What I've been up to
Other possible titles:
Feel sorry for me
How many times can a person say "nipple" in one post?
Could anything else go wrong?
February 18 - Lawson's follow-up with the hematologist.
February 18 - Jordan walk-in for mastitis
February 20 - Jordan walk-in for mastitis
February 24 - Jordan Dr. appointment for abnormal postpartum bleeding and thrush
February 24 - Jordan uterus ultrasound
March 2 - Lawson Breast Feeding Centre
March 2 - Jordan walk-in for possible abscess
March 3 - Lawson Dr. appointment for possible tongue tie
March 5 - Jordan 2nd uterus ultrasound
March 6 - Jordan walk-in clinic for abscess
March 6 - Jordan St. Pauls Hospital for surgery on abscess
March 9 - Lawson Dr. appointment for baby well check up
March 10 - Jordan Body Talk
March 23 - Jordan Dr. appointment with family doctor
March 30 - Jordan Dr. appointment with surgeon
That list is boring. I will give you the details, but I just wanted the list of appointments we had in 6 weeks to look as long as it felt. I was afraid the multitude of trips to clinics would be lost in a paragraph!
Lawson was born on February 11 and when we came home from the hospital on February 13, I felt great. I mean not, 100% of course. I did just have a baby, but I felt really good considering. In fact, I felt so good that we invited my sister and sister-in-law over for coffee the next morning. It was a bit of a mistake. I woke up on February 14 engorged. Like REALLY engorged. I don't just get full of milk. All the tissue between the milk ducts also gets swollen, so my milk does not move. In fact I was so hard that by mid-morning on the 14th Lawson refused to latch on my right side. I tried to express in the tub, but it was no use. NOTHING was moving over there. I can't begin to tell you how painful this is. And not to undermine other people who get engorged, but I have been told all 4 times by various health officials that my engorgement is the worse they have seen. It is bad. The internet says it lasts 24 to 48 hours. Mine doesn't start to break until 72. I did lots of crying and became very sore from bad latches. It sucked because it was either a bad latch and some milk moving or no latch and no milk moving. I decided to worry about the engorgement first and the latch later.
By the morning of Tuesday, February 17 I was finally able to get Lawson to latch on my right side. She hadn't eaten over there since the 13th (in spite of MANY attempts each day to get her on - so many in fact that my nipple was a bloody mess). I was coming out of the fog. I was optimistic. I felt like I was on the upswing. I was so wrong. The next day (February 18), on the way home from Lawson's follow-up with the hematologist I noticed a bit of soreness on my right breast. By the afternoon I was confident it was mastitis, because I could see a slight red streak. The doctor confirmed, gave me antibiotics and told me I should start to see things getting better in 24 hours. At this point there was a bit of pain, but nothing like the engorgement. I was confident that catching the mastitis so quick was going to help keep me on the upswing. I was so wrong. Again.
My mastitis kept getting worse. We called my mom for reinforcement on Thursday, February 19. My mom was so worried about how I looked when she arrived that she insisted I call the health line. The nurse there told me that it can take up to 48 hours for the antibiotics to work. I had 24 more hours to go for that to occur. I was feverish and the mastitis that was once just a slight streak had spread to over 1/2 my breast. I had pain down my side, through my armpit and down my arm. The nurse on the health line told me to try to ice to numb the pain. I spent the night making trips back to the freezer for a new pack of frozen peas. I barely slept and I wasn't eating. It was the most pain I have every been in (save labour). It was horrible.
By the 48 hour on antibiotics mark, my mastitis had taken over 90% of my breast. I was so swollen that Lawson hadn't eaten on my right side since early the morning of the 18th (the day I learned I had mastitis). Once again, I was so swollen that she wouldn't latch. The doctor and health line nurse had both said to keep nursing, but even attempting became futile. I tried pumping, but would only get 1 - 2 ml each time. The pumping was shredding my already decimated nipple, so I just quit doing it. I know it seems like I should have kept at it, but I was in so much pain already and not only was pumping causing more pain, I wasn't getting any milk moving (which is what they want you to do when you have mastitis). Mom my was quite concerned and so was I. The antibiotics didn't seem to be working, so Hugh drove me back to the walk-in clinic. The doctor there was bad. He didn't even look at my breast. I was very upset while I was in there. I was in a great deal of pain and could not see the end. He was more concerned I was suicidal (not kidding) than about my mastitis. He even turned to Hugh and one point and talked to him like I wasn't even there. The doctor then said that antibiotics can take 72 hours to take hold. I bawled. I didn't know if I could handle it. He also told me I needed to keep pumping and that I shouldn't ice. The ice was the only thing that got me through the night. I was devastated.
