The Circumcision Discussion - page 78

I know this can be a HUGE debate, and I'm not looking to start any arguments. I was just wondering as you are OB nurses. I'm expecting a boy in July and not sure if we should circ. or not. My... Read More

  1. Visit  meluhn profile page
    2
    Bob is right, They strap that little guy to a board while he screams his head off. I watched it in nsg school, it was awful.
    I went out with a guy for 4 yrs who wasn't circumsized. I was young so I didn't have enough experience to notice that it looked different. But now that I am older and wiser, I realize that it looked a little funny but functioned the same as any other penis. He never had a problem with infections or anything like that.
    The people/person who does see your sons penis eventually will probably not care if he is uncircumsized and so few people will see it, does it really matter?
    JanisM and consult2 like this.
  2. Visit  cruisin_woodward profile page
    0
    Quote from dawngloves
    Medical reasons can be, an increase in UTIs, Yeast infection, increase in penile cancer. All small percetages. My Grandfather also had to have his removed when he was older.
    I know the do use an anesthetic, can't think of it to save my life right now.
    Read up, think about it. Do what you feel is right. Good luck!
    I had to make the same decision about 7 months ago. It was awful. I hated being put in that position. My husband was like, no big deal. My reasons, for having it done were due to my experience in the OR. We do circumcisions, all the time on older children and adults. Yes, anesthesia is used, but still, I wouldn't want to have the memory of that. It really killed me to have to do it, but I figured better now than when he is two, or worse even, 22!

    I will say though, that when it was done, they took him out of the room, and they did not bring him back until he was calm. He slept most of that day. It is a hard decision to make, but in my opinion, it was the right decision for me. If I have another boy, I will have it done, but I will feel just as bad!
  3. Visit  Joe12 profile page
    3
    Quote from DNPstudent-Michigan
    I had to make the same decision about 7 months ago. It was awful. I hated being put in that position. My husband was like, no big deal. My reasons, for having it done were due to my experience in the OR. We do circumcisions, all the time on older children and adults. Yes, anesthesia is used, but still, I wouldn't want to have the memory of that. It really killed me to have to do it, but I figured better now than when he is two, or worse even, 22!
    I am very suspicious when I hear this. Having spoken about this with friends in the respective fields in those countries that don't routinely circumcise, they say it is very unusual that a medical circumcision is performed. I've been told the rate is at worst 1 in 15,000 or so. It also seems that the rates vary depending on the country's history with circumcision. Those that have no history have by far the lowest rates of 'medical' circumcision for example most of continental Europe it is almost unheard of.

    Some 'in the middle' countries have had relatively higher rates of medical circumcision which decreases with the years. For example, Britain, which largely abandoned circumcision in the late 40s, had a relatively higher rate of medical circumcision. However, as doctors become more familiar with conservative treatment, that rate continues to fall even 60 years after they dumped circumcision. A study looked at circumcision in Scotland over the 10 years from 1990 - 2000 and found a significant drop that accelerated of the second half of the timeframe. This seemed to indicate increasing familiarity with differentiating between natural development and actual problems and also conservative treatments when there are problems.

    I get the feeling that in the US we treat any anomoly as needing circumcision and it is important that we fix that problem too. It's kind of like a dentist who always pulls teeth with cavities rather than drilling and filling.
    Last edit by Joe12 on Mar 15, '09
    dnp2004, Smurfette752, and consult2 like this.
  4. Visit  consult2 profile page
    5
    "My reasons, for having it done were due to my experience in the OR. We do circumcisions, all the time on older children and adults."

    Yes, but this occurs only in America where doctors are woefully ignorant about the normal penis and its care. In foreskin-educated countries, it is almost never needed.

    First of all, for a man who was not circumcised as an infant the chances of him having to get circumcised as a adult are extremely rare. In fact it's only 6 in 100,000. (0.006%)

    Health officials of each Scandinavian country were queried about adult circumcision.. None of the health officials could provide precise data, because the numbers were so small that they weren't worth compiling. Each official stressed that foreskin problems were present but said they were largely treated medically-surgical solutions were extremely rare.

    "in Oslo, Norway, over a 26-year period in which 20,000 male babies were cared for, 3 circumcisions were performed-a frequency rate of 0.02%.

