I'm so sorry things didn't work out well for you Bobby
You must be so disappointed and frustrated

I think you should tell your pdoc your med plan isn't working for you and it's time to shake it up and/or try something different. I know you are concerned about the "new" meds on the market, but some of those "new" ones have actually been out there for quite a while, and their side effects and efficacy are already well known. Maybe he will want to try one… ? IDK. There must be something he can do that has the potential to break this cycle.

When is your next appointment?

Thinking of you today my friend