6 ms·

"Kids don't need anesthetics. If they are young enough, they won't remember the pain, so you can just operate without anesthetics. They are also easier to restr

"Kids don't need anesthetics. If they are young enough, they won't remember the pain, so you can just operate without anesthetics. They are also easier to restrain than adults." This was state of the art in medicine for quite some time. I fear the general trend of "medication bad" will get us back to those dark times. Btw, those dark times ended only as recently as 1987! https://www.newsweek.com/when-doctors-start-using-anesthesia-babies-medics-thought-they-couldnt-feel-pain-1625350 https://www.newsweek.com/when-doctors-start-using-anesthesia...

throwanem 1y ago
This research is aimed precisely at making it safe enough to administer general anesthesia in these populations for that to become standard of care. Let me preempt one possible line here: I do not love the circumstances under which I would have been circumcised as a neonate in Mississippi in the very early 1980s, and I do not resent the result. Living that far tied up in the past is for men who can't figure out how to do anything else. I am not one of those and despite an essential sympathy with the theoretical basis of their position that no putative benefit remotely justifies the the risk of the intervention, I have a short way with "intactivists." But if it had been possible safely to administer more than EMLA (perhaps!) for pain relief, not even in that place and time would anyone be so barbaric as to refuse it. Of course. And that, making possible that precise measure of mercy in the case where the intervention is not merely cosmetic, is exactly that at which this research is directed. So, to anyone looking to make a cause of the ghosts of a billion foreskins or whatever, I would say please do not attempt even by implication to recruit my argument in support of your position.
- holowoodman 1y ago
  I didn't say anything about a foreskin anywhere. And my point is, they did not just do minor stuff like a circumcision (which I think is a barbaric, pointless and immoral practice to inflict on non-consenting minors in any case except to maybe cure phimosis). They did major surgery. Like opening the cranium or abdomen. Like removing limbs. Like removing burnt skin by brushing it off and applying skin grafts. And no, they didn't even apply Lidocain, because children don't feel pain. At best, they gave muscle relaxants as chemical restraints and to make the tissue easier to cut.
  - Der_Einzige 1y ago
    [flagged]
    - holowoodman 1y ago
      Yes, any, male or female, genital mutilation is life-changing. What I meant is, it is "minor" as far as surgery goes, as opposed to "major". The distinction is about the risk to the life of the patient, the kind of anesthesia you need (local vs knockout), the setting you do it in (walk-in vs stay at the hospital) and the amount of aftercare required (change the bandage vs. medication+monitoring+hospital). And those studies are BS, done to prove a preexisting point. Any properly done study by independent researchers without an agenda doesn't show any kind of effect from circumcision beyond the resulting sensory problems, deformation, nerve damage, erectile dysfunction, scarring and adhesion.
  - throwanem 1y ago
    According to a social media influencer.
- watwut 1y ago
  I really do not understand why did you felt the need to push for circumcisions here. Like, no one asked or discussed them one way or the other. Like ok, it is religious for Jews and Arabs, but no one else have to care.
  - throwanem 1y ago
    Who pushed? Jesus, I tried as hard as I knew how not to start a fight, knowing this place plays host to a few foreskin mourners. Better just to avoid entirely, it appears, and duly noted. What a shame the eyeroll emoji is filtered here. That, apparently, is the level people are on. A paragraph is too much! Or is everyone still rationing since Cerebral, or whatever that telemedicine pill mill was called, shut down a few years back? Is that why no one is reading today? I never thought I'd say this, but for God's sake and as a favor to us both, pipe my shit through ChatGPT and ask for a reframing on a sixth-grade reading level. You pay for access to the damned robot, let it wipe your nose through the remedial work. I've got embroidery to do and movies to watch.
    - AlexeyBelov 1y ago
      Take your pills, please
- rscho 1y ago
  [flagged]
  - throwanem 1y ago
    What? How are you making that leap? I'm not insulted; we've never met. I am confused, though, and you are a licensed professional facing specific ethical requirements and constraints on your issuance of medical advice. Perhaps you'll explain what you know that I don't.
    - rscho 1y ago
      Circumcision induces keratinization of the glans (one of the reasons this makes us more resistant to many STDs). I noticed a huge difference in touch perception before vs. after and I strongly resent that this was brought onto me. I'm not trying to insult anyone. It's personal.
