My name is Dustin Lyons, a shoemaker and writer living in Joseph, Oregon. I'm very fortunate to have a small cabin and workshop on two uncombed acres at the foot of Chief Joseph Mountain. I've been building custom shoes and bags as Alkahest Leather (instagram.com/AlkahestLeather) since 2011. Most of my business is done on the road, at art fairs and various festivals throughout the Pacific NW. This affords me a very modest but quite satisfying life. I have been dealing with manageable lower back pain since my 20s, that is until 3 years ago, when it slipped out and the daily pain started. I wear a back brace in the workshop every day now, and at shows. I've been through years of Physical Therapy, acupuncture, Rolfing, steroid shots, nerve ablation, etc. just to land right here: still in crippling pain and nearly out of options. I've had to fight my insurance company every step of the way to approve and pay for procedures my PCP, PT, Physiatrist, and Surgeons have recommended. They've denied nearly everything, including the spinal fusion surgery I've now had 3 surgeons recommend. In the United States this surgery is upwards of $100,000+ out-of-pocket. This has pushed me to seek out-of-country care in Mexico where the same procedure + physical therapy costs $21,000. This is money I do not have, and so, I find myself here asking for help. The wear and tear on my back: traveling to shows, setting up, breaking down; not to mention the leatherworking/shoemaking itself--this has all pushed me to shift a portion of my year into starting a shoemaking school Spring of '26. There aren't many shoemakers left and I'd like to teach the next generation. I yet intend to do shows and make shoes for many years to come, but I do fear, without spinal fusion, that the limitations I'm currently experiencing at 47 will amplify to the point that I simply can't...can't do my work, both occupationally and domestically. My deepest and sincerest thanks for any help you can offer.