    In Denmark. 1968 children up to the age of 17 were examined over a period of several years. In this group, 3 circumcisions were performed-a frequency of 0.15%. In this study, in retrospect, the physicians believed that all three operations might have been avoided. Both of these studies related to the infrequency of circumcision and puberty, they did not deal with the issue in adulthood.

    Wallerstein, Edward, Circumcision: An American Health Fallacy. pg 128

    In Finland -- a non-circumcising country -- the operative rate is only a tiny fraction of this percentage. A male's risk of being circumcised for any reason during his entire lifespan is less than one in 16,000.

    http://www.fathermag.com/health/circ...mcision4.shtml

    The Finnish National Board of Health provided national case records for the year 1970 for both phimosis and paraphimosis. A total of 409 cases was reported for males 15 years and older,which represents only
    2/100ths of 1% (0.023%) of the total male population in that age group. This means that 99.97% did NOT develop a problem. Moreover, according to Finnish authorities, only a fraction of the reported cases required surgery– a number too small to reliably estimate.
    Wallerstein, Edward, CIRCUMCISION: AN AMERICAN HEALTH FALLACY p.128

    http://www.sciencebasedmedicine.org/?p=269

    The problem is NOT the normal penis--it is the ignorance of the American medical Industry.
    MT-Matt, Elvish, JanisM, and 2 others like this.
  5. Visit  consult2 profile page
    4
    "I will say though, that when it was done, they took him out of the room, and they did not bring him back until he was calm. He slept most of that day."

    There is a reason for this calmness and sleeping--it is called trauma-induced coma..

    HARM CAUSED BY CIRCUMCISION
    The increasing doubts about Jewish circumcision are based on the understanding that it causes harm. Anatomical, neurochemical, physiological, and behavioral studies confirm what mothers already know: infants feel pain. Drs. Anand and Hickey, in a comprehensive review of recent medical literature on newborn pain, conclude that newborn responses to pain are "similar to but greater than those in adult subjects."11 This study is accepted by virtually all medical authorities and is often cited in the literature whenever there is a discussion of infant pain. As a surgical procedure, circumcision has been described as "among the most painful performed in neonatal medicine."12 Studies of infant responses show that the pain of circumcision is not like that of a mere pin prick. It is severe and overwhelming.

    The relationship between infant pain and vocal response needs explanation. The cry may be reduced by the effect of anesthetics given to the mother during labor.13 These anesthetics enter the infant's body and, according to pediatrician T. Berry Brazelton, it can take over a week to leave.14 Other factors can also account for minimal vocal response. Justin Call, infant psychologist and professor-in-chief of child and adolescent psychology at the University of California, reports that "sometimes babies who are being circumcised . . . . lapse into a semi-coma."15 Tonya Brooks, president of the International Association for Childbirth at Home and a midwife, observes, "In four of the nine circumcisions that I have seen, the baby didn't cry. He just seemed to be suddenly in a state of shock!"16 Studies demonstrate that even though an infant may not cry during circumcision, the stress hormone level in the blood still increases dramatically, and medical researchers consider this change to be the most reliable indicator of pain response.17 Therefore, lack of crying does not mean that the infant feels no pain. It could mean that he is withdrawing from unbearable pain.

    http://www.circumcision.org/spectator.htm

    http://www.cirp.org/pages/parents/circ-why/

    PAIN, STRESS AND RISKS

    Until recently it was believed babies felt no pain due to their immature nervous systems. Studies however, indicate that babies experience physical and psychological stress both during the circumcision and for hours thereafter. The procedure is undeniably painful. Some babies cease to cry or lapse into a deep sleep or coma which is how they are able to cope with the traumatic experience.

    Some babies are so severely traumatized by the experience that they fall into a semicomatose state. Some circumcisers still pretend that these babies are just falling asleep! Nothing could be further from the truth. No one falls asleep when his sex organs are being cut with a knife. Because he is tied down, a baby has no way to escape, no matter how much he thrashes. Going into a comalike state is one way for the baby to distance himself from his agony, but it has dangerous consequences for the brain, as you will read below.

    http://www.nospank.net/fleiss1.htm
    MT-Matt, GooeyRN, dnp2004, and 1 other like this.
  6. Visit  consult2 profile page
    5
    "It is a hard decision to make, but in my opinion, it was the right decision for me. If I have another boy, I will have it done, but I will feel just as bad."

