Friday, April 24, 2009

April 4, 2008

(Subtitled: A tale of Pain)

Hello all. This one is mostly just about me. You'll see why as we go along.

Oh, also, feel free to skip the gross parts, I'll try to warn you when
one is coming up.

Around March 17th or 18th I began to suspect I was getting mastitis
again. You guys know this from my last email. On the 21st I finally
had a fever and called my primary care physician to get some
antibiotics. He proscribed five days of antibiotic A for me. I got
it filled and started taking it. My mastitis seemed to be getting
better. Until Sunday. So, Monday I called the midwives.

"Hi, my mastitis isn't getting better"
"Yeah, you better come in"

So I go see the midwives. (We're up to Tuesday the 25th now.) They say
"We always give at LEAST 10 days of antibiotics for mastitis, get this
new prescription and go home, you'll feel better."

So, I get it filled, I start taking it. I feel better. Until Friday
the 28th.

Now, Friday we were going to Maine for Kay's (that's my mother in law)
birthday. I spent the day doing laundry and packing and taking care
of Elliot while Waxor was at work and my mom (who was back in town)
was speaking at a local high school. By the way, have I mentioned
that my mother had caught the plague somewhere? No? Well, she had. A
flu with a racking cough and lots and lots of phlegm. Sorry, that was
gross and I didn't warn you. Ah well.

So Friday I was busy, and sort of ignored my breast not getting
better. Saturday (in Maine) I realized the folly of that, because the
lump (which had been just another part of my mastitis) was now two
inches across and about 1/4 of a inch high, tight, red, and throbbing.
Hmmm... I said, I need to do something about this.

So we called the midwives. They tell me that if I haven't spiked a
fever (I hadn't) and if I could sleep (I could, although with
difficulty) I could wait and come in to the emergency room on Sunday.
They'd give me an ultrasound and see if it was an abscess, and we'd go
from there.

So Sunday dawns. I feel wretched. The abscess is throbbing. We
drive down to the hospital in Beverly, check in, and wait. I have an
ultrasound, which involves some sadistic med tech taking an ultrasound
wand and PRESSING DOWN on my ABSCESS.

owwwwww...

The ultrasound confirms, yes, abscess it is. So my midwife calls in Dr
Johnson, a breast specialist, to come and drain it. Now, some of you
may think, "Ah, draining, you just poke a hole in it, right?"

WRONG!

(Warning: Gross Bit Imminent)

First we bare the breast. Not too painful. Then we wash it with
bacteen, also not too painful.

Then we shoot it up with Novocain. Now, this hurts. It's like
holding still while you get four or five bee stings in a row. Still,
that's not too bad if it numbs you, right?

Here's what the doctor doesn't tell you - sometimes, if the swelling
is too bad, it DOESN"T WORK!

So, all unconcerned, I watch with fascination as he makes the first
cut. Cool! That is an amazing fountain of goo coming out of that
abscess. He goes in for the second cut, I'm ready, I'm interested,
I'm...

HOLY CRAP I CAN FEEL THAT!!!!

"Ooh, sorry." Says the Doctor.

(Momentary side note, the Doctor is actually a really nice guy, he was
not being clumsy or anything, I was just in such a position as to make
it not possible for this to not hurt, and it had to be done.)

Now, the Doctor is concerned I have MERSA, a particularly resistant
bacteria, so he wants a swab of the inside of the abscess to culture.
"OK" I say. Fool. FOOL! The Doctor takes the swab, sticks it in the
new cut in my breast, and SMASHES IT AROUND A BIT. This is when I
start squirming. It feels like... well, imagine you have a giant gash
in your chest and someone is smashing a cotton swab around in it.

(Another side note. These description are all from the perspective of
how it felt. Waxor could tell you better what he was actually doing.
Apparently, having that much inflammation increases the discomfort
enormously.)

So, all done with the culture? Good. Now we just have to flush it
out. This should be no big deal, right? We'll just fill that big
syringe full of sterile water, stick it in the cut, push the plunger
and... WHY ARE YOU TORTURING ME!? At first, it's just cool water.
Then I realize that the center of the abscess must be numb, but the
edges, where we really need to rinse, those feel like he's stabbing
them with the needle.

