To prevent urine or fecal matter from being in direct contact with your skin, it is necessary to use a barrier cream. A barrier cream is essential to protect the skin from the uric acid in the urine or digestive acids left in fecal matter. Also, a barrier cream, even if only Vaseline, makes cleanup easier after a bowel accident. Barriers commonly used include Vaseline and adult diaper rash cream such as Balmex, and Desitin. The primary ingredient in diaper rash creams is zinc oxide. The percent of zinc oxide varies from around 11% to a maximum of 40%. The lower percentages should be fine for bladder incontinence. For those who are need protection for longer periods or who are bowel incontinent, the 40% zinc oxide creams provide a more effective and longer-lasting barrier against digestive acids in feces. A thick barrier can last through multiple changes, unless you have a bowel accident. Lotions also may be used. Lotions are better than nothing but provide less protection and for less time between changes or bowel accident. I also have used generous quantities of plain old Vaseline, or its generics, because it is so inexpensive. Liberally coat your bottom and cheeks with barrier cream, and also up the crack of your rear. A male also should coat the particularly sensitive skin of the scrotum and the lower portion of the penis – any part of the body that will come in contact with the wet or soiled part of the diaper. Unfortunately, 40% zinc oxide will leave you looking as if someone had whitewashed your genitals and backside I routinely use a cream with zinc oxide such Balmex, Desitin, or Equate Diaper Rash relief. I prefer the Equate Diaper Rash Relief with 40% zinc oxide. If any early irritation does not quickly clear up, despite the use of a zinc oxide cream, I change to a stronger, more medicated cream. For serious rashes, Triple Paste is highly effective (although costly). I do not wait for this irritation to become a full blown rash. If that is not effective, see your doctor immediately. My dermatologist approved the use and sequence of Vaseline, zinc oxide cream, and Triple Paste, but I found that just using a 40% zinc oxide barrier effectively prevents any rashes, even when wearing premium diapers for long periods (up to 8 hours). Powder, usually ordinary baby powder, often is used in lieu of, or in areas not covered by, a barrier cream or lotion. It both keeps you dry and reduces odor. I sometimes use baby powder with a breathable diaper for rash prevention when I am at home during periods in which I am unlikely to experience a bowel accident. If you are FI only and are going to change immediately after a bowel accident, lotions or powders should be o.k. for skin care as your skin will not be exposed to the acids in feces for a lengthy period. For cleanup at home, it is presumed that you shower or bathe once a day. For other diaper changes it still is important to wash. You can use a hand-held shower to rinse just your bottom, if you have the time. More frequently, it may be convenient to wash with a soft washcloth and warm water. The hand-held shower is particularly helpful when cleaning up after a messy diaper. Try not using soap as it may be too drying and cause more skin irritation. If you use soap, choose a mild one. For cleanup on the go, use moist cleansing adult wipes. Adult wipes are much better than toilet paper or paper towels. While cleaning a messy diaper, toilet paper will stick to your hands, your bottom, and to the feces. In addition to having enough wipes for your bottom, include wipes for your hands. Adult wipes are much larger than baby wipes - my adult wipes are 13” on a side, large enough that I can fold them and use both sides. Wipes made specifically for adult incontinence work best as they often include chemicals to neutralize acids from urine or feces. I may use 1 to 2 wipes for a bladder accident, and 3 to 9 for a bowel accident. Baby wipes are just too small. Sometimes changing with a proper cleanup, or only with wipes, just is not practical. In such circumstances I do a “field change” or “wet change” by just swapping the old wet diaper for a dry one, without any cleanup. However, I try to avoid doing this two diapers in a row. If I have to skip a cleanup, I always try to do a thorough cleanup at the next diaper change. As I am well hydrated, there will be very little odor. Unless you have very sensitive skin, this may work for you.
If you have problems with chaffing, there are several things you can do. First, fold the diaper lengthwise to narrow it at the crotch. Wear a smooth cover on top of the diaper and plastic pants to reduce any friction. I like to wear compression pants (like bike shorts) or Spandex underwear. You can experiment with Vaseline, lotions, or powders to reduce friction, but again note that they will cause most vinyl or PUL pants to degrade. Finally, if your chaffing occurs with exercise, be sure to begin the exercise with a completely dry diaper. You may need to limit your exercise period to one wetting to avoid friction between your thighs and the increasingly swollen diaper. If you go to a gym, you should be able to get 1 ½ hours of solid exercise in before you need to quit.
If you are concerned about personal odor, particularly in a close social situation, an option is to use an internal deodorant. These are FDA-approved tablets of either bismuth subgallate (such as Devrom brand) or chlorophyllin-copper (such as Nullo brand). They will reduce body and urine odor. They will not completely eliminate fecal odor, but they will markedly reduce it. If one product does not work for you, try the other. Results vary markedly because of differences in personal body chemistry, diet, and dosage. One negative factor is that most cause some degree of constipation.
STEALTH “DIAPER BAG”
The last thing an incontinent guy wants to be seen with is an obvious diaper bag. Most men will choose to use a backpack, messenger bag, briefcase, computer bag, or gym bag. Women may prefer to carry a larger purse. In addition to a clean diaper, the kit should contain wipes, barrier cream, latex gloves (for cleaning up bowel accidents) and disposal bags. Many use plastic bags from grocery stores for diaper disposal. The grey and semi-opaque ones are preferred.