quantumwoke 1y ago
My wife is a doctor and looked into the history of this for a bit more context. Apparently, there were some cases in 1987 where premature neonates were paralysed but not given general anaesthesia due to risk of immediate death. This led to a position statement from the paediatric society at the time that nobody should be operated on without pain relief / general anaesthetic. Note that this does not mean that general anaesthesia was not given at all to kids before 1987, but that there was a belief in the USA (and elsewhere) that newborns did not need pain relief during anaesthesia. Your use of 'kids' versus 'newborns' is a bit misleading in that respect.
- holowoodman 1y ago
  https://www.sciencedirect.com/science/article/pii/S1526590013000254 https://www.sciencedirect.com/science/article/pii/S152659001... > textbooks at the time taught that [open heart] surgery [...] ‘‘could be safely accomplished with only oxygen and a paralytic’’ 69(p.580) when performed on infants. Textbooks isn't "some doctors errorneously believed", it is what most doctors believed, taught and practiced. > infant surgery routinely conducted with no or minimal anesthesia well into the 1980s "Routinely" isn't a few isolated cases, that's the word for "this is the usual thing to do". https://pubmed.ncbi.nlm.nih.gov/20608214/ https://pubmed.ncbi.nlm.nih.gov/20608214/ > The study by McGraw (1941), although badly designed, convinced the vast majority of clinicians that infants do not feel pain and do not require analgesia. This theory, reinforced by the fear of using opioids in young children, dominated medical thinking for more than 30 years. "Vast majority" and "dominated" also doesn't sound like just "some cases". https://www.nytimes.com/1987/12/17/opinion/l-why-infant-surgery-without-anesthesia-went-unchallenged-832387.html https://www.nytimes.com/1987/12/17/opinion/l-why-infant-surg... > surveys of medical professionals indicate that as recently as 1986 infants as old as 15 months were receiving no anesthesia during surgery at most American hospitals. We can discuss the definition of "kid" and "newborn", but I would no longer call them "newborn" when they start walking. Also "most American hospitals" means the practice was very widespread even in 1986. I think the whole situation is one of the medical community failing to recognize and admit their own mistakes. Instead, the obvious barbarism of the whole situation is played down, diminished and belittled. Thereby protecting their own feelings and standing at the cost of the victims' right to the truth. And thereby paving the way for a repetition of such gruesome mistakes. At which point I would argue, it might even be a little callousness or even intent...
Der_Einzige 1y ago
[flagged]
Nifty3929 1y ago
This right here. Medicine is not bad in general. Mother Nature is a wicked mistress. Pain and suffering are her defaults, and glimmers of happiness fleeting. Modern technology and medicine in particular have made our lives better and longer in ways our near ancestors could not have dreamed of or hoped for. It's not hard to find counterexamples of course: opioid addiction, climate change, etc. But on balance we're a hellava lot better off now than 50 or 500 years ago. Nice to use a bit less anesthesia for faster/better recovery and money savings. But for goodness sake - let's not go TOO far down that path.
- thelaxiankey2 1y ago
  Do notice that the comments about 'pain and suffering are mother nature's defaults' have very little to do with anything else you said, or with the discussion more broadly. I think these sorts of things are bad internet hygiene and promote an actively depressive state of mind. They can be memetic concepts, and should be treated with care. If you do actually feel this way about your own life, I'd encourage you to seek some kind of help. And besides, there's nothing natural about surgery... I think the rest of what you're saying is fairly accurate, though.
throwaway173738 1y ago
Compare that with the whole “twilight sleep” way of delivering babies and you can see a whole misogynistic thread of not respecting natural systems and of trying to minimize or eliminate the behavioral symptoms of pain while doing little to actually ease the patient.
rscho 1y ago
> I fear the general trend of "medication bad" will get us back to those dark times. I think this won't ever happen. Modern docs would absolutely not accept working under such conditions. Anesthesia is not only comfort for the patient, but also for care providers. As you can often see when surgeons advise patients on refusing local anesthesia or nurses demanding benzos for the screaming demented patient at 2 a.m.
tzs 1y ago
Another medical horror story that only ended way more recently than it should have (mid 1950's probably): https://www.straightdope.com/21341781/in-medicine-what-s-the-difference-between-an-ectomy-an-ostomy-and-an-otomy https://www.straightdope.com/21341781/in-medicine-what-s-the...

