It sounds like you haven't exhausted all of your medical options yet, specifically the biologics. I know they sound scary, but I had no adverse reactions to them. Unfortunately, I had no positive reactions to them either! I was very ill before my surgeries--unable to work, unable to leave the house without having accidents. I'm only a month out from my takedown surgery, and I'm still waiting for things to calm down, but I'm already feeling healthier than I have in a year. But you might give the biologics a try before you take the irreversible step of surgery.