Nikki makes an excellent point: total or near-total pituitary loss is devastating.  

My one experience with a woman with Sheehan's involved not blood loss but oxygen deprivation unrelated to blood loss.  It's not the loss of blood per se that causes the damage, it's the *lack of oxygen* to the pituitary - something neither I nor any of her doctors had thought about, and one of the reasons my poor client went a year without a diagnosis.

A reminder for those who work with a woman with massive pituitary damage:  It may take her a long time to feel reasonably healthy again, and even then she faces a lifetime of ingested - and injected - artificial hormones, which are always cruder than the originals; some of them can't be replaced at all.  She's going to be mothering not only with little or no milk (my client did produce a tiny amount) but also with little or no oxytocin or prolactin.  Put all that together, and it may not be possible for her to keep any form of breastfeeding going - yet another huge loss in a mountain of huge losses.  Respect her need for a smoother-than-average path, so that she can do the best job she can of mothering under really stressful conditions.  Frankly, I've been humbled to see how much my client loves the child whose birth did this to her.

Diane Wiessinger, MS, IBCLC  Ithaca, NY  USA
www.wiessinger.baka.com

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