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  1. #21
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    FYI my son had the EMLA procedure, had no complications and cried for the 10 secs it took to get him to my breast. Oh, I am also a registered nurse and have worked in NICU and paediatrics, I also hold a Diploma in Children's Services, for all those who doubt "intelligence level".

    And some "witnessed, actual, multiple" situations I had to intervene in as a R.N in aged care, was uncircumcised men with serious penile infections and foreskins stuck behind the "head" of the penis causing tissue death and severe pain with resulting adult male circumcision.

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  3. #22
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    Quote Originally Posted by delirium View Post
    With respect this isn't true, and hasn't been for years. My son is going on 8 and he had the ELMA cream then a local anesthetic. I would never have gone ahead with it otherwise. I'm not saying every dr that does the procedure using a local, but a vast majority do...
    I am aware of your experience, delirium, but I don't think you can generalise that to the "vast majority" without evidence, particularly when many of Australia's most prolific circumcisers (eg Terry Russell) openly describe their Emla-only method.

    Meanwhile, while this piece of research is interesting (and perhaps some of the commentators here might actually want to read the paper before posting), there is a long way to go before we can make definite pronoucements. It is in any case surplus to requirements in terms of the argument against RIC, which is quite strong enough already. Which is why the vast majority of Australian boys are no longer circumcised .

  4. #23
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    Quote Originally Posted by Amgine View Post
    Oh, I am also a registered nurse ...
    Oh, please, spare us the "I'm a nurse" anecdotes. No one denies some intact adult males may experience recurrent balanitis or paraphimosis. The question is: how many?? Answer: total medical problems requiring circumcision later in life affect about 3% of intact males over a lifetime. That's a terrible argument for RIC!

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  6. #24
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    But is that not what you are doing? Generalising without evidence? I would like to see research and data from Australia to confirm a majority don't use a local. When I saw the dr about DS being done I spent 30 mins with him ensuring what the procedure entailed, what anesthetic was used. He actually looked surprised when I asked if he used a local and said "of course I do. Everyone does now". Now I'm not so sure about 'everyone'. But I fully stand behind my belief a majority DO use a local now. If you can show evidence to contradict me, I'll humbly retract. But I'm going to go out on a limb and say I'll be very surprised if you find it.

    As to Terry Russell.... I'm not a fan. Believe it or not I'm not even pro circ generally. You have zealots for every opinion, belief or sub group. If he is advocating only ELMA he's an idiot. Period. Just bc he happens to support the choice to circ doesn't mean I blindly follow him.

    I also want to put out there - since you often say circ rates have fallen a great deal then why haven't we seen a big fall in autism rates? in fact I thought they are continuing to gradually rise? Correlation does not equal causation.
    Last edited by delirium; 24-01-2015 at 10:56.

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  8. #25
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    Quote Originally Posted by delirium View Post
    But is that not what you are doing? Generalising without evidence? I would like to see research and data from Australia to confirm a majority don't use a local.
    There is no definitive research on this, but this is what I do know. It is probably true that the majority of providers use what would be regarded as adequate anaesthesia (ring block or dorsal nerve block), nonetheless the majority of procedures are EMLA only.

    That's because of the 223 providers who performed at least 1 RIC in 2013-14, 12 accounted for more than half of all procedures. These are all GPs running lucrative "clinics" who are simply not qualified to provide the anaesthesia required. I have been able confirm this (and other details) by phone with 8 of these high-volume operators, as well as email correspondence with Brian Morris, who maintains a list of circ operators.

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  10. #26
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    Quote Originally Posted by JohnC View Post
    There is no definitive research on this, but this is what I do know. It is probably true that the majority of providers use what would be regarded as adequate anaesthesia (ring block or dorsal nerve block), nonetheless the majority of procedures are EMLA only.

    That's because of the 223 providers who performed at least 1 RIC in 2013-14, 12 accounted for more than half of all procedures. These are all GPs running lucrative "clinics" who are simply not qualified to provide the anaesthesia required. I have been able confirm this (and other details) by phone with 8 of these high-volume operators, as well as email correspondence with Brian Morris, who maintains a list of circ operators.
    A majority of providers use adequate anesthesia but a majority of procedures are EMLA only? Are you saying that most have the access to and qualifications to use a local but don't?

    Granted I don't know the facts this deeply. But if you are a GP with qualifications to do a circ you'd be qualified to give a local wouldn't you? I'm not a fan of Morris either. He is another zealot, just on the other side. I've read his articles and.... trying to be polite here..... I think he has issues.

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    Quote Originally Posted by delirium View Post
    I also want to put out there - since you often say circ rates have fallen a great deal then why haven't we seen a big fall in autism rates? in fact I thought they are continuing to gradually rise? Correlation does not equal causation.
    I think I've already made the point about correlation/causation. But if in fact RIC does turn out to be a risk factor for autism, we wouldn't expect to detect it without a statistical analysis of thousands of cases. This research paper used a population of 343,000 boys and the additional cases possibly attributable to RIC was about 11 boys in terms of absolute numbers. The hypothesis being investigated is scientifically interesting but not of great clinical significance.

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  13. #28
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    Quote Originally Posted by delirium View Post
    But if you are a GP with qualifications to do a circ you'd be qualified to give a local wouldn't you?
    You don't need any qualifications to do a circ in Australia (you don't even need to be a doctor!). However, penile dorsal nerve block (the most effective)requires some specialist training. The high-volume providers don't bother.

  14. #29
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    Quote Originally Posted by JohnC View Post
    You don't need any qualifications to do a circ in Australia (you don't even need to be a doctor!). However, penile dorsal nerve block (the most effective)requires some specialist training. The high-volume providers don't bother.
    Well that's crazy then. They should absolutely need training and I'm shocked anyone can do it. My GP received specialised training. That should be a must. As to the clinics who don't use a local, they need to be shut down. We did a risk benefit analysis with our son. Only having ELMA would shift that for us substantially. No way in hell I would use a clinic like that.

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  16. #30
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    Quote Originally Posted by JohnC View Post
    Oh, please, spare us the "I'm a nurse" anecdotes. No one denies some intact adult males may experience recurrent balanitis or paraphimosis. The question is: how many?? Answer: total medical problems requiring circumcision later in life affect about 3% of intact males over a lifetime. That's a terrible argument for RIC!
    Like I said "Google Doctors" and fear mongering. You should be ashamed of yourself. I have plenty of "Medical books" I can quote from too, I just refuse to waste my time spouting what parents should/shouldn't do and throw all these crappy 2 second job articles/ research papers that will likely be redundant in 2 years.

    This site is for support, not for individuals to come on and scare the hell out of people!!!!!!

    Next you'll be giving people your "learned" advice on test results and ultrasound scan results.

    Just what were your qualifications again?

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