It's back and forth. Some feeds are fine, and some suck (ha ha). She does seem to get very, very upset when my let-down isn't right there for her. There isn't too much I can do about that except for try to hand express a bit at first so that it is quick, but TBH I rarely bother because sometimes it really is fast and then I just have milk spraying everywhere as I try quickly to get her on. We are just mudding through it instead.
My dr said that it isn't thrush, so that is awesome. He said that the itching is the chafed hickeys she has given me trying to heal. I have some cream to put on them to try to speed up the process and I have to air them out after each feed. He said that they were probably caused by her bouncing and jerking off to look around without letting go; it has damaged my skin. So I have to be careful to watch for that.
I think we are good to go for a while though now! I seem to be over my slump emotionally and have more resolve again. She is back to waking only once a night after her DF to nurse, so the extra sleep helps!