I know this is not the place to vent our disappointment in the knowledge of
ob/gyn physicians in a particular area.  I am aware that this list abounds
with knowledgeable and supportive physicians and wonder why we can't have
more of you.   What I want is a sample letter that will not let my anger come
through between the lines.  I want to send correct information, inform the
doctor of the inappropriateness of his comments, and at the same time not
make him turn off to the the information he needs.

Situation:  Mom calls me reporting symptoms of mastitis--extremely red and
firm area on breast with mom feeling flu like symptoms and fever of 103.
Suggest she call her doctor.  OB/GYN prescribes amoxycillin for breast
infection.  I, not being allowed to correct that first error,  tell mom to
continue with heat, massage, nurse, etc., and call me back to let me know if
any improvement.  After more than 24 hrs.  no improvement (of course) and
actually area of redness and tender firm mass is increasing in size, mom is
feeling worse not better, and wants to know when meds will start to work.  I
suggest she call md back to discuss the worsening of her condition and ask if
there is a better course of treatment he can prescribe.  Again, I hate this
feeling of not being able to just say the drug he gave you is WRONG WRONG
WRONG.  (Oh, sorry, that was a bit of a vent there, oops.)
His response was, "I gave you the drug you need, if it is not working you
will have to accept this as NATURE'S WAY of letting you know breastfeeding is
not for you.  I want you to stop nursing and ice your breasts.  I am sorry, I
know you wanted to breastfeed, but obviously it is not good for you or the
baby and you must stop."  Thankfully, mom sees me regularly at support
meetings.  She is a determined mom and has already overcome a severe case of
thrush that she decided to take care of herself after reading Pat Gima's
thrush treatment information I forwarded to her.  (Thanks to Pat  for a great
information site.) Even though she hung up the phone from him in tears, she
has no intention of weaning.  She needs to receive proper treatment and I
don't think she will wait for her ob to be willing to change his mind--not
his usual behavior on most issues.  I have an ob/gyn who will properly treat
her, but I still want to politely and with the attitude of "I know you want
to know this" coming through correct her current doctor.  What really adds to
my anger is this ob/gyn practice includes treatment for infertility and sex
selection.  How come NATURE is not in charge with him in that area of his
practice.  As you can see, if I am left to my own devices what I write will
surely come accross as sarcastic, agitated, frustrated, fed up, etc.  I know
there are those of you here with the gift of informing without condemning,
and so could you perhaps e-mail privately if you wish, some "nice" ways of
handling this.  I have the mother's permission and encouragement to do this.

Thanks,
Pam MazzellaDiBosco, IBCLC

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