We've both been pretty happy with Karen's release the day of the surgery. We already had a prescription for fentanyl patches and another for oxycodone - to help with breakthrough pain - but the surgeon had also prescribed a 5% lidocaine patch. It's a local anesthetic, which means it just affects the area it's applied to. He had said to cut strips and put it on either side of the wound. He also gave us a prescription for antibiotics.
We tried to get them filled at the hospital pharmacy before we left, but some issue with the insurance was stopping the lidocaine patches from being filled. I assumed we needed a preauthorization and left a message with the doctor. Remarkably, they found us in the hospital before we were completely discharged, and said that for some reason it's almost never covered. After all the delays with wound VAC, I was content paying out of pocket to have the painkiller now. It was going to be almost $100 for 10 patches though, and one of the doctors suggested we wait until tomorrow to see if Karen had $100 worth of pain.
The day after was actually quite painful for Karen. She was using the breakthrough medication as often as she could, which was every hour. I am willing to bet, if we had been in the hospital, they would have had her on a pain pump administering dilaudid. Karen quickly decided it was more than $100 of pain. I called a couple pharmacies to check stock and compare prices. Walgreens suggested I check GoodRx.com. The site not only compares drug prices at different pharmacies, but gives you discounts on those drugs. We managed to fill the prescription in about an hour for only $34.14. There were no charges to use the site or get the discount. What a great find. We've never had a prescription not covered before, and with a couple days of back and forth we probably could have got it, but I have no regrets in simply paying out of pocket to have it immediately, especially at this discount rate.
It made an amazing difference for Karen, and she was able to back off the oxycodone immediately. The patch is 12 hours on, and then 12 hours off. Karen was feeling so well on Tuesday that we forgot to put the lidocaine patches back on after being off for 12 hours, and did she start to hurt again! I'm surprised they haven't used this with her at the hospital before. It probably wouldn't have done anything for the huge HIPEC surgery she had had, but it probably would have helped with the previous surgery, when the mesh was put in. At least we know to ask for it in the future.
We had the one week follow up today. With such large caliber sutures, the body is much more likely to "reject" them, and "spit" them out. This is also more likely to occur in an area that's had a lot of trauma. So the idea was to take them out after just one week, and switch to dermabond. Our concern has always been that removing them so soon would allow the wound to open up again. On our visit, the surgeon said the tissue around the stitches looked quite healthy, and if we're up for leaving them in longer we can check on them again Tuesday. He removed the JP drain, which was the most irritating thing for Karen at this point. It's connected through a hole in the skin a couple inches to the left of the wound, and is held in place by stitches of it's own. So she's happy that's out now. Everything is looking good so far.
