Hi Deb,
Sorry to hear about your daughter's stroke. I hope the appointment with the Neurosurgeon in Toronto goes well.
Obviously, I am not a doctor, but I can try to answer you questions with my own personal experience:
1. Five blockages? Sounds like a lot, but it all depends on how much the blockages are. If they're small, not as much of a concern... larger blockages are more concerning.
2. I would say that there is a higher risk of hemorrhage while on blood thinners. Moyamoya vessels are fragile and can bleed very easily.
3. At centers where they specialize in the treatment of moyamoya, a lot of people have the direct (STA-MCA) surgery seven days apart. It depends on the type of surgery and how well the patient is doing. With the indirect surgery they will sometimes do both sides at the same time.
4. Moyamoya specialists try to get patients in for surgery as soon as possible after diagnosis.
5. I haven't personally heard of Dr. Tymianski but there are several posts about him on the "doctors" board. I would suggest typing his name in the Google search at the top of this page. It will search all of the moyamoya.com message board threads for his name.
Hope this helps some. HANG IN THERE!

DJ