Discussion with friends - brought up painful experiences and circ

[K703]

Some friends of mine were talking about "painful experiences"; one of them said that he once had minor surgery without any kind of anesthetic. I then said "lots of American males (but luckily not me) have"; it took him a minute to figure out what I was talking about (circumcision). It seems that circ is so regular that many don't even consider it surgery.

[hakunangovi]

You are correct that in North American culture circumcision is not considered surgery, or painful, or as having any long term ramifications. How bizarre is that line of thinking?  A few weeks ago, I had an interesting conversation with a woman who makes her living as both a therapist and a birth educator. We were discussing how, and to what extent, do early traumatic life experiences affect one's brain.  She related how her daughter had required an intravenous needle at the age of 7 months, and the nurse was having so much trouble finding a suitable vein that she ended up putting the needle in the baby's scalp.  Fast forward to age 17, and the girl is getting an intravenous needle and suffers a panic attack. The nurse asked her if she had had a bad experience in the past. She replied that she had never had an intravenous before. So you see, although she did not consciously remember the first one, her brain sure did.  This lady stated that every experience from birth, and even before, leaves a trace on our brain.

[rnra]

Scalp IVs are very, very common for young children.  In fact, they are often a preferred place for IVs in newborns.  There are fewer nerve endings in the scalp (as opposed to other areas such as the hand) so it should be less painful during insertion and they get bumped less after insertion.  Scalp veins are often more visable than peripheral ones, so they are more likely to be successful on the first try--thus eliminating other needle sticks.  Also, because the IVs are not exposed to the movement of joints (such as those in a wrist or ankle) they tend to last longer than other sites.  

I've seen lots of people who are scared of having an IV inserted, or having blood drawn, or having a pap smear, or of getting an EKG, or any other of a myriad of health-related discomforts.  It isn't necessarily because they have some psychic remembrance of the event happening before, it is because they have heard stories, or they realize that sharp things inflict pain, or they are anxious about the healthcare environment, or they are nervous about the results.

I don't support circs, but it's not because I think the babies will remember it.

[mama24-7]

Originally Posted by rnra 

I don't support circs, but it's not because I think the babies will remember it.

Are you aware of the study (not sure it was a study, but I'll call it that because I think it was a study studying something else) that was done that found that boys who'd had been circ'd had a bigger negative response to vaccinations (not sure of the details, as it's been a long time since I read about it)?  What do you think babies remember?

Sus

[hakunangovi]

Mama24-7 , I think what you were refering to is this: www.cirp.org/library/pain/taddio2/  which is found among many other papers on the subject at www.cirp.org/library/pain/ .

Also of interest, and related, is:  www.cirp.org/library/psych/  which also references quite a large number of papers, one of the most interesting of which is:  www.norm_uk.org/circumcision_psychological_effects.html  

[hakunangovi]

Let's try the last one again:  www.norm-uk.org/circumcision_psychological_effects.html   written by Janet Menage.

[rnra]

The 15 year old study you are referencing used two methods of pain relief for circumcision--one, nothing, and two, a topical cream (EMLA).  In their study, they found that EMLA cream did not seem to make a difference in later pain response vs. using nothing for pain relief.  However, the study really is not all that applicable because most circumcisions performed on infants today (at least in my area of the country) do not use either of those pain control methods and the study authors even state that the pain relief offered to infants in the study was possibly insufficient.  There is better pain control available today.

What I have seen used in a combination of dorsal penile nerve block, sucrose and pacifier sucking during the procedure, and Tylenol and liberal breastfeeding afterwards.  The authors of the study you cited state, "Insufficient afferent blockade during circumcision and the days that follow surgery may have contributed to central sensitisation in both treated and untreated circumcision groups.  Study of the vaccination pain response of infants who had received more effective circumcision pain management (ie, dorsal penile nerve block and adequate postoperative pain management) would be interesting." 

So, while the study you cited sparks interesting ideas, it really needs to be updated and used to investigate later pain response when more effective pain relief is used during the circumcision procedure.  Following their study results, it seems to be logical that more effective pain relief at the time of circumcision would mean less of a negative response at a later time.  

[jessjgh1]

Or we could just stop cutting boys and then we wouldn't need to re-do the study or any other research
Anyway, there have been recent studies that show very little drs follow the AAP guidelines for pain management for circumcision.