Ok, here's the deal. Talked to the Doctor today. We did talk about alternate treatments. His comment was that they take care of the symptoms, but not the damage. Moderate Severe is as bad as the Doctor who did the readings will write. There is real damage.
The end result is that I will have surgery on April 10th (unless there isn't room in the schedule, in which case it will be done the 17th).
The surgery is as non-invasive as it can be. His comment about his partner, who still does it in an old way, was very amusing. His whole attitude was "that is so 19th century".
He will cut a very small incision and go in with a probe. He says that if I needed to I could play a show that night. He doesn't advise it, but it is that non-invasive. He'll do both hands and the thumb (if it is still necessary) that day. I will miss work that day, and probably stay home the next as well, although he does not seem to think that is necessary. I should be back to normal in a few days.
One person on FB was worried about insurance. My insurance will pay for everything.