I'll try all of the meds, but if I'm miserable, I won't give them all that much time to work. And if I'm really miserable, I probably wouldn't even do any drug trials. I don't want to be as sick as I was with my first flare ever again.
Editing to add: I think a patient should be able to decide when they're ready for surgery. If I decide I'm ready, and my GI tells me no, I'll schedule a consult with a surgeon anyway.