Syme amputation

We opted to *not* get an amputation and just get a customized prothosis. It is essentially an AFO with a prothetic pilon and foot below it. She uses her ankle as a knee and this was an option because our daughter has a fully formed foot, ankle, and lower leg. The results have been outstanding and she (age 9) now does biking, roller blading, pogo stick, rock-climbing, jumping out of trees, etc. I know some who opted for symes and some who didn't. I would recommend asking the following questions:

1. Why recommend the symes as opposed to no amputation? If the reason is "cosmetics" or "it will fit in pants" or "easier to fit in a prosthetic" then I would seriously question the recommendation. We consulted with many different doctors and it was amazing to see the difference in recommendations. We had one surgeon who had a reputation as a cut-happy-fiend try to pressure us into letting him do surgery because "of how she'd look in a wedding dress." Every other surgeon said - no operation is necessary.

2. How will functionality be impacted? When we were first researching what to do, many prostheticists said that if you amputate at a young age there is a high probability you will have to worry about bone spurs, weeping, ingrown hairs (later in life), and increased risk of injury from things like jumping down.

3. Why do it now? You can always do an amputation later. There are some stories of people who opted to do a symes as a teenager. Others as an adult. Mike, the guy who started PFFDVSG (I think) had his daughter at an early age. You might try contacting him.

4. Drugs. What sort of drugs will the surgery AND RECOVERY entail? How long after the surgery will the drugs be given (e.g. pain killers) and what are the long-term effects?