Hi Karen. Good to hear from you. You can bring up the subject of surgery by asking if it would help you. Remember, you do not have to consent to doing injections, and discuss how much your physical therapy has helped or not. Failed results from physical therapy are considered in moving toward surgery and may be a requirement for the insurance company to cover the costs of surgery. If the physical therapy was working, you would be able to avoid surgery... right? Sometimes surgeons play the waiting game hoping you will go elsewhere. Think of yourself as hiring a surgeon for a job. It is your decision who you choose, and if this candidate is not giving you what you need, and not explaining and justifying their position, you can shop around for a new surgeon. I got refused so many times, I always had a plan B and had picked out another doctor if things didn't work out. You have to advocate for yourself. I agree. waiting is just wasting time, and because it takes time to get an appointment when you are starting over again with a new doctor, waiting doesn't make sense if you know you need help. Ask enough questions to figure out if this doctor is interested. If not, move on. You can always discuss here with me. Good luck today. Don't be fearful of being sent home. You are in charge and can always get another opinion. You just have to find the right doctor who is interested in helping you. I was passed over 5 times, but I found a much better surgeon, so it was the best outcome. I just wished I hadn't been so patient jumping through hoops and wish I had come to Mayo sooner and not wasted time with doctors who didn't want me for a patient.