>>Surgeon X says he talked to six different surgeons including the Local
Breast Facility's breast guru and they all took his side and say Client
should wean completely. He pooh poohed (sp?) the idea that the packing was
stimulating production. He also said they all laughed at my statement that
there could be breast milk formation for months to years after stopping. He
said none of them had heard of that and they all agreed it would be 7-10
days max before the breast would dry up if she quit tomorrow. So much for
lactation experts in surgery!<<
The preceding statement is from the GP w/ the client w/ ongoing abscesses.
She is currently just 10 days post 3rd abscess drainage. My thinking is
that the 3 weeks suggested by many on this list or the 4 weeks suggested by
Riordan for abscess healing is what we should be considering here. Riordan
also states that incisions on the underside and/or closer to the
nipple/areola take longer and, guess what? Her largest incision is on the
underside and very close to the areola, so she has 2 confounding factors
that lengthen healing *regardless* of weaning or not.
The GP also believes that the stimulation of the affected side is keeping
milk production going, but the surgeon blames the milk production on keeping
the infection going. This client is *not* septic and the infection *is*
resolving. The couple wants to seek a breast expert's opinion, but the
facility mentioned in the above e-mail would be where said experts reside.
If the surgeon has already consulted w/ the experts and they are really
laughing, then I NEED AMMUNITION. It seems the MD credential is important
to the surgeon, so if you have that after your name, please take time to
send me your opinion. Will weaning from the unaffected side cause the
affected side to suddenly dry up in 7-10 days and healing to miraculously
occur? Can you guarantee that this client will have *no more milk* in 10
days if we wean tomorrow?
My understanding is that involution may occur in 7-10 days, but that milk
can remain for an unspecified length of time that varies w/ individual
women. I'm apparently too tired to be Googling correctly and am drawing a
blank in searching this tonight, so if you have references, please send them
my way.
Another question...what packing media do you use? The surgeon is saying
that the breastmilk sugar is causing the staph to grow, but some packing
gauze is dipped in *honey*...so how does the sugar theory make sense?
I know the answers to these questions, but what I need are "experts" with
"credentials" saying I'm right (or wrong) *and* permission to forward
opinions to the wonderful GP involved in this frustrating situation.
TIA again and again,
Rebecca DeYoung Daniels, MBA, RD, LD, IBCLC, RLC & MOM to 5 who just can't
find time to become an MD tonight <g> and is angry that the LC credential
isn't flying w/ the surgeons
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