I continue to count down the days until Raymond’s birthday (5 ½ more to go!) with great anticipation. One of the many reasons is because after Raymond’s first birthday he is statistically out of the danger zone for a second bladder infection. Which means that every time he gets a fever over 101 I do not have to take him to the doctor and have a catheter done and that I no longer have to have a hidden nugget of guilt that my decision may cause him to have kidney damage. Whew.
Some background: Raymond is uncircumcised. I don’t really want to open this conversation up to debate about the “circumcision decision.” All I want to say is that Morgan and I did a lot of research and consultation which lead us to the decision not to circumcise and we are VERY pleased that we did not cosmetically and irrevocably alter our child.
But, despite our resolve, this decision was seconded guessed when Raymond got a bladder infection. This is the information I have --- DISCLAIMER, I am not a medical professional! --- Males under 1 year that are uncircumcised are more likely to get a bladder infection/UTI than circumcised males. Males that are uncircumcised that are older than 1 have almost no occurrence of bladder infections/UITs … among many other longer term benefits … here I am about to go off on my tangent … refocus. I think the statistic is that uncircumcised babies have 1 and 10,000 chance of getting an infection. However, after the first infection occurs, uncircumcised babies have 1 in 100 chance of getting a secondary infection (I am certain about the second statistic).
Okay, no big deal, right? Antibiotics will clear it up. That actually depends on who you ask. By the time the baby has a fever and you know there is an infection the bacteria has penetrated the kidneys and gotten into the blood stream, which could mean that your baby boy is at risk for kidney damage and or failure.
Why does the baby get the infection? Babies poop in diapers and before the foreskin retracts you cannot necessarily be 100% that you have gotten all of the poop out. A small particle of poop may get in the shaft and work its way back until it gets into the urinary tract and so forth. Additionally there may be other factors – such as urinary tract reflux – or other irregularities in the baby’s bladder and associated parts – that make the occurrence of a secondary infection more likely.
Back to our story: After we were properly diagnosed with the infection by our pediatrician we were referred to have some tests and imaging done of Raymond’s bladder, urinary tract, kidneys, etc. The main thing there were looking for was the reflux. We had an ultrasound done and then this terrible horrible dye/catheter/x-ray series done where there looked for the reflux. Raymond did not have any reflux BUT there was indication of a slightly dilated part of the uritar … dilated means it isn’t even narrowed! But the “abnormality” plus the fact that Raymond is uncircumcised meant that our pediatrician wanted us to see a specialist.
Side note: I love our thorough and thoughtful group of pediatricians but admittedly I am a little worn out on the culture of fear created by malpractice insurance. A topic of another time.
Specialist number 1: Total ASSHOLE. To start, he so unprofessional as to be loudly dictating notes about the client next to us so I knew all the specifics of our case … then he didn’t even LOOK at my child when examining him and was very cold … but moreover he pretty much told me that I was negligent for leaving Raymond uncircumcised because he would likely have kidney failure due to infections, that I was like his dumb Mexican clients for leaving him uncircumcised (I am biting back the fact that NO OTHER COUNRTY IN THE WORLD HAS ROUTINE CIRCUMCISION as a secular practice which was a part of our decision process) and then he recommends that I put Raymond on antibiotics for the FIRST YEAR of his life as a preventative measure to make sure there isn’t another infection. I won’t even go into the other blatantly racist actions by him and his staff towards Hispanic clients that I witnessed. I was so shocked by my experience there that I wrote a long letter to my pediatricians so they would be advised and consider if they wanted to make referrals to the doctor again.
The pediatricians passed my letter around and I got a call to apologize for the referral but also to state that they would like me to see someone else. There are about 10 doctors at my practice and they consulted and approx half felt I should put Raymond on antibiotics and a preemptive measure whereas the other half did not. I got the warning (my file was noted for their liability reasons I’m sure) and was referred to the big time pediatric urologist at Duke. Here we go AGAIN!
Specialist number 2: I got to Duke and Dr. Superspecialist looked at all of the images and records for Raymond and couldn’t figure out what exactly what the “irregularity” as the dilatation was well within “normal range.” He did say that it was good that I followed up to be certain. He also told me that unless there is a real serious irregularity he never recommends the use of preemptive antibiotics as the current studies show that it only helps 1 in 7 children whereas the rest of them still get bladder infections and also suffer the effects of being on long term antibiotics when there is no bad bacteria – basically totally voiding their immune systems and altering their bacterial flora for life. Exactly what I wanted to hear and what I knew to be true from all the research we did prior to making the “circumcision decision.”
Despite this report the way I was treated by the first doctor had left an inkling of guilt in my heart and soul that my baby boy could hurt or really be hurt by our decision not to circumcise. It is really pathetic that I have held onto it as I know so much about the benefits he will experience as a result. But the 1 in 100 statistic is very real and I have dutifully kept my eye on any fevers, had 1 extra catheter and held just a little bit of my breath in worry.
I should also admit, maybe for the first time, that part of my fear was not only for Raymond but for myself as I have been so vocal in our family and community about our decision that if Raymond had complications as a result I would have been wrong. And all those who stand in slight silent judgment of our decision would feel validated. Which is also ridiculous because it isn’t like he would have ever had a moment to had kidney damage as we have been so proactive in his care. But these are the worries you carry around as a mother.
5 ½ more days until one less worry …
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