    Outside of some very rare need for having it done later, what makes you believe it was the right decision for HIM?

    Believe me, HE will feel worse having it done than you ever will--unless you have your genitals damaged.
    MT-Matt, JanisM, morte, and 2 others like this.
  7. Visit  dnp2004 profile page
    7
    Quote from DNPstudent-Michigan
    I had to make the same decision about 7 months ago. It was awful. I hated being put in that position. My husband was like, no big deal. My reasons, for having it done were due to my experience in the OR. We do circumcisions, all the time on older children and adults. Yes, anesthesia is used, but still, I wouldn't want to have the memory of that. It really killed me to have to do it, but I figured better now than when he is two, or worse even, 22!

    I will say though, that when it was done, they took him out of the room, and they did not bring him back until he was calm. He slept most of that day. It is a hard decision to make, but in my opinion, it was the right decision for me. If I have another boy, I will have it done, but I will feel just as bad!
    I am not sure I am following you. Based on your experience in the OR, why do you think circumcisions are so necessary? As a nurse, then as a OB/GYN in several countries, I had to be involved with four, yes 4, medically necessary circumcisions on newborns in over 40 years as a health care provider! I have never participated in medically unnecessary circumcisions on a boy or girl. Even when the cost was my job. Also I am not sure why you think your sons would need a circumcision by age 2 or even 22? Foreskin maintenance adds less than 10 seconds to a daily cleaning regiment.

    In my experience as a nurse and later as an OB/GYN, I know that over a patient's lifetime, the female labia is far, farmore prone to problems than the male foreskin. That doesn't mean I feel it is ethical to preemptively remove labia tissue from my newborn girl patients to prevent the possible of future problems. When I have had to remove tissue from patients of any age due to disease or deformity, I have always used anesthesia. No one has ever proven to me that a newborn's nervous system is too undeveloped to feel pain. As a mother and a health care provider I would not let someone cut off parts of my son or daughter without a pretty d*mn good reason!

    Here are a few points I would like to make that I am sure I will get flamed on but here it goes:

    • Many health professionals believe the foreskin/glans penis combination is a nightmare that has to be removed from birth to prevent trouble. For some reason, those same professionals apparently think the labia is less problem prone and should remain intact.
    • Most U.S. healthcare professionals have not actually talked to many males who have had circumsisions in adulthood. So most of their opinions are based on hearsay, religion and tradition.
    • Based on a WHO report many actually believe the foreskin makes transmission of HIV much more possibe. Yet how many of you have really looked at the numbers. Look at this link from Consult2 on this thread: http://allnurses.com/ob-gyn-nursing/...ml#post3498869
    • When the discussion is about performing male circumcisions in the U.S., the politically correct thing to do is to offer "parent choice" and to provide objective "unbiased pros and cons" about the procedure. When the discussion is about performing female circumcisions in the U.S., the politically correct thing to do is to call the authorities to have the "poor girl" taken in to State custody to prevent genital mutilation.
    • The foolproof way to avoid an uncomfortable discussion or choice you have to make about circumcision is to bring up freedom-of-religion or culture background. Health care providers absolutely hate to offend a culture, much less a religion. Actually, foolproof and absolute are a bad choice of words on my part because the above only applies to male circumcisions. No matter what religion or culture you are from you will be hard pressed to find a health care professional who will even make a small slice in to a newborn female's genitals without a medical reason.

    Many of my female colleagues who have circumcised their sons oppose female circumcision because they say it removes sensitive tissue that prevents a woman from enjoying sex and/or having orgasms. When I asked them how many "circumcised" female patients they have actually ever dealt with I almost always get a blank. Unfortunately, I have personally dealt with well over a 1000 such cases throughout my career. Many of these women can enjoy sex and do have orgasms. Of course many cannot, it depends on many factors. Just don't offer medical opinions on something you have never studied or seen in the field, it is irresponsible. I would never try to teach any of you Brain or Heart Surgery because that is beyond my scope of knowledge/practice.

    Many of these same female colleagues say that removal of the foreskin does not have an effect on a males sensation or ability to orgasm. To which I reply, "HOW COULD YOU POSSIBLE KNOW, YOU ARE A WOMAN?!" At this point I am usually flamed and called a female sexiest (ha,ha,ha)! After a while most of them see my point. No matter how many medical degrees I have, as a woman, I can't possible know what it is like to a have a foreskin. Much less to have one removed without anesthesia, though I don't want to even think about that one. So at the risk of sounding offensive, I have to say that an uncircumcised man's opinion has more weight on this topic than anyone. As a mother, when it comes to pregnancy and childbirth, I am sure my opinion counts more than any males. No offense intended for my male colleagues.

