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Doctor [drawing on paper next to the empty Circumstraint, and talking to the baby's father before the operation begins]: This is the penis itself... in the final look, there's a little groove and then there's the actual head of the penis like this, right? (Uh, its a little to big for this diagram...)
Father: Right...
Doctor: But basically, the foreskin comes all the way along here right over the top...
Father:Mmm-hmm
Doctor: ...and up like that. You're gonna take it back to about here.
Father:Okay.
Doctor: So. This is the natural skin, when we're all finished;
Father: Mm-hmm.
Doctor: This is healed where the skin was taken away; and this is completely one line, completely free.
Father: Okay. Okay.
Doctor: If that was your question...
Father. Yeah. Yeah. That's... that's what I want. [Laughs nervouslyl.]
Doctor: Okay? Alright! That's what you're gonna get!
Father: Yeah okay, good...
Doctor: We're gonna set 'im down right here.... [Undoing the straps of the Circumcstraint.]
Father, [to the doctor:] He's all yours....[to his son:] C'mere my boy....
Doctor [To the father :] He's GROWN!
Father: Yeah.
Doctor: Look at the size, eh!?
Father: Oh my!
Doctor [putting the baby in the Circumstraint]: Look at him! He is... [baby begins to cry] Now, you'll notice, that he was nice and quiet - he's already fussy. Why? Maybe he doesn't want to be in this position, maybe he doesn't want to move his arms or his legs. You'll find that one of the things that they most don't like is being unable to move. Cuz, their legs are normally flexed, right? And what we do is we take their legs out and we put 'em in a position- see how much he's reisiting me just now?
Father: Right. Right....
Doctor: And as soon as he realizes that he can't move that he gets all... He IS getting chubby! Let's put his sox on....
Father: He's gained, uh, seven ounce now... [Baby cries again as the doctor straps his legs down.]
Doctor: See? If you were standing outside the door, and you hear that, you'd say 'Oh my goodness! What's happening?'"
Father: Yeah- 'what is that?'
Doctor: [Opening up the baby's diaper] Oh, he's actually... a good size! Now. Of course, we check that the penis is fully normal, right? We also check and make sure both testicles are okay. (We've checked this before on him.) But, he's a little bit pudgy here and I'll show you what I mean by 'pudgy'. [Baby cries again.] Now we've done nothing to him. LISTEN to him! And that's important because everybody gets all excited about how they...
Father: Is it okay if I put this in? [Referring to a pacifier/soother]
Doctor: Sure! By all means. By all means.
Father: Quiet him down a bit... [To his son:] Okay. son, okay....
Doctor; Alright. So, the first thing we do...
Father: [To the baby] Go to sleep... Go to sleep. Go to sleep....
Doctor [Putting Betadine, an anti-infectant, on the baby's penis and scrotum]; Now this doesn't burn or anything. Also just the wetness alone will get them all excited here. [Baby cries again]
Father: Okay son. Okay....
Doctor: But, If he's quiet and doesn't move his legs, he's quiet. You watch the hands and legs! (They hate this....)
[Baby begins to scream, then shriek as two needle-nosed clamps are closed on the opening of his foreskin, a bigger clamp is inserted into the foreskin's opening, and the foreskin is torn away from the penile head.]
Doctor: What we've done here is we've completely separated all of the skin from the head of the penis- you can see the outline of the head of the penis, right?
Father: Yeah...
Doctor: So we've taken the skin right down, here, right? Right down to that level we talked about.
Father [to the baby]: Okay. Okay... okay....
[The doctor makes the dorsal crush with the flat hemostats. As the baby begins to shriek over and over.]
Father: Is that the anesthetic?
Doctor: What?
Father: Is that the anesthetic, or?
Doctor: No that, that just crimps the whole thing.
[The baby begins to choke on spit in his throat while still shrieking- "gargling"]
Doctor; We'll let that sit for just a moment. K? What we could do is release his arms... [The doctor undoes the baby's arms from the velcro straps.] So he feels less.... [Baby continues to scream higher and higher.]
Father: I was aware that you'd use an anesthetic.
