Hi Doc, as always, thank you for your valuable input, time and effort. You and and Mrs D are marvels.

Plan B, the fusion, it's been on the table ever since I had the L4/5 S1 fusion last year when they learned L2/3 was problematic. My NS referred me to a new PM, hence the trial and unsuccessful SCS implant. I'm very wary of having yet another fusion done, in hindsight, I wish I had not had the L4/5 S1 fusion done. The last L4/5 fusion done in the 90's I think was holding itself as well as it could and that the actual problem was the L2/3 but because I had the stress fracture to S1 and X-rays showed the L4/5 fusion failing they focused on that. If I agree to have the L2/3 fusion, it will be my 5th, it will not reduce my thoracic or cervical and left arm pain so I'm not sure if it's worth it..

Plan C, the Boston paddle, if I don't have the lumbar fusion. Having a laminotomy apparently is a very painful procedure to recover from and I'm not 100% convinced it will work and block the pain in my thoracic, cervical and left arm. The Boston paddle here in WA is rarely used, to get it I need to see yet another NS and PM. I don't get to trial it and I can't find out from anywhere if the new Boston paddle runs at the high frequency like the Nevro with no buzzing sensation. With my headaches, I just don't think I would be able to cope with constant buzzing sensation.

So I'm exploring all non surgical routes so that when I see the NS next week I will at least in my mind be able to make informed decisions. Medicinal cannibas is illegal here in WA.

I have decided against methadone, I hope to return to the workforce and with the detail you and Mrs D gave along with further research I can see that it's a drug that won't work well for me. It's all very frustrating and I guess I'm just feeling despondent, demoralised - feeling sorry for myself and wishing I could turn back time rather than getting on with it and being more positive. Apologies to everyone and thanks for taking the time to read my posts and offer your valuable insight.