Planning surgery for your newly adopted child

Many parents who bring home children needing non-urgent surgery struggle with knowing the best timing for surgery. Should they do it as soon as possible to promote bonding or will it hurt bonding? Maybe waiting until the child is settled in and have a better understanding of what will be happening is better. Making the right decision will depend on a lot of variables–the age of your child, their language acquisition, how big of a surgery it will be, and if the surgery will involve traveling out of state, that adds yet another consideration.

Both of our sons needed a surgery related to their special need, but neither was needed immediately. Our experiences were very different, so I thought I would share them so you can see how the optimal timing isn’t set in stone.

We brought our son Leo home right before his second birthday. (Oh my goodness, he is so tiny and chubby in the picture I dug up!) He had an unrepaired cleft palate. We visited a craniofacial specialist soon after returning home. The doctor was happy to leave the timing of surgery in our hands. We decided that as soon as possible would be best. Our first consideration was to promote his speech development. Leo had come to us almost nonverbal. He could only make about four sounds. While he could eat okay, the open palate does cause meals to be messy. Leo was from an area that spoke a dialect rather than Mandarin, so translation services wouldn’t be a help to us, however we felt that a two year old wouldn’t really be able to understand what was happening even if we could communicate it to him. We hoped that the surgery would promote bonding.

Leo was scared but he was very comforted by us. He knew that we would not leave him. While speech continues to be a struggle three and a half years later, we were able to start speech therapy with him almost immediately. We felt we had made the right decision.

When we brought August home, we fully intended to repeat the experience. August turned three while we were in China. He was very verbal. Although we only know a handful of Chinese words or phrases, we could pick up some of what he was saying in China. August’s first orthopedics appointment was within two weeks of arriving home. However, we did not move towards surgery as quickly as we thought we would. We eventually discovered that our local hospital was trying to fill a vacancy. They were stalling us until the new doctor arrived. We sought out other opinions while we were waiting for him to arrive. One doctor informed me that he required children be home for a full year before surgery because he felt it was detrimental.

In the end, August was home for nine months before he had his surgery. Almost four is much older than barely two in developmental terms. I explained to August that we would be going to the hospital to have surgery on his leg to prepare him. August had several surgeries in China, so he has a lot of medical trauma. We were able to be with him in recovery almost immediately. August wanted me to hold him in bed, so I climbed in and stayed there for almost all of the next 24 hours.

Having August be so verbal was an enormous help. When he started crying, he could tell us “Leg hurt real bad.” When we checked to see how he was feeling after the pain medicine had enough time to take effect he replied “Feel better now.” He had some control over his environment by being able to tell us exactly what food he would like to eat and what movie he wanted to watch. When the Child Life specialist asked him if he wanted to go play with some cars in the playroom, he gave an enthusiastic yes.

Because August had been with us for so long, I can’t say that we saw a different in bonding per se. However, seeing that we were with him in the hospital every minute was a very healing experience for his medical anxiety. Many of his anxious behaviors were greatly reduced. He had been a confirmed thumb sucker since we got him, but within a few days of surgery he was down to only sucking his thumb while sleeping. I’m very glad now that we weren’t able to do the surgery immediately. While one surgery was soon and the other after a long acclimation period, they were both perfect timing. When you are making that decision for your own family, remember that there is not a perfect time for surgery that is universal. Make the decision that is best for your individual child.



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