Re: Rheumy visit
One way to earn brownie points with a doc is to explore the treatments they recommend. What sort of topicals has your doc recommended?
Some of the topicals do not get into the bloodstream in an appreciable way, are simply utilized locally & dose can be very small, which tends to minimize impact on breastfeeding. (Nevertheless, always ck out drugs & dosages, even OTCs, with your baby's pediatrician, as I hope you have ckd for the Tramadol & Tylenol, if you are taking them while BF).
Has your doc recommended a topical prescription compound, like a lidocaine cream or patch, or a topical NSAID? Or just OTC mentholated arthritis rubs? (Nix on the latter.) Of course, if you've tried it all & it's not effective, that needs to be communicated.
You might ask your doc if, in his opinion, a Epsom-salts baths would be OK to try, and also about the EPA fish oil concentrate. He may shrug his shoulders & say 'likely wouldn't either hurt or help,' which would then give you then a green light to check with the ped. re: BF issues., if you are interested.
You may also find a pharmacist, or if a compounded prescription is given, a compounding pharmacist, to be very helpful on questions of how a drug, OTC, or topical, is metabolized, whether it is likely to get into breastmilk, and if it would be a problem for the baby.
A big YES to asking the doc to refer to PT; hopefullyone who is skilled in working with fibro. This is something that you can try while BF, and (unless you get into aquatic therapy with a heavily chlorinated pool & happen to be sensitive to chlorine) , it's not likely to be harmful.
You might ask the doc to ck your free estrogen & free testosterone levels in addition to the free thyroid hormones. Hormones generally aren't rheumies' area of expertise, but some who have specialized in fibro may recognize a connection.
I hope you will let us know how it goes! I'm hoping there's something doable that will provide a measure of relief.