    I mentioned earlier that I was involved with few medically necessary circumcisions. When I was overseas I talked to many male patients who had the procedure performed on them as adults for religious, cultural and spousal acceptance reasons (long story). I had not had children yet and wanted "unbiased" opinions. The vast majority told me it did reduce their sensation and made orgasm more difficult. They said the glans became very irritated and painful after the procedure because it was no longer "protected" from direct contact with clothing. Then they said the skin on the glans changed "texture", became thicker and was much duller in sensation than it was before the operation. If pre-circumcision feeling was at 10, they said within a few months after the operation they were averaging between 3-6. They were not the only ones who noticed problems. Their spouses were complaining too because they were aware that something changed. Some wanted to reverse the operations. Though back then...

    I have more to say on this but I will cut it short for now. I did not circumcise any of my boys or girls. Its very simple:

    1. Always practice "do no harm".
    2. If it ain't broke don't fix it.
    3. Baby boys and girls aren't designed with non-essential throw-away parts.
    4. Babies feel pain too.
    5. Just because a practice is old doesn't mean it is right.
    6. When a child turns 18, they can make their own medical choices.


    DNP2004
    MT-Matt, SecuredFloorNurse, meluhn, and 4 others like this.
  8. Visit  Jubilayhee profile page
    0
    Research has proven thet circumcision reduces the spread our aids in hetersexuals. No lie. Is that a good enough reason for ya'll.
  9. Visit  NurseyBaby'05 profile page
    4
    Quote from dnp2004
    I have more to say on this but I will cut it short for now. I did not circumcise any of my boys or girls. Its very simple:

    1. Always practice "do no harm".
    2. If it ain't broke don't fix it.
    3. Baby boys and girls aren't designed with non-essential throw-away parts.
    4. Babies feel pain too.
    5. Just because a practice is old doesn't mean it is right.
    6. When a child turns 18, they can make their own medical choices.

    DNP2004
    These were pretty much the same reasons we didn't get ds circumcised. It's not like we can let it grow back if he decides he wants it.
    GooeyRN, JanisM, dnp2004, and 1 other like this.
  10. Visit  dnp2004 profile page
    4
    Quote from Jubilayhee
    Research has proven thet circumcision reduces the spread our aids in hetersexuals. No lie. Is that a good enough reason for ya'll.
    I don't understand your point. What research are you speaking of and what is the amount of reduction in HIV spread? If you can, please post a link to the study here because I would like to see it. Jubilayhee, if I could prove that by removing the labia and/or clitoral hood from newborns I could reduce the spread of AIDS in U.S. women by 50%, do you think that would be a good enough reason for me to advocate such an operation? Suppose the rates of abstinence/monogamy went way up and the STD/STI/AIDS transmission rate went way down in "lightly" circumsised females. As with the male group you mentioned, in the case of the females, do you believe what is good for the goose is good for the gander?

    Speaking of studies, tell me what you think of this number crunching from a very intelligent person on this same thread. I think it is very well laid out.

    "4. The HIV, STD issue. This is just ridiculous. There is a WHO recommendation but the WHO recommendation applies only to countries with high prevalence and not to countries like the US. And let me just explain to you why especially in the US, and other first world countries, the HIV argument is pretty much BS. It's also a stupid policy in Africa and will almost certainly be a long term failure but for other reasons and as others have said would require a different thread.

    Anyway, to determine the probability of not becoming infected you can use the following formula:

    (1 - [chance of transmission from sex])^[sexual encounters]

    Now for the estimates, let's assume that there is a risk reduction of 50% for circumcised men. This is the number most often banted around by the popular media and those clowns at the UN and WHO in their reports from Africa. The probability of infection in any one encounter with an HIV positive partner varies depending on viral load, co-infection, and numerous other reasons. For example, people are most infectious soon after being infected. Infectiousness lessens after a few weeks which is one reason HIV spreads so fast in Africa, read The Invisible Cure: Africa, the West, and the Fight Against AIDS, by Helen Epstein, to find out why it's so infectious in Africa but not anywhere else.

