Surely this is a ridiculous reason to go to A&E but what do I do?!

[ColourfulHairbands]

I know there’s men on here but I don’t care anymore! I have to post on here for traffic and to see if anyone has ever experienced similar.

For nearly two weeks I’ve had extreme pain in my nipples. The pain doesn’t come and go, it’s there constantly and the best way to describe it is that I have shooting pains directly from my nipple going into my breast.

My nipples have been hard for two weeks non stop. You know the feeling of having hard nipples when you’re quite cold and eventually it gets a bit uncomfortable, that’s my life.

I have no clue what’s going on. I haven’t stopped breastfeeding or anything like that. I don’t know if it’s a hormonal thing (I have the implant so not a side effect of my period). I called the GP and he was none the wiser bless him. He booked me in for a blood test this Wednesday but he did say that he doubts anything will show up. I called 111 and they said go to your GP or A&E.

I’m seriously considering going to A&E. I don’t know how they can help me (they probably can’t) but I think I may need to be examined at the very least. Has anyone experienced anything like this? The pain is bringing me to tears daily and I’m starting to worry that this may be somewhat serious

You need to see a gp to have a physical exam, prescription if required and then referral if necessary.

Book this today. Don't be fobbed off with a blood test - what are they testing for anyway if you've not been examined.

This is not an accident or medical emergency, absolutely not a reason to present to A&E.

GP, not A & E.

I got what you meant about the not breastfeeding OP!
Definitely get a GP appointment, sounds really uncomfortable.

This also sounds like thrush to me, I’ve had it and it’s agony. Like needles in your nipples.

Go and see a pharmacist first to see if that helps and book in with the GP for a few days time

Hi @ColourfulHairbands - I get Raynaud’s Syndrome in the nipples. It is most often associated with BF, but not always. I have had it since my teens. Are the nipples the same colour as always? Are they red, white-tipped or even blueish? It sounds VERY much like what you have described. (Excruciating!) Can you see if the pain and dilation is eased a bit with a hot water bottle (over your clothes) and some ibuprofen? If it is this, Raynaud’s is a bizarro autoimmune response that can be triggered by cold, stress, lack of sleep, ill-fitting bras (nipple version) and vibration (ie, car ride). It most commonly affects hands and feet, but can affect “peripheral) circulation. I’m lucky enough to get it in hands, feet, nips, lips and occasionally ears. I have attached a link below, but the article explains it in relation to BF. As I stated, it’s not always due to BF.
Linketydink

If it feels a bit like someone is pushing thick needles through your breast it sounds like deep tissue thrush. I can’t recall the specific treatment but I had to have quite a strong discussion with my gp to get treatment- I took a print out of what was recommended. Paracetamol can help take the edge off.

Noooo don't go to a&e for that, try your pharmacist or a different GP.
Sounds like thrush maybe?

Has the GP examined you op or spoke to you on the phone? I'd try to get a GP appt, pref with a woman, and ask to be examined first.

Sounds like when I had thrush. I had to put a cream on. Sorted out within days. Ask Drs to prescribe cream?

Could it be thrush or some kind of fungal infection or other bacteria (I have no idea!) I'm thinking hot + sweaty with maybe not changing bra or sleeping in bra? Could be culprit?)

Just obviously ring your GP again and request a face to face with examination. A&E is for accidents and emergencies. As everyone else has said it'll probably be something that will clear up with a cream but you do need a Dr or practice nurse to examine you. Good luck.

That sounds like how I felt when I was pregnant.

Thrush is a fungal infection. You need anti-fungal cream, which is what Canesten is. If you use it and you don’t have thrush it will do you no harm. Give it a try.

