Thursday, July 30, 2015

Getting the Percentages Right

After a bris, I try to explain to parents what things will look like over the next few days, weeks, and months as the circumcision goes through its different stages of healing.

There is swelling, a reminder of what things look like before vs after, there are stages of healing, a couple of long-term reminders:  the Chubby Baby Syndrome and the Fusion Challenge.

I often comment about the importance of using a marker to indicate where the edge of the foreskin is before circumcising. When this is done in advance of the bris, and when the mark is actually followed during the circumcision, the incision can be very even and beautiful (to quote a colleague who loves to use the word 'beautiful' to describe his work).

But what are we marking? Why can't a rough estimate be sufficient?

There is a very definite point where the foreskin ends, and that spot is where the skin of the shaft lies naturally beneath the outer edge of the glans/corona. A "beautiful" circumcision has all of the foreskin plus the membrane beneath it removed at exactly that spot.

However, owing to the reality that most circumcisions are not accompanied by a complete removal of the membrane beneath the foreskin, there is a benefit to removing a little more than just the foreskin, because leaving MORE skin plays a significant role in the Fusion Challenge, and especially in the Chubby Baby Syndrome (I get many questions from mothers who ask about the need to pull down the skin over the longer term. Depending on how the circumcision goes, this is an issue for some people, or may never be an issue at all.)

So let's say there is 100% shaft skin to leave behind. A good mohel will actually leave between 88-95% of the original shaft skin, since the remains of the membrane will make a proper fusion with the shaft skin and fill in the remaining 5-12 percent of the shaft as needed.

Without using the marker, the chances of removing 50% or more of original shaft skin are not unheard of. And the incision has a decent chance of being significantly unbalanced - one side having more skin removed than the other (a little uneven is not bad - these things have a tendency to heal nicely nonetheless). This form of operating is a tremendous disservice to any baby.

Being educated about circumcision takes a lot of guesswork out of the process. Best of luck to everyone!

Sunday, July 19, 2015

The Good Ole Perks

A few years ago, there was a to-do in some Israeli newspaper or in the world of a sector of Jewish blogosphere over a Facebook post posted by a rabbi who announced he had shaved during  Sefiras Ha'Omer. He also mentioned that he is a mohel.

Why people made such a to-do is beyond me. The custom not to shave during Sefirah is just that - a custom. And the fact that he is a mohel gives him every excuse to shave on the day of a bris.

And, the same holds true for the mohel (and the father and the sandak) during the Three Weeks, and even the Nine Days. 

So if you want to have every excuse to shave during the three weeks, look into becoming a mohel. Get busy! And every bris should come your way so you should grow in your experiences and feel confident (and people should feel comfortable with you) so you can shave without hesitation during the Nine Days.

Or, you can be Sefardic. :/