Pick up on the previous posts in this series 1, 2, 3,

You have concluded that going through with hand surgery is the best course of action, but now you need to decide WHEN to do it.

I don’t think any parent gets too excited about the prospect of their child being put under anesthesia, ever.  But even more so as an infant.  I met a mother last year who was contemplating hand surgery for her newborn due to another birth condition, and she was struggling greatly with the thought of her 8-month-old being put under.  And yet if surgery is going to take place, there are great benefits to doing it earlier rather than later.

So let’s work through this:

There are pros and cons to each of the possible decisions.  If you are still on the fence as to whether or not to have your child undergo hand surgery, stop HERE first.  This post is for those who have made the decision; hand surgery will happen, now the decision is when to have the surgery.

I break down the options into three possibilities:

Newborn (under a year)

Toddler (1 year – 5-ish-years)

Older (School age and beyond).

For some, diagnosis came too late for newborn to be an option.  If that is you, pick up from where you are and simply make the best decision you can from here.  There is no benefit to annoyance, anger, frustration, etc in a late diagnosis.

Newborn

There is great benefit to doing the surgery early.  Your child will grow up knowing only the adjusted hand.  S/he will grow up learning to use the hand in the same way that s/he learns to use the other hand.  Learning to adapt will become second nature.

On the flip side, the through of their little, helpless infant being put into surgery is frightening.  So much can go wrong, and they are so little.  They don’t understand what is going on.  There are very real dangers to every surgery.  Those need to be considered, especially if your child has other conditions/medical issues along with Poland Syndrome.

Despite the risks of surgery, under most circumstances, those risks, while real, are minimal.  A reputable doctor at a good hospital  will do things right and keep your child safe.

Toddler

Your child is a bit older and stronger now.  You may believe that by waiting, your child will physically be better able to handle surgery.  And yet s/he is still young enough to have time to adapt to the new hand.  S/he is not yet school age, so there won’t they have time to adjust and adapt before the stresses and responsibilities of school occur.

There are some downsides to the slight delay: your child is more likely to experience fear and anxiety associated with the surgery than a newborn.  But at the same time, depending on the child, you will be able to explain what is happening and they can understand what is going on.

By waiting you and the doctor have more time to see how the child currently uses his/her hand; what functionality does it currently have and how can that be adjusted for improvement.

Older

There is always an option to have the surgery, no matter what the age of the child.  It could be due to a later diagnosis.  Or maybe insurance issues.  Or even a change of heart from not wanting the surgery to later on deciding it would be helpful and beneficial.  For whatever reason, you are considering a surgery in your school age child.

They are older and stronger.  They can much more fully understand what is going on and why this is going to happen.

At the same time there will be a greater learning curve to the new hand.  S/he has already lived a number of years with the current hand, and will now have to relearn with the new hand.  It may be a very frustrating endeavor at this stage of life.

Everything becoems more public at this stage of life as well, which may be a benefit or an unwanted burden depending on the person.  Friends, teachers, classmates have all known your child with a certain hand.  Now surgery will take place and the hand will clearly be different — does your child want the task of answering questions?  Because questions are sure to come.  It may not bother your child at all, but it may bother them greatly.  That is an important factor — and if your child is now an infant and you are seeking to choose how long to wait, you must realize that you cannot forecast how your son/daughter will handle this in later years.

If your child is already in this age group, you may not have a choice.  It is surgery now or not at all.  All of the challenges are overcomeable.  But it is always best to be informed and to know what to expect.

I hope that is helpful.

Do you have any experience with this?  What would your advice be to a new parent dealing with these decisions?

Coming soon: Reconstrutive Surgery: the If, When and How.