were available on prescription!!) For the moment, the output is quite thick, which she was pleased to hear – although I did say I thought my blow-out this morning was partly due to pancaking because it was so thick!

As we left, both the nurse and the HCA were very sweet, and the HCA said, “Nice to see you again.” I said to my hubby on the way down, “What a great appointment! That’s how it is supposed to be!” I certainly didn’t feel like that on the previous two occasions! Coming out this time, I felt I had had a very positive experience, my questions and observations had been listened to carefully and responded to in a considered way; the atmosphere was friendly, and there was decent dialogue. Should be expect anything less?

My First Blow-Out!

The first of two posts for today.

Shoshi has ARRIVED! She has had her first blow-out!

I had major problems this morning. I woke to find my first blow-out!!! It was very thick, fortunately, and hadn't penetrated beyond my nightie, but it was on my right hand, and one very strange thing – I wear 2 silver rings, one on my thumb and one on the 2nd finger, and both these had gone a dark copper colour as a result of the reaction with Kermit's output, but I've polished it off with silver cleaner and all is well again. When I was in Iceland all my silver jewellery went black from the sulphur fumes constantly in the air there from the volcanic activity, but this was a coppery brown with a few patches of blue-black which looked like blued steel. Interesting reaction between digestive enzymes and silver!

The top right of the bag as I look down had blown out and there was a great splodge of poo sticking out! When I got up and cleaned myself up, I noticed that the moat around Kermit had returned somewhat – it’s worse at the top when I'm standing, where my tummy is sagging a bit forward. So I've gone back with a Salts convex bag again. Thank goodness I'm seeing the stoma nurse this afternoon, so I'll be able to discuss the problem with her. I'm also very glad that each time I've changed the type of bag I'm using, I have kept the remaining ones and not returned them to the clinic.
It's a real pain in these early days when everything is still shifting about and one's shape keeps changing!! Sometimes I wish I was Tin Man and had a nice rigid stomach to stick the bag to.

I think part of the problem was that last evening my skin was itching, not immediately around Kermit (although of course the skin is quite irritated again this morning) but I'd put a banana flange on (Ostofix large frame from OstoMart) and I really don't like them – they are hard to get off even with adhesive spray remover, and they do seem more itchy than the bag, and I had peeled it back a tad so I could have a good scratch, and the edge of the bag came up too – I pressed it all back firmly but the seal in that place may have been a bit compromised. Also, yesterday at lunch time my hubby made us a huuuuge cheese omelette (I keep on to him about portion sizes but he keeps giving me too much food, and I can't get over the childhood injunction to "eat up everything on your plate" lol!) and I think the eggs may have bound me up a bit. The poo was quite thick (good thing, actually, or it would have spread much further) and it had pancaked a bit, and a lot of it was at the top of the bag, and the pressure probably caused the blow-out. So I'm not 100% convinced that the SenSura flat bag was the problem. I was lying down, of course, so it had no reason to flow to the bottom of the bag and keep Kermit clear.

One amazing thing – as I woke up I was vaguely aware of a slight poo smell and thought it was drifting along the landing from my hubby's bathroom. There was barely any smell at all. I am now using a combination of a short spray of 3% hydrogen peroxide and a fresh mint tic-tac in the bag each time I empty, and it really does eliminate the odour!

I am hoping eventually to be able to have the Trio silicone banana flanges from my supplier – these are so fantastic. They have backing paper on both sides, and after you've applied the banana flange, you remove the top backing paper to reveal an ultra-thin, highly flexible and transparent flange which is practically invisible and which moves with your skin. Their silicone products are amazing.