Just....help. No-circ mamas?

[Melaine]

Baby has another UTI. I am so upset. The ped and urologist have both said that after his second one he will NEED to be circ'd. I know I am also going to have to take him to the hospital for the VCUG. Now I am overwhelmed with guilt that I didn't do it in the first place. I know many people would still say not to circ.

I feel like I am falling apart. I am so tired and worried and now hungry from the dietary changes for the MSPI. We have to start homeschooling, my home is a complete disaster, DH is so worried about money. We owe over $9000 for DS's birth and haven't come close to meeting our astronomical deductible. We are only $500 over the annual income limit for qualifying for medicaid.

Now I am hiding in my bedroom from the girls, crying into a burp cloth.

[wendmatt]

No circ advice but wanted to send you hugs and say how sorry I am. I hate the health insurance stuff here, I'm from the UK and health care covers everything (no it's not free we pay national health insurance, like health insurance but a percentage of wages) but owing $9000 for birth is just awful. Take some deep breaths, you will be fine, so will your baby.

[DietCokeLover]

I don't have anything useful to offer re: circ, but I just wanted you to know I'm sorry and I'll be praying or you.

[TwinFoxes]

No circ advise, but I'm sending you hugs and P&PT. I hope things start to look up soon. :hug:

[carolinamama]

Not sure on the circ stuff....but I couldn't read and not post. Just wanted to send you hugs. You will get through all this.

[BabyBearsMom]

Just lots of :hug5:

[mom2MandC]

Sending hugs and prayers for you and your little guy! Sorry, no circ advice, I have 3 girls. Hope you are feeling better soon.

[wellyes]

I'm sorry.

You did the right thing in not circing. If you circ now, you will also be doing the right thing. There is no wrong choice. Only love. You love your son and are being a good mama.

Debt sucks, being tired sucks, being hungry sucks, stress sucks. Hang in there, and take it one step at a time.

[misshollygolightly]

Big, big :hug:, Melaine! I am so sorry for all the stress you're dealing with right now. I wish I had some concrete ideas or advice for you.

I will say that DS (who was not circ'd) had some issues w/ a persistent foreskin infection early on and we were referred to a urologist who supposedly specialized in pediatrics and he basically insisted we needed to forcibly retract and start cleaning under the foreskin and applying ointment, and he also indicated that we might need to circumcise if this didn't clear up. I was so freaked out and worried I had screwed everything up for DS and yet it didn't set well with me that we should forcibly retract a 15 mo's foreskin after everything I'd read to the contrary. ANYWAY, long story short, the infection totally cleared up on its own after a while and we've had NO problems since. I honestly don't know why the urologist started talking about circumcision considering that I'm pretty sure (in retrospect) that we were just dealing with a yeast infection.

I don't know...circ may really be indicated for your son, given his UTIs. But you might want to post over on the Mothering CAC intact care board (http://www.mothering.com/community/f/17426/intact-care) and see if any of those ladies can give you some feedback or offer some BTDT. Hang in there! No matter what happens (whether you end up circ'ing or not), you're a great mom and you're doing the best you can for your kids!

ETA: Can you ask your ped and urologist to clearly explain all of your options? Is there any way to treat his UTI with an oral antibiotic?

[JBaxter]

Im going to suggest you chat with ladies on MDC. < mothering.com> they are a wealth of knowledge.

[Melaine]

Going to mothering. Thanks guys. I appreciate the prayers, my GAD is really taking a hit right now.

[AnnieW625]

No circ. advice, but lots of hugs and I think if I were you I would do what is best for your family. Is there anyway that you can appeal a Medicaid decision if you have been denied? I would try applying if you haven't already and then just be persistent. Good luck, and :grouphug:

[mctlaw]

Man, I'm so sorry. You are going through a lot. Just know there's a ton of us sending PT. You're a strong mama.

[brittone2]

Doing a quick search, it seems like sometimes there are underlying issues with the urethra or other parts of the urinary tract that can cause issues, and aren't always resolved by circ'ing. I would want to know if that might be the case before making the decision. I don't know what I'd do. Maybe try to find a pediatric urologist, preferably one who is reasonably intact-friendly?

Dr. Fleiss in LA usually has a lot of research and info on intact issues.