• Found this: Antifungal Tablets. You will need an antifungal tablet to treat the ductal thrush. Fluconazole is the drug used, although the company that makes the drug has not licensed it for breastfeeding. This does not mean it is unsafe for breastfeeding women. The WHO says that fluconazole is compatible with breastfeeding, but you may have to convince your doctor to prescribe it. Your next issue will be to ensure you are given the correct dose. It is common for doctors to give women the incorrect dose, meaning that the thrush persists. To start with you should be given a larger dose on day one (known as a "loading dose"). This should be 15-300mg. You will then need 50-100mg two times a day for at least 10 days. If you have particularly aggressive or persistent ductal thrush, you may need a higher dose (see below).

If you have deep tissue thrush, topical cream won’t help.

I’ve just bought it! I’ll put some on quickly before work. I hope this works for me because I’m in agony! I won’t turn up to A&E I promise haha

Sounds like thrush that's got into your milk ducts. It's very painful! You need Daktarin cream and possibly also antifungal pills.

Phone the gp back and ask for a face to face. If the receptionist fobs you off ask to speak to the practice manager. Say you will hold for the practice manager.

An interesting thread as I had thrush of the inner breadt tissue when ds was breastfeeding and also suffered acute nipple pain when latching which didn't relate to a poor or difficult latch iyswim. It was also an Arctic winter and chilly in an old house despite ch and open fires. I developed Reynauds a bit later.

However @ColourfulHairbands none of us are drs or medically trained. You need to make an appointment F2F with another GP. If they are dismissive or not helpful then you need to request an appointment with a breast consultant. Persistent breast pain may be a good enough reason for a two week referral as a precaution. Sadly, as this is women's health once the potential nadties are ruled out, you will probably have to pay to get a diagnosis and the correct treatment.

I hope you feel better soon. I cannot imagine having two under three and being in constant pain and working too.

As someone who works in a surgery when they cant offer an appointment it's not being 'fobbed off' it's that they don't have a suitable appointment to give out. Also the hold for the practice manager line, I'm not sure what you think that'll achieve. It just sounds petulant.

Especially when it sounds like the surgery provided the OP a good honest service and have arranged for further tests, I imagine with advice along the lines of abnormalities we'll contact you, regular OTC analgesia advice, persisting beyond x time or xyz occurs then recontact for review.

We all wish there were enough appointments available to meet demand but there will never be some some people will need to wait. I run a specific type of clinic within the surgery (I'm not a doctor) but always end up with about a third of my patients being incorrectly booked because they've ended up making such an extreme fuss or lying about their issue because they felt they absolutely had to be seen by someone/anyone that same day. So then they take the day off/wait to come in and see me and then are almost rageful when after I listen to their concerns it's not something I can assess/help them with and all I can do is apologise they've been incorrectly booked to see me and to try again another day but be clearer on their issue so they can be correctly booked.

For clarity I run an urgent care clinic, so great to deal with a new problem or exacerbation ?need antibiotics/pain relief, do I need to be concerned kind of thing. But the third of patients take up appointments with very complex issues/long term disease management that the GPs/specialists have been looking after for years. The patient then expects me to address some subtilty in a condition which I only have a very superficial awareness of, no where near the competence to give advice/alter therapy or explain why the hospital specialist altered their therapy or explain x test result and how it'll affect the surgical treatment they're on the list for.... They've just taken up an appointment that now won't be available for the feverish child or ear ache etc and nothing is gained for them.

Ask GP for a referral to breast clinic, all referrals are seen within 2 weeks. Best of luck!

@SleepyRich if what you say is the case, do you not think it would have been helpful if the Dr had explained to the op why they thought a blood test was the most appropriate course of action and what they were actually testing for?

What a shame the receptionists bung the persistent patients into your clinic rather than fit them in to see their GP who may have the expertise to deal with them but you don't. I imagine the GP Partners have given that instruction because they don't give too many figs about wasting patient time.

Your gp is rubbish and should have referred you for mammogram or to gynae. As you see, gp doesn't know everything. Hope it's nothing serious.

It would have been helpful certainly but sounds like the GP didn't recognise the symptoms as any disease in particular so hard to give very specific advice.

