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Date: | Fri, 10 Sep 2004 23:11:38 -0500 |
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Thank you to all who provided assistance for my client who seems to have
"ongoing everything". She just emerged from surgery two days ago with a
third abscess. This one required re-opening the incision on top of her
breast and creating another opening on the underside. The abscess was the
size of a *medium orange*.
The family doc called an outside infectious disease doc this time and
currently cultures are only growing staph. The incision sites are being
left open and are packed daily under heavy sedation. This requires that my
client be NPO after midnight *until the surgeon gets to her the next day*.
I've inquired about "why" and whether different drugs can be used if that's
the issue because this mother was finally attended to at 3 p.m.
today...that's 15 hours w/out eating while coping with a compromised immune
system and breastfeeding a 2-month old baby. (Sorry, that's the vent part
of this with my faded RD hat in place, too.) The nutritional status part
has prompted my client's mother, a staunch advocate of breastfeeding and a
professor of clinical nutrition, to start suggesting that her daughter wean.
I need some ammunition...
The surgeons are continuing to say she should wean from the left side...the
affected right side now has many, many damaged ducts and nerves, but still
has some leaking milk. I have searched and Googled but have coughed up
nothing to say that bilateral weaning would be helpful for this unilateral
problem. I have asked the mom to request evidence-based research from the
surgeons to support their claims and I would like to have it in hand before
they hit her with any that may exist. I'd also love evidence for "our
position"...continued breastfeeding with *multiple* abscesses. The family
doc likes the analogy I suggested that if one kidney's infected the solution
is to quit urinating??? <g> However, if weaning would truly help, I feel
ethically and morally obligated to provide the info to the mother and let
her make a decision. The surgeons claim that they can line up LCs from KS
to Australia and all LCs would disagree w/ them...hmmmm.....
Thanks for listening to a late-night ramble and you may e-mail me privately
if you don't want to clog the list.
Struggling in KS,
Rebecca DeYoung Daniels, MBA, RD, LD, IBCLC, RLC & MOM to 5
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