I wish I had seen this sooner! Oh, Mama, you are really having a rough time.
Whoever told you to bind and cold turkey wean: get away from him! (I think you know this.) (I had a client who did this ended up with full sepsis and still didn't get treatment and she had a psychotic break from the poisons in her blood, it was finally treated, but the original mastitis was first "treated" with amoxicillin (doesn't work on mastitis and I told her this ahead of time, she chose to take it anyway) and then when I felt a burgeoning possible abscess in one of her breasts she went back to the same doc who told then her to bind and cold turkey wean and it's probably one of the worst lactation nightmares I've ever seen in more than 20 years in practice. She spent 4 days in a locked Psych Ward, (with sepsis and an untreated abscess) before she finally got treatment.) Not trying to scare you, but abscesses are serious, and it does speak to the power of advocating for your own health, even though it's scary with doctors who get bossy sometimes. Is there someone you trust, maybe a partner, you can bring to the appointment with you, and he or she can read what you want to say? I've found this works when Mamas are overwhelmed and not able to advocate themselves.
I'm a lactation consultant and it sure sounds like a galaotcele to me. (I can't say for sure without seeing you.) You'd be sick with an untreated abscess this size, fever, nausea, chills, even hallucinations and severe tremor plus sepsis and severe illness.
It's a fairly large galactocele, but I see no reason that it could not be drained. You just stick the needle in the side of the breast (after some numbing of the tissue) and withdraw and look at what you have. 99% of the time, it's just milk. About 40-80% of the time the galactocele fills back up, and you have to have it drained again. It may take several drainings. If you weren't in so much pain, I'd leave it be, but the pain is bothering me, so it should be treated. Is it possible to see an other doctor at an other hospital NOT related to the people you've already seen? They are obviously not doing you any good, and you need treatment.
Galactoceles are harmless, but if they are causing pain, you and your pain should be treated seriously. I am glad the doctor is at least treating the pain appropriately but a draining would be on my agenda if you were my client.
One more question: If it gets smaller when you nurse, then fills back up, it's probably a blocked or "blind duct." A blind duct is a duct that, for some reason has no way to easily empty into the nipple pore and the milk just causes stasis in the duct. These can be tender, but they usually dry up in a month or so on their own. A galactocele may get slightly smaller while nursing, but they usually stay about the same size, get bigger or smaller usually not based on what is going on during the nursing. They can go away on their own, but I'm worried about your pain and the size of the thing.
(Many women with blind ducts have had breast injury or breast surgery around the area of the blind duct.)
Can you see someone else and get this thing drained and make sure they take the aspirate (the stuff that comes out of the cyst) is taken to the lab and analyzed? (That should be done anyway, but you know how some doctors are.) It IS possible that you did have an abscess and the "shell" of the abscess is still there, and is filling with milk, in which case, you still need it drained and analyzed a galactocele will be mostly milk, an old abscess will be mostly pus,maybe some blood, they LOOK the same in the syringe, so they need to be taken to the lab for analysis.)
Good luck. I know it's hard to advocate for yourself when going through something like this, but keep nursing and taking your pain meds and see that new doctor.
Blessings on your healing.
Edited by MaggieLC - 12/4/13 at 8:22am