I guess you really do have to create a balance sheet, pros of staying on one side, cons of staying on the other side.

WHY do you not like where you are? (Don't tell me, but research it.) You do sound as though some of it is what life is all about: change. You're right in that you can't go "back" in many ways, and some of what you are feeling is just that: feeling and longing for things when they were maybe better?

I decided that I will be just as unhappy or happy wherever I live, no matter what. It's up to my perspective. With that understood, I look at what I have now: a great support team IRL, with status quo on insurance authorizations, and realize, that yes, it's up to me to make where I am now "work" the best for me.