Sri Lumpa said:
steverhcp02 said:
To your previous post. Traumatically (and this is a whole new can of worms) losing a part of your body you have grown accustomed to, even as little as foreskin, even with your consent can have psychological effects. For example even when we have ostomies by election, we may consult psychology, for gastric bypass, which is far more common because it actually CURES diabetes 2 in some instances as well as hypertesnion and obstructive sleep apnea, we dont know why but it does cure diabetes in over 75% of cases, gastric bypass surgeries result in consults because mentally altering ones known body has effects on dopamine and seratonin secretions and their physical image of themselves. There is the issue of pain as you mentioned, but also vascularly it is more conducive to do it at birth because an infants blood flow and hemoglobin levels are obvious less than that of an adult.
I didnt mean to imply we use lidocaine as a standard practice to reduce pain in a painless procedure. What i meant was they are part of a set we call "circ sets" this is because, as i have stated many many times, there is not a standard practice for circumcision, thus it is elective and not mandatory because unlike congestive heart failure where we diagnose based on an ejection fraction of < 40% of the left ventricle and then MUST prescribe an ace inhibiotor (Lisinopril) and an ARB (Diovan or Atacand) because these are what we call "CORE MEASURES" Measures in which studies have proven prescribing these meds reduce discomfort and promote quality of life as scientific fact, circumcision is a toss up. We do it for the reasons iive stated more than i care to count in this thread.
By saying we offer lidocaine is because some physicians who practcie medicine at our hospital choose to error on the side of "why not" use the lidocaine, that in and of itself is dangerous as the lidocaine can penetrate tissue inappropriately but thats a whole new discussion. Our hospital uses PPO's (pre printed orders) this is to aleviate stress on our inpatient pharmacy and allow order sets to be enetred instantly which contain multuiple meds. Rather than leave lidocaine out we enetred it into the order set since some physicians elected to use it during their circs. Then if they chose not to they send the bottle to be credited from the patients bill to our pharmacy and since it has not been opened it goes back into circulation until its expiration date.
Hope that clears up the issue.
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For the lidocaine part, it does clear the issue, so thank you.
As for adult circumcision being potentially traumatic, like I said earlier, it is just part of the decision process of the person considering undergoing the procedure, and if a psych evaluation helps with the decision (either way) then why not.
I do however have a hard time believing that it would be that traumatizing for the vast majority of people (there are always people who are more fragile mentally, in which case the potential trauma would be a heavy cons against doing it) as not only do some people do it as adult, but a lot of people do similar or even more radical modifications to their bodies without traumatic effect. I am not talking about ostomies that add a new hole to your body and an external artificial appendage in exchange of clear and definite advantages but about tattoos, piercing and scarrification which I consider to be closer to circumcision as they modify the appearance of the body and can be more or less painful procedures to undertake. I am talking about comparing the level of trauma associated with it, not the medical advantages here, but I find them more comparable given the lack of clear and overwhelming advantage for circumcision.
So let's say that you could have a medical tattoo that had some potential health benefit. It would be more traumatic to get it when a teen/adult due to the pain (which can be mitigated with anaesthetic) and the change in body image that can be negative (though it can be positive too, if one prefer their look after the tattoo/circumcision procedure) but in my opinion, unless there is a clear advantage to doing it at birth, like if it was the best way to protect from a childhood disease, as opposed to doing it when the kid is old enough to at least participate in the decision (i.e. if he is a teen, it should be done with both his consent and his parent's consent; if he is adult then only with his consent) then the decision should rest with the person concerned.
Is there such an advantage to circumcision that cannot be had if done during teenagehood/young adulthood that overrides the right of somebody to their person?
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Well, we still see circumcisions medically for recurrent infections. Those are elective and usually its while theyre hospitalized for the infection if its that serious and the urologist offers it as a solution. So that ties into why its more beneficial as a young child. Glans penis infections without foreskin are very rare, ive never seen one and no one i worked with while rotating through any area of the hospital and any urologist has that ive come in contact with. So you talk about the actual cost of surgery, the time/paperwork of the urologist attempting to convince the insurence company its medically "necessary" as logic doesnt matter when it comes to insurence companies, if theres a cheaper (antibiotics, living with the pain, missing work) way for them to get around it they wont cover the surgery. So, this is why its prophylactically offered at/near birth. Its covered under the maternal insurence benefits because the baby after being born is "tied" to the mothers insurence rather than its own as long as it is not admitted to the neonatal ICU or admitted for an illness in which it is technically a patient. So, you have parents making a decision based on either A) sometime in the future its possible the foreskin may cause a problem. B) if A takes place its costly. C) Its free now with less risk (IE no patient side trauma be it mentally, emotionally or monetary)
I think a lot of parents generally feel its just more practical to remove it than not. As far as using terms like mutilation, thats like saying you have herpes when someone asks what that cold sore is. Or herpes when you get shingles or chicken pox. Would one use the terminology "Thank you doctor for mutilating my childs cleft lip so he can feed and receive proper nourishment"? The child isnt consenting to having the surgery of cleft lip repair, i wouldnt call it mutilation, the only reason people use the term is because its strong and draws a spike in attention. It overexaggerates.
The people wanting to ban this choice are overexaggerating the ill effects, which to my knowledge is using buzzwords like "mutilate, dismember" All in the interest of the "patient" not being able to make their own decision. Those wishing to simply have this choice at birth do so by simply saying the outcomes are more positive than negative, so it makes sense. I dont understand why people insist on pushing this "value" on others instead of just being content with having it to themselves and embracing it within their family.
In the end i dont know of medical cases where in the notes i read "if foreskin had been present this infection/issue would not have occured" However i have personally seen men in their 70's and 80's with recurrent UTI's and foreskin adhereing to their glans because they either forgot or physically couldnt clean all of the smegma and it became crusted thus harboring bacteria and resulting in infection.
So i think ive contributed enough to this thread. In the end it has nothing to do medically, its just another horrible social movement trying to do nothing but cause a stir based on not science but cultlike mentality. If in our country we were circumcizing babies routinely because of the "facts" we have and people were petitioning to have the choice thats a proper news story. This is nothing more than people who dont know enough about the benefits, or people who havent experienced real life situations where they can see its beneficial, thus they are too narrowminded and egotistical to acknowledge there are actual reasons medically why this is offered trying to force their ideology on everyone rather than just being content with their lives and theyre choices and "morals"
Pretty soon we are going to see legislation where if men masturbate and the sperm are flushed or washed away they face prison time for destroying potential unborn children (NOTE the large amount of sarcasm IE not a serious analogy)
People just need to let it be, there is a reason its done and if you dont like it dont do it. People trying to ban this choice arent helping anyone now or in the future.
