Not much in the way of advice for you, but my first thought was a good lactation consultant. Glad to see you'e going to get help.
My first DD pretty much tore me up too; when the LC looked at my nipples, her reaction was, "Well, I've seen worse....!" :shock: Apparently she hadn't seen MUCH worse, though. I was able to express using the slowest and most gentle setting on the electric breast pump - I still had to grit my teeth, mind you, but it was still less painful than actually nursing. I also have NEVER managed to nurse lying down - just one MORE reason we don't do a family bed. :?
What I ended up doing was having the nighttime feeds be formula feeds so that my nipples had a chance to heal during the nights, and then going back to BF during the days. There was some engorgement, but as I was pumping right before bedtime and nursing first thing in the AM, it wasn't too bad. Once it started to hurt less to nurse, I was able to go back to breast milk full time, although we kept the bottle at bedtime (formula + expressed milk) so DH could put her to bed till she gave up bottles on her own at 8 months.
People have different feelings about using formula, either on its own or in conjunction with BF, but it did work OK for us; in fact, it actually SAVED us from having to stop nursing altogether. It's a personal decision, though.
Please let us know how you make out at the clinic today.