throwanem 1y ago

This research is aimed precisely at making it safe enough to administer general anesthesia in these populations for that to become standard of care. Let me preempt one possible line here: I do not love the circumstances under which I would have been circumcised as a neonate in Mississippi in the very early 1980s, and I do not resent the result. Living that far tied up in the past is for men who can't figure out how to do anything else. I am not one of those and despite an essential sympathy with the theoretical basis of their position that no putative benefit remotely justifies the the risk of the intervention, I have a short way with "intactivists." But if it had been possible safely to administer more than EMLA (perhaps!) for pain relief, not even in that place and time would anyone be so barbaric as to refuse it. Of course. And that, making possible that precise measure of mercy in the case where the intervention is not merely cosmetic, is exactly that at which this research is directed. So, to anyone looking to make a cause of the ghosts of a billion foreskins or whatever, I would say please do not attempt even by implication to recruit my argument in support of your position.

holowoodman 1y ago
I didn't say anything about a foreskin anywhere. And my point is, they did not just do minor stuff like a circumcision (which I think is a barbaric, pointless and immoral practice to inflict on non-consenting minors in any case except to maybe cure phimosis). They did major surgery. Like opening the cranium or abdomen. Like removing limbs. Like removing burnt skin by brushing it off and applying skin grafts. And no, they didn't even apply Lidocain, because children don't feel pain. At best, they gave muscle relaxants as chemical restraints and to make the tissue easier to cut.
- Der_Einzige 1y ago
  [flagged]
  - holowoodman 1y ago
    Yes, any, male or female, genital mutilation is life-changing. What I meant is, it is "minor" as far as surgery goes, as opposed to "major". The distinction is about the risk to the life of the patient, the kind of anesthesia you need (local vs knockout), the setting you do it in (walk-in vs stay at the hospital) and the amount of aftercare required (change the bandage vs. medication+monitoring+hospital). And those studies are BS, done to prove a preexisting point. Any properly done study by independent researchers without an agenda doesn't show any kind of effect from circumcision beyond the resulting sensory problems, deformation, nerve damage, erectile dysfunction, scarring and adhesion.
- throwanem 1y ago
  According to a social media influencer.
watwut 1y ago
I really do not understand why did you felt the need to push for circumcisions here. Like, no one asked or discussed them one way or the other. Like ok, it is religious for Jews and Arabs, but no one else have to care.
- throwanem 1y ago
  Who pushed? Jesus, I tried as hard as I knew how not to start a fight, knowing this place plays host to a few foreskin mourners. Better just to avoid entirely, it appears, and duly noted. What a shame the eyeroll emoji is filtered here. That, apparently, is the level people are on. A paragraph is too much! Or is everyone still rationing since Cerebral, or whatever that telemedicine pill mill was called, shut down a few years back? Is that why no one is reading today? I never thought I'd say this, but for God's sake and as a favor to us both, pipe my shit through ChatGPT and ask for a reframing on a sixth-grade reading level. You pay for access to the damned robot, let it wipe your nose through the remedial work. I've got embroidery to do and movies to watch.
  - AlexeyBelov 1y ago
    Take your pills, please
rscho 1y ago
[flagged]
- throwanem 1y ago
  What? How are you making that leap? I'm not insulted; we've never met. I am confused, though, and you are a licensed professional facing specific ethical requirements and constraints on your issuance of medical advice. Perhaps you'll explain what you know that I don't.
  - rscho 1y ago
    Circumcision induces keratinization of the glans (one of the reasons this makes us more resistant to many STDs). I noticed a huge difference in touch perception before vs. after and I strongly resent that this was brought onto me. I'm not trying to insult anyone. It's personal.