In addition to the stealth bag, it is advisable to keep a “disaster” kit in the trunk of your car. In addition to extra diapers, wipes, creams, and disposal bags, the larger disaster kit should contain an absorbent pad to protect the car seat and a complete change of trousers, shirt, and socks.
Good diaper brands to begin with are Tena, Molicare, Confidry, Wellness, Abena, and Tranquility.
SPECIFIC RECOMMENDED DIAPERS
(Although I prefer diapers with an all-plastic shell, I have included all breathable diaper and hybrid diapers in the selection below. I only recommend diapers that I personally have used.)
Tena Slip Maxi – this is a plastic-backed European diaper, not manufactured in the U.S. It may be thought of as a Wellness Superio Signature diaper on steroids. Although a relatively thin diaper, it has a maximum absorbent capacity of 140 ounces or slightly over 4 quarts of urine! The diaper has a front plastic taping panel, strong tapes, and effective leak guards. Particularly good for social occasions in dress clothing. Case of 72 size Large for $123 at XPMed ($1.70 ea). Highly recommended. Order directly from XPMed. [Note: included for reference as the plastic-backed version has been discontinued.]
ConfiDry 24/7 – this heavy-duty diaper has strong but soft white plastic backing. Wide and strong reusable tapes. Waist elastics both front and rear. Very high standing leak guards. No wetness indicator. A wide crotch. Unusually roomy “drop” space for fecal containment. Maximum absorbent capacity is 90+ ounces. Sizing is a little larger than most diapers. Good odor containment. Plastic is a little noisy but acceptably so. May be too bulky for wear with dress clothing. Case of 72 in size Large for introductory price of $99.95 at XPMed ($1.39 ea.). Highly recommended.
Molicare Super Plus – a heavier, high absorbency, diaper with a purple all-plastic shell and good absorbent mat in the wings. Diaper mat has good wicking ability. Can be worn during the day for heavy incontinence and very good for overnight. This diaper has soft and quiet plastic. Size Large holds 46 oz. Case of 56 size L for $75.19 ($1.34 ea.). Recommended. Order from JDCSupplies.
Molicare Comfort Super – a medium absorbency diaper, good for day use. This diaper is a hybrid with a white plastic center but breathable side panels. 44 oz. rated capacity. Case of 90 for $105.95 ($1.18 ea.). Order from XP Medical – XPMed.
Abena Abriform Premium Air Plus – this diaper has a cloth-like breathable shell with refastenable Velcro tapes. Standing leak guards. Wetness indicator. Elastic waistband. Very quiet. Level 3 in size Large holds 115 ounces. In Level 4 and size Large it has a maximum absorbency of 135 ounces of liquid. Very good fecal containment. Case of 80 size L4 for $99.95 ($1.25 ea). Order from XP Medical – XPMed.
Wellness Superio Signature – this is an excellent new diaper with a white all plastic shell. It has unusually high leak guards and leg gathers. Excellent fecal containment. It has a front plastic landing zone for tapes. Mat is very absorbent, despite its thinness. Additionally, the rate of absorption is very fast. I tested this diaper with a working capacity of at least 44 oz. (1.3 quarts) of fluid (water) while actually wearing it. Maximum absorbency is much higher. This diaper is surprisingly thin - to be preferred for wearing to work, wearing with dress clothing, or when in thin athletic attire. For women, the thinness may permit more options in clothing. A case of 54 is $80 ($1.48 ea.) direct, before coupon. With the frequently available 10% coupon the price per diaper is $1.33. Recommended. Order direct from the Unique Wellness Company.
Tranquility ATN (All Through the Night) – this is a moderate thickness diaper intended for heavy incontinence and nighttime use. It has a plastic shell with absorbent mat that extends down the rear and into the wings more so than some other diapers. The diaper has internal leak guards. The diaper is very comfortable as the mat is very soft and fluffy. The plastic is somewhat noisy, perhaps more noisy than some people will want to wear while outside the home. The ATN has good fecal containment and odor control. Absorbs 33 oz. A case of 96 is $89 ($.96 ea.). This may be the one of the best values available in a plastic-backed diaper. Order from Magic Medical.
Tranquility Slimline Fitted Briefs – this is a relatively thin diaper that is unusual in that it is available with either a plastic or an all-cloth-like breathable shell. It has good leak guards and leg gathers and is effective for bowel incontinence. It is very comfortable and very concealable. I wore this diaper with a breathable shell while on the Amazon River in Brazil in extreme heat and humidity when a plastic shell would have been excessively hot. Absorbs 21 oz. Case of 96 for $83.00 ($.86 ea.) (size L) from Magic Medical.
Absorbency Plus – this is a new generic plastic-backed diaper designed by, and made for, XP Medical (XPMed) whose owner is, himself, incontinent. The diaper does not have leak guards, but does have a very absorbent mat that extends significantly into the side and wings to reduce leaks and very good leg gathers. This diaper should be very good for urinary incontinence and satisfactory for bowel incontinence, particularly when worn around the home. Level 3 is rated for 64 ounces. Level 4 is rated for 86 ounces. Case of 64 L3 is $75 ($1.17 ea.), case of 64 L4 is $89.95 ($1.40 ea.), both a very good value. Order directly from XPMed.
