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Reading your initial message, it sounds to me like your dr. is p..ssing in the wind!! Sorry, but thats the way I read it. First he says you shud, then he says try new meds, then he says you shud think about it....whats going on!!! With your govt insurance it seems to me that you shud see a true neurologist familiar completely with PD. He should be informing you of your options and why he thinks so. Since a Pallidotomy is such a serious move...seek the highest level second opinion. My dr. here in NY is Director of the Movement Disorder Group...PD...and of all people he should know me after 13 years.... When he felt that there was no way to make the quality of my life easier with meds...he then offered surgical options...from DBS to "P". I (we) choose "P" and he recommended (the team) DR. LANG at TORONTO WESTERN as a neurologist and DR. LOZANO as the surgeon. My "P" was done in May and for what my dx was it was successful in all respects. PLEASE see qualified PD/movement disorder specialists....BEFORE you make up your mind. THIS IS A VERY BIG DECISION NOT TO BE TAKEN LIGHTLY. BEST OF LUCK. Joyce