Monday, August 8, 2011

Acute Lyme, Treatment, and Breastfeeding - The Beginning

(Nothing in this post is intended as medical advise. If you have or think you may have Lyme Disease, you should seek professional medical help)

  I started getting sick about a month ago. It started with that feeling, the one I can really only describe as the "I'm probably going to be sick tomorrow" feeling. I felt just not quite right, a little achy, a little fevered. I woke up fine, but felt the same way in the evening. Three days of that, then the headache. It wouldn't go away, no matter what! I took Tylenol, it dulled the ache, but couldn't take it away. The headache started to feel like it was running down my neck and in between my shoulder blades. My fever went up a bit, it would run between 100 and 101.5. With Tylenol, it would break, but as soon as that dose wore off, it would spike again. The first headache lasted 8 days. Muscle and joint pain accompanied, with severe fatigue and that flu-ish achey skin feeling. In the middle of this, I had finally seen a Dr. and gone to GigantorLabs for a blood draw. I expressed a concern for Lyme disease (thanks to my medical degree from Google University and the fact that I've had maybe 20 tick bites this summer. We are outdoors often and while we take precautions and remove ticks quickly and safely, the smallest ticks are often the carriers, and believe me when I say, they are very very small.We live in an area with a high rate of Lyme contraction, so it'd been on my mind. )

   I waited 5 days for results, and the tests all came up negative. I had a vitamin D deficiency and that's about it. I was feeling better at my results appointment, so my GP told me to get some vitamin D, rest up, and call if symptoms returned. 4 days later, they did. The headache came first, and within 24 hours, all the rest followed suit. I got back to the Dr. as soon as possible and paid a bit extra to have them draw blood right there in the office that day. The Dr. recommended checking liver, kidney, and a couple other things, as well as the Lyme test again. Another week of waiting, and being sick. I finally got a call that the results were back and at the result consultation my Dr. wasted no time in telling me we finally had an answer and it was Acute Lyme Disease (Acute is the opposite of Chronic, it just means that I contracted the disease fairly recently). Then the Dr. told me "Good news is, it's very treatable with a strong round of Doxycycline. Bad news is, with this medicine, you'll have to wean."

   I felt like someone had punched me in the gut! Dragon Baby is only 8 months old. I am nowhere near ready to wean. Nursing is a very important part of our day, and night, and everywhere in between. I usually just mumble things at doctors I don't agree with, so I shocked myself when I said, quite calmly "That's not an option. What are our alternatives?" I asked about other medicines, there's one, less effective antibiotic, but I'm allergic to it. I really must get better, and so I need the best medicine I can get. The Dr. is telling me that if I'm going to continue nursing while taking the medicine, it's going to be a very careful balance of a schedule, watching out not to nurse during the peak of medicine after the dose, then "pump and dump" (a big myth, but I'll cover that in a different post), then nurse before the next dose. I tried to clear my head enough to discuss what I knew about NOT needing to pump and dump, but the Dr. wasn't hearing it. I left the Dr.'s office with my head spinning.

  I was determined to make the schedule work. The Dr. told me the peak of this medicine would occur between 2 and 4 hours after the dose, so at 4 hours "pump and dump", then nurse until the next dose. I wanted to get in touch with an IBCLC to see what Dr. Hale (the leading MD in the world of lactation and pharmacology) had to say about Doxycycline, and to see if I was correct in thinking that pumping and dumping was the old way of thinking about undesirable things in your milk, and that, unless I was concerned about my supply diminishing, there was no reason to pump and dump. The medicine, just like alcohol, would disperse in my milk the same rate as my blood. Breasts are not containers, they are glands, and milk doesn't just sit there waiting to be drunk, it is constantly changing. The IBCLC provided Dr. Hale's information about Doxy and confirmed my thoughts about pump and dump.

    Dr. Hale doesn't recommend long-term nursing with Doxy, long-term being 60-90 day treatments like the ones needed for treatment of Anthrax, but for my 30 day cycle, our schedule of careful nursing around the peaks of medication should work, with minimal risk.

Our plan is this: Mompyre takes probiotics every day to hopefully ward off thrush, that's not something we want to do again. Dragon Baby takes in high-calcium foods in his solid food diet, as calcium will help to protect from the trace antibiotics he will get. Our day will be divided in to quarters of 6 hours each.
  • First Dose: Bedtime
    • Nurse at the same time I take the pill, as it won't enter the bloodstream right away.
    • Absolutely no nursing for 4 hours, to avoid the peak of the medicine
    • Try very hard to not nurse the next 2 hours, to provide a bit of "cushion" time.
  • Free Nursing time!
    • Nurse and pump as much as I care to in this 6 hour window, anything pumped can be offered in the next 6 hours while we can't nurse. 
Then, repeat! and repeat, and repeat, and repeat.

I'm a little concerned about how it's going to go, for us, emotionally, etc. DB nurses quite frequently throughout the day and night, for thirst, hunger, and comfort. I'm going to try to meet his needs in other ways, but it will be a big learning curve for us. I'm going to try and post some of our experiences, simply because in all my research online, I haven't read of anyone doing what I'm doing. I have read of lots of people weaning.

I do welcome questions and comments, though I thought of disabling them for this series of posts. I have run into some really abrasive posters out there in the dark corners of the interwebs on the subject of Lyme and weaning, Lyme and breastfeeding, etc. But I think it is more important to make myself available to others who might need help than to protect myself from the possibility of hurtful words. I'm not here to advise others on what to do, just to share my story. We are confident, as a family, in the choice we've made, and I did not take it lightly. I hope hearing my story helps someone out there. I know it will help me to share it!

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