Super Seni Quatro – European diaper. Breathable diaper with cloth-like shell but an air-permeable and waterproof barrier inside. Does not stretch and sag as much as other breathable diapers. Elastic waist both front and back. Wetness indicator both front and back. Internal standing leak guards. Excellent wicking – uses most of the diaper. Maximum absorbency – an incredible 4 liters (128 oz.). Holds most urine between legs, rather than in front. Good tapes. Good fecal drop zone. Very quiet. Mat does not clump. Best breathable diaper I have tested. Case of 60 (Large) is $103 ($1.71 ea.). Highly recommended, but available in the U.S. only from XP Medical.
Tranquility Premium Overnight (pullup) - While I generally do not recommend pullup diapers, and particularly for bowel incontinence, the best pullup I have found so far, including fecal, is the Tranquility Premium Overnight. In addition to its higher absorbency, it does have effective standing leak guards and good leg gathers. Although labeled “overnight,” this diaper would serve as a daytime diaper. Holds 34 oz. Recommended. Case of 64 for $62.00 ($.97 ea).
There are many well-reviewed brands of diapers, which I have not tested. These include Attends Extended Wear, and TotalDry C-Plus (formerly Secure-X Plus). Don’t hesitate to experiment. Remember, if one diaper works for you, don’t change! (pun intended)
OTHER ULTRA-HIGH ABSORBENCY DIAPERS
Some highly absorbent disposable diapers are available that seem particularly suitable for night time use. Unfortunately, to the best of my knowledge neither of the diapers below is available in the U.S. via regular distributors, so I have not had the opportunity to test these, except for the Super Seni Quatro. Rearz Inspire diaper - 4.5 to 5.0 L maximum capacity. Made in Canada for Rearz. Available in Canada for $2.81 (Canadian) each when bought by the case. Shipped by the case to the U.S. for $2.63 each. Comficare L10 – size large holds a maximum of 5 L. Made in Germany. Available in Canada from Rearz. Bought by the case, $2.66 (Canadian) each. Shipped by case to U.S. for $2.63 each. Bambino Bellissimo - a thick and very high absorption plastic-backed diaper. Aimed at the AB/DL market, it will have babyish prints on the taping panel but who else is going to see it? Absorbency said to be 3.5 - 4.0 Liters. Noisy plastic. Standing leak guards. Difficult to reattach tapes. For best performance tapes need to be reinforced. Very wide crotch. Best for night use. Expensive. GET Price
For most people, drugstore diapers usually are inadequate for all but very light incontinence. For better prices and more variety, order online from a medical supply house or adult diaper specialty retailer. Diapers soon become expensive as the cost adds up over time. Unfortunately, you get what you pay for, so avoid cheaply made, inexpensive diapers. Some inexpensive drugstore diapers are not poorly made, but have very low absorbent capacities which easily are exceeded. To save money, one thing you absolutely must do is purchase your diapers online by the case. There is a very serious savings in purchasing by the case that can reduce the price of individual diapers by as much as a third! Normally, there is no shipping charge for diapers purchased by the case. Some companies and vendors make discount coupons available. Don’t hesitate to call and ask for help. Not all companies size their diapers the same and there may be variations from one diaper line to the next, and even within the same brand. If possible, I strongly recommend that you first order samples to be sure that they fit you well. The samples usually are costly on a per-diaper basis but will save you from expensive mistakes. Otherwise, order just a package (usually 14-18 diapers). Amazon Prime is a good way to save on shipping charges when ordering less than a case.
• XP Medical - XPMed is my main and preferred vendor. I have had nothing but good experiences with them and recommend them highly. Gary Evans, the owner, is himself incontinent and is very helpful and honest.
• NorthShore Care Supply – good general-purpose supplier. Good variety but often more expensive than the other vendors in this list. Adam, the owner, has displayed serious interest in better serving the incontinent community.
• Magic Medical – especially good for Tranquility products.
• Amazon – particularly if Amazon Prime is used. Excellent for individual packages of diapers and smaller purchases as it avoids shipping charges. Good for wipes, barrier creams, etc. Diapers are shipped in unmarked boxes.
Disclaimer – I have no relationship with any diaper company or diaper vender except as a user of their products and have received nothing in return for my recommendations.
Diapers are not cheap – in fact, they become quite costly. However, do note that the more expensive quality diapers, if chosen wisely, usually will prove to be cheaper. This is because fewer diapers will be required per day, particularly if you have severe urinary incontinence. Consider the cost of 4 to 5 good quality diapers plus one extra-absorbent diaper for night as opposed to 8 to 12 cheap diapers. Drugstore diapers may turn out to be among the more expensive diapers. Usually, a less expensive diaper from a quality brand should give you better performance than a drugstore diaper. Most good diapers cost between $1.10 and $1.75 per diaper, when ordered by the case. Some extra-absorbent diapers intended for night use can cost $1.80 or more. You will pay a much higher price per diaper for samples as the vender has to open a case and repackage it, and particularly if shipping is included. Nonetheless, it is worth it to avoid costly mistakes as you purchase in greater quantities.
