I was diagnosed with HOCM at 50 but I was able to function fairly well with moderate activity taking verapamil (and Norpace until it had to be discontinued). I didn't tolerate beta blockers as I already had low BP. In 2005, I got a second opinion at Mayo Rochester and was told I would likely need the septal myectomy eventually. My shortness of breath and fatigue worsened as my septum continued to thicken until I started passing out, needing a defibrillator/pacemaker. I went on Camzyos 2 years ago, it was an up and down experience over several months due to my responding 'too well' and cardiac output dropping below protocol even on 2.5mg. One year ago (at 74) I felt so lousy I made my appointment online with Mayo again, (I live in rural CO) and had the septal myectomy last April. For me, retrospectively, I wish I had done it much earlier. The recovery time was really about 6 months, but with cardiac rehab and just walking I can say it was worth getting my energy and function back! I still take the verapamil but nothing else now, so woohoo. As has been stated on this blog, everyone is different (esp with drugs) but I have no regrets having the surgery and had great confidence in the expertise of the Mayo Clinic surgical team and post op caregivers. They were informative every step of the way and supportive with all my questions before and after the procedure. I encourage you to ask as many questions as you need to, in order to feel confident in the direction and choices you make. This blog was extremely helpful for me as well.