quantumwoke 1y ago

My wife is a doctor and looked into the history of this for a bit more context. Apparently, there were some cases in 1987 where premature neonates were paralysed but not given general anaesthesia due to risk of immediate death. This led to a position statement from the paediatric society at the time that nobody should be operated on without pain relief / general anaesthetic. Note that this does not mean that general anaesthesia was not given at all to kids before 1987, but that there was a belief in the USA (and elsewhere) that newborns did not need pain relief during anaesthesia. Your use of 'kids' versus 'newborns' is a bit misleading in that respect.

holowoodman 1y ago
https://www.sciencedirect.com/science/article/pii/S1526590013000254 https://www.sciencedirect.com/science/article/pii/S152659001... > textbooks at the time taught that [open heart] surgery [...] ‘‘could be safely accomplished with only oxygen and a paralytic’’ 69(p.580) when performed on infants. Textbooks isn't "some doctors errorneously believed", it is what most doctors believed, taught and practiced. > infant surgery routinely conducted with no or minimal anesthesia well into the 1980s "Routinely" isn't a few isolated cases, that's the word for "this is the usual thing to do". https://pubmed.ncbi.nlm.nih.gov/20608214/ https://pubmed.ncbi.nlm.nih.gov/20608214/ > The study by McGraw (1941), although badly designed, convinced the vast majority of clinicians that infants do not feel pain and do not require analgesia. This theory, reinforced by the fear of using opioids in young children, dominated medical thinking for more than 30 years. "Vast majority" and "dominated" also doesn't sound like just "some cases". https://www.nytimes.com/1987/12/17/opinion/l-why-infant-surgery-without-anesthesia-went-unchallenged-832387.html https://www.nytimes.com/1987/12/17/opinion/l-why-infant-surg... > surveys of medical professionals indicate that as recently as 1986 infants as old as 15 months were receiving no anesthesia during surgery at most American hospitals. We can discuss the definition of "kid" and "newborn", but I would no longer call them "newborn" when they start walking. Also "most American hospitals" means the practice was very widespread even in 1986. I think the whole situation is one of the medical community failing to recognize and admit their own mistakes. Instead, the obvious barbarism of the whole situation is played down, diminished and belittled. Thereby protecting their own feelings and standing at the cost of the victims' right to the truth. And thereby paving the way for a repetition of such gruesome mistakes. At which point I would argue, it might even be a little callousness or even intent...

Der_Einzige 1y ago

[flagged]

Nifty3929 1y ago

This right here. Medicine is not bad in general. Mother Nature is a wicked mistress. Pain and suffering are her defaults, and glimmers of happiness fleeting. Modern technology and medicine in particular have made our lives better and longer in ways our near ancestors could not have dreamed of or hoped for. It's not hard to find counterexamples of course: opioid addiction, climate change, etc. But on balance we're a hellava lot better off now than 50 or 500 years ago. Nice to use a bit less anesthesia for faster/better recovery and money savings. But for goodness sake - let's not go TOO far down that path.

thelaxiankey2 1y ago
Do notice that the comments about 'pain and suffering are mother nature's defaults' have very little to do with anything else you said, or with the discussion more broadly. I think these sorts of things are bad internet hygiene and promote an actively depressive state of mind. They can be memetic concepts, and should be treated with care. If you do actually feel this way about your own life, I'd encourage you to seek some kind of help. And besides, there's nothing natural about surgery... I think the rest of what you're saying is fairly accurate, though.

throwaway173738 1y ago

Compare that with the whole “twilight sleep” way of delivering babies and you can see a whole misogynistic thread of not respecting natural systems and of trying to minimize or eliminate the behavioral symptoms of pain while doing little to actually ease the patient.

rscho 1y ago

> I fear the general trend of "medication bad" will get us back to those dark times. I think this won't ever happen. Modern docs would absolutely not accept working under such conditions. Anesthesia is not only comfort for the patient, but also for care providers. As you can often see when surgeons advise patients on refusing local anesthesia or nurses demanding benzos for the screaming demented patient at 2 a.m.

tzs 1y ago

Another medical horror story that only ended way more recently than it should have (mid 1950's probably): https://www.straightdope.com/21341781/in-medicine-what-s-the-difference-between-an-ectomy-an-ostomy-and-an-otomy https://www.straightdope.com/21341781/in-medicine-what-s-the...