I saw these three references cited, you could try reading them in pubmed. Obviously this isn't comprehensive, I'm just trying to give you some idea of questions you could ask?

2. J. Winberg, I. Bollgren, L. Gothefors, M. Herthelius, and K. Tullus, "The Prepuce: A Mistake of Nature?" The Lancet 8638, no. 1 (March 1989): 598-599.
3. S. M. Downs, "Technical Report: Urinary Tract Infections in Febrile Infants and Young Children," The Urinary Tract Subcommittee of the American Academy of Pediatrics Committee on Quality Improvement, Pediatrics 103, no. 4 (April 1999): e54.
4. M. A. Gill and G. E. Schutze, "Citrobacter Urinary Tract Infections in Children," Pediatric Infectious Disease Journal 18, no. 10 (October 1999): 889-892.

Phone number listed at the bottom of this site says they may be able to direct you to an intact friendly doc. Might be worth at least hearing their opinion, so you have some questions you could ask no matter which route you go.

http://www.drmomma.org/2009/08/protect-your-uncircumcised-son-expert.html (eta: I am not endorsing her blog or her posts or anything, just trying to quickly link you to some resources where you might find intact friendly urologists to consult)

A dear friend has a DD who went through repeated UTIs as a result of reflux. I don't know if any of the less invasive forms of testing for that can rule it in/out.

eta: Do they know for sure he was fully cleared up after the first episode? Could he have a resistant strain?

[JustMe]

I'm sorry.

You did the right thing in not circing. If you circ now, you will also be doing the right thing. There is no wrong choice. Only love. You love your son and are being a good mama.

Debt sucks, being tired sucks, being hungry sucks, stress sucks. Hang in there, and take it one step at a time.

:yeahthat:

[brittone2]

Don't worry about HSing right now. DDs are kindy age, right? Read to them when you can and it will be alright. I promise. Don't stress over that aspect of things right now. You have plenty of time to work with them when things calm down a bit. :hug:

Many hugs and much love coming your way. I hope you can find some answers :hug:

[StantonHyde]

I'm sorry.

You did the right thing in not circing. If you circ now, you will also be doing the right thing. There is no wrong choice. Only love. You love your son and are being a good mama.

Debt sucks, being tired sucks, being hungry sucks, stress sucks. Hang in there, and take it one step at a time.

:yeahthat:

Its ok--your son will be fine if you circ him, it is not the end of the world. You are trying to get to a place where you are both healthy and that is what counts.

[elektra]

Maybe try to find a pediatric urologist, preferably one who is reasonably intact-friendly?


So sorry for all the piled on stress. Above is what I would personally try.
I got nothing but a major guilt trip from the people at mothering.com. Maybe things have changed in the past 5 years but don't let anyone make you feel guilty if you end up deciding that circ'ing is the best choice for your DS.

All we can do is make the decision we think is best at any given time with all the info we had available at that time.
You chose to not circ him as you thought that was the right decision when he was born. It was the decision I made too. But if my DS's health was on the line, a flap of foreskin is not something worth going to the mat for to try and save KWIM? So I might just try to get one second opinion from a dr. who seems reasonable intact-friendly and go from there.
From experience, all I would get on mothering.com would be added stress and guilt over even considering circ'ing.

[o_mom]

Baby has another UTI. I am so upset. The ped and urologist have both said that after his second one he will NEED to be circ'd. I know I am also going to have to take him to the hospital for the VCUG. Now I am overwhelmed with guilt that I didn't do it in the first place. I know many people would still say not to circ.

I feel like I am falling apart. I am so tired and worried and now hungry from the dietary changes for the MSPI. We have to start homeschooling, my home is a complete disaster, DH is so worried about money. We owe over $9000 for DS's birth and haven't come close to meeting our astronomical deductible. We are only $500 over the annual income limit for qualifying for medicaid.



A few things...

#1 there is no cut and dried 'must circ after two UTIs' at all. It is your choice and they should to present you with alternatives. If they don't, then find someone else.

#2 I would ask them what they would do if you do circ and he has another UTI? What if that doesn't solve it? What would they do for a girl with multiple UTIs?

#3 You really need to rule out other problems before deciding if circ could fix them, so the VCUG is probably the first step. I would absolutely not agree to any circ until they ruled out other anatomical problems.

