Is circumcision still painful? - Page 2

[drs0410]

Reading these replies has me feeling even more relieved that my son never had to go through that. I can't believe that this is still going on. What's really horrible is that the medical community often leads ignorant parents to believe that they're doing what's best for their sons. Parents think their babies have to go through this torture to avoid diseases, infections, and humiliation in the future.Why isn't anyone taking the time to educate those doctors so that they can provide better information to the parents?

[kythe]

I went through nursing school in 2006 and witnessed a circumcision where lidocaine was used.  The baby didn't cry at all, just whimpered a little and squirmed when they were tying him to the board.

Our instructor was very pro-circ and explained that she has watched them for the last 30 years without anesthesia and babies always "do fine".  Sure, they scream, but they do that just from being tied down.  She continued to explain that she sees no purpose in anesthesia, its just to make the parents feel better.

The thing is, she was explaining this *during* this baby's circumcision.  We were watching him not scream from being tied down, he wasn't screaming at all because he wasn't in pain.  Some of the students pointed this out, but the instructer seemed not to notice. 

A different instructor, and incidentally the only male instructor in our program, was very anti-circ.  He actually influenced some students against circ by agreeing with them that pain relief does matter and that babies are not just crying from being held down.  He said we would scream too if someone cut off the most sensitive part of our body without pain relief.  Some students were very influenced by him because he was a man and they felt he had more empathy than the female pro-circ instructor who didn't care that babies scream when anesthesia is not used.

[Pirogi]

Originally Posted by kythe 

I went through nursing school in 2006 and witnessed a circumcision where lidocaine was used.  The baby didn't cry at all, just whimpered a little and squirmed when they were tying him to the board.

Our instructor was very pro-circ and explained that she has watched them for the last 30 years without anesthesia and babies always "do fine".  Sure, they scream, but they do that just from being tied down.  She continued to explain that she sees no purpose in anesthesia, its just to make the parents feel better.

The thing is, she was explaining this *during* this baby's circumcision.  We were watching him not scream from being tied down, he wasn't screaming at all because he wasn't in pain.  Some of the students pointed this out, but the instructer seemed not to notice. 

A different instructor, and incidentally the only male instructor in our program, was very anti-circ.  He actually influenced some students against circ by agreeing with them that pain relief does matter and that babies are not just crying from being held down.  He said we would scream too if someone cut off the most sensitive part of our body without pain relief.  Some students were very influenced by him because he was a man and they felt he had more empathy than the female pro-circ instructor who didn't care that babies scream when anesthesia is not used.

I actually might sort of agree with this bolded sentiment, strangely enough.  An adult WILL have adequate pain relief during circumcision, and if it's not adequate, he has the capacity to let someone know.  But, he is an adult, and I would imagine his options for pain relief are a lot different (more extensive, more effective) than for an infant.  I wonder if the "pain relief" used in RIC really is pain relief, even when properly done and when the circumciser waits an appropriate amount of time to begin forcibly separating the glans from the foreskin.

Where your female circumciser and I differ is that I could never agree that an infant is capable of being "fine" with having his foreskin ripped from his glans and amputated without any pain relief.

[kythe]

In this particular case, I think anesthesia was effective. Maybe she had seen cases where anesthesia was not used effectively, but it bothers me that she doesn't see this as a fault with the anesthesia. She sees this as evidence that babies don't feel pain at all since they are just screaming as a normal part of the position they are placed in.

[QueenOfTheMeadow]

Just a quick reminder of the forum guidelines:

This is not a space to bash others. In an effort to minimize language which might alienate those seeking information, we are cautious about using pejorative terms such as abuse, barbarism, mutilation, etc. when routinely discussing circumcision. Let the facts speak for themselves

[Lauren82]

This is to the OP. I couldn't get the quote thing to work right.

I saw circs when I was taking the classes to be a nurse aide. I was planning on going to nursing school to become a nurse midwife eventually. Our class got to spend the day at a very large inner city hospital and I ended up shadowing nurses in the nursery. It just so happened that an OB came in to perform circs and "my" nurse had to assist. I was only 17 years old when I saw them. I went into that room clueless and walked out an intactivist. I don't think I've witnessed anything else in my life that stunned and horrified me as much as that did.

[major_mama11]

Originally Posted by drs0410 

Reading these replies has me feeling even more relieved that my son never had to go through that. I can't believe that this is still going on. What's really horrible is that the medical community often leads ignorant parents to believe that they're doing what's best for their sons. Parents think their babies have to go through this torture to avoid diseases, infections, and humiliation in the future.Why isn't anyone taking the time to educate those doctors so that they can provide better information to the parents?

Here is the thing that boggles my mind, at my place of work (90%+ circ rate): even when presented with more info, parents, especially dads, here seem dead set on circ. Maybe the only answer would be for docs to just refuse to perform them.