Doctor: What?
[The doctor makes the dorsal slit along the crush line with a pair of scissors.]
Father: I was aware that you'd uh use an anesthetic?
Dcotor: We mix into the mixure here...
Father: Okay.
Doctor: And that just takes the edge off it, okay? And uh...
Father: [To his baby] Okay, son....
[The baby continues to shriek and choke as the foreksin is laid back off the glans.. and the doctor wipes the blood from the glans with a piece of gauze, until there is no sound heard from him until he gasps and resumes shrieking and choking]
Father: 'I need your help'
Doctor: [In a soothing tone to the father.] Alright. We'll settle him down. [Baby's still sputtering.]
Father: [Neverously] Okay. No problem. No problem.
[The doctor assembles the Gomco clamp over glans and pulls the foreskin through the plate and over the bell with tweezers as the baby chokes and chokes and screams!]
Doctor: [To the father] Oh, he's gotten himself upset. [To the baby] I think Dadd'ys getting excited! Its okay Dad. We'll be okay....
[The baby continues to shriek and choke as the rocker arm is assembled on the Gomco clamp and the nut is tightened.]
[The baby keeps choking.]
Doctor: Nice big swallow he had there.
Father: Yeah
Doctor: ...now he got it out.
Doctor: We'll just let him sit a little bit.
Father: You're okay. You're okay.... Okay son. Okay..... Okay... Its almost done. Okay....
[The baby continues a bleating cry, alternating with occasional shrieks, while finally the foreskin is cut off in a circular motion with a scalpel against the bell of the clamp.]
[The baby stops crying and begins a quick, raspy panting as the ring of detached foreskin is cut off with scissors.]
Doctor: Okay now we let him sit for a little second.
[The doctor gets out some petrolium jelly.]
Father: Mmm-hmmm
Doctor: Just so that uh... what it does is stop all- any potential for bleeding. Okay? So he's sitting there with the clamp on... and he seems to be... reLAXING a little bit! So we let him sit for a few minutes and that's it. [Baby still is panting loudly through his nose.] And uh, there's a drop or two here and a drop or two here- and that's your total blood-loss.
Father: Mm-kay.
Doctor: Actually, at this point, what I do normally is go through the instructions with the parents cuz t gives a chance for that. So all we're gonna do is we're gonna change the diapers frequently, simply to keep the stool and the urine away from the area...
Father: Right.
Doctor:...- something that you'd do anyway; you'd be changing him frequently. The big trick [the baby begins a plaintive cry.] is large amounts of Vaseline to that area.
Father: Okay.
Doctor: Okay? And this prevents the penis from sticking to the diaper.
Father: Right.
Doctor. So each diaper change, just a great big glob. Now I put it on a piece of gauze here- just some people lift it into place, but when you're changing him, you can put it directly onto the penis, okay?
Father: Okay... [The father continues with various "Mmm -hmm's" and "Okay..." 's and "Rights"...as the doctor continues his explaination.]
[The baby still is crying and complaining off and on with the clamp still on his penis.]
Doctor: If he DOES soil himself with stool all over the cut area, right? You're gonna wash with a warm water, but you're not gonna use any soap until its healed cuz the soap will be hurting, right? You're also not going to rub it hard- just to remove the stuff, right? And the child remains, you know, settled on... comforatable or whatever his normal position is- usually on the back, right? After a few days or so, there's a white-yellowish, yellow tissue- like you burnt something? If you've ever burnt yourself or grazed yourself, you have this scab-like material that forms? Do not attempt to rub that off; its a normal part of the healing process, okay?
