Thursday, October 9, 2014

How the Spinal team let us down

I have been debating whether or not to write this down, whether it warrants a formal complaint to the hospital, or whether I should just take a deep breath and move on. I'm going to write it down because it is part of our story, and it has been a source of much dissatisfaction for me in relation to the medical care that Maddy is getting here in Hong Kong.

We have been seeing the Spinal orthopedic team here in Hong Kong for several years, since Maddy first developed scoliosis. It has been my primary medical concern and was one of the main reasons why last year, we wanted to see Dr William Mackenzie in the US for his opinion on how to manage Maddy's scoliosis. Up until our trip to see Dr Mackenzie, I'd had no major complaint with the spinal team here. They were monitoring her, and when I mentioned consulting with Dr Mackenzie, they seemed open to doing so. 

Now due to the early onset of Maddy's scoliosis as well as the location and severity, we almost always see one of the top spinal doctors. These guys are very good doctors - they are professors and are the current and previous heads of the orthopedic department at the largest hospital here in Hong Kong. They are experts in congenital scoliosis and have pioneered some new technologies for treating such conditions. That said, they previously have not treated any patients with diastrophic dysplasia as Maddy is the first case diagnosed in Hong Kong. In my mind, if we were able to get the opinions of two teams, one of whom was a scoliosis specialist and the other who was an expert in diastrophic dysplasia, we would be giving Maddy the best medical care that she could get.

As soon as we came back from the states, however, it was obvious that the spinal team here had absolutely no interest in conversing with Dr Mackenzie on any level. They didn't agree with his opinion, and did not plan on following his recommendations for bracing Maddy's spine. One of their senior doctors told me "There is no point in talking to him as we are not going to change our opinions anyway."

Then there was the matter of the hemivertebra which our doctors insisted that Maddy had and Dr Mackenzie insisted that she did not have. Even when the CT scan proved that Dr Mackenzie was right on this issue and our team here were wrong, they still did not think he was worth consulting with.

In this post, I spoke about my discomfort at being stuck between two opinions where our doctors were refusing to communicate with Dr Mackenzie. I had to learn, however, the uncomfortable truth that ultimately, even though we consulted with Dr Mackenzie (and paid a ridiculous amount of money to do so, I might add!), he was not our doctor and we had no choice but to follow the treatment path recommended by our Hong Kong doctors.

Since we have been talking surgery, Dr Mackenzie's opinion is even more important to me now more than ever. He has done this exact surgery on many diastrophic patients and understands the ways in which their bodies respond which is not typical. I have continued to ask the team to consult with him and one doctor promised to do so.

On our last appointment with them, I asked after that - did they consult with him? What did Dr M say? Did they agree/disagree? I was floored when the doctor told me they hadn't contacted him after all. "We are worldwide experts in congenital scoliosis and we know all the other experts in congenital scoliosis. I haven't even heard of this Dr Mackenzie so why should we consult with him?" I was very upset and told him "You may be experts in congenital scoliosis, but you certainly are NOT experts in diastrophic dysplasia - and Dr M is. He sees hundreds of patients with this condition and you have seen only one. He has done this surgery on many of these patients, and you have done it on none."

It is a very hard place to be in when you have no choices - and I am thankful that we are leaving Hong Kong and so I can say goodbye to this arrogant team of doctors who think they are too "expert" to consult with doctors who may be experts in other areas. It is hard to say what would have been if we had've been able to follow Dr Mackenzie's advice of bracing. It certainly wouldn't have corrected her scoliosis, but it might have slowed the progression or helped with her back pain. Regardless, we are where were are and we have to make the best choices that we can with the options available to us right now.

I am thankful that Maddy's spinal surgery will not be performed by the doctors here. It will be done in Australia instead. While I have not yet met our surgeon there, I have heard good reports about him. I hope that he will be more open to consultation as I hope Dr M will still be able to have some input into our girls' medical care.


  1. Unbelievable. I feel frustrated for you. I hope Maddy gets everything she needs from the doctors in Australia.

  2. Do u have an insagram account

  3. I hope Australia is alot better for you and Maddy...

  4. My impression of Hong Kong doctors from the very first time I consulted with any of them (both in the public system and private) was that they are indeed arrogant. Our daughter has asthma. She has had several asthma attacks over the past couple of years and the doctors here--even the "good/best/most recommended/professional" ones all chalked it up to "just allergies." She went misdiagnosed for 2 years and then this summer in the States she had a severe attack and got a proper diagnosis. The doctors there were shocked at how she could have been having these symptoms in such a polluted city and not been diagnosed already--they were afraid for her safety. So, yeah, in all cases of importance I would ALWAYS get a second opinion on any advice a HK doc gave me.