Hi,

My name is Karen Klusmann.  I am a RN IBCLC working in a 14 bed birthing
center.  I have been working as a Care Coordinator and Lactation
Consultant for a little over 1 year after working 25 years as a LDRP and
nursery nurse.  I have been lurking on lactnet for about a year and have
learned so much from those more experience than I.  Thanks for sharing
your knowledge.

        I have a pt in the hospital with an abscess.  I will give you a
little history about her.  She delivered 9 weeks ago.  She claims she has
had not had a great experience with BF.  She had very sore nipples for
about 6 weeks.  (To my knowledge she never sought help with that.)  She
said that she has been fighting plugged ducts and mastitis for 7 weeks.
She has been on antibiotics on and off for that long.  She was admitted
to the hospital Wednesday for a breast abscess.  The doctor aspirated
about 40 cc's on Tuesday and another 20-25 cc's Thursday.  On Thursday
when I saw her she had a large lump on the upper aspect of the areola and
continued up approx 3 inches into the breast tissue.
        She is got Ancef 2 Gms on admission and 1Gm 3-4 times daily.  Her
first doctor said that she was going to try to get rid of the abscess
without surgery.  The doctor on this weekend said that she should have
the surgery.  The area behind the areola is softer today.  The breast is
only slightly softer.  Are things improving now?  Should she wait a while
longer before okaying the surgery?  What will her recovery be like with
or without surgery?  She really wants to keep BF but is unsure if she
wants to hassle with the doctors and possibly risk ending up like this
again.  Any info would be greatly appreciated.  E-mail either privately
or to the list.

TIA
Karen Klusmann RN IBCLC
West Linn, OR
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