I have a mom, 3 months postpartum with baby number 4.  She breastfed the other
children for at least one year each with no problems.  Initially there were no
problems with this one either, but about 2 weeks ago or so, her husband (a
dentist) called to ask about use of novacaine during a dental procedure he was
doing on her in the office r/t breastfeeding.  Shortly after that she
apparently experience what I thought was a postpartum anxiety attack --
shortness of breath, racing heart, feeling that she was having a heart attack.
It didn't last too long, but then happened again a couple of days later.  She
went to the ER, and they gave her some Xanax.  This time, in addition to the
racing heart rate she was extremely dizzy; could hardly get off the couch.
She took it and reported it made her feel as "though someone was standing on
her chest."  She called her OB who referred her to an endocrinologist for a
workup.  He did some of the basics (thyroid, etc), and decided she had
postpartum depression and put her on Paxil.  About two hours after she took
the Paxil, she called me to say that she felt terrible.  She was having
horrible hot flashes, severe dizzy spells, racing heart, and couldn't get off
the couch.  These episodes became more frequent -- she was simply almost non-
functional.  They scheduled her for an MRI which she had on Friday.  (It was
normal).  She told me that on Thursday night, when she breastfed, she had one
of the spells, and it was the worst ever.  She got horribly dizzy, with pins
and needles feelings all over her body, felt as though her blood pressure had
plummeted (this was starting to happen just before the episode Thursday
night).  When she talked to me at 8:30 on Friday morning, she hadn't breastfed
for 12 hours (or pumped), and her breasts were just beginning to feel full,
but she was feeling just awful -- unable to get up and care for her family.
Of course, she wanted to know if this was breastfeeding related.  I can't
think of anything that would be bf related this far into the game,
particularly with three uneventful bf experiences behind her, and over 2 full
months of positive bf before these symptoms.

She denies feeling as though she has any sort of depression.  At the
beginning, postpartum anxiety (panic) attacks seemed to be an appropriate
diagnoses, but this has gotten far more severe and seem to be lasting longer
than a typical anxiety attack.  It's late for pp depression to be starting.
She is nauseated most of the time, though says she is eating normally, as she
is forcing herself to.  Even with that, she has lost 8 pounds in the last
week.  She's done a lot of reading on pp depression, and doesn't believe she
fits the typical symptoms (though pp depression can be manifested in many
ways).  She says if she talks on the phone for any length of time, she becomes
more dizzy because of the disequilibrium of having the phone at one ear.  I
suggested a neurologist as the next step.  She has decided (almost) to wean
the baby, as she can't handle it any more.  I did suggest getting a prolactin
level just to see if there was anything abnormal there, but again, this would
be unusual at this point in time, I would think.

Thoughts anyone?

(I just called her to ask if I could post this to you all, and she said she
was able to get up this morning, very very slowly, and felt better -- enough
to go with the family to the mall for a short period of time, and then do a
few things around the house, but is beginning to feel badly again, so is going
to go back to bed.)

Jan Barger, in cloudy, Novemberish looking Wheaton, IL