Back Surgery in Kyoto? URGENT ADVISE

Hello,

I just saw the blog about your daughter. I would not jump into surgery too quickly. How bad is her pain? How long has she had it, and has she tried everything else first? I have had bulging discs in L4-L5 since I was 25. I am 47 now. I know what it feels like to have sciatic pain. But I have managed my life without surgery, and I still practice martial arts.

I lived in Japan for 3 years. I would absolutely get a couple more opinions. If possible, send the MRIs to a neurologist with a good reputation in the USA for another opinion. Maybe set up a phone appointment with a doctor in the USA, even if you have to pay straight out for it.

I'm not agains surgery, but I would not jump in to it too quickly, especially if your daughter is only 22. Is she athletic? How is her overall physical health? If anything, before surgery, you might consider cortisone injections. They are usually very safe and harmless. Also, have her change her lifestyle if necessary. I was a very avid tennis player, but I gave it up. Over the years my back issue got better, and I have been back into the martial arts for over 6 years. I am just very careful and I know my limitations.

Also, what medications has she tried. Definitely make sure she is on anti-inflamatories right away. Ask the doctor about a 1 week dose of steroids to knock out the pain if this is just a bad spell. Don't be concerned about the word steroid. The ones used to knock out inflammation are not the same that body builders use.

Back issues are serious, and one should not jump to surgery too quickly without trying everything else and getting several doctors opinions. Believe me, I know what the pain is like. It's gotten so bad that I have considered surgery many times. I'm not agains it. Back surgery has greatly improved over the years. But it really should be a last resort.

Japan is a little different when it comes to recommending medications. It's a big part of the doctor's revenue. I would assume it's the same for the surgeries they perform. I would try to get opinions from a couple American doctors first. Surgery is not a bad idea if necessary, but I just would not take that last resort step unless the pain is unbearable, and until you have some very trustworthy opinions from other doctors.

Best regards,

Rob Fillpot

Thanks so much for your thoughtful reply!

I've had experience similar to yours, so I understand the prudence around surgery.

It seems like the doctor's read on the MRI is that surgery is required -- he wanted her to have a preliminary consultation next week.

I have a few of the images and have a very prominent medical scientist friend who will look at them.

I think the main question will end up being:  If it's clear she needs surgery, is she better off in the US.  The doctor she's seen is at the University of Kyoto, and I know they have a good reputation.

However, my friend's gut was that she'd likely get much better care in the US -- we live in Seattle and have access to great resources here.

Again, thanks so much.  Let me know if you or anyone has a gut feel about whether you'd feel comfortable having you/your child get surgery in Japan.  Of course, I appreciate it's a big generalization...

thanks,
victor melfi