BUYING DIAPER COVERS
A good vender for diaper covers is Fetware (site caters to the AB/DL fetish but has the best selection of ordinary plastic pants). Fetware also operates DriWare, a site without the AB/DL fetish material and with a good, but more limited, selection of mainstream diaper covers. Amazon has a great selection, but is best if you have Amazon Prime.
HOW TO PUT ON A DIAPER (self-diapering)
You can exercise more control if you can put on your own diaper. Self-diapering preserves privacy and dignity and you get the fit you prefer. Before you begin, wash your hands to remove any powder or lotions on your fingers as they can cause the tapes to become unstuck. First shake out the diaper and ensure that the leak guards and leg gathers are free and erect. Fold the diaper lengthwise along the centerline. A soft fold is desired, not a hard crease. Standing is the preferred and recommended position for putting on a diaper. Lean against a wall or door, slightly squatting, with your buttocks holding the rear top of the diaper in place against the wall or door behind you. Bring the front of the diaper up between your legs. The top of the absorbent mat inside the front of the diaper should come up to, or just below, your navel (the plastic will come even higher). Tape the bottom tapes first, then the top. Attach the lower two tapes first, angled about 20 - 45 degrees upward. Then the top tapes, angled 20 – 45 degrees down. Fold any extra plastic inside the waistline. Practice in front of a mirror. In bed – takes practice. Diapering in this position is more difficult than standing. Sitting – possible, but it may be difficult to get the tapes tight. Note - a diaper with a snug fit has more absorbent matting in contact with the skin – a desirable trait for urinary incontinence. This improves the efficiency of absorption. Do not over-tighten the tapes. If you are bowel incontinent, a too tight diaper eliminates much of the sag at the bottom that would provide space to contain feces. Note #2 – another reason for not over-tightening the diaper’s tapes, particularly the lower tapes. We want the diaper to be snug around the legs, but, as the diaper swells with the absorbed urine, the backing must be able to stretch and allow more room inside the diaper for the now much larger volume of fluff and SAP gel. This problem is greater with high-absorbency thin diapers containing less fluff and a lot of SAP (high-quality premium diapers). That high ratio of SAP causes the diaper to swell significantly compared to its original thickness. Remember, even though the outer shell may not split, the liner on the inside of the diaper can split and release thousands of swollen SAP gel crystals, a real mess to clean up.
PRACTICE MAKES PERFECT
Particularly with a messy (poopy) diaper, you should practice changing at home so that you do not soil your outer clothing when changing in a public restroom (ugh!). When you have a messy diaper, first try to change it while standing in the bathtub to make cleanup easier while you learn how to handle the situation. When not wearing trousers or shoes, you usually will be able to pull the diaper down over your hips and lower it to the floor without spilling the contents. Next, practice removing the messy diaper - without first removing your trousers and shoes. Do this while sitting on the toilet as you might in a public restroom. The side panels of many diapers can be torn by hand. However, to avoid spilling fecal matter on their clothing, some users carry a small knife or pair of scissors for cutting the sides of the diaper.
ABSORBENT PADS (Chux)
Absorbent pads are necessary when changing a leaking or messy diaper in bed or on a floor. Absorbent pads also are a must to protect your car seat from a leaking messy diaper. Many people do not realize that their mattress covers usually do not provide adequate protection against a significant urine leak from a diaper. The urine may ruin an expensive mattress. It is helpful to place a large absorbent pad under the sheet and on top of the mattress cover. I use a large absorbent pad (30” x 36”) capable of absorbing 40 ounces of liquid.
WEARING DIAPERS OUTSIDE THE HOME
New adult diaper users always are extremely anxious about wearing diapers outside the home for fear that everyone will be able to tell that they are wearing diapers. That absolutely is not true. People do not look, they do not recognize the indicators they may see, and people really do not care. If you use the tricks I have recommended, it won’t matter, as no one will be able to tell, not even your family! Do you put on a fresh diaper when leaving home for a substantial time or social occasion? Although I hate the expense of wasting the unused part of the diaper I am wearing, I change, as I find it just too risky to leave home, wearing a diaper that is half-saturated, and counting on being able to change before a leak.
WHEN TO CHANGE?
When to change a diaper is a personal decision based on several considerations. First, of course, is the type of incontinence - a messy (poopy) diaper must be changed immediately. A wet diaper will be changed based on some or all of the following:
• Diaper’s absorbent capacity – each diaper has a point of failure beyond which leaking is unavoidable.
• Diaper sag – after some volume of urine, the diaper will begin to sag uncomfortably from the weight of the urine.
• Waddle – as the diaper swells with urine, the crotch of the diaper will become so bulky that you cannot help but notice it. Then it becomes increasingly difficult to walk without a waddle. Such a situation is uncomfortable, may lead to chafing with the inner thighs, and slowly may become evident to others.
• Odor – based on factors discussed elsewhere in this paper, urine odor slowly will become noticeable, mostly for those wearing for more than one wetting. However, other factors usually dictate a diaper change before odor becomes a major consideration.