I have been present many times when one of our (younger) pediatricians at work talks to the parents and obtains consent for the circumcision she is about to do. She *always* explains that there is no medical reason at all for circumcision, and that it is purely a cosmetic procedure. I have even seen her reiterate the cosmetic procedure aspect to a dad who was present as his infant was being strapped to the board. But I have never seen a dad change his mind about consenting to the procedure. (I've seen plenty of moms cringe, but then they still tend to defer to the dad's wishes).

[Galatea]

Originally Posted by major_mama11 

Originally Posted by drs0410 

Reading these replies has me feeling even more relieved that my son never had to go through that. I can't believe that this is still going on. What's really horrible is that the medical community often leads ignorant parents to believe that they're doing what's best for their sons. Parents think their babies have to go through this torture to avoid diseases, infections, and humiliation in the future.Why isn't anyone taking the time to educate those doctors so that they can provide better information to the parents?

Here is the thing that boggles my mind, at my place of work (90%+ circ rate): even when presented with more info, parents, especially dads, here seem dead set on circ. Maybe the only answer would be for docs to just refuse to perform them.

I have been present many times when one of our (younger) pediatricians at work talks to the parents and obtains consent for the circumcision she is about to do. She *always* explains that there is no medical reason at all for circumcision, and that it is purely a cosmetic procedure. I have even seen her reiterate the cosmetic procedure aspect to a dad who was present as his infant was being strapped to the board. But I have never seen a dad change his mind about consenting to the procedure. (I've seen plenty of moms cringe, but then they still tend to defer to the dad's wishes).

Which goes to show that it is not about logic at all, which we knew - it is about hurt people hurting people.

[PlainandTall]

Sorry posting from a phone cant post links. Google "stang snellman circumcision practice patterns" for a pain relief survey among various specialties in various usa regions. This was published in the AAP journal, pediatrics.
Google "anna taddio circumcision" for a study on the long term consequences of circumcision trauma. Even children who had some pain relief for circumcision showed worse reactions to 6mo. vax. Than children never circumcised.

[SashaBreeze]

Here are the links you wanted posted (i think) Plainand Tall

http://pediatrics.aappublications.org/cgi/content/full/101/6/e5 

and

http://www.cirp.org/library/pain/taddio2/ 

also OMG I was pretty much horrified at my home states % when I checked out the first link.  I figured it would be bad, but wow.  Seems the OB's are particularly bad about not giving any type of anesthesia.

[nd_deadhead]

I've had lidocaine injections - they hurt like crazy.

My son had 5 stitches in his hand when he was 12 or 13. He got 2 shots of lidocaine before the stitches (with adequate time for the hand to feel numb). After 3 stitches, he could feel again, and the doctor reached for the lidocaine needle. My son stopped her - he said he'd rather feel the stitches than get another injection.

The circumcision itself might hurt a lot less with a DPNB, but the lodicaine injection surely must hurt.

[sosurreal09]

Originally Posted by nd_deadhead 

I've had lidocaine injections - they hurt like crazy.

My son had 5 stitches in his hand when he was 12 or 13. He got 2 shots of lidocaine before the stitches (with adequate time for the hand to feel numb). After 3 stitches, he could feel again, and the doctor reached for the lidocaine needle. My son stopped her - he said he'd rather feel the stitches than get another injection.

The circumcision itself might hurt a lot less with a DPNB, but the lodicaine injection surely must hurt.

when I was 9 a dog ripped off my bottom lip...seriously and I got 96 stitches. I had a TON of lidocaine shots and mid-way i felt everything and I said the same thing just keep stitching b/c the shot hurt so much worse.

[buckeyedoc]

My older son got a nerve block to his finger when he was 2 years old, because it was fractured and needed the nail to be put back in place with stitches. He went crazy over the injection and was a screaming, sweaty mess.

The only answer is just don't have the circumcision done. So simple!

[NSmomtobe]

Originally Posted by Lauren82 

 Even with injections, can you imagine how painful it would be to have them in your genital area and then still feel part of your flesh being ripped, crushed and cut off? 

I could feel ever stitch I received after delivering my son, even though I received numbing injections. When I told the doctor I could feel it, she said, "You ARE frozen, but it's a sensitive area so you are going to feel it. There's nothing more we can do for you. You'll just have to deal with the pain." Then they gave me ibuprofen, tylenol-3 and laughing gas to distract me as I screamed with each stitch. 

[Lauren82]

Originally Posted by NSmomtobe 

Originally Posted by Lauren82 

 Even with injections, can you imagine how painful it would be to have them in your genital area and then still feel part of your flesh being ripped, crushed and cut off? 

I could feel ever stitch I received after delivering my son, even though I received numbing injections. When I told the doctor I could feel it, she said, "You ARE frozen, but it's a sensitive area so you are going to feel it. There's nothing more we can do for you. You'll just have to deal with the pain." Then they gave me ibuprofen, tylenol-3 and laughing gas to distract me as I screamed with each stitch. 