    Anyway, I've seen numbers for women infecting men range from 1/700 - 1/2500 and interestingly enough, a recent publication in the Lancent of Infectious Diseases and reported at Aidsmap, put the risk of an HIV infected woman infecting her male partner at 0.04%.

    From Aidsmap:
    Researchers conducting a meta-analysis of studies of the risk of HIV transmission during heterosexual sex have found that, in high-income countries prior to the introduction of combination therapy, the risk per sexual act was 0.04% if the female partner was HIV-positive, and 0.08% when the male partner was HIV-positive. However these rates were considerably higher in lower-income countries, if the source partner was in either the very early or the late stage of HIV infection, or if one partner had genital ulcer disease, write the researchers in the February issue of The Lancet Infectious Diseases.
    They continue:

    Pooling the data from studies in high-income countries, the researchers calculated that the risk of transmission from an HIV-positive man to his female partner was 0.08% per sexual act: in other words, it was likely to occur once every 1250 sexual acts. When it was the female partner who was HIV-positive, the male partner's risk of acquiring HIV was 0.04% per sexual act - in other words, once every 2500 sexual acts.
    I bolded the last, though it isn't pertinent to the discussion, I might come back to it later. I'll only say that is so obvious I don't know why they made a point of it. It was been well known that people were more infectious in early and late stages or if they had genital ulcer diseases. Also note that they said prior to the introduction to therapy which means the true rate may actually be lower now but we'll go with it.

    So based on that, we'll start the estimate that the chance of infection is 0.06% a bit higher than published in the Lancet article. That means a male having unprotected sex with an HIV positive women has about a bit more than 1 in 1800 chance of being infected. Base line risk intact men vs circumcised men 1 random heterosexual contact with an HIV+ partner.

    [1 - 0.0006]^1 99.94% ~= 0.06%
    [1 - 0.0006 * 0.5]^1 ~=99.97% ~= 0.03%

    But the HIV distribution in the US population is about 5 in 1000 or 1/200 so, in general, there is only a 1 in 200 chance that I'll encounter someone who is HIV positive. Actually the risk is much lower but we'll discuss that in a bit. Given that as a fact, a closer estimate of the risk of becoming HIV infected after the 1 encounters is more like:

    The chance of event A (encountering an HIV positive individual in the general population) * the chance of event B the likely hood of getting infected during that encounter.

    1/200 * 0.0006 = 0.000003 --- 1 - 0.000003 = 99.9997% = 0.0003%
    1/200 * 0.0003 = 0.000006 --- 1 - 0.0000015 = 99.99985% = 0.00015%

    Of course, the number of sexual encounters is important too. For 1,000 encounters, the difference is 1.5 hundreths of a percent. That's is what circumcision bought you, big deal. Over the course of 1,000 random encounters an intact guy has 1.5 hundreths of a percent larger chance of becoming HIV positive. Circumcised guys, party on!

    Of course there are some caveats to this. First, your per-exposure risk might change based on other factors and the 1/200 is quite high since 75% of the HIV positive population are men. If women only account for about 1/4 of the total, this reduces the 1/200 to between say 1/700 or 1/1000. This is what it looks like when we adjust the prevelence among women:

    1/700 * 0.0006 = 0.0000008571 --- 1 - 0.0000008571 ~= 99.99992% = 0.00008%
    1/700 * 0.0003 = 0.0000004286 --- 1 - 0.0000004286 ~= 99.99996% = 0.00004%

    That's a whole order of magnitude. Now we're talking about a difference of 4 thousandths of a percent if we have 1,000 random partners. Party on.

    For Doctors, especially in the US, to entertain the notion that circumcision is going to in anyway impact a boys chances of acquiring HIV is very misleading, not truthful, or ethical. The commonly cited 50% has to be understood in context. Circumcision as a prophylaxis for any STD is, if it is even true, over stated especially in first world countries like the US. I find courious though that it keeps getting pushed, consider HPV. Now here is something that we've been vaccinating against for over three years yet people still try and tie circumcision to HPV, why?"
    consult2, MP5PDW, Smurfette752, and 1 other like this.
  11. Visit  Joe12 profile page
    3
    Quote from Jubilayhee
    Research has proven thet circumcision reduces the spread our aids in hetersexuals. No lie. Is that a good enough reason for ya'll.
    Go back and read my post the pertinent section of which dnp2008 has quoted and tell me if reducing ones chance on the order of a few hundredths or thousandths of a percent (assuming he had about 1000 partners figure in the fact that the average number for a man in the US is 7 and condoms are available which I didn't figure in), of a disease that is easily avoidable anyway, is worth the risk to that part of his body. Regardless of what you may have read, 50% is a relative reduction and isn't all it's cracked up to be. So it's a question of how does that information apply in the US context.

