Hi Liz
There are many different drugs that can be either added to the methotrexate or used separately. Certainly if you regularly have flares the disease is not controlled well enough and does require a different treatment regime.
With the foot problems you describe it sounds as though you should be having regular rheumatology/orthopaedic checks. Hope the nurse is able to organise something for you and refers you to the appropriate specialist. I have had a number of foot ops too but fortunately haven't lost any toes ... just metatarsal heads!
As others have said blood test results are not always a reliable indicator of inflammation so don't worry too much about these. A CRP of 9 really isn't particularly high (normal values = less than 6mg/L) and could actually be normal for you because we are all different. Likewise ESR (normal range 1-7mm) varies considerably; my normal is 15-17mm.
It sounds as though you are having quite a difficult time so do keep posting and let us know how you are.
Lyn x