Author: Henry Feeser (Page 9 of 73)

86 yr old retired military on dialysis. Currently living in the Granbury, TX area.
See www.feeser.net for more info

What is HFX with AI SCS?

During Friday’s visit to my neuro clinic, we decided to go forward with the SCS (Spinal Cord Stimulation) device permanently. Next Friday, I’m scheduled to have the temp device removed. In three weeks or so, I will have the “permanent” device, known as HFX, installed. I’m certain many are in the dark about these devices as they are relatively new (FDA approval for use in the US 2023). Thus, I’ve filled in the blanks with the information that follows. I’d like to note that I now have feeling in my lower legs, can feel the ribs in my socks, and have not had one incident of sleeping leg cramps since installation. It’s working.

What is HFX with AI SCS?

  • HFX is a proprietary, high-frequency spinal cord stimulation therapy, primarily used for managing chronic pain, especially in conditions like diabetic neuropathy.anesispain+1
  • AI SCS (Artificial Intelligence Spinal Cord Stimulation): Modern SCS systems, such as Nevro’s HFX iQ (which is what I am to receive) use AI algorithms to personalize and optimize pain relief for each patient. The system continuously learns from patient input regarding pain and lifestyle changes via an app connected to the stimulator, making tailored adjustments automatically to improve outcomes.wvumedicine+2

How Does the Process Work?

  1. Pre-Implant Trial: Patients are fitted with an external SCS device to see if pain levels improve before considering permanent implantation.baptisthealth. This is ongoing now.
  2. Implantation: If results are positive, a minimally invasive surgical procedure implants a small electrical stimulator in the hip or back. Wires (leads) are placed in the spinal column near target pain receptors.baptisthealth
  3. Ongoing Adaptation: Patients regularly provide feedback (via an app) on their pain, allowing the AI to “learn” and alter the stimulation parameters for optimal relief—even as their symptoms fluctuate over time.fiercebiotech+1

The Science Behind It

  • The system delivers high-frequency (10,000 Hz) electrical pulses to the spinal cord, which interrupts abnormal pain signals from nerves reaching the brain, reducing or eliminating the perception of pain—including numbness and dullness in diabetic neuropathy.redbuttepain+2
  • AI makes the system more intelligent. The stimulator’s programming is guided by a vast database of real-world patient outcomes—over 20 million data points from tens of thousands of users. The AI identifies effective settings based on this data, and adapts therapy as needed for each patient.fiercebiotech

Results and Improvements

  • Pain Relief: About 76-80% of patients see significant and lasting pain relief, far outperforming traditional management with medications.csog+2
  • Improved Sensation: Some patients experience restoration of sensation in their feet, not just pain relief. This reduces the risk of injury due to numbness—an important benefit for diabetic patients who may not notice wounds.redbuttepain
  • Quality of Life: Reduced pain and improved sensation allow for greater physical activity and reduced reliance on opioid painkillers.wvumedicine+1
  • Glycemic Control and Weight Loss: There is emerging evidence that patients undergoing this therapy may also see improvements in glycemic control and modest weight loss, both beneficial for diabetes management.pmc.ncbi.nlm.nih

The AI Aspect

  • Personalization: AI learns from your ongoing feedback and adjusts therapy without the need for frequent office visits or manual programming by clinicians.fiercebiotech
  • Data-Driven: Utilizes massive datasets and cloud platforms to identify and recommend effective therapy adjustments for maximum relief.fiercebiotech
  • Adaptive: As your symptoms change (e.g., pain intensity, sensation), the AI can tweak the electrical parameters to match your needs, aiming for continuous optimal results.wvumedicine+1

In summary, HDX with AI SCS for diabetic dullness in the legs represents a breakthrough using high-frequency electrical stimulation—personalized and optimized by AI—to dramatically improve pain, sensation, and overall quality of life for patients with diabetic neuropathy – which is me, folks.

More information about the device may be found at the following link: https://www.nevrohfx.com/

Underway Again

This morning, we have a follow-up appointment with Trinity Pain Center in Fort Worth to discuss my spinal cord stimulation device’s alleviating of the lack of sensations in my lower legs. Thus far, I do seem to have more