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Lactation Information and Discussion <[log in to unmask]>
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Tue, 28 May 2002 14:21:49 -0800
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  A mom I have been "helping" unofficially has given me permission to post what she wrote about her history.  She is sick so often, maybe one of you can figure out where to go from here to get mom well!   I find the HX interesting in the real life tribulations this mom has to go through (multiple doctors and various TX) in order to get this far.  The good news is she is NOT weaning!
  Terriann 

  case history 
  For 20 months starting one week after my second daughter's birth, I had chronic mastitis, the last 5 during which I had weaned and was pregnant.   Symptoms included  headache, low-grade fever, EXTREME drop of energy, hard, flushed warm area on either one or both breasts that gradually broke up and moved down to the nipple and was nursed out.  For the first 15 months I had 1 to 2 infections a week.  Several times I felt fine for over 1 week and once for a 6 week period.  Probable cause: too little rest and a finicky nursing baby, going 6-10 hour stretches without nursing.  It may also have been aggravated when I went for several weeks at a time eating very little due to post partum depression and later from fits of stupid dieting.  At those times my milk supply would almost disappear and I'd have to eat for a solid week to get it back up.   I couldn't afford antibiotics or a Dr. 

  I weaned at 8 weeks into my third pregnancy, but couldn't seem to shake the feeling that my breasts were just too tender for normal pregnancy sensitivity.  I think I overexerted myself cleaning, smoking, canning and freezing 70 Salmon in one week, and I hit a wall of symptoms.  I was 18 weeks along in the pregnancy.  My blood pressure went up and my heart would race and palpitate over any exertion or excitement.  I could hardly dress myself and finally at about 30 weeks into my pregnancy, I concluded I may have an underlying mastitis after consulting with a nursing specialist. 

  I insisted on a white blood cell count test with a Dr. who I consulted with (who didn't believe it was mastitis).  My white blood cell count 
  was up and she prescribed amoxicillin for 10 days.  I told her my 
  nursing specialist recommended at the very least 14 days, 21 for an aggressive mastitis, but the Dr. said I didn't need more that 10 days and that it wasn't mastitis. 

  Within 48 hours on the amoxicillin I felt 100% better in everything 
  except persistent breast tenderness--5 days after I finished the 
  antibiotics, I fell sick with fevers and chills and could hardly walk 
  and my breasts were a much more tender.  I got a new Dr (Dr. D, the 6th Dr. I had consulted) and she prescribed Augmentin for 14 days.  This time I maintained a fever for 9 days, but by the time the 14 day course was finished, I felt better.  During the last week, however, I had an echocardiogram  to check my heart because of the palpitations I had been experiencing.  The technician pressed the ultrasound wand down very hard for a prolonged time and I felt bruised in that area  (right over my heart) for a week or more. 

  I enjoyed health for 7 weeks and gave birth in December.  But the moment my milk came in after the birth, I noticed a very large lump (about the size of a walnut) where the technician had bruised me and simultaneously developed a mastitis.  Dr. D. prescribed augmentin for 14 days again and ordered an ultrasound of the lump.  She believed it to be an abscess and thought it might need to be aspirated--but she wanted to try antibiotics first. 

  We went to Fairbanks at that point where I resided for three months and was unable to contact Dr. D.  The abscess went up and down with my milk supply and burned and itched from time to time.  I sought out the care of a 7th Dr. in Fairbanks (Dr. C) who was incompetent.  When my baby was 11 weeks old, I developed 6 breast infections in a row (heart palpitations, low grade fever, and EXTREME loss of energy).  I asked her for antibiotics and she refused and I couldn't get Dr. D on the phone.  I believe the mastitis and the cellulitus from the abcess were happening simultaneously.  I was getting very poor sleep at the place we were staying and intermittently dieting. My health care ran out, which only covers 2 months post-partum, so I waited--2 weeks and ten infections later, I went to the ER room. The Dr. could not determine for sure that I had mastitis because I was mostly over the most recent one, but prescribed dyclocksacillin and said to wait until I developed another one before I took it--upon the chance that I was better. 

  Two days later I was covered with flushed blotches on both breasts.  I started the dyclocksacillin.  My symptoms worsened over the next 5 days so I went back to the ER.  The 8th Dr., Dr. T, immediately noted that I was not experiencing mastitis, but blood poisoning which he said usually came from an abcess--I had been too sick to remember to tell him about the lump.  Upon examination, he prescribed Clindamycin for 2 weeks.  I asked for 3 weeks and he agreed. 

  I came back home and consulted with a colleague of Dr. D's (as she is out of State) and she, Dr. W, noted that my breasts were still slightly flushed and the lump still burning and she lengthened my prescription for another 10 days with the option of another 10, which would complete a 6 week treatment.  But three days before I finished 33 days of Clindamycin, I consulted with a Dr. C. (Dr W being unavailable) and she could not find Dr. W's notes.  She ordered another ultrasound which showed the abscess had become very small.  Dr. C. was inclined to wait and see (go on a trial off the antibiotics)--she wanted to consult Dr. W's notes before she decided.  Thursday my prescription ran out and I called for her decision and could not get in touch with her.  Another Dr. in the office, Dr K, left me a message to "go off the medication, but call back if I got another breast infection".  I called back and told a nurse that I didn't have mastitis at the moment and that it was a very serious decision to discontinue my antibiotics--she said I needed 48 hours to refill a prescription. 

  So I hung up and  all of my symptoms were back within 48 hours. I went back in to see Dr. C and Dr. W happened to step in also.  They saw the red markings (pink rings that widened and migrated every hour upwards) and said that didn't know what it was exactly or why it looked like it did, but put me back on Clindamycin indefinitely--they said that had no other options and surgery seemed too invasive (which I agree!) especially since the abscess had become so small. 

  I've been back on the antibiotics for 7 days now.  I started feeling 
  better for the last 4 days (high energy normal blood pressure, no heart palpitations or racing) however, both breasts are still covered in flushed blotches.  The rings are gone, but I still experience tingling and itching and burning around the abscess area (11 O'clock on the left breast).

P.S.  May 28 
I've been on clindamycin for nine weeks now and have experienced several breast infections while on it.  Head ache, low-grade fever, no energy.  The flushing has in the last week gone down a little bit, but is still there as is the abysses. Also on my chest and under my breasts I have broken out in acne--which I have never had before in my life.  A friend with some medical background thought I might have an underlying candidus infection.  I've been taking assidofilus and caprillic acid. 

My objective is to get well--I'm sick of being sick.  I'm too busy to be sick! 
                           

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