#4 Find out if there is any way to adjust your DH's income to meet the requirements and what aid programs/payment plans are available.

:hug:

[chottumommy]

My son (DS1) had/has hydronephrosis. We didn't circ at birth. However in order to rule out anything we did a VCUG at about 1 week. It was very painful for me to watch but not sure DS felt any pain. He cried because he was disturbed. I was so exhausted, emotionally and physically with all the doc visits for low weight gain, urologist appt (2 hours away) and the no nap, 2 hour sleep cycle at night I was ready to do anything the urologist suggested.

The urologist put him on a 6 month antibiotic (since we didn't circ) to prevent UTI. I'm convinced that it messed up DS1's gut and his eating habits and also his sleep to some extent. Even at 3 he has mushy poop (TMI). He was so fussy with sleep, feeding and everything till he got on solids at 8-9 months.

I wish I had done some more research or atleast outsourced the research to some friend/family. There is no right or wrong way - only options with risks.

Even if you decide not to circumcise, the urologist might put him on antibiotics which has its own set of problems, so like a pp mentioned ask them what course of action they would with either of the options (circ or no circ).

[codex57]

Last thing you need is more guilt.

My only intent is to hopefully help relieve any worry or guilt you may be feeling. No judgment on my part.

I'm circed. I don't remember squat. Shoot, I don't remember much of anything before the age of 4.5 or 5yrs old. I apparently shattered a glass door with my head when I was 2. Freaked everyone out. Don't remember anything. Circ for a guy, unlike what I've read circ for a girl involves, isn't that big a deal. Honestly, as a guy, I think people are blowing this issue up way beyond what it really is. It's slightly beyond piercing the ears and actually better than a tattoo for a kid IMO.

In any case, I don't remember any pain, etc. I'm not traumatized. I hold no resentment to my parents for circing me. Honestly, if you had your son circ'd cuz you were told to by docs, he's not gonna resent you for it. He'll feel love because you were doing what you needed to make him better.

Think about it objectively. How is this really any different than heart surgery? Or chemo. It's a medical procedure designed to alleviate some bigger problem. Cept it's far less harmful than those things. You recover in like a week.

[american_mama]

If it helps, I know two families who ha their sons circumcised at elementary age. The family I know better had it donoe at age 6 and he was fine. It can be done at many different ages. For him, the circumcision was, I believe, deemed necessary because of some relationship with another problem (maybe undescended testicle?) requiring minor surgery. The boy is very athletic, had to miss gym for a week or so, but was back at school in a day or two, appearing fine, etc. I would definitely ask the doctors if waiting is an option, explain it's a terrible time for you to make this kind of permanent decision and you want to wait.

As for insurance, you may want to poke around this website for your kids:
http://www.insurekidsnow.gov/
Medicaid and CHIP (Child Health Insurance Program) are two different national programs that provide insurance for kids. I know a couple families whose kids use CHIP in my town and they seem to like the coverage, provider choice, etc. Since you have an infant, you may also want to look into WIC and/or food stamps. At least one of my friends using CHIP also used WIC and felt it helped.
http://www.fns.usda.gov/wic/howtoapply/whogetswicandhowtoapply.htm

Keep your chin up. You are clearly exhausted and worried right now, and that makes everything seem worse. I would not schedule surgery in that frame of mind. You are taking care of him by tracking his symptoms, getting him to the doctor, giving antibiotics and exploring your options. We all make the best decision we can before a baby is born, and sometimes those decisions change later on as circumstances change. The hard part is the in-between, and then the smart course is probably to assess changed circumstances and explore your options. That's what you're doing now.

[Melaine]

Thanks everyone. I have returned to a semi-calm state. I'm reading up on this and reminding myself to be thankful we caught it before it got worse. I'm reading every link and I just thank you guys so much for all the help, prayers, PMs, and suggestions. You are the best!!!!

Codex, I also appreciate your perspective and I am sorry for discluding you by requesting "mamas" in my thread title. ;)

If circumcision would truly keep him from getting any more UTIs I would do it in a heartbeat but at this point I am unconvinced. I'm going to keep reading and maybe schedule an appointment with a more informed doctor. They will want him to finish the 10 days of antibiotic before doing any further testing anyway.

