The Worst Thing About Mastitis is Everything

In honor of World Breastfeeding Month (August) I'm trying to post something boobalicious every time I post. So even if I post something purely anecdotal, like "OMG MY CATS ARE TEH CUTEZORZ" there will be a follow-up post having to do with those fabulous mammalian feeding appendages.

Today we're going to talk about mastitis. Which I apparently have. Let me just start by saying ow. Like, really. OW.

Mastitis is an infection of the breast, occurring in breastfeeding mothers. It's usually linked to a lack of constant schedule for feeding, or going too long between feedings. When there is prolonged engorgement (remember, fetish video comments?) the breasts will sometimes become infected. However, it's important to point out that some women just get mastitis, even if they are feeding their baby every two hours like clockwork. Some of us are just prone to infection.

The first stages of mastitis are quickly onset, and involve temperature spikes and flu-like symptoms. In the course of one day I went from happily taking walks and going to birthday parties to vomiting, a fever of 103, violent chills, and body aches. And of course your boobs hurt. Like really, really hurt (although that didn't catch up with me until today). Other markers of mastitis are peeling skin around the nipples, and reduced milk production. Of course some of us lucky ladies get feeding chafe anyway, so the peeling skin is hard to notice. And there are also those of us to whom the reduced production does not apply for a day or two. I actually pumped 7 ounces right before I left for the Emergency Room.

Yeah. Emergency Room. I'm sure by now we're all aware of exactly how I feel about being in the hospital. And we're also aware of how long Kaiser can leave you waiting in those tiny little rooms while they run around doing more important things. Of course in an ER it's hard to argue that you're more important and require more urgent care than, say, the 6 year old who got kicked in the collar bone in a jumpy-house and now can't lift one of her arms (she came in while they were triaging me) or the 85 year old woman who fell in her kitchen and was there for several hours before anyone found her (gleaned from nurse conversations in the halls) or even the mysterious and strangely beautiful Latina lady across the hall who speaks no English.

They started by checking me for everything BUT mastitis. My mother was with me, and she said that if I had mastitis I'd probably be talking about the pain more. My mom had mastitis and she said it's very very painful. So far it hasn't really been that bad, but Angie says it's probably like giant boob back pain. You don't really notice it because you're used to it. It's just when someone makes it STOP that you realize how much it hurt. So similarly if my breast has been hurting for a while, but only increasing slowly I wouldn't notice it nearly as much. Also I have a pretty good tolerance for constant pain, it's just surging or stabbing pains that I'm a wimp about. But they (and I, as well) figured that if I wasn't complaining of breast pain it probably wasn't mastitis. I didn't have any red or hard spots on my breasts, and while I had been vomiting and had had some diarrhea, I had also had a particularly spicy burrito made by a new guy at my favorite burrito place the night before, and was not particularly surprised by either. As an aside, let me say that if you ever order anything called "devil sauce" you expect it to burn. I am no different, and when I don't order the Salsa Diabla, but it shows up on my burrito anyway, I don't just throw the burrito away; I eat the delicious 12-chile-sauce-smothered-chicken with a slightly apprehensive, but appreciative smile on my face, knowing full well I will probably pay for it in the morning.

After being checked for everything from pneumonia to endometritis (different from endometriosis) complete with chest x-rays and pelvic exam (check it out, that's extra special uncomfy when you're all sewn up down there) they checked the urine sample I had given them four hours prior. The initial results were that I had a UTI that was asymptomatic due to the amount of medication I was on, and the postpartum dilation my body was experiencing. Women who have recently delivered vaginally are usually dilated in the vaginal, cervical, and urethral areas for a while after the birth, which can lead to UTIs that fly up to the kidneys instead of creeping. Frequently postpartum women don't know they have a UTI until it start affecting their internal organs.I was excited to be out in so short time, and to have only been stabbed twice, once for an IV and once because she couldn't get the IV in the first time. I am still a hard stick. They sent the rest of the sample for the lab for the final results, and told me they'd be setting me up with some antibiotics soon.

You may notice, however, that this post isn't about nearly missing kidney infection, or uncomfortable peeing. So I'm sure a smart person like you can figure out what happened next. The results from the lab came back both corroborating and negative. Corroborating in that they did indeed find skin cells and white blood cells in my urine. Negative in that they did not by any means find a large quantity of either. So they decided I couldn't go home, and they were going to need to stab me several more times. To make it better this time the stabbing wasn't going to be anything as nice as an IV in the crook of the elbow. They needed full blood cultures, so they needed to find multiple sites that were uncompromised, so they couldn't use the saline lock that was already in my arm. They needed to find new and exciting places to stab me. They chose the backs of my hands. And they needed to rigorously clean the area before they went in with the needle.

Now, it's not that I don't understand the word "rigorous," but for some reason I was still envisioning little wipes or something, not a full exfoliation with a hard white sponge and skin-bleach. the upside is the back of my hands currently feel similarly soft to Elliot's. However, that kind of rigorous cleaning left my hands really and truly sensitive, and they were still recovering from the blown veins from the LAST time I was in the hospital, so this was extra special painful.  Like "lower the head of the bed because the combination of finding out that I'm not going home, haven't eaten in nine hours, haven't fed the baby in seven hours, am in the hospital again, and am sleep deprived on top of now being stabbed in a newly sensitized area has brought me to tears and they don't want me to hyperventilate and pass out" painful. It was new and exciting, and somehow still not above a 5 on the pain scale. It was like somehow my body did not recognize that this wasn't that bad, and was channeling my 3 week old baby, looking for a more appropriate response than taking cleansing breaths.

After all that they did another breast exam. We're now at the seven hour mark. I've been through chills so bad my hips have seized up, I've had radiation poured into my body via X-ray, I've been stabbed too many times, they've put all kinds of instruments in me, I've been tempted with "you can go home soon" only to have that hope dashed against the floor, and now they're re-doing the only real non-invasive test they've done. And THIS time they decide my breasts look aggravated, and that there's some localized swelling and hardening. Never mind that I haven't expressed milk in almost 8 hours because "this won't take long, we won't need to bring you a pump," and the course of action for mastitis is almost EXACTLY THE SAME as the course for a UTI.

They tell me they're going to confer with the ER attending, and try to get my discharge papers and prescriptions rushed. Guess how well that went? If you guessed "not too well, actually," you get a prize! I left the hospital after having been in the ER for 9 hours, with directions to take my pills every 6 hours for the next 10 days, to feed or pump every 2 hours, and to get lots of rest. Someone, please, explain to me how I can be awake for half an hour out of every two and get lots of rest at the same time?

So I'm currently trying to be a good patient. I'm waking up every two hours in the middle of the night to feed Elliot what tiny amount of milk I can produce in that time, then staying up with him til he falls asleep again, which usually allows me 45 minutes of sleep at a time. I'm taking my pills at 4 and 10 and 4 and 10 again. My right breast actually DOES hurt now, and there seems to be an actual blockage in there somewhere. I'm constantly waking up covered in sweat from the repetitive fever which goes up to just under 100 and then breaks, several times a day. The funny thing is that other than the fever there wasn't much going on in the way of proof of infection. But of course, after not expressing any milk for almost 10 hours I think any new mother would get mastitis.