By the 72 hour mark my mastitis had finally stopped getting worse. My mom stayed on to help until Sunday, because I was so out of commission. In the meantime I was having weird postpartum bleeding. I won't get into the details, but on Monday, February 23 I called my doctor's office and they wanted me to come in the next day. After speaking to the doctor, she wanted me to have an ultrasound. She said she would get an appointment booked for me and gave myself and Lawson a prescription for thrush. Like mastitis wasn't painful enough. She also extended my prescription for my antibiotics. She had looked at my breast and noted that 3 more days of antibiotics was no where near going to clean up the mastitis (my breast still about 80% infected). On Wednesday, February 25 I had an ultrasound and the Dr. noted that I did have excess fluid (blood) in my uterus. I was given pills to take as soon as I got home to decrease the risk of infection. The pills basically cause your uterus to do the same thing it would if you were miscarrying. Hugh came home for the afternoon to take care of Lawson and myself. I spent the afternoon and evening on the couch with a heating pad.
The following Monday, March 2, Lawson and I were booked in to see our family doctor, but unfortunately, something came up and our doctor had to rebook. I had previously booked an appointment at the Breast Feeding Centre, so on the snowy afternoon, Lawson and I headed into the city. Breastfeeding still was not happening on my right side. The swelling had come down a bit, but Lawson refused to latch. I had picked up on the pumping late the previous week as my nipple had healed, but I still wasn't getting any milk. I began to wonder if that breast had stopped producing milk. The lactation consultant thought the same thing. Now Lawson wasn't latching properly because I was swollen, she wasn't latching because she wasn't able to pull any milk down. The lactation consultant also checked Lawson's suck. She thought that between that and the fact that Lawson's tongue looked heart shaped that she was tongue tied. The lactation consultant also thought that I should get in to see a doctor again about my mastitis. It still wasn't cleared up (about 1/2 of my breast still looked infected). That afternoon I headed to a walk-in clinic. I saw a great doctor who thought my mastitis had caused an abscess. He suggested that neither of us get ahead of ourselves and told me he would get me in to get an ultrasound as soon as he could to confirm the diagnosis.
On Tuesday morning (March 3), I took Lawson to the ears, throat and nose doctor. He told me that lactation consultants correctly diagnose tongue tied babies 99% of the time. He had a look in Lawson's mouth and declared that she just had a short tongue. I guess she was the 1%. I was glad we didn't have to do anything (the doctor told me that cutting tongue tied kids is controversial - which I had no clue about, so didn't do any reading), but disappointed that the pain I was feeling wouldn't be eliminated. In the afternoon, I headed back into the city for an ultrasound on the lump in my breast. The radiologist came to see me right after the ultrasound and let me know he didn't see an abscess. Once again, I was relieved, but disappointed that I would continue to suffer. The walk-in clinic doctor had given me some more powerful antibiotics, so I hoped that was the answer.
Things were just not getting better for me. On Wednesday (March 4), I called back to my doctor as I was having more abnormal postpartum bleeding. I had an appointment the next day (March 5)for an ultrasound. The radiologist performed the scan and let me know that there was some fluid, but less than last time. She thought I should just be patient and see if it cleared itself up. Luckily, by the next week things were back to normal in that department.
That Thursday night (or early Friday morning, I guess), after Lawson's 3:30 am feed, I pulled her up to burp her. I noticed blood and yellow pus all over her belly. I looked down and it was all over my bra. Once I got her back to bed, I headed to the bathroom. Sure enough, there was an abscess and it had broke through my skin. The open spot was about the size of my pinky nail and filled with thick puss. During the day on Thursday I had noticed some yellow under my skin on that spot, but having just had an ultrasound 2 days before, I chose to ignore it. I obviously couldn't ignore it anymore.
Hugh, Lawson, and I headed to the walk-in clinic for its opening that morning. I was quite certain I did have an abscess, but needed a doctor to confirm and give me an action plan. The doctor took one look and confirmed what I thought. He then took a sample of the infection and let me know my options. He said that since it had ruptured itself, I could wait and see if it would just drain on its own, or he could refer me to a surgeon and let them decide what to do. At this point I had been dealing with pain for over 2 weeks. I didn't want to wait. My luck was crap and I figured waiting to see a surgeon would likely just delay the inevitable. The doctor made the referral and we were off to St. Paul's hospital.
Sure enough, on Friday March 6, I had surgery. I was quite scared about being put under, but the nurses and doctors were very kind and did there best to put me at ease. I was only booked in the operating room for 15 minutes. The doctor increased the size of the hole and dug around to remove all the pus that had built up. The surgery went well, but my blood pressure was quite high after 168/80 (my normal blood pressure is 95/60). They had to give me some medication to bring it down, which prolonged my stay, but I was giving the all clear at about 8 pm and was sent home. Fortunately, for me (and Lawson), they only suggest that you pump and dump milk once. I pumped for 12 hours, because I am paranoid, but Lawson had taken a bottle before, so she did just fine.
