How do I say this?

[ashleedio]

My kids go to a group of peds that I really liked... until... at my son's 2 month appointment, I watched in horror as the dr began to try and retract him and I SCREAMED "DO NOT RETRACT HIM!" as I lunged forward towards the dr. He froze and was taken quite by surprise and said, "I would never do that! I was just looking at the opening!" I couldn't think on my feet quickly enough to say "That IS retraction, and there's no medical need to see the ureter." I just got my baby back in my arms and the exam was over. He DIDN'T retract, I stopped him in time, but I was sick over it almost happening. Then, I had him in for another check and I insisted that the diaper stay on (different dr). She asked me why, and I told her, "I've had issues with other drs in the group attempting to retract him, and I'm just not comfortable with his diaper being removed. There is no need." She then asked, "Is he uncircumcised?" Yes, he's also lobotomized. *grimace* I said, "He's intact and there's no reason to remove his diaper." She obliged. THEN went on to tell me that as he gets a little bigger, urine can collect in the opening, and I should very gently pull the foreskin towards his body and clean the urine, or risk infection. ??

I'm appalled, and I just can't think on my feet quickly enough to come up with a reply, so I'm looking for something to say BEFORE the exam starts and to educate this group of drs on proper intact care. Something that will grab their attention and possibly make them go do a little research on their own. However, I'm not one to really stand up and be nasty, so I'm looking for the gentlest, but firmest way to get my point across, or I WILL be finding a new pediatrician. The head ped in the group told me before my son was born that not circ'ing leads to HIV and UTIs. I let this go, and vowed not to let my son see that dr. I really do like the group, for every other reason but this. What can I say, and how do I phrase it so as not to be nasty, just to be firm and informative? It really does blow my mind that there's so much misinformation out there.

[AustinMom]

I'd show them this before the examen him

http://www.cirp.org/library/normal/aap/

[rubidoux]

I don't have any advice for what to say, but I think you did an awsome job asserting yourself in both instances. I'm sure your little one would thank you if he knew.

[fruitful womb]

Really?

He said having a complete set of male genitals will lead to UTIs and AIDS???

Whoa!

Do these...

damn.



sighs...

I wonder, do American doctors advise parents to spread the labia of their daughters and clean it because urine can get trapped in between the folds? And because she has a complete set of genitals, do they say it will lead to UTIs and AIDS???

[sunfish21]

Originally Posted by fruitful womb

Really?

He said having a complete set of male genitals will lead to UTIs and AIDS???

Whoa!

Do these...

damn.



sighs...

I wonder, do American doctors advise parents to spread the labia of their daughters and clean it because urine can get trapped in between the folds? And because she has a complete set of genitals, do they say it will lead to UTIs and AIDS???

Exactly what I was thinking! Worried about how I will handle these things after DS comes the end of next month.

[MilkyMuse]

Originally Posted by fruitful womb

He said having a complete set of male genitals will lead to UTIs and AIDS???

I had a ped. say the same thing -- about my 4-year-old! I was appalled and wish I'd had the presence of mind to say what I thought of later: "Do you mean to tell me that here in America he is *likely* to suffer from a life-threatening UTI simply because he has an intact penis? More likely than a girl to get one in the first place? What on earth do you recommend for your female patients?!"

I did say that I knew it was unlikely that he'd get a UTI, and the ped's response was that UTIs can get very nasty very quickly and you can't tell if there's a foreskin in the way. Riiiight.

This same moron told me that hepatitis A is sexually transmitted. Needless to say, I did not return to that practice!

[Claire and Boys]

Wow. Urine is sterile, so there is no way that would lead to infection. I would definitely be printing off the AAP document on intact care and taking it in.

[erin23kate]

Time for a new doctor. Head to your local tribe and ask for rec's.

You shouldn't be afraid that your son's doctor is going to hurt him. If the local board isn't helpful, look for doctors with non-european last names. Stereotypical, unfortunately - but non-native-born doctors are MUCH more likely to be intact themselves and therefore will know how to handle an intact baby boy.

[morgainesmama]

In the past, I've printed out the AAP's statement on circumcision as medically unnecessary and brought it in, along with info on caring for an intact penis.

I can't seem to put my hands on these in the revamped website.

You might also print out information for this ignorant ped. about the fact that 9% - 10% of circumcised boys experience a problem called meatal stenosis -- a narrowed urethral opening caused by circumcision. MUCH more likely than a UTI (which your uncirced son has maybe a 1 in 1,000 chance of getting).

I would put together a packet like this, and send it to the office and office manager.

