@pidge32. I'm unsure why the end of a loop ileostomy is supposed to be "under the skin". I had two different loop ileostomies and neither one had and end that was supposed to be under the skin. Mine looked like if you cut a hose partway through and folded it back on itself.

How many times a day are you emptying your appliance? I'm unclear if you have an ileostomy or a colostomy. If you have an ileostomy and empty multiple times a day you should be using a drainable pouch. It's never going to be really clean. Are you using a transparent pouch? If so you can switch to an opaque pouch (not as gross).

If you have a colostomy and have one movement a day my understanding is most people just throw the closed end pouch away.. if you use a two piece appliance this would be easier than doing a change (I think).

Can you do an in person appointment with your WOCN? These are things that are much easier to figure out in person, when you can point to what you are talking about.