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Comment by jpmattia | Hacker News Reader

The first thing that occurred to me when I read the title: Tonsillectomies used to be very common when I was growing up, and eventually that stopped. See eg:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5883156/

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A friend's child had snoring problems before the age of 5, possible obstructive sleep apnea. There can be serious developmental consequences to this, some of which were showing early signs.

The specialist diagnosed his tonsil enlargement as grade 3 (4 maximum) and recommended tonsillectomy and adenoidectomy. This is recommended in grade 3s with his symptoms; strongly advised in grade 4s. But the specialist gave them thorough context that led them to go against his advice. Children go through 2 growth spurts of the neck around ages 5-7 and ages 10-12. After these growth spurts the ratio of tonsil mass to neck cavity decreases, giving even large tonsils more room -- possibly enough to no longer require surgery.

They pursued simpler treatments like saline sprays before bed to make nose breathing easier, which greatly reduced snoring. Developmental delays were caught up, and now at 6 years old they are glad they avoided the surgery, though admit it wasn't necessarily bad advice and were prepared to reconsider it if no progress was shown in 6 or so months.

Circumcision is another big one which used to be widely purported to have some positive health effects.

I'm against circumcision because foreskin can be used to make a vagina, if your baby boy turns 18 and decides to be a woman instead.

It's part of my "Weird hills to die on Grand Tour"

https://en.wikipedia.org/wiki/Sex_reassignment_surgery_(male...

Not because genital mutilation of children is just barbaric?

The US CDC (Center for Disease Control) currently recommends male circumcision for positive health effects.

Yes, but almost all of the studies referenced in the guidelines took place in Africa, where proper genital hygiene and sex-ed is not taught. If you teach your kids to properly clean under the foreskin, circumcision largely loses its advantages.

That's kinda the point - the healthcare bureaucracy is up to its ears in precisely this kind of bullshit. The "studies" demonstrating the beneficial properties of circumcision are often backed by groups with obvious biases (eg, Jewish or Islamic religious groups) and almost never mention the possibility (and likely correct explanation) that the causality behind the improved health correlation goes the other way: healthy people are simply more likely to be circumcised (more likely to be from or join a religion that values cleanliness, restricted sexual behavior, etc.), rather than circumcision itself causing improved health.

How surprising that in a country where cutting off parts of baby infants is culturally acceptable, the national associations recommend it. Its just shocking to me that anyone can defend the practice, health benefits or not.

I've read that one of the positive sides of it is hygiene.

If you cut off your arms will you no longer have to wash your armpits?

Someone did a great short story of a society where everyone got their fingernails removed for this reason (as an analogy to circumcision).

Apparently, in the UK many people used to have their teeth removed when marrying.

Not just UK , and not just when marrying. If you could afford it, removing all your teeth before 30 was a great idea, since a rotting tooth and the subsequent infection would most likely kill you. So it just increased your chances.

Washing regularly also helps hygiene. As a bonus it doesn't require cutting off a body part according to the suggestions of a fairy tale.

Circumcision for hygiene is a bit like shaving your whole head so you don't need to use shampoo(Edit: with the difference that hair can actually grow back and doesn't have countless sensitive nerve endings).

But are they placebo based health effects?

Placebo does not just mean an effect that is questionable or might not be present.

Placebo is a name for procedures and drugs that have no direct effect. They might have indirect effects, such as alleviating anxiety by convincing the patient that you are taking care of them. Or, it might just be indirect effects where people try to be helpful and report some improvement in their conditions, even if none has occurred. Or, it might just be reporters fudging the data to support the medicine's effectiveness. They may also change patient behavior through effects such as 'sunk cost' or more complex ones, like circumcision possibly reducing sexual pleasure, therefore decreasing the chance of risky sexual behavior.

But there is 0 evidence of placebos having actual positive effects aprt from the first one about subjective symptoms.

That’s why the "effect" of placebos is highest in every study about pain (which is highly subjective).

A placebo never stops a virus infection, although you might feel like it helps a bit.

WHO and the UN agree it does have positive health effects -

https://www.who.int/teams/global-hiv-programme/hiv-preventio...

My tonsils get seriously inflamed once a year and I wish i had had them removed. Yes, i tried various gargles. I've been given antibiotics, and all sorts of stuff. Nowadays my doctor just gives me Vicodin when i complain that my tonsils are inflamed. I then subside a week on nothing but warm soup. (I cannot take vicodin - makes me feel like i am thinking through a fog. i hate the feeling).

Sadly, tonsillectomies on adults are actually quite complex and dangerous, but as a chronic tonsil sufferer, i assure you, removing them would not be a placebo. And every year, i have a week when i check hourly whether Laser tonsil ablation is available and approved in USA yet.

I relate to this story. However, after several years, I figured the inflamed tonsils were just a side-effect of other issues. Check if you have postnasal drip, a deviated septum, or a nasal polyp. Several related chronic issues may also cause it.

Look into Orthotropics and Mewing. Oral posture does wonders. The jaws should grow forward, not be retracted by braces and extractions. There should be enough airway space. Look for airway-focused dentists for treatment.

jpmattia says >"Tonsillectomies used to be very common when I was growing up, and eventually that stopped"<

Luckily, as a child I had my tonsils removed. It was just something almost everyone did. After that I had only an occasional sore throat. In contrast friends who still had their tonsils had serious illness, visits to the hospital, weeks out of school and parents who constantly worried.

So as far as tonsils are concerned my feeling are "Good riddance!"

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