Mary:  with this level of pain, and with the only LC who is available to
you having already been unable to help, I would consider doing two things:
(a) study latch-on and positioning very intensively over the next few weeks
to see if any small bit of info, heretofore missed, might provide the key;
and (b) make a trip to an area where more LC's are available to observe and
assist, preferably before severe damage re-occurs.

Also, you might want to evaluate your combination of ibuprofen and
acetaminophen, which you used continuously for up to 3 weeks.  You and the
baby might both be safer with the T3s, or some other method of pain relief.
Sedation, while a potential danger, may be preferable to the risk of
possible damage from the other regimen, which I understand increases with
combining the two drugs over time.  There are experts on Lactnet who could
speak to whether this was a danger or not.

Of course, I hope you don't need pain relief this time.  You have done a
good job of considering potential problems--I would encourage you to keep
looking and considering until you have the answer.

Arly                [log in to unmask]
MS, CLE, IBCLC