• Skin protection – those with sensitive skin may find it necessary for personal hygiene to change a diaper before it has reached its absorbent capacity.
• Concealment - as the diaper swells with urine, it may bulge out more in front and in the rear (Exactly where depends on the design of the diaper). If in public, a diaper change may be dictated by the increasing difficulty of concealing the diaper.
• Sensitive skin – if you are prone to skin rash, your skin’s sensitivity may dictate the length of time between changes, rather than the diaper’s absorbent capacity.
• Economics – the longer a diaper can be worn without leaks, the more economical it becomes.
HOW CLOSE ARE YOU TO A LEAK?
Of course, each diaper is slightly different, with those diapers containing a lot of fluff feeling firmer while those containing a lot of SAP tend to feel softer. When we are alone, or at least have some privacy, the easiest thing is to reach down and feel the outside of the diaper. Here is my guideline for when I change a ConfiDry 24/7 or an Abena Abri-form Premium Air Plus in Level 3 (very absorbent diapers), based on a diaper’s absorbent capacity, by feeling the crotch:
• Diaper is firm – diaper is not near its maximum capacity
• Diaper is very soft – diaper has used much/most of its capacity
• Diaper is slightly “squishy” – diaper is nearly at capacity. Plan to change
• Diaper is “squishy” – diaper is at capacity. Time to change
• Diaper is very soft and watery –– leak is imminent. Change immediately.
When diaper squeezing is not practical, you still can judge reasonably accurately by a combination of the elapsed time since the last change and the sag and waddle factors. When a leak is near, I also first feel wetness at the leg gathers. Then my bottom begins to feel wet - immediately before the leak begins.
DAYTIME DIAPER CARRY
Which diaper do you carry with you for changes during the day at work, school, or shopping? Many seem to select a thinner diaper to carry in a backpack or purse. As I use a small backpack (day pack), my choice of diaper is determined more by my clothing and the type of activity I expect. If I am able to leave my backpack nearby in my car, I often will include both a heavy-duty diaper such as the ConfiDry 24/7 and a thinner diaper such as the Tena Slip Maxi. I can fit three thick diapers plus wipes, disposal bags, etc in the back section of my day pack, leaving the other sections for other uses. If I had to, I could fit five diapers in my day pack.
CHANGING AWAY FROM HOME
This is when you will be glad that you have made a “Go Kit” of essential items needed for a change and have it with you. It can be very helpful to have a small hook to hang backpack from toilet stall wall. This will both keep it off the floor and importantly, within convenient reach. It also helps to have a small square of plastic to set things on as the floors of public toilets are notoriously unclean. A small pair of scissors or a pocket knife will help you more quietly remove the used diaper (particularly if you have reinforced the tapes). The only truly embarrassing moment may be when you exit the stall and place the disposal bag in the trash. Fortunately, while that may attract attention, very few people will recognize what it is. You may choose to put the used diaper in your diaper bag and dispose of it later.
Changing a disposable diaper can be a noisy process. If I must change a diaper in a public restroom, it sounds twice as loud to me as normal. Men may be more concerned about this as women have trash bins in their stalls and make some noise when using feminine hygiene products or changing baby diapers. Crinkling, rustling, and tearing sounds are not normal from a men’s room toilet stall. Flush the toilet repeatedly to cover most of the noise made while removing the diaper, opening up the plastic disposal bag, and preparing the new diaper.
LEAKS AND CLEANING UP
Just changed and detected a few small drops of pee on your plastic pants? If so, just wiping it off with a paper towel or a wipe may be enough for now. If a greater amount of pee, just rinsing the plastic pants thoroughly in hot water may be enough. If there is a significant amount of pee, or it has been on the pants for a while, hand washing in mild soap and water is the best solution. However, if I am lazy I will wipe them off or dry them and put them in the washer. If there is even the slightest trace of feces, the pants must get a thorough hand or machine wash.
BOWEL ACCIDENTS WHILE AWAY FROM HOME
In the event of a bowel accident when out of the home, plan in advance whether you will try to change the diaper in a public restroom or return to your car and drive home. When they are available, family or disabled restrooms are best, as they provide some privacy. Know where the restrooms are, particularly the family or disabled restrooms. In the event of an accident, first complete the fecal void! Do this in the diaper. That is, do not rush to a toilet and immediately pull the diaper off before fully completing the bowel movement. In the middle of changing, you do not want one final bowel spasm to leave fecal matter over your only unused diaper, your plastic pants, and your outer clothing. If you sense an unavoidable fecal accident about to happen, move to a nearby area away from people. You may make some sounds while defecating into your diaper. To cover up any body movements, it can be helpful to fake a somewhat animated cell phone call. Other tricks include taking pictures, adjusting a cane, etc. Taking pictures of a low object with your smart phone can help by providing you with a reason for bending over or stooping.