Additionally, there are forms you can print for signature by doc at the beginning of your visit (I've seen them at NOCIRC site etc) discussing the risks of retraction and your doctor's agreement to NOT handle the foreskin/penis without discussing with you first.

My concern would be that if they are both uninformed and harassing you about this issue, what other issues will present?

[Cetan Luta]

Wow. Ignorance is amazing sometimes. First, I don't understand why a ped would try to retract it anyway. I mean it starts off attached and loosens as they get older, but I guessed some peds have never seen one uncirced? My 2 boys are uncirced. The youngest had very tight foreskin, so i just cleaned it as best I could when he was an infant, but he loosened it himself once he got old enough to notice he had something to mess with down there. I have taught them to pull their skin back when wiping off, and they generally take good care of themselves. Regular bathing prevents any build up of urine droplets should they occasionaly be slack. I have had to occasionally put neosporin on my youngest for slight redness at the opening when he has been slack about being thorough (5yo) but had no problems with it when he was a baby, and never any UTIs, or any redness that didn't clear up within a day or two. If we ladies can keep all of our complex folds neat and clean, than surely we can keep our boys clean without being invasive, and teach them to care for themselves as they get older. All men on the whole planet start out that way right? Doctors always seem to be convinced that nature doesn't know how to design bodies that function without alteration for some reason. There is a NO CIRC group that puts out lots of excellent Truth about circumcision. I will post a link or something if I can find it. Did you know that the incidence of sexual violence, esp. rape is significantly lower is nations that do not practice routine circumcision? Just because something requires a little more care and attention, certainly doesn't make it worth violently removing it form the body!

[tutucrazy]

I am glad you didn't let him "see the opening" A doctor did that to my son and it set him up for a very premature separation episode, which was painful for my son. Pulling back at the tip of the foreskin, even just a little can break the natural adhesions and lead to what my son experienced. Great job protecting your boy.

I would just tell your doctor that there is no reason to "view the urethral opening" and that your son pees just fine!

[ashleedio]

Thank you for all of your advice. We have an appointment tomorrow to check the dosage on his Zantac, and I will be insisting that the diaper remain on. My printer is out of ink, unfortunately, but I will be suggesting that they refer to the nocirc site or the aap guidelines if they make some kind of comment about it. In the meantime, I'm likely going to look for a new ped - I do love the group, they've been wonderful with my daughter, but I can't be afraid that they'll hurt my son each and every time we go. It makes me sad, because I went to the group as a kid myself (only 2 drs are left, mostly all new drs since I was a teen), and I liked them then, too. They're among the top-rated in Pittsburgh, but this is a high-circ area.

[claddaghmom]

This is why we have a FP! I don't have time to educate someone who makes, oh 10000% more than I do! Unless they want a bill for services rendered!

[ashleedio]

I'm definitely looking for a new group - the more and more I think about it, the angrier I get. It really bums me out - they're totally pro-bf'ing and have fantastic LCs that I've been working with.

[Greg B]

Originally Posted by ashleedio

I'm definitely looking for a new group - the more and more I think about it, the angrier I get. It really bums me out - they're totally pro-bf'ing and have fantastic LCs that I've been working with.

If they are so good in some areas, perhaps they will turn around on males if they get education. But it may be difficult to get through to them if the guys in the practice are emotional and defensive because they are circumcised. You may have to be adament with them and let them know that their unprofessional and uneducated way of deal;ing with foreskins will lose them a patient and set them up for lawsuits...

Tough choice for you to make.

Best wishes

[TyrantOfTheWeek]

My heart did a little happy dance when I took my 48 hour home birthed boy in and all they did was feel that both testicles were in the right spot. No "peek" at his urethra.

[DocsNemesis]

I have to agree about the non-american doctors...granted, I have an awesome american ped and there are others of course who know not to touch, but yeah. I've been lucky.

I remember taking my eldest into the urgent care clinic because he wasn't peeing. The on call doctor wanted a urine sample and I mentioned that he wasn't circ'd. He said "uh...so?" I said well, I thought that increased the risks of UTI so I thought I should mention it. (Btw, this was in 2000, ds was just a baby) He laughed and said no, it doesn't, and his penile state had nothing to do with whatever was going on. It didn't occur to me until later but he also had a heavy accent and looked like he was from...well, I really don't know. He looked kinda like Lucas on ER? Anyway, I realized later that he was probably intact himself.

[tutucrazy]

btw, my son balloons every time he pees and has for over a year. This is a normal part of the process. So urine passes under his entire foreskin before exiting and he has never once had and infection. Urine actually aids in rinsing out the dead skin cells.