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Both were accompanied by their Moms, in each instance 2 classy ladies who were well dressed and very articulate, and one reserved Dad for good measure.  You can believe the best part about doing the circ is walking out to the waiting room and calling Mom and Dad back to join their son in the recovery room.  Smiles and a look of contentment from the patient (”no big thing”) can instantly provide more assurance than ever I could.

Yes, it is a big thing, because each step of the way, we are providing every quality control measure that this operation will go exactly as anticipated with zero pain, and that the patient will have the opportunity to watch work in progress and approve of the final result before the dressing goes on.

Is it time for breakfast or lunch?  Claire, ask the patient what he has a yen for..  We have fresh French bread and roast beef in the refrigerator, or hot sausages and eggs with coffee to wash it down.  Don’t forget the OJ and our fancy napkins.

Both patients were seen on Saturday and looked great.

Harold M. Reed, M.D.

The fallout seems that 50% of my work is revising the work of other doctors and that is all well and good.

Have to be careful not to cast aspersions, afterall most of what that other urologist does may be excellent.

Two days ago, received a patient from Canada, a college graduate in the science of physical wellness, who
had a circumcision about 6 months ago.  Heavy dense thick scars like pebbles and an irregular suture line, large suture tracts spaced somewhat widely apart, a tough thick frenulum, mis-match of the frenulum and raphe.  But fairly tight circumcision and also low.

My mission was to remove as much underlying scar, (all of it hopefully) freshen up the incision line, remove the frenulum and realign the raphe.  The case took longer than 2 “virginal” circumcisions back to back.   Had to use loupes.

Ultimately the patient had a very acceptable result.  Hand held mirror nearby throughout the case for his review and comment.

Seen at the Whitehouse Inn yesterday and looks great.  Bed rest for 2 more days.  A hematoma or collection of  blood under the skin is a set-up for inflammatory fibrosis which is a great enemy of good cosmetic (soft natural) wound healing.  Even if a patient looks dry on the operating table, simple hydraulics tell us

If a patient is upright, even sitting up, there is a venous column of blood potentially pushing trace oozing out of every ruptured capillary that has yet to seal off.  Simply raise your hand above your heart and the veins on the back collapse.  Less blood, less oozing.

We are careful never to promise perfection, but usually we can greatly improve appearance.

Harold M. Reed, M.D.

Have heard of and seen  tight frenulums pulling down the head creating the SST deformity.  Like the tilt down nose of the Concorde jet, but never saw it cause angulation of the penile shaft.  Think this may be my first case, where the frenulum which was attached to the distal shaft actually produced a 45 degree downward angulation of a medically induced erection in the office confirming “penetration not possible in all positions.”  

The remedy is release of the frenulum.