I usually cut and paste to respond but this is so similar to what I need to 
inquire of all your great minds:
PTP I am working only by phone, with a woman who assumed she had a plugged duct, 
then mastitis in early July. Was given antibiotics and the fever went away, but 
the plug never did. I FIRST heard from her July 26th. at which point the baby 
was refusing that side (left) and nothing will pump out. She had been using heat 
and massage, all the basics. I suggested she try cold packs and vibration rather 
than massage, and since she was already taking IBU, I stressed that value of 
taking it consistently by the clock rather than prn pain. I also suggested she 
go back to her Dr. if not better in 2 days. I heard from her August 3. She had 
no real change in the lump/ plug,  even with 3 ultrasonic treatments and I 
insisted she see a Dr.to really assess what this lump is made of, that we 
couldn't assume this was a basic plugged duct if it wasn't having any relief/ 
change from the basic treatments for plugged duct.
 Heard from her today August 7. She had been to a surgeon who has used a syringe 
after looking at her overfull breast with ultrasound, and removed 4 oz of milk 
and blood from her breast. No mention of pus and she has not had fever since 
early July. The surgeon said he has never seen anything like it. He thinks a 
duct ruptured. She cannot express anything from that breast.
 Well, her breast has filled back up, she is in debilitating pain and the 
surgeon wants her to wean both breasts. I can send her info. from R. Lawrence's 
book on the milk supply being different and the left can stop producing and the 
right keep going, but I think he is concerned in the now as is the mom, about 
the fullness in the breast she can't relieve even with ice and cabbage leaves. 
Baby is now just over 5 months. It costs her $500 she says to go see this Dr., 
and he doesn't want to keep draining the breast as he is worried about 
introducing infection into the breast.  Any ideas out there????JANET FISHSTROM 
DOMBRO,IBCLC,RLC





________________________________
From: Pat Torngren <[log in to unmask]>
To: [log in to unmask]
Sent: Tue, August 7, 2012 11:01:32 AM
Subject: Mother with engorged breast

Hello,

I have a mom on one of my internet groups with one very engorged 
and painful breast.  

She wrote:  "I have a massive rock hard engorged left boob that is 
blocked and nothing I do will unblock it, I've fed him from different 
positions, expressed with a pump and my hand, hot shower and I don't 
know what else to do but it's really hurting so much I am crying.  The 
fact that my baby is cutting a tooth isn't helping.

"I had had an electrical pump on all night, but nothing is coming out.  I 
have also laid him on his back and tried to feed leaning over him to 
use gravity -- and also pumped in this position.  My nipple is in more 
pain than I have every experienced in my life. It started a bit more than 
24 hours ago as though I'd not emptied my breast fully and has 
continually gotten larger. It's tender and really hard but not hot.  I have 
had it in warm water with epsom salts for over an hour, but nothing is 
helping."

She has been to the doctor who has put her onto antibiotics, though 
there is no sign of infection at this stage.  She is not getting any relief.  
Ideas would be greatly appreciated!

Pat Torngren (Cape Town, South Africa)

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