@tmtm4 Hello again. I had been chatting with you in your other post about dental issues. I am a Mayo spine surgery patient, and also had surgery there for a broken ankle. Anything affecting mobility is a tough recovery and has been my challenge the last couple years. Am I understanding correctly that you have had one spine surgery but also have multiple problems with damaged discs and scoliosis with RA and osteoporosis?

When I was getting second, third, etc. opinions about my spine, I was choosing surgeons at different medical facilities. Sometimes, a surgeon in the same medical center as your last doctor, doesn't want to challenge their opinion particularly if the first surgeon is a department head or in a supervisory role. They do have a degree of common ground in their opinions about your condition. I understand that you are retired and finances are a concern. Are you at this time considering surgeries for both your spine and dental issues? Either one of those would be a lot by itself. Is one of those problems more urgent than the other?

Have you asked your provider if Orencia should be discontinued? I understand it is a medication for Rheumatoid Arthritis. It would be worth asking if stopping this medication would have negative side effects for your present condition. Are you being treated for Osteoporosis?

What are your goals now with respect to your medical conditions? You had mentioned possible spine surgery that would include rods to strengthen the spine. One other factor that affects what spine procedures are possible is osteoporosis because you need to have good enough bone quality if spinal hardware needs to be attached with screws or those screws may pull out or break from pressure. Surgeons need to try to balance the spine so it can support the body weight even if that means a loss of spinal movement. It is a question of what is a better choice between a rigid spine, or the body held in a position that adversely affects function. My mom has severe osteoporosis and had a spine compression fracture because of it. She didn't qualify for a procedure with bone cement to glue the vertebrae back together because of the osteoporosis and was instead given a back brace during the healing phase. Would a back brace be an option for you?

I am sure these are difficult decisions. Is there something holding you back in the decision process? What is it that worries you the most? Do you need assistance at home for daily living? Have your doctors recommended what should take priority for treatment? What can I do to help ease your mind?