What should I think about this dr's appt?

[~Jenna~]

I took my 9 week old to a WBC today. It looked like the dr. was about to retract ds so I said, no! and grabbed his hands. The dr. looked at me funny and said, did you think he was going to pee on me? I said, no I thought you were going to retract him. Dr says, I wasn't going to retract him I just need to see if the tip is there.

What does that even mean, is the tip there?? I was too flustered to ask him and he(the dr.) was flustered too. He went on to tell me that no one should ever retract the foreskin except the boy because someone else doing it can cause damage, so at least he knows that.

I have on older ds and his ped. never even touched his penis - just opened up the diaper, took a peek and put the diaper back on.

I really really like this new ped because he is so laid back and doesn't give me grief about not vaxxing.

[Mewsin]

I don't know for sure but I've never had a dr check to see if the tip is there, where else would it be? My dr has never even touched K's penis.

[Lula's Mom]

I don't know what he was going after, but I think you did the right thing. It's great that he said "no one should ever retract him", but it seems there are many peds who are DOING it while saying that same thing! I would think in the future he won't even need to look. But if he takes your son's diaper off (rather than just peeking and putting it back), I would probably say cheerily "OK, but please don't touch his penis!" to remind him.

[InDaPhunk]

I bet he was checking for hypospadias and the reason I think that is bc our ped tried to do the same thing.

When our ped was doing her first exam of him she looked like she had it in her head to mess with DS's penis even though we had just had the "do not retract at all" conversation and she seemed like she was on board with that and was familiar with the AAP recommendations (she is by-the-book AAP). When her hands got in that area I said "I mean don't retract him even the teeniest, weeniest, smallest little bit" and she said "I need to check for..." and I interrupted (bc I was 2 secs away from all out panic) and said "I know, I know, hypospadias, but if it was severe hypospadias we could see it from the outside and if it isn't then we wouldn't do anything about it anyway...." and she interrupted me and said "You're exactly right" and that was the end of it.

To be honest, I don't even know if I was right, but it seemd good enough for her. I meant to post here before DS was born and ask if there's any reason whatsoever that a newborn should be retracted to check for anything at all during that initial visit, because I knew someone would want to retract him and I wanted to have all my facts and figures exactly right, but I didn't, so basically I just pulled something out of my tail end and hoped for the best. Can anyone enlighten me here for next time around or just for my own FYI? I've read everywhere do not retract ever, etc etc, but when those drs get in front of you it can be intimidating and it's just easier if I have as much specific knowledge to defend with as they have. Was I correct about my hypospadias info? Is there anything else they would have to check for- as long as DS is urinating normally (I'm not talking about NOW, I'm talking about the initial newborn ped check in the hospital or the first ped visit)?

Anyway, after that the doc seemed completely fine with not retracting him to "check" for anything, it was like she had a mental checklist she had to go off of and as long as I absolved her of checking him out, she was fine with it. I wonder if she worries that some kid would have mild hypospadias and the parents wouldn't know and she wouldn't check and then they'd find out years later and go back to her all pissed and whateva bc she hadn't checked for it?

We have a military ped, BTW.

[A&A]

Originally Posted by ~Jenna~

Dr says, I wasn't going to retract him I just need to see if the tip is there.

What does that even mean, is the tip there??

It means he's an asinine doctor who was going to retract him (at least a little) but who came up with an asinine reason for it. I saw a doctor just like him when my son was 4 months old! Uggh!

[CallMeMommy]

Originally Posted by ~Jenna~

Dr says, I wasn't going to retract him I just need to see if the tip is there.

Is he concerned it might NOT be there? What? My circutry can't handle this much stupidity at once...

[Frankly Speaking]

Originally Posted by InDaPhunk

To be honest, I don't even know if I was right, but it seemd good enough for her.

You hit it dead on!

I meant to post here before DS was born and ask if there's any reason whatsoever that a newborn should be retracted to check for anything at all during that initial visit, because I knew someone would want to retract him and I wanted to have all my facts and figures exactly right, but I didn't, so basically I just pulled something out of my tail end and hoped for the best.

You did great!