SHAVING “DOWN THERE”
While not, strictly speaking, a diaper issue, shaving one’s pubic hair helps anyone who is incontinent and wearing a diaper to achieve three objectives. Pubic hair makes it more difficult to apply a barrier cream, particularly for males, greatly complicates cleanup after either urination or a bowel accident and often retains odor even after a cleanup, particularly when away from home and having to use wipes. Shaving the pubic hair markedly reduces all of these problems. The pubic hair does not need to be shaved completely bare (as I do) to see an improvement, but needs to be cut to a very short length. Shaving particularly is recommended for those who are bowel incontinent as feces often become intermeshed with the pubic hair, causing a very difficult cleanup. Shaving the pubic area can be difficult, particularly for males. It is important to avoid irritation and nicks which could lead to a rash or infection. A hand-held mirror and a body shaver help accomplish this. I have found the Norelco Bodygroom Pro electric body shaver used with a lubricating shaving gel (no alcohol please) to be very good for this purpose.
TRAVEL IN DIAPERS
Unless you wear drugstore diapers, you cannot count on finding a premium diaper, particularly in your size, locally. Plan ahead and take enough diapers with you. For extended vacation travel, some travelers ship diapers ahead to local post offices for “General Delivery” pickup, to a hotel, or to a local Fedex store for pickup.
Car travel frees you of many of the worries of travel in diapers by air or sea, including TSA scans. However, it still is necessary to plan ahead. Even when driving around your hometown you should have an emergency diaper change kit with a change of clothes in your trunk. For road trips, it is a pleasure to have the space in the car for all those diapers you will need. However, in the event of a delay, you should have diapers for an extra 24 hours – just in case. If you normally wear cloth diapers, consider wearing disposables just for the travel time as they are so much easier to manage as well as less bulky. Don’t forget plastic disposal bags. If you will be staying in one location for an extended period, consider having your diaper supplier mail a bag or case to that location instead of to your home. This is a particularly good choice if they offer free delivery! You may wish to include small garbage bags to contain the smaller disposal bags, prevent odor, and have more privacy if you need to dispose of them yourself. For extended road trips when it is impractical to carry enough diapers with you, five good options for diaper resupply include:
1. mailing diapers ahead to the local U.S. Post Office addressed to General Delivery, your name, and your approximate arrival date.
2. having your online supplier ship diapers to a local Fedex store for pickup. Be sure your supplier ships using Fedex.
3. mailing diapers to your future hotel Check with the hotel desk before doing this.
4. Use the local WalMart. WalMart carries Molicare diapers, including Super Molicare. You can order online and pick the package up from the store closest to your destination, with no shipping charge.
5. Use a local medical supply house. Search online then call the store to confirm the availability of your preferred diaper, in your size or to have them order from their warehouse. You should be able either to place a hold on the diapers until your delivery, or purchase and then pick them up at the store.
The “gravitational phenomenon” (or “gravity effect,” if you prefer) – when you are sitting most of the time, and for extended periods of time, gravity will pull urine to your diaper’s seat, which tends to fill up faster than the center area. This can increase the likelihood of leaks. For those who wear premium diapers for extended periods, the time may be reduced by this phenomenon. Where to change when on travel away from your home area? Some suggested places to change with “clean bathrooms,” and which offer at least some level of privacy include:
3) Lowes/Home Depot
5) Walgreens/CVS Pharmacies
6) Cracker Barrel restaurants
7) iHop Restaurants
In Airports, handicap toilets offer better privacy and are preferred for diaper changes – particularly if you have a messy diaper. Be considerate and don’t use them for longer than absolutely necessary. If you are fortunate enough to have access to an airlines club, very private toilet facilities will be available.
Diapers in checked luggage
Diapers in luggage are not a problem and will not cause your bags to be opened. However, lost luggage will present a special challenge.
Diapers in your carry-on
Always carry extra diapers in your carry-on bag – even for a one-hour flight. A booked 1-hour flight has been known to actually last 8 hours! If your luggage is lost, the diapers in your carry-on should last you until you reach your destination.
TSA security inspection
Do not act overly anxious. Acting overly anxious may be interpreted by the TSA officer as suspicious behavior and cause you to be flagged for a private inspection. The bulk of the diaper you are wearing, and the plastic pants, are not important. However, many people change into a thin diaper before entering security. It is important to have a dry diaper before going through the scanner. Change before entering the security area if necessary. You may wish to wear just a very inexpensive diaper or pullup. Remember, after passing security you can change into whatever diaper arrangement you wish to wear for your flight. You can opt for a physical pat-down in lieu of the scanner. I discussed this with a TSA agent who said that it is not a “big deal” to the TSA officials. If you wear a onesie, be sure that it does not have metal snaps. Don’t use diaper suspenders with metal clamps. If you are wearing a cloth diaper, it is unclear whether the metal diaper pins will set off the scanner. In your carry-on, have a small diaper change kit with the minimum essentials. Note the TSA size limits on lotions or creams - use travel sizes and note that these will have to be in a small transparent plastic Zip-Lock bag that you can place in a bin to be scanned. TSA Disability Notification Card – TSA has a small card which you can print and on which you can list that you are wearing diapers and have diapers in your carry-on bag. You can hand this silently to the TSA officer. It does not guarantee that you will not be scanned. The TSA Disability Notification Card may be found at the following URL: https://www.tsa.gov/sites/default/files/publications Knives are a no-no, regardless of size. As I usually reinforce the tapes on my diapers, I carry a small pair of blunt-nose scissors in my day pack carry-on bag to make it easier (and quieter) to change in a public restroom.
