Tuesday, October 8, 2013

The Story ~ The End, Part 6 ~ Candida and Beyond

At the same time as I was suffering from blood pressure issues, I was aching where it mattered most for Yousef: in my breasts. I had thought our breastfeeding relationship was established but one day, almost six weeks later, I woke up to massive and constant pains. It hurt when I nursed, it hurt when I did not, it hurt between nursings. My breasts throbbed, they burned. I cried when anything or anyone came remotely close to my nipples.

But I had to feed him, so I did; many time begrudgingly. Many times I tried to avoid feeding him. Many times I wished I did not have to. Formula feeding was looking very attractive. I debated the matter. I seriously considered it. I also considered going the exclusively pump and bottle feed route. I did my research and called around for hospital-grade pump rentals.

I played scenarios in my mind, looked at feeding an infant from many different angles, told myself I could muscle through it. I counted the days in my mind. “I can make it to six months through this pain,” I told myself. “I could pump and give him breast milk for another twenty four weeks,” I considered. “Formula feeding never hurt anyone,” I tried to convince myself. But I was not convinced. No matter how I looked at it, I could not bring myself to give up nursing and yet I wanted the pain to stop.

I reached out for support. I contacted a friend, then another, and a third. I fielded calls to lactation consultants. I went to breastfeeding support group meetings. I posted on my virtual support forum. I saw my OB. I researched online. I knew I would find an answer but I did not know how to pose the question.

The first thought that crossed my mind was a “latch issue.” I worked on that. There was no improvement. Then I thought he had a tongue-tie. That was not it either. Maybe the pain would go away once my body got used to nursing. It did not. My nipples were not cracked. My ducts were not blocked. It was not thrush. It was worse. It was candida, and it was ductal. It was diagnosed by every lactation consultant I spoke to, and confirmed by the one who visited me. Only my OB was not convinced; and he held the key to my cure.

My OB preferred to take the conservative route to my diagnosis. He agreed that I was suffering from something, but we disagreed as to what it was. He first suggested the APNO. I agreed to try it. There was only one place that composed it. The insurance did not cover it. It cost over $60. I hesitated. Two days later I broke down and bought it. It did nothing.

I went back to the OB. I called and emailed him. I sent him research findings. I waited for his response. He prescribed the medication, but not enough pills were dispensed. He was not yet on board with the suggested course of treatment. I resolved to ride the wave longer. I took the pills I had on hand and called around for assistance.

I found a lactation consultant who took my insurance. Within 24 hours she was in my bedroom helping me out. We discussed the treatment. We agreed on a course of action. I followed all the steps leading to the last resort: a 14-day supply of fluconazole in addition to the APNO, the grapefruit extract and the probiotics. I needed someone to prescribe the antifungal. The question was who.

My cousin is a doctor. I tried to convince him to dispense it. I knew NPs in other parts of the US, I reached out to them. I called my aunt in Lebanon and emailed my sister in Australia. I found a website that would ship internationally. I was desperate. If only my OB would write the script. Finally, I was referred to a lactation consultant who was also an NP. She agreed to dispense the required dose should my OB continue to refuse. She also agreed to see me at a discounted rate to call the medication in. Things were looking up.

I gave my OB one last try. I emailed him the progress I was feeling on just a couple of pills. He had a change of heart! I am not sure if it was my last email, my pleading, his compassion, his sympathy or a combination but all of a sudden a refill to the original prescription was called it. All was good with the world!

I religiously took the medicine, applied the grapefruit extract, waited for it to dry, aired out my nipples, applied the APNO, waited some more, washed my bras and shirts and towels and pillow cases and sheet and Yousef’s clothes daily. I sanitized bottles and nipples and shields. Anything that touched my breasts went straight into the dryer or microwave. Everything that had touched them was boiled, sunned, sanitized. The pain was gradually subsiding until one day I woke up “normal.” The pain was gone and the milk was still there. I was still nursing, happily now.

At the time of writing Yousef is over seven months old and still nursing like a champ. He is eating some solids but still prefers mama’s milk. After everything we have been through, I am glad I worked through the pain and arrived at a point of comfort. My last breastfeeding journey is looking good and I hope that it will continue as much. I may even be lucky enough to end it the way I had wanted to end the previous one: when we are both ready.

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