I'm so sorry you had to go through that. :(

[Crunchy Frog]

Yes, it is still painful.  And yes, you do see that arguement on other message boards and there is some kernel of truth to it. 

It is in fact now standard of care to use some kind of pain control for circumcision, and I would guess that at the current date a majority of newborn circs are done with some kind of pain control.  I believe that even ten years ago the majority were done with no pain control at all.  So this much is true.  The other thing that you see on the message boards; that they were there for their son's circ and he really wasn't in pain is probably true in many cases as well.  I would guess that doctors who are comfortable having parents in the room for a circ are much more likely than most doctors to actually use pain relief effectively.

However, I think that in the majority of newborn circs the baby is still in extreme pain.  Firstly, even if a majority of docs now use some pain control, there is a very substantial minority who still use nothing at all.  Secondly, of the docs who do use something, I believe that the majority either do not use an effective form (they may use a sucrose paci and call it pain control, or use EMLA cream alone which has almost no effect on the pain), or else, as has been pointed out on other posts, they use Lidocaine injections but don't place them properly or don't wait for them to take effect or both.  The parents who post that they were there and the baby didn't seem to be in pain are a self selected minority who used the doctors who are most likely to use pain relief effectively.  Their experiences may be valid for themselves and their babies, but they are not representative of what circ is like in the majority of cases.

My only personal experience in this area is from hanging around my own OB's office during my high risk twin pregnancy.  He does them in his office rather than in the newborn nursery and apparently does use an injection of lidocaine (I heard a nurse say that to a weeping mother as she was relinquishing her son).  I was there for one circ where I watched a baby get taken away and was wailing and clearly miserable when he was brought back.  On another occasion I was waiting in an exam room and could hear as a baby was brought back to be circed.  The soundproofing was heavy and the sound was very muffled and distant, but that baby was clearly screaming and in intense pain.  So I would say that in the case of my own OB, he uses anesthetic but does not use it effectively, and the babies that he circs are in extreme pain during and after the surgery.  My guess is that this is pretty much the norm for circs done in this country today. 

So yeah, the vids of circs being done with NO anesthetic whatsoever are outdated in that they are probably in the minority now, but it is still the case that most babies being circed are still experiencing something akin to torture.

I am hoping to go to nursing school soon and I expect I will witness circs in person then.  At that point I guess that I will get a better idea of what they are really like. 

One of the nurses in my babies' NICU, when she found out I wasn't circing, told me that they were "barbaric" and "horrible" and that it was the only thing she ever saw in nursing that made her pass out.

[Pirogi]

Originally Posted by Crunchy Frog 

Yes, it is still painful.  And yes, you do see that arguement on other message boards and there is some kernel of truth to it. 

It is in fact now standard of care to use some kind of pain control for circumcision, and I would guess that at the current date a majority of newborn circs are done with some kind of pain control. 

From the 1998 Pediatrics study (questionnaire, so take it for what you will) linked above:

 A total of 67% of the doctors in the West are using anesthetics, which is significantly more than their counterparts in the other regions of the country (45% in the Midwest, 37% in the South, and 28% in the Northeast; P < .0001)

I wonder what the percentages are today.

Also, the study says that between 75-90% of circumcisers who use pain relief use a DPNB, depending on where they live.

The reasons cited in the survey by circumcisers who don't use pain relief make me ill. 

[kythe]

When my dd was born in 2000, we were looking for a ped who would circ if (she was a boy). I remember asking her ped if she used pain relief. She said, "Of course!" and implied that pain relief was the norm, there was nothing to worry about. I didn't ask what kind, or how they do it, since obviously we didn't get that far. But I still believe her, at least in intent. She also was a very young doctor, so she wasn't conditioned from years of training and experience with not using anesthesia as the norm. She may have learned and witnessed appropriate use of anesthesia even from medical school.

I still don't know what the reality is vs the selling point to parents, but it wouldn't surprise me if newer doctors are better trained in this now and those that don't use anesthesia are more "old school". If it isn't entirely true now, I think things are gradually moving in that direction.

[sosurreal09]

when I witnessed those circs at the Brigham and womans they gave the babies sugar, seriously, and this was 2007!

[T-man's Mama]

I am glad that my son did not experience such a trauma, but you know, this alone is not really satisfying. He is just one of thousands of babies born every day in the US. Knowing that poor little baby boys are being tortured in this way day in and day out makes my heart ache. I don't care that they are not my sons, or that I will never meet most of them. The sad fact that this torture is still legal and commonplace is simply maddening and inexcusable. I just wish people would come to their senses and just.stop.cutting.babies. How can anyone in their right mind think it is not painful? Good lord.