Monday, July 22, 2013

Mastitis and the Treatment or LACK of That One gets in Never Never Land...

When I was pregnant with Phiz, my case manager at Care1st called the area I live Never Never land, because if you need good medical care you're never never going to get it.  Oh my good golly is that ever the fucking case when it comes to good old Antelope Valley Hospital Medical Center's Emergency Department.

Over the last week I dealt with a nasty clogged duct in my left boob.  THE boob, the one with the pacemaker up top, so it's painful when that boob even gets full, let alone a clogged duct, but they happen. Of course when it happens it's that boob and the duct right under the pacemaker. Since the pacemaker is generally sore ANYWAY, and something I never mention because frankly, if I mentioned every time something hurt on me I'd never say anything else.  So the clogged duct had a weird milk blister thing that I was able to get easily with a sterilized tweezers and the milk started flowing just fine and all was well that day. The next day, the duct was clogged again, and it was sore all up under my pacemaker.  No milk blister this time, but when I pumped, what came out was a clogged looking thick, stringy, almost snot consistency(I know, TMI and this is gross.) and I'm developing a fever.  This is Saturday.  So I call the nurse line for Care1st, and she says call your doctor's service and see what they say to do.

So, I call my doctor's answering service and leave a message to call me back asap.  And I wait.  And I wait.  So my fever creeps up and I start getting the chills and Dr Google informs me I've bordered into mastitis territory so I call back and ask to just speak to the doctor direct please.  She puts me on hold, comes back and tells me the doctor does not want to call me in a prescription for antibiotics, if I feel as bad as I say I can go to the Emergency Room, or I can wait until Monday.  At this point, I'm like ok...mastitis is not really something you want to fuck around with in a healthy person let alone someone with a pocket full of LIFE SAVING DEVICE attached to that same boob and cardiac pain tolerance of about zero.  So I call Care1st back and let them know what the doctor's exchange told me and explain I have no transportation and here's the scoop.  I have one choice here...I can stay here and watch my fever continue to creep up or I can take an ambulance which would they prefer?  Care1st says, well, your doctor told you to go to the Emergency Room, you do what you have to do to get there, it'll get covered. This is all on Saturday.  Remember this part, this is all on SATURDAY.

I waited it out a while longer, because in my head I couldn't justify calling and ambulance for mastitis.  It felt weird.  So Sunday I feel really shitty.  BARELY able to move around, don't want to eat or drink, don't want to do anything but lay there with my sore boob in the dark watching the back of my eyelids. So my husband says, ya know what, why don't you call the cardiologist and see what she says?  Ok, so I did,  I don't know how coherent I was during that, I cried while I was talking to her.  I know I told her mastitis.  I know I told her I'd rather be at White Memorial than AV but that I had no way to get there.  I know I told her that Care1st had ok'd and ambulance to the ER and I know she told me they'd get me admitted and get me transferred down there for overnight and get me fixed up. She gave me her cell phone number and told me to have them call her as soon as I got there, and told me she'd get me through this, she always does and told me to calm down. That was the end of the conversation.

I got my purse ready with a brush, my iPad and charger, a couple of snacks and got dressed to make the call.Someone made the call and the ambulance came and as always my 12 lead looked paced with a LBB and my o2 sat was low because it hurt to take a deep breath.  My blood pressure was almost non existent for me at barely 80/50, so I was worth a trip to the ER cardiac wise if nothing else. But they didn't bother to check too much into anything to be honest.  The ambulance ride was uneventful for me, sometimes I crash, sometimes I throw up, this time I'd taken an ativan and was super calm so all was well and I just wanted to be done with this shit and home.  Remember all I really wanted out of this whole fucking deal was for my doctor to call in a prescription for some antibiotics.  We get checked in and the woman running the computer inputting my information gets to the part of baby's age and I tell her 2. She looks at me a little funny and says, like just turned two or two and some? And I say does it make a difference? kind of jokingly and then said No, he just turned two on the 6th. And that I feel like a rockstar being able to nurse a baby as long as the WHO recommends. She kind of wanders away.  They put me in Trauma Bay 6.  I thought it was weird that I was in a trauma bay, but it was pretty quiet and I didn't bitch because the beds are softer in there.  Just so happens I have some Post Traumatic Stress about that particular bay though because that's where I was the first time I went into SCA.  Anyway...In pretty short order the doctor comes in and takes a look at my booby and ya know, at this time in my life, I've had a lot of people see my boobs, I just don't care, so he's poking and prodding and it's painful and tender and bringing tears to my eyes and he says, yes, he thinks it's mastitis.  He comes back a few minutes later to poke and prod at my device pocket and asks me if it's sore too and I say yes of course.  He says, well everyone's is, is yours more sore than normal and I say yes.He goes over my list of meds that include a beta blocker, an ace inhibitor, digoxin (the smallest dose possible), an anti depressant(low dose), an anti anxiety(low dose), a muscle relaxer and a heavy duty narcotic pain killer. He says that's a lot if meds, and I say yeah, I look too healthy to be that sick eh Doc? Again, he walks away.

