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Subject:
From:
Kirsten Husband <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Wed, 25 Feb 2004 14:19:26 -0500
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I received a call yesterday from a mom with an interesting situation. I
need all the detective help that I can get on this one, although I have a
hunch as to what the problem might be.
This mom weaned her baby about 5 months ago after a severe case of
mastitis. That same breast had always caused her troubles--bleeding nipple,
engorgement, plugged ducts, etc.
Her concern is that that nipple still hurts her--but only when erect. In
fact, she has been so worried about the pain that she had a mammogram a
week ago. The radiologist actually showed her the films ( bless him) and
reassured her that everything in the breast and nipple looks normal. Her MD
just shrugged and said he didn't know why her nipple hurts---and to live
with it.  ( hmmm)
She called me out of frustration and weariness with the whole situation. I
hope that all of our collective wisdom and experience can find the answer
for her--and then, maybe, a solution.

She says that there is no obvious scarring on the nipple. There is no
discharge. No sign of infection. No cracking. No evidence of candidiasis.
The pain ONLY occurs when the nipple is erect---for example, when she gets
out of her warm bed in the morning, when she is cold, when she steps out of
the shower. ( she seemed a bit embarrassed, so I did not ask about sexual
arousal!) When she is fully dressed, there is no pain---as if putting on
her bra solved the problem.
I asked about color changes, but she hasn't noticed any. But after thinking
about it thought that her nipple *might* be more red or purplish, but
thinks it is because she is touching it when it hurts--looking for the
cause. There is no specific area that hurts---just the shank of the nipple
in general. She describes the pain like a sharp tugging--like the initial
latch on to a sore nipple. Her *instinctive* reaction to the pain is to
apply heat. The pain is not particularly long-lasting, and does not occur
every day.

I have asked her to observe for color changes and whether heat helps to
relieve the pain. My hunch is some sort of Reynauds. But can that be
unilateral? Can it be a consequence of nipple damage?

Thanks for your wisdom and insight and suggestions!!

Kirsten

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