On Saturday the home care nurse came to change the packing and dressing. I could not look, but Hugh did. My abscess had the diameter slightly bigger than a toonie and Hugh said it was about 3/4 of an inch deep. There were also pockets of open space under my skin that needed to be packed. This was the most painful part. That morning the nurse pulled 7 feet of packing out of that hole. It had gotten dry and really hurt coming out. As the nurse got the last of the packing out I started bleeding. Bad. So bad that she wanted me to rush to the hospital. I called my brother to look after the boys and Hugh drove me to the hospital. Fortunately, they got me in right away and one of my surgeon's residents came to look at me almost immediately. He checked the wound and it had stopped bleeding on its own (thankfully). He packed it up and got us on our way.
The nurses came every day for almost 2 weeks to change my packing. The idea with a wound like this is that it needs to heal (or fill) from the bottom up. If they had just closed it up, the pocked would have just filled up with infection again. At the one week post-surgery mark I noticed a large increase in the amount of fluid coming from the wound. The nurse said it must be the body expelling the infection, but the more days I had large amounts of fluid, the stranger it got. Finally, 3 days into the heavy fluid, a nurse suggested maybe it was milk. Sure enough, 2 days later I was able to confirm this. As I got out of the shower, I noticed milk pouring through the packing from the wound. It got to the point that I would have to change the dressing 3 times a day and was still soaking through my bra and shirt. In fact, it was so bad that I started wearing a diaper on my breast at home, to prevent leakage. Feel free to laugh at this!
On Wednesday, March 18, the hole had almost filled and the pockets under my skin they were packing were so small that the nurse thought putting packing in would delay healing. Home care then started coming every second day. Since they didn't pack it my wound was open when I changed the dressing. I gathered up the courage and had a look. It was disgusting. Hugh laughed at me. Apparently, it was so much worse before. I'm so glad I didn't look. At that point, I couldn't even change my dressing without milk pooling up and running out. The nurses were concerned that my wound wouldn't close up with the milk coming out. They wanted me to start feeding Lawson on that side. It didn't make any sense to me. I already hadn't been stimulating that side for a month. If I actually put her on, I was just going to have more milk produced and therefore more milk to run out the hole.
I saw my family physician on Monday, March 23. She had never seen or heard of anything like my abscess draining milk, so she left the room to touch base with a couple of her colleagues. They had also never heard or seen anything like it. All of them thought it best for me to try and drain the milk through my nipple. I didn't muster up the courage on that Monday, but on Tuesday I pulled out the pump. I didn't get one drop of milk out. I tried a couple more times over the next few days and still got no milk. On Thursday, while out for a walk I noticed that I was having increased pain in my breast. Fearful that I had done to much, I headed to the bathroom to take a look the moment I got home. Thankfully my wound looked fine. Upon further examination I noticed that part of my breast was engorged with milk. This was great news, yet a little frightening. The fact that I was engorged meant the milk ducts in my wound that were leaking milk were being pinched off by tissue growth. The frightening part was that I couldn't get any milk moving earlier in the week and sitting milk was part of the reason I had gotten an abscess. I mustered up the courage and latched Lawson on to my abscess side at her next feed. She would not go for it. The milk just wasn't coming.
Over the next few days I noticed a considerable decrease in the amount of milk coming from the abscess. It hadn't stopped, but I didn't need to wear a diaper anymore! On Monday, March 30 I went back to see the surgeon (referred to by my family doctor). He told me that in 10 years he had never seen or heard of milk coming from an abscess. He actually called a colleague in Toronto at the breast centre there to ask him about it. Apparently, although not common, they do see cases like mine there. In fact, the doctor in Toronto said that they don't like to do those types of surgeries on breast feeding moms because of it. My surgeon said the only way to totally make the milk stop would be to stop breast feeding and take some medication to make my milk stop. He agreed with me that it wasn't a good option - particularly because the milk flow was decreasing.
In the meantime on my good side, Lawson was having a heck of a time eating. She was so congested she was having trouble breathing while being latched on. She was pulling off 20 - 25 times a feed. It was exhausting. After almost a week of being on/off, I developed a blister on my good nipple. SERIOUSLY. It was incredibly painful. Not to mention emotionally exhausting. I did a solid 48 of pumping to give the blister time to heal and am currently doing about half pumping and half breastfeeding. Lawson is breathing better, so it is making things a whole lot easier. We used saline drops to help her breath, but my friend Danielle, who is having the same problem with her son is using a pressurized can of saline solution that works amazing. We are picking one up tonight!
So here I am. Tuesday, March 30. I am changing the dressing a couple of times a day on my abscess and hoping that in a couple weeks from now the skin will have completely covered over it. I have only been leaving the house for medical appointments, with the exception of heading outside a couple of times with the boys. I hate to even put a time frame on "feeling good" because every time I have done this something comes up to impede on my progress. That being said, I am hopeful that by the end of April this will be behind us. Fingers crossed that by then my abscess will be healed and breastfeeding will become a bit easier and a bit less painful.
Congratulations if you read this entire post. It is long and probably quite boring if you aren't me!