I had engorgement and I took some ibuprofen and that offered some relief. I am pumping and have not produced a good amount since the engorgement weeks ago...ugh!
I too had a clogged duct and massaged before and after each feeding - they also said to always let him nurse on the side that is clogged first - I took IBUPROFEN for mine - but like you said clogged duct is the step before mastitits - but it hurts too - so I am so sorry I know you are in much pain.
Have you tried any homeopathic medicine? I had a very VERY bad clogged duct, extremely painful and nothing worked to help reduce it...was about the size of a quarter.
I tried Lecithin and it didn't seem to work but it's good at keeping your ducts healthy and bonus also good for your brain.
What really worked for me was Phytolacca Decandra 30. I took it religiously everyday, six pellets, about 2-3 times a day in the beginning and gradually reduced it off.
If you don't have a healthfood store that carries it, you can purchase it online. I bought mine for I think $7.99?
Give it a try...it's safe for you and the baby, no side effects and all natural.
Also, for the nipple thrush, Dr. Jack Newman's All purpose Nipple ointment does wonders. I had a badly cracked and sore nipple, they also burned like crazy. This ointment cleared it all up incredible fast. The nipple cream must have a req from a doctor for the pharmacy to make or from your midwife.
http://www.drjacknewman.com/help/Candida-Protocol.asp
Here is a link for the ointment and if you're not familiar with who he is, he's like the Guru of breastfeeding in Canada...check out his site.
http://www.drjacknewman.com
I think Mastitis is the next step. I have to be on antibiotics to clear it up.Fionn does drain it but because of the other issues Like the thrush I stopped pumping also so that might have been the issue. Also Fionn is now sleepingduring the night a bit more so I get 5-6hrs instead of 2 hrs.
I did have a clogged duct-I don't know if that'd the same thing as mastitis? It was painful. I took Tylenol, got in a warm shower, and then just massaged away. Then I pumped. It took a few times to get it cleared. I read you're supposed to be sure to "drain" the breast at each feeding to avoid this.