And we will definitely get the VCUG to check out his kidneys. I suspect he will be diagnosed with Kidney reflux I just pray that no long-term damage has been done.

As for the insurance, we did apply and get turned down for the kid's version of Medicaid, missing the cut-off by $500. I do intend to re-apply just in case they will take our bills into account but I'm not very optimistic. I also intend to call the hospital and plead our case but I just haven't worked up the energy.

Now I am going to go to bed and hopefully for more than three hours.

[123LuckyMom]

I'm glad you're feeling better, and I'm wishing you much sleep! I just wanted to chime in from my own experience. I know you don't want to have an unnecessary procedure performed on your son. I didn't either. My husband was not circumcised in infancy and developed a really horrific infection the doctors told his mother was due to his not having been circumcised. This may not have been the case, but it is what DH believes. He had to have surgery that left him with scars and trauma. When DS started having problems in infancy that our doctor told us would be solved by circumcision, DH insisted we have it done. He was unwilling to take the risk of causing DS trauma later on when he would remember it as DH does. We circumcised. The problems did go away. DS has no memory of the procedure. I know some people think of circumcision as akin to mutilation, but I have to disagree. There's nothing wrong with being intact if you can avoid infections, and there are millions of circumcised men out there enjoying healthy, happy sex lives with their circumcised genitalia. If you do have to circumcise, it really is not the end of the world.

[California]

Early on I randomly discovered that docs who grew up in countries with low circ rates are just... more relaxed and better informed about caring for an intact boy. Europe, South America, India and Russia all have low circ rates. Just a tip- may or not work for you but so far it's worked for us.

[joules]

I have a good friend whose brother had it done when he was in high school. I don't know why. I remember her saying that he was sore in was in bed for a little bit. But nothing traumatizing.

Good luck to you and DS!

[HannaAddict]

We didn't circumcise and had one UTI at age three. Doctors all excited to do invasive testing right away (VCUG) and we declined and did U\S first and no issues seen. Second opinion said probably a one off issue, dehydrated a bit (summer) and day camp and potty training and normal U/S. He had not had one is since. At the time I was pretty distraught at the invasive testing and what I had "done" by not circumcising at birth. It all worked out and we didn't have to do anything else, but I would definitely see what they can see with non-invasive U/S first before agreeing to other testing and circumcising. I'm so sorry!

[dogmom]

I had a friend with no insurance with her kids he had to get her son circumcised when we has in preschool. (I don't know the circumstances.) It was an office procedure and she shopped around and negotiated a price with a doctor since she had to do it out of pocket. If you do wind up doing it, and I agree it is not clear now you will, there are options.

[Jupiter]

I did a quick search "government help for hospital bills". Ehow.com had some go information. It might take time and work but there are often resources we don't know about. Hope that helps.

I know nothing about circumcision, I told my husband if we had a boy it was upto him. :shrug:

[Tondi G]

Both of my boys are circ'ed and have had no issues at this point. I would get a 2nd or 3rd opinion if you need to feel comfortable that circing is the best decision for your DS. If you do and find that it's the best route to take, then so be it. Chances are your DS won't remember a thing and hopefully it will prevent any more uti's or issues for him in the future!

I have a friend who's son had to be circ'ed when he was 6 or 7 years old and she regretted not just doing it as a newborn. Her older DS was and she said the recovery was more difficult for an older boy.

HUGS ... I totally understand the medical insurance issues. We have collection agencies calling all the time. We already depleted our savings account on medical bills.... just have nothing left to give them. Our boys currently have no health insurance... we are researching options. We do not qualify for Healthy Families. Found another option that runs $75 a month for each child but the providers don't seem to be great and not exactly local (and they only cover ER and office visits ... no hospitalization). To add the kids to the insurance DH is offered though work is close to $500 a month.

Just wanted to add that if he's taking abx then you might want to be giving him daily probiotics for that .... they can also be helpful for urinary tract health too!

[smilequeen]

Well, my impression is that the situation you are in is probably due to something more than just his foreskin. What would they do if he was a girl? Or an already circed boy? It's not impossible that circ is the solution to the problem, but my guess is that it's unlikely that it will completely solve the problem. If you need to circ though, you shouldn't feel guilty...not for having to do it now, and not for choosing not to do it in the first place.