    ETA: Here is an interesting article (press) just published in Australia assessing the situation there after someone else suggested circumcision might be a useful tool in Australia. It's interesting because anthropologically speaking the US and Australia are very similar (much more than the US and parts of Africa) and epidemiologically the HIV situation between the US and Australia is very similar. Some key differences:

    1. Circumcision was essentially dumped in the very early 80s. The rate of circumcision in Australia today is about 10% and has been stuck there for some time.

    2. The epidemic in Australia is largely driven by homosexually acquired HIV. According to the article with a population of 21 million, Australia only recorded 850 new cases of HIV in 2006 Only about 9% (77) of which were heterosexually acquired by men. Testing, tracking and treating are probably as good if not better than in the US, this is a first world country after all.

    3. According to the article, the average age of HIV infection by heterosexual sex for men was 46 (in the US it's early 30s) and no man under 24 acquired HIV by heterosexual sex in 2006 however 10 men over 60 did which accounts for the increase in heterosexual male infection experienced since the 2000 numbers. This is interesting because with Australia dumping circumcision in the early 80s one might expect this group to be 'especially vulnerable' men over 60 on the other hand are proabably circumcised. It doesn't seem that it is necessarily the case that circumcision was very useful in predicting infection.

    4. For purposes of comparison the US with a population of 300 million (15x Australia) picked up about 40,000 additional cases (more than 40x) in 2006. Of which it's estimated that about 10% were heterosexually acquired by men (numbers available at avert.org). Very much like Australia in terms of proportion but it's strange that with the highest rate of circumcision in the first world we would have numerically far more new infections per year than our population would suggest. But the group that circumcision is supposed to protect proportionally gets the same number of infections.

    5. I think what the differences is in how we approach sexual matters as perhaps they do in Australia and certainly Europe. Europe also shames the US with numbers that are far lower too (about the same as Australia). Having lived in Europe I know that they are far more open about sexual matters with their children and the children seem better prepared to protect themselves. I am not sure it's that way in Australia but I bet it is. HIV is a social problem not something that necessarily needs a biomedical solution to curb it. If we were to stop cutting and start talking I think we'd do much better. Cutting doesn't really add much to the equation.

    It seems to me the practice of circumcision is largely driven by fear not rational thinking. And mating circumcision with HIV was inevitable.
    Last edit by Joe12 on Mar 16, '09
    consult2, Smurfette752, and morte like this.
  12. Visit  consult2 profile page
    1
    "Research has proven thet circumcision reduces the spread our aids in hetersexuals. No lie. Is that a good enough reason for ya'll."

    You mean that flawed and questionable statistical studies SUGGEST that..

    but the critical question is, is there scientifically credible evidence that it does..

    The most fundamental and critical criteria for scientific validity are:

    All conclusions based on known flawed data cannot be considered valid,

    A hypothesis MUST fulfill its prediction every time to be considered credible.

    Reality:

    Every study on HIV and circumcision have many known flaws.

    Many circumcising countries have HIGHER rates of HIV than intact countries...The US has the highest rates of HIV of all of the industrialized countries ( all intact).

    So, yes, a lie.
    JanisM likes this.
  13. Visit  Smurfette752 profile page
    2
    Quote from Jubilayhee
    Research has proven thet circumcision reduces the spread our aids in hetersexuals. No lie. Is that a good enough reason for ya'll.

    No offense but that is one of the most ignorant things I have read in this entire thread....That IS A BLATANT LIE....you obviously haven't done your research...you obviously DON'T know what the heck you are talking about!!!!!



    Joe12...you are the BEST...I love your informative posts!!!!! Keep them coming!!!!!!!!!!!!!!!!!!!!!!!!! I hope that maybe YOU will change the warped views of many!!! Thanks!
    JanisM and Joe12 like this.


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