On the plane
Airplane toilets just are not designed for an adult diaper change, so avoid them if at all possible. If you have a short flight and can wait, do so. If you have to use them, you will find them to be very cramped. Place the used diaper in a disposable bag, compress it as much as you can, and place it in the (very) small trash bin.
At Sea (Cruise Ships)
The security check at the ship is less rigorous than at an airport and should not be a cause for concern. Again, knives usually are prohibited, but small blunt scissors are permitted. Please note that no cruise line offers adult diapers for sale aboard. Plan accordingly – and very carefully. Ship’s infirmaries do not sell diapers – those they stock are of low quality. To fly with diapers to the U.S. departure port, I must pay the cost of an additional suitcase filled with diapers and booster pads! Cruise ship travel offers some flexibility to those who wear diapers as it provides a safe base of operations from which you can leave on excursions and return, without the need for packing and unpacking. You can request a larger trash can or small diaper pail for your cabin. The room steward or maid will empty the trash daily. You can request a protective pad for the bed. Store your stash of extra diapers in a suitcase under under the bed. Public rest rooms on most cruise ships offer excellent privacy as the stall walls usually extend completely down to the floor. Public men’s rooms usually will not have trash bins in the individual toilets, so you still may have to exit the toilet with your used and bagged diaper. Cruise ship tour excursions can offer a challenge for the diaper wearer, particularly in a foreign port where you do not speak the language. The nature of the individual tour may make it either easy or impossible for a change of diaper. Look at the length of the tour and its specific itinerary to judge whether it is practical, from a diaper perspective, to take that tour. The best case is where lunch is scheduled at a good restaurant with public toilets. Wear a more absorbent diaper than you think you will need. Don’t go “A Bridge To Far.” You never, never, should slow down a public tour to change your diaper. If your means permit you to engage a personal tour operator you will have more flexibility. In many ports you can engage an English-speaking taxi driver for a driving tour, with stops as needed. To return to the cruise ship from a tour excursion, you usually will have to ride a crowded shuttle bus or take a tender (small boat – usually a ship’s lifeboat). Bear in mind that if you have a messy diaper, it will be impossible to conceal that fact while returning back to the ship, and once aboard, to your cabin.
Camping (car or trailer camping)
Privacy may be challenging (lacking) and camp bathroom facilities often are less than desirable. Accordingly, you may have to change in your tent or camper. As indicated previously, disposal bags are a must.
Traveling with others
If you are sharing a multi-room unit with private bedrooms with others, you must decide whether to tell them about your diapers so that they will not be shocked when they notice something. You do not have to do so, but hiding diaper disposal and odor will be big challenges. If sharing a room with someone, you should inform them ahead of time to save everyone much awkwardness. Because of odor and trash it would be impossible to hide the fact.
Order Diapers Online in UK & Europe
As in the U.S., retail stores in the UK normally do not carry a large stock of adult diapers. It is convenient and quick to order from reputable online local suppliers, listed below. Most can deliver either the next day or the second day. Most will deliver to hotels.
• SaveExpress GMBH – Ships throughout Europe and the UK - Abena, Tena, A+, Molicare, Comficare.
• Dorset Nursing Supplies <dorset-nursing.co.uk> - Next day delivery in UK - Tena, Abena, Molicare. Highly recommended.
• Incontinence Uk <incontinence.co.uk> - next or 2-day delivery in UK. Tena, Molicare
• Incontinencechoice.co - delivers within 36 hrs - next day delivery in UK, including Saturdays. Tena, Abena, and Molicare.
• Cuddlz Adult Nappy Store <Cuddlz.com> - AB/DL store but with plain white adult diapers. Next day delivery available.
• Age UK <ageukincontinence.co.uk> - Next day delivery, including Saturday. Abena, Tena, Attends.
• Home and Medical <Homeandmedical.co.uk> - Next day delivery in UK. Molicare, Abena, Tena
• Every Nappy <everynappy.co.uk> - Next day delivery in UK. Abena, Molicare.
Retail Stores for Diapers in UK
In the UK, your best bet for finding adult diapers in a retail store may be at the local chemist (pharmacy/drugstore). Boots usually is recommended. Don’t forget that you are looking for “nappies.”
• Boots (chemist/drugstore) - carries adult nappys, including Tena
Order Diapers Online in Canada
• B4NS - <www.b4ns.com>. Ships to Canadian and U.S. addresses from separate distribution points. No guaranteed delivery times listed. Dry 24/7, Tena, Abena, Molicare, Bianco, SecureX, NorthShore. Ships worldwide.
• Age Comfort - <agecomfort.com> Free shipping in Canada on orders over $50.00. Express Courier Delivery is available. RearZ - Inspiron, ConfiCare, Abena, Molicare, Tranquility, ConfiDry 24/7, Wellness.
• RearZ - <www.rearz.ca>. Ships internationally but no guaranteed delivery times listed. RearZ, ConfiCare, Inspire, Abena, ConfiDry 24/7.
Retail Stores for Diapers in Canada
In addition to the below listing, also check with medical supply and seniors stores.