And then, the healing itself usually takes about 3, 4, 5 days, and at that point, after about 3 days or so, they can go straight into the bath. K? You don't want to dump him into the bath while he still has the open cut, right? Here's an important point, it says - "Keep the skin down"- This is particulary important point for HIM, because [Baby's Name] has- ummm ... uh.... he's kinda chubby in that area. So what happens is- is we've removed the skin to here- there's quite a bit of fat around the base here and sometimes what happens is the skin will push up over the head of the penis. So today or tomorrow while its still MOVEable -It won't be moveable AFTER that- but today and tomorrow you just watch- and you make SURE that it stays at the level it is. It should. It should. Just in case is does go up, we take the four tingers [uses the thumb and index finger of each of his hands as he demonstrates in the air] and push that skin down to its normal position so it HEALS at the level we want it to. Okay? That's what we mean by "Keep the skin down" over here. And once he's completely healed, there's no special, you know- ANYthing! - just wash and bathe as normal. You don't have to retract to clean cuz there's nothing there!
Ummm. ... I've never had an infection, but I have to tell you about it. Obviously if you have a foul odor or puss draining from that area or it gets all red, there's a possibility that there is an infection. Uh, what CAN happen at times is excessive or ongoing bleeding. Umm... Again: Its not something that happens USUALLY. Uh, you can apply a little bit of a cloth with some pressure; that usually stops it; if you can't stop it, it needs attention. And there shouldn't be any problem with him passing urine immediately after the procedure. So you'll know from that he's passing urine. This will go with you- [he hands him the instruction sheet he was just reading from]. so you don't have to remember ANY of that and we'll give him just a minute more and we'll take that off and you'll- you see that its the way you want it to be.
Father: So... there WAS some form of anesthetic...?
Doctor: A topical sort of things, yeah., yeah.
Father: Okay...
Doctor: Not MUCH- it just takes the edge off. And you see he's sitting with the clamp on, munching away.
Father; Mmm-hmm...
Doctor: Now, there's a big debate, of course, about injections or others or whatnot... Its been done for thousands and thousands of years without ANYthing and it doesn't seem to be a problem.
Father [laughing nervously]: Yeah....
Doctor: Although, there's some recent research that comes out CLAIMING that there's... you know... [sarcastically quoting] "irreVERSEable damage done!'....So there's a LOT of people with a LOT of irreversable damange running around!
[Father laughs nervously again.]
Doctor: I don't quite buy into that. [Father continues laughing.]
Doctor: But we can do it with a clamp or without a clamp... freehand... We can do it with or without FULL anesthetic; some people are even saying "anesthetize the whole bottom part of the body"... And some people are saying it doesn't really make a whole lot of difference. The big thing is tying him down. Once he's relaxed, nothing; you take a normal baby and they're not gonna be happy.
Doctor: There IS pain.
Father: Yeah, I guess so.
Doctor: There IS pain- but its very transient... As you can see, he's still sitting here with the clamp; he seems to settle quiet nicely. And I don't think he's exhausted, because as soon as I start moving, he's gonna start making noise again. [The doctor starts to unscrew the nut on the Gomco clamp.] Let me see if I can do it gently...
[The baby begins his bleating, plaintif cry again.]
Doctor: And there he goes.
Father: [To the baby] Okay... Okay....
Doctor: [to the baby] Shush, shush, shush-shush-shush.... [To the father] 'Just let me have my soother,' he says.
Father: [Laughs, then says to his baby] Its all yours.
[The Gomco clamp is now disassembled and removed, but the bell is still stuck to and on the glans of the baby who is still whimpering and then the plaintif cry - with intermittant sucking on his soother.. As the doctor wipes the remaining blood from the glans with gauze, the crying gets more intense and despirate.]
[Doctor continues his explaination; the father continues his "Mmm-hmmm's" and "OKay"s and "Right, right"s.]
Doctor: This is all bleeding; this old blood. Okay? There you go. [Finishes wiping with the gauze.] [Demonstrating with his index fingers and thumbs again and occasionally while explaining bumps the baby's glans with a finger.] And if you look carefully, completely nice even line all the way arround. And this is the level that you want to keep- see he's chubby here right?- so, we don't want the skin going up on top because he's gonna... right into position right like that, right? [Motions quickly upward around the penis with this fingers and thumbs again.] Now he's completely- this is what you meant by 'completely completely exposed'. See? All the way around? And there's no bleeding. And all we do is put a little bit of Vaseline on it [he puts the gauze with Vaseline on the baby's penis finally] ....
[The video stops here abruptly.]
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