A young man walks in and asks me if I need anything and I said water and he said he's not sure he thinks he has to ask the Dr, they might be giving me an IV but he'll check.  He comes back with a glass of water.

The doctor comes back in with a nurse I hadn't seen yet with a stern look on her face and she stands at the foot of my bed.  The doctor sits in the chair next to me, the chair that would ordinarily be taken by your family member or friend if you had one with you, but I so rarely do in that situation, so mine are generally empty and it seemed so out of place for him to be there.  His eyes look up at me and the look I can't place is a mix of pity and maybe disgust, maybe shock, I'm not sure.  He begins to ask me why I'm still nursing my son at his age, when was I planning on weaning him?  I said when he wanted to be done and the man looked at me like I'd grown another head.  He told me I was on medication.  I said  yes I know.  He told me my medication was contraindicated for breastfeeding. I told him I'd been informed.  He moved to another tactic and told me my milk could brain damage my child because of the chemicals in it. He told me my son could eat other food as if I had had no prior knowledge and had never shared a solid meal with my TWO YEAR OLD SON. He gave me a look of pity as he got up, he put his hand on my hand and said he'd go call my cardiologist.

He came back a few short moments later and said that my cardiologist said she didn't think I should be breastfeeding either, handed me back the card with her direct cell phone number and said that since they didn't see any abscess that needed draining they'd just go ahead and get me started on some antibiotics, and left the room.  I got out my iPad (no wifi in the ER) and settled in to read a little.  No more than I had read three lines the original check in lady hands me a prescription for antibiotics, and my release papers.  I didn't even have to sign them.

I told her I had no way home, that my cardiologist had led me to believe I'd be admitted for overnight IV antibiotics because of my CHF and history with unknown high white cell counts. The woman looks at me like I'm crazy, tells me she doesn't know anything at all about that and tells me that if I'm lucky I can catch a bus that will let me ride for free with my hospital bracelet on.

I walked home, I didn't see even one bus going my direction my whole walk there.  I live more than two miles away from there, and that may not seem like much to some people, but in the desert, with no water, suffering from mastitis, without even a water bottle, wearing black yoga pants, and a black tank top, in ill fitting flip flops, it was not a comfortable journey.  But I had no one to call to come pick me up.  That's how alone I was in all of this.  Humiliated, Scared because I was facing a walk in the heat I wasn't sure I could make, and thirsty.  I hadn't had anything to eat all day.  I had had maybe 3 glasses of water because I had been nauseated. And they just sent me packing, walking home in the heat. All because I'm nursing a toddler.

I don't understand what I've done wrong to have been treated like that or if that's normal procedure for mastitis treatment.  I don't get it.  I just know I feel degraded and ashamed of something I thought was so beautiful.

So they question me and don't realize that I know what I'm doing and that his pediatrician knows.  I was there to be treated, not to be interrogated. I time my meds so the half lives at most are such an insignificant amount for his weight, and we watch for any reactions and the only fucking thing wrong with the little shit is that hes rude and surly and spoiled and too smart for his own good.
 AND HE'S TWO! it's not like I'm pumping the remnants of morphine into a newborn. I waited until he was over a year to go back to a pain management, living every moment of every day with bone against bone pain and dealing with it.  And I take the SMALLEST DOSES POSSIBLE to make sure he is not affected.  Theses are indeed meds that they give mothers of newborns anyway are they not?

Until next time...

1 comment:

Amy Rhime said...

I am so sorry this happened to you! It's a terrible thing to seek help for a legitimate medical concern and be met with judgment and dismissal instead of compassion and care.