Call us when you quit nursing, we can help you then

[amandaleigh37]

I just wanted to vent about my visit to urgent care a few days ago.

My husband and I both developed a strange rash after returning from vacation (stayed in a hotel). At first we thought it might be scabies, so he went to the Dr. last week. That dr. said it was just dermititis and gave him a steroid cream for us to use. We still suspected it might be scabies so have been treating it as such, and using tea tree oil. Anyway...

On Wednesday I started getting flu-like symptoms and very sore breast that made me think I had mastitis (never had it before). My son is 17 mos. So I went to the urgent care. Yep, it was mastitis. I also had the doctor look at my rash to see what she thought.

I was initially relieved when the female doctor asked how old my son was and said "You're still nursing?! Good for you!"

She quickly agreed I had mastitis and said she would give me antibiotics to treat it. Then she looked at my rash. She said it "could be" scabies, and my husband and I both needed to treat it. I told her we were already using TTO but she said "that won't work." She went out to get a book, returned, and said "I can't give the scabies cream to you, it's not for nursing mothers. When are you going to stop nursing him?"
Me: "Whenever he's done. Maybe another year, maybe more."
Her: *blank stare* "Oh. Well maybe you will have to store your milk to give him while you take the medication... but you'd have to find out how long it's in your system." (Isn't it HER job to find that out anyway?)
Me: "Hmmm..." (I wasn't buying what she was saying so no point arguing at this point...)
Her: "I'll be right back"
I thought she was going to go check this for me, or try to find another treatment. Instead, a nurse returns with 2 prescriptions. One is for my mastitis and one is the scabies medication for my HUSBAND. She hands them to me and I ask "So um... I guess you can't give me anything to treat this rash?"
Her: "No. Not while you're still nursing."
Me: "So what am I supposed to do?"
Her: "Call us when you're done nursing and we can treat it then."
Me: "So in a year or two?"
Her: "Um.. that's a really long time. How long do they say you should nurse him?"
Me: "they?"
Her: "The doctors. I know you're supposed to stop the bottle at 12 months..."
Me: "The longer the better. The APA recommends a minimum of one year, the WHO says 2 years. The benefits for him will continue as long as we keep nursing. I don't plan on stopping anytime soon."
Her: "Ok then. Have a nice day."

So basically they were telling me that my rash (which may be scabies) won't go away on it's own, but I can't treat it unless I stop nursing. (Since that visit 48 hours ago it has cleared up quite well with the TTO so I'm not concerned about further treatment at this point.) But I was really annoyed at their attitudes about nursing. I figured that would be common if he were 3 or 4, but he's not even 1 1/2 years old yet!

And to send me out of the office like that with no hope for getting rid of my rash? I was beyond pissed off when I left, as you can imagine.

Do you think I should write a letter? What would I say? Obviously the nurse had no idea that nursing was beneficial past 12 months. The doctor seemed to get it at first, but didn't really try to work with the situation. Although she didn't come out & say it, she implied that I needed to quit nursing or just live with the rash. UGH.

[waiting2bemommy]

Apparently, it just gets worse. My ds is just shy of 4 months old, and today someone came up to me and said, "how long *did* you nurse your baby again/" I said, "I still am, I hope to keep doing it for quite a while." She said, "Yes, it would be great if you keep doing it another month or so before you wean." Seriously????? at 5 months????

[mamajake]

First, if you have the name of the medication, get thee to a copy of Hales (your local LLL Leader should have access to one - PM me if you trouble getting access to one) and find out whether indeed the medication is in any way dangerous to use while breastfeeding. Docs like this one will just look at the manufacturers label, all of which say not to use in pregnant or breastfeeding women.

Then, armed with the information concerning the safety (hopefully) of the med. go to a different health care provider. If indeed there is a reason not to use that particular med., how likely is it that that is the only treatment available? A doc should be able to help you find safe alternatives.

As for complaining about ignorant doc, I am sure lots of folks here will help you draft a complaint letter if you choose to. I might wait until you have worked out the medication issue so you can include the additional information about how you had to do all this work that was really the responsibility of the doc.

Oddly, I don't see a contradiction between the "good for you" remark and the rest of it. I have seen too many docs who are completely clueless about breastfeeding give what looks like support but is really more patronizing when it comes down to it. :

[frontierpsych]

I agree about finding a copy of Hales.

I'd also try to see a naturopath about it if you keep getting flak. There could be a way to get rid of it without dangerous meds.

[Ruthla]

I had treatment for scabies while nursing DS.

IIRC, there were two different meds that could be used- one incredibly unsafe for babies (so unsafe that SO shouldn't have even been holding DS while the cream was on) and another perfectly safe for kids and nursing moms. We had to treat the whole family- me, SO, both girls (I think in 1st and 2nd grade at the time) and (under 7mo) DS.

My primary concern was how to nurse DS while the medicated cream was on my body, since it's a topical med, not an oral one, and it needed to cover my whole body for over 8 hours. In the end, I put it all over me except for the central part of my left breast, and I nursed him only from that one side during treatment.

Make sure you properly wash all bedding as well- you'd hate to get re-infected after the problem clears up!

[tinuviel_k]

I'd go see a skin doctor for the rash. At urgent care they are trying to get folks in and out of the door. They are great if you have a broken arm or need stitches, but not if you have a rash that needs attention. A doctor who specializes in skin problems will know more about which drugs would be acceptable for a nursing mom than an urgent care doc who needs to know just a little about a zillion kinds of conditions.

[mamallama]

Seriously, Urgent Care is great if you need stitches or something, not so great if you need thoughtful care.

[Samjm]

A good urgent care should however be able to get you a referral to a specialist (which is needed for insurance to cover the specialist fees in many cases)

[ColoradoMama]

Originally Posted by amandaleigh37

Do you think I should write a letter?

OMG - yes, yes, yes, yes, yes. Absolutely write a letter. I'm not sure who to - I'm sure someone else can tell you that. Tell them what you've told us and back it up with the statements from the WHO etc. Good luck.

[columbusmomma]

Originally Posted by tinuviel_k

I'd go see a skin doctor for the rash. At urgent care they are trying to get folks in and out of the door. They are great if you have a broken arm or need stitches, but not if you have a rash that needs attention. A doctor who specializes in skin problems will know more about which drugs would be acceptable for a nursing mom than an urgent care doc who needs to know just a little about a zillion kinds of conditions.

I'd see a dermatologist.

[MommytoTwo]

How crappy but I cant say I am surprised. I was told by a psychiatrist to come back after I quit nursing, I was there for ppd. You should *definitely* write a letter.

[sapphire_chan]

Originally Posted by Samjm

A good urgent care should however be able to get you a referral to a specialist (which is needed for insurance to cover the specialist fees in many cases)

And the failure to refer you when they couldn't treat you should be the main complaint of your letter. It is okay for an urgent care doctor to not know everything about every medication, it is not okay for an urgent care doctor to send a person away with no information at all.

[Bekka]

Originally Posted by mamallama

Seriously, Urgent Care is great if you need stitches or something, not so great if you need thoughtful care.

I don't mind generalizations in general, but I went to urgent care while pregnant and my CPM couldn't write a script for a UTI. I went in there to get a script for abx, and planned on defending my decision to birth at home tooth and nail. Instead the nurse had worked for midwives at one point and loved them, and the dr.'s wife was an alternative practitioner and he said they wished they'd home birthed. Made my day--you never know what you're going to get. I got my script and a great day.