[indigo99]

DS has had one infection under his foreskin. The ped told us that he'll have to get circ if he gets a second. She told us to retract it and clean underneath, but that was actually uninformed/bad advice.

It's normal for little boys not to be able to retract the foreskin until age 5 or 6 and not really cause for worry until they hit puberty. Forcefully retracting it can actually lead to scarring and make it more difficult to retract. We read that we should encourage him to play with his penis in the bath. He won't pull it back too far b/c he can feel if it starts to hurt, but that will get water in there to wash everything out. I know it's normal for little boys to play with themselves sometimes, but I'm not sure I want to encourage it.

[kochh2]

Ok, so I'm Brittone's friend with a DD who has a significant amount of UTI issues, as a result of bilateral Kidney Reflux (vesicoureteral reflux)... she started at age 4 months, and i was so afraid it was caused by cloth diapering, or something we did.... everyone assured us, it was most likely caused by an internal abnormality- in her case, it was the reflux.
it's pretty common, BUT if you let it go unchecked, even just once, or if your babe gets a bad UTI/kidney infection, you could be where we are now, which is protecting the one remaining Good kidney- thats right, nothing to joke around about-- so, I don't know what I'd do in that situation, as DS is also not Circ'd, but knowing what I know now, despite how strongly i feel about not-circing, i would definitely get a few opinions about whether the foreskin has anything to do with it (i seriously doubt it does, but that's my own opinion LOL) and consider the pros and cons of keeping it. as for VCUG, it is the only way to see if reflux is happening, a relatively quick study, but even with good insurance, it's expensive. Again, knowing what i know now, and knowing that we acted swiftly and have never NOT treated a UTI, DD STILL has extensive scarring, i'd say your babe is 100% worth whatever it takes to rule out reflux. just my 2 cents, but i feel for you... hang in there!!

[larig]

I'm sorry.

You did the right thing in not circing. If you circ now, you will also be doing the right thing. There is no wrong choice. Only love. You love your son and are being a good mama.

Debt sucks, being tired sucks, being hungry sucks, stress sucks. Hang in there, and take it one step at a time.

One big enormous :yeahthat:

[Jacksmommy2b]

How is your little man doing Melanie?

[dec756]

so sorry to hear this!! please take care of yourself and keep your head up :grouphug:

[essnce629]

UTI's are one of the most common pediatric infection. Studies show that there IS a slight increase in UTI's in intact boys, but this is only during the first year of life (one study said first 3 months). After that, "UTI's predominate in females."

http://www.aafp.org/afp/1998/0515/p2440.html

How old is he now? Studies also show that breastfeeding helps protect against UTI's in infants. But overall, girls get WAY more UTI's than both intact and circumcised boys. I personally don't know any boys, intact or not, who have had UTI's (and both my boys are intact) but I can name several girls I know who have dealt with persistent UTI's (including myself as a young child). No one is suggesting surgery for the girls, and the recommendation is usually to start taking probiotics, to take dairy out of the diet, drink cranberry juice, etc. I've even heard of girls going on long term low dose antibiotics before anything like drastic surgery is talked about. I really don't understand why it is different when it comes to intact boys. Surgery should be the very LAST result when all other measures have been tried (and failed).

I'd start DS on an infant probiotic (jarrow and Udo's Choice make infant ones) and I'd make sure that you are taking one yourself if you are breastfeeding. UTI's are often caused by E. Coli bacteria and probiotics can help reduce the amount of E. Coli in the body. Are you exclusively breastfeeding? Dairy intolerance can often lead to UTI's and I've heard of success of going dairy free in girls with recurrent UTI's.

And definately visit MDC as well!

[katydid1971]

First HUGS to you. I haven't read through all the posts so sorry if this has already been said. I know how it feels when your child keeps having medical problems. DD still has chronic UTIs (she's having one right now). She has had several surgeries and will be having her like 6th or 7th VCUG in October. There are lots of reason why kids get UTIs and the VCUG might show some other problem completely unrelated to his not being circ'd. About the hospital bill, my SIL has terrible insurance and she and her husband went to the hospital and talked with someone in the billing department and brought in their tax returns etc and showed that they had no way of paying for DN's very high hospital bill and the hospital wrote off the loss. You might want to call and see if that is an option for you and DH. Good luck and HUGS!!!