• RearZ - <www.rearz.ca>. Warehouse in Ottowa, Ontario; retail store in Kitchener, Ontario, Waterloo, Ontario. RearZ, ConfiCare, Inspire, Abena, ConfiDry 24/7.
Swim diapers, contrary to popular expectation, are not designed to hold urine. They are designed for those who are FI to contain feces. The more correct name is fecal containment system. The chlorination in public pools will negate any urine passed through. There are several brands of swim diapers available, but perhaps the best rated (and the one I personally wear) is the SoSecure swim containment diaper (fecal containment diaper) intended to be worn under swimwear – The SOSecure attaches snugly via very strong Velcro in the wings. Although it is not advertised or intended to contain urine, it will contain a small amount effectively. I often get water inside the SOSecure swim diaper. When I do, as I am coming out of the pool I actually have to break the seal at the leg holes to let the excess water out. A problem could be that, with some pool water getting inside the diaper, along with some urine, a more substantial amount of liquid eventually will have to be released somewhere - a shower in the changing room would be my recommendation. Please note that, to work effectively, the SOSecure swim diaper must be worn fairly tight - somewhat more than snug. I have to lie on the bed, position the diaper, and fasten the Velcro wings. That can make putting the swim diaper on difficult for someone with reduced motor skills. However, when put on properly, NOTHING is getting out of this diaper until you let it. There also are single-use disposable swim diapers. Two of the more popular ones are Swimsters and Swimmates.
Swimsters – disposable adult swim diapers. Designed to contain solids and not to absorb liquids. Designed not to come apart in the water. Can be worn under swimwear. This swim diaper looks somewhat like a pair of plastic pants. Swimsters also markets a reusable swim diaper.
Tranquility Swimmates – look very much like a Tranquility disposable pullup. Has inner leg cuff guards for bowel containment. Designed not to break apart in the pool.
While not exactly a diaper issue per se, protecting the mattress from a leaking diaper is something we all must do. Please note that an ordinary mattress pad is not designed to contain a large amount of leaking urine – some will pass through to the mattress below. Two things can be done – place a waterproof vinyl mattress protector, usually zippered, over the mattress, and an absorbent mattress overlay on top. Alternatively, large waterproof and absorbent mattress pads are available, both disposable and reusable. For lesser leaks, another method is just to place disposable absorbent underpads below the sheets.
DIAPER STORAGE SPACE
Most of us never seem to have enough space for diaper storage. If you buy by the case, a generous supply of premium diapers can occupy a surprising amount of space. A case of thick, highly absorbent diapers with a lot of fluff such as the ConfiDry 24/7 contains 3 packages of 18 diapers each (54 diapers) and will take up a fair amount of space. In contrast, a case of the excellent absorbing but much thinner Tena Slip Max will take up much less space per diaper. Thin drugstore diapers will require even less space. Do you store empty suitcases? Fill them with diapers and use them for storage. 1 ½ packages of ConfiDry 24/7 diapers will fill a medium size suitcase; two packages will fill a large suitcase. Under-the-bed plastic storage units also are great for storing diapers. So long as the diapers are sealed in their original plastic packaging, you can store the overflow in your attic or basement for months.
DO DIAPERS EXPIRE?
Some diaper manufacturers place no expiration date on their diapers; others place a date, saying that the date is required by law, but that their diapers do not expire. Nonetheless, a typical disposable diaper is said to have an expiration date of about three years. Normally, diapers may show discoloration, but with little or no effect on performance. If stored for years in high temperatures, the elastics may degrade and tapes may loose some of their stickiness.
FYI: you will come across sites referencing the term “AB/DL.” This stands for “adult baby/diaper lover,” which is a fetish. Some of the AB/DL vendor sites have very useful, high-quality, products and information about diapers. Some merchants, e.g. Fetware or its sister company, DriWare, have excellent products.
RECOMMENDED SOURCES OF INFORMATION
Diaper reviews - perhaps the two best diaper reviews that include detailed diaper specifications are at the links below:
INTERNET SUPPORT GROUPS
I strongly encourage everyone who is incontinent to participate in one or more of the three Internet incontinence support groups listed below. These groups focus on how to live with functional bowel and/or bladder incontinence (regardless of the cause) and how best to select and wear diapers. The number of new messages per day in each group is very small, but it can be extremely instructive to read the archives of past messages.
3) AdultIncon - Yahoo! group “adultincon”
We learn from our own experiences and (hopefully) from the experiences of others. I want to offer my very special thanks to those who made significant contributions to this paper, including “Zenute” who provided a unique and very personal woman’s perspective, ILuvLA who, as I do, loves to travel and provided highly valuable suggestions on how to do it better, “Rope_Wrench” for his valuable insights into cloth diapers, and “SeattleDoug” for his experience in using diapers while in a wheelchair. My thanks also those who did not directly contribute to this paper, but who contributed to my own understanding of how best to live with adult diapers.
Best wishes to all and hoping that you stay dry,
John Davis (JDinVirginia)
(Revised March, 2015)
© John Davis 2015.
You are free to repost this paper online, or to pass it on to any person or group who may have an interest in it. My only requirement is that its authorship be credited and that it be disseminated without changes If you have questions or wish to provide useful feedback, you may email me at jdinvirginia (at) yahoo.com.