Can anyone enlighten me here for next time around or just for my own FYI? I've read everywhere do not retract ever, etc etc, but when those drs get in front of you it can be intimidating and it's just easier if I have as much specific knowledge to defend with as they have. Was I correct about my hypospadias info?

Dead on!

Is there anything else they would have to check for- as long as DS is urinating normally (I'm not talking about NOW, I'm talking about the initial newborn ped check in the hospital or the first ped visit)?

Not inside the foreskin.



Now, these are the things they may try to check for or say they are checking for:

Hypospadias - Already covered

Infection - Any infection will quickly manifest itself to the outside. Catching one before it did would be akin to winning the Powerball lottery 3 consecutive weeks. Don't need to retract.

Meatal Stenosis - purely a complication of circumcision. Intact boys don't get it. Usually when they say they are looking at the tip, this is what they are looking for. They'll never find it inside a foreskin.

Phimosis - Highly unlikely and I suspect you could diagnose this better yourself than the vast majority of doctors. However, this is probably the most misdiagnosed problem with the human body with doctors saying it is present when it is not.



Frank

[~Quse~]

I took my ds to a WBC recently where the dr. did the same thing!

He was looking at ds' penis and I said "You're not going to retract him are you?" and the doc said "No."

Next thing I know, he retracts ds but ds didn't cry or act disturbed at all (he was 3 months) so I thought maybe this isn't really retraction (but he was pulling the foreskin down and exposing the head). The doc explained that I should do this every day to make sure it stays retractable and to clean the smegma!!!

So I came to MDC to check up on the facts and find out he's WRONG. I should have prepared myself better beforehand. I knew retraction was wrong but when ds didn't cry I thought maybe it was okay.

I like this doctor though because he's okay that we don't vax so I'll probably keep him (we hardly ever go anyway). Hopefully he won't be offended when I tell him to keep his hands off the baby's penis!

[Frankly Speaking]

You should provide him with information as to why he shouldn't do this. If he's telling you this, he's telling every mother of intact sons to do the same thing and many moms aren't on top of this enough to know to come here. Those boys are being put at a far higher risk of infections, permanent adhesions, phimosis and many will be candidates for a circumcision later.

Not only will you be doing those moms a favor, you'll be doing the doctor a favor and saving many boys from surgery and infections.



Frank

[~Jenna~]

Frank, the problem is that these drs don't think they *are* retracting. At least mine doesn't. I wish the AAP said something like, just keep your hands off, instead of saying to not forcibly retract.

[Frankly Speaking]

I can't imagine what they think they are doing when they do it after being told specifically not to do it. If he just slightly flared the tip of the foreskin, I could understand the misunderstanding but we've seen all too many cases where a mother has told a doctor not to retract and he/she goes on to fully retract within the next few seconds, even after they have said they wouldn't. That's not a misunderstanding, that's putting the mother off guard when they fully intended to retract from the begining. In a recent thread a mother posted that she told the doctor not to retract and the doctor agreed and immediately fully retracted the child and continued to lecture her about how she had to do it daily and clean the smegma off. That doctor never intended to not retract that child.


Frank

[Daisyuk]

I'm a bit confused now.

How come during a circumcision the glans has to be separated relatively slowly with a blunt probe, but these doctors seem to be able to rip it back within milliseconds?

[Frankly Speaking]

Doing it with a blunt probe doesn't take very long, maybe 15 -30 seconds. Ripping it back is like ripping a fingernail back. It only takes a split second. The difference is that the nail is rigid and resists pulling back and the foreskin is flexible so less resistance. In the finger nail, you're pulling at the entire bonded area and in the foreskin, you're only pulling at the leading edge as it peels back.



Frank

[Daisyuk]

So why do they bother with a probe then? Why don't they just rip it back during a circ?

[pdx.mothernurture]

I actually think they probably use the blunt probe/blunt scissors to separate the glans and foreskin during circumcision because they have to fit instruments under the foreskin and bring the foreskin up over whatever device they're using (in the case of gomco/plastibell). They also already have the os stretched open with hemostats. I think forcing the foreskin back over the glans with the thumb and forefinger would cause more trauma, more swelling, and the result would be the foreskin bunched up behind the glans, making it harder to pull up over the device.

Sorry, I know that's graphic and I didn't like typing it, but that's my theory.

Jen