Only you will know what is right to do, so follow your instincts and information you gather. And be sure to talk with family/friends about all the details, it will help give you clarity. And yes, commonly it is Imuran, then Remicade, then Humira (depending on your reaction to remicade) then surgery. That was how my medicine flow went - humira was my last chance medicine. The thing is that this process took me about 7 years to go through all the medicines, and I was just getting sicker and older, but I was trying all the medicines so there wasn't any surgery regret. Now, in retrospect I realized the doctors were really just going through the medicines b/c I had to go through them, but I think in my case they all knew it was inevitable (4 opinions). The other thing is that we have to be honest with ourselves when we are living predinisone dependent which for me I learned was: 40mg for a month, then a taper, then get sick again, then back on predinisone while I try the next new medicine, taper, get sick, etc......The longer you are on pred. the more tissue damage it could be doing and is probably the reason why drs. talk surgery when meds seem to be failing.