I mean from the brief info given essentially they could be thinking - affecting both breasts simultaneously so not sounding like a tumour/abscess,
Sounds like a nerve pain in description affecting a single dermatome, but bilaterally. Could be Shingles but would have probably seen some vesicles (spots) appearing now.
Could this be a infective/mastitis/fungal?
Could this be hormonal - persisting not associated with menstrual cycle....

Not very clear what it is but doesn't sound obviously life threatening/no red flags, most things do resolve on their own in time, lets run some general heath/screening bloods now, hope things settle on their own but if they don't at 4 weeks then it's a good sign intervention might be required and re can review with these blood results and reconsider if sounding more like a specific illness or is referral to specialist required....

They don't get an appointment that day with the GP because their appointments are booked up so they need to wait but aren't willing to. I can only speak to my experience in the surgery and I'm amazed by the volume of patients the GPs are looking after on a daily basis in addition to all the pathlinks and behind the scenes goings on. They're at capacity.

Since I don't see routine patients all my slots are only bookable on the day. Essentially you get x patient calling up wanting a Dr appointment to discuss their illness/medications/requesting a review, if there are no suitable Dr appointments for their request that day they'll be told the next routine appointment is x days/weeks depending on what the issue is. This is fine for most patients, although frustrating certainly if it's weeks. But some patients think by being demanding, essentially saying words to the effect of "I'm in agony, not coping, can't manage, it's an emergency, I'm going to keep calling until I can see someone, I'm going to make x compliant....". So in case it is a genuine severe exacerbation/the person does need to be seen that day ?do they need hospital admission, or just being human and wanting something good to come of it the receptionists book them in with me... Who then gets the person who appears very well, has normal observations, 'oh hi yes I'm under Dr Smith the consultant nephrologist at prestigious hospital advised me to discuss with the GP about titrating down some of my antihypertensives and diuretics because of a recent blood result and could this be discussed with cardiology as I had an angiogram 3 weeks ago and the results weren't on the system.... I'm due for a review next week but I'm going on holiday then and I was hoping to get this sorted beforehand....

The GPs are really quite frustrated when my slots are waisted because they care about missing a patient who needed urgent treatment having to goto A&E when they shouldn't have needed to. The partners definitely haven't given the instruction for the receptionists to just book them in with me because the absolute expectation is for the slot to be waisted - patient frustrated I couldn't help - generally saying 'well why was i booked in with you then not a Dr' - answer because you insisted it was an emergency that you were really unwell and couldn't wait. They need to book the Dr appointment anyway so it's just twice the time for the same issue and now an urgent patient has to goto 111/WIC/A&E or hopefully they weren't too bad and it gets better on its own.

It could be Raynauds of the nipple, I had it when I was pregnant, it was excruciating.
The GP should be able to give you nifedipine to try.
It's definitely NOT either an accident or an emergency, so not for A+E.
Your GP should also NOT be referring you urgently to the breast clinic, as you would be taking an appointment needed for patients with symptoms which may be breast cancer. Fortunately it is vanishingly unlikely that breast cancer would present with bilateral nipple pain - my local breast clinic will not see patients with breast pain alone unless they have had it for over two months, and it has not responded to treatment from the GP, which you have not yet had..

You still haven't explained why the GP couldn't have explained their reasoning to the op and why they couldn't have suggested some pain relief as the op is finding the pain unbearable.

I don't behave as the patients you have described but my practice wastes so much time it is hard to believe they are overworked. 56 day prescribing for starters which is unnecessary for stable conditions such as hypothyroid and which my practice cocks up time and again.

Last week I received three calls every 20 minutes that I couldn't answer. 4th call the practice left a message to tell me.I needed to make an appointment for a blood test. Then they rang back and left another message the following day.

As far as I can see there appears an awful lot of time available to waste and zero respect available for my time.

Agree with this. OP was essentially left untreated and in pain.