At this point the Novocaine begins to wear off. Funny thing about
Novocaine, it stings just as much going out as it does going in. Only
it lasts longer, cause you're getting less numb, instead of more numb.

Last, but not least, it's time for him to pack the hole with stuffing,
so it doesn't close up too quickly. This, he says, should not hurt.
Not in the normal course of events, anyway, where I still have
Novocaine numbing me. So, the packing is a little 1/4 inch wide tape
that he inserts about an inch at a time with tweezers. He put in
about five inches worth, which means about five times he took his
enormous metal tweezers and shoved them in the no longer numbed HOLE
IN MY BOOB!

AAAAAAAAAAAAAaaaaaaaaaaaaaaaaa
aaaaaaaaagggggggggggaaaaaaaaaaaaaahhhh.

That, by the way, is the sound of pain.

I held still through all of this. He kept telling me I was a brave
girl, which may sound condescending in print but was very much
appreciated at the time. I didn't cry til it was over, and then only
a little bit. But I couldn't stop shaking, I think I had a little bit
of shock reaction to the whole thing.

So then they give me an IV of antibiotics and pain killers. The nurse
can't find my vein and has to poke around in my arm a bit. At this
point I resign myself to EVERYTHING hurting that day.

The Doctor gives me two prescriptions, one for Bactrum (an antibiotic)
and one for Vicodin (a narcotic, in case anyone doesn't know). Both
are supposed to be safe for breast feeding.

I get them filled. I start them that night.

Monday Elliot is sleepy all day and cranky whenever he is awake. I
stop taking the Valium because I'm positive that this is causing his
sleepiness and crankiness. A later conversation with a midwife
confirms this - it's SAFE for him, but that doesn't mean it won't
affect him. Alas. Bye, bye painkillers.

Monday afternoon I pull the packing out. All I can say is, it hurt a
lot less coming out than it did going in.

Monday night I notice a rash on my hands. By 10 pm it's clear I'm
breaking out in hives. Oh, yeah, and remember the plague my mother
had? Well, I've started coughing.

Tuesday morning my hands and bottom lip are swollen and I have large
welts on my arms. I get through to the Doctor, who says it's probably
a reaction to the Bactrum and that I should go back to my old
antibiotic, since it turns out I didn't have MERSA after all. My
whole problem has been cause by a milk duct that doesn't have proper
drainage to my nipple, thus increasing the risk of infection and
inflammation. Keep this in mind, it'll be relevant later. Anyway, I'm
back on my old antibiotics, taking an antihistamine for the hives,
taking Ibuprofen for the inflammation, and my cough is getting worse.

Wednesday I wake up with a swollen top lip, a red face mask, giant red
welts on my torso, and a racking cough. Waxor says "you're going to
the Doctor." (Primary Care Physician, this time) She says "Yeah, you
have hives. Take an antihistamine."

THANKS A LOT!

Wednesday is miserable. I have a high fever, chills, the cough, the
hives, a draining hole in my breast, a cranky baby, and, oh yeah,
Waxor gets a stuffy nose.

Today I had my follow up with Doctor Johnson, who drained the abscess.
He takes one look at my hives and calls in the student nurse to look
at them, because it is such a spectacular case of hives. Hah! He
should have seen me yesterday when my lip was swollen. The hives have
now receded from my hands, but are worse on my torso. I assume this
means that they'll be slowly getting better now, but who knows.
Anyway, Dr. Johnson looks me over, and says I'm doing well, and I'm
all healed, and that the hole in my breast won't close until I wean
Elliot, because it's directly on a milk duct and that duct will keep
producing milk which will keep leaking out, thus preventing the hole
from closing. However, I can go ahead and nurse on that side and even
let Elliot nurse from the fistula (open hole) if I want.

FINALLY! SOMETHING AWESOME! I officially have a third lactation spot.
I am a medical anomaly.

My fever broke last night, and today I coughed up a lot of phlegm, so
I think that round of the plague is getting better. Tragically,
remember Waxor's runny nose? Yup, I'm sitting here sneezing and
blowing my nose.

Anyway, I hope everyone has enjoyed my tale of misery and woe. I just
told my brother something I think is true: After all this, you either
act chipper, or you just go ahead and give up, lie down, and DIE.

I think I've had enough illnesses to last a while.

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