Well, we survived the GI appointment today. As soon as Dr. B pulled out his mic-key button, this tall, distinguished, most eloquent of doctors, muttered one solitary word.... "eeeewwww".
That pretty much covered it.
The wound care nurse made a pass through and agreed that the months of placing tighter and tighter buttons has only added to the problem and caused not only irritation, but the beginning stages of pressure necrosis.
Basically, in the effort to stop the stoma from leaking, the pressure has been depriving the surrounding skin from much needed bloodflow. Thus, no healing.
Plus, she also agreed that his current button was waaay to big.
According to her there is really no need for one that large in a child so small unless we're planning on tube feeding him a steak.
During this process, Dr.B allowed Vincentio to hang out with no button in to give the site a rest and let it "tighten"up a bit. After our visit he resized the stoma tract and decided on a 16fr 1.2cm mic-key. He stated after placing it, that he should have to use a bit of pressure to insert it, but he could have.. and I quote.."thrown the mic-key from across the room and still made it in that hole". So, tomorrow, while his belly is empty, we get to remove the button at home for 3-4 hours to let it really close up some.
That, plus a better fitting button, plus the addition of some serious barrier cream. Which by the way, was a pain in the keester to find, and we should have ourselves a fix.
If, after all this, he doesn't show improvement in a couple of weeks we have another option. During his ear surgery, Dr. B could make a short appearance and insert (temporarily) a GJ tube. This would bypass the stomach altogether, sending his formula straight into the intestine. This would allow his skin a break from the leaking and give it a chance to finally heal. Then later, after all is well, he would remove the GJ and go back to the regular G button.
For now I'm ordering the skin paste and keeping my fingers crossed.