You know, David, you seem to take pride in your "patience," but sometimes it can be a detriment to your health, and a euphemism for doing nothing.
Obviously, I can only draw conclusions from your conveyance of the situation, but it seems you are being treated in a very shabby manner. It sounds like your doctors don't know what to do (understandable, given your unique set of circumstances) and as a result are kind of blowing you off (not so understandable).
You also take pride in being a "compliant" patient. It would seem that the reasonable limit of compliance is long past.
It has been suggested, by me and others, that maybe just picking up the telephone and calling Duke might get things moving. Or, at the least, calling your doctor and asking them to pick up the phone and get things moving. If that was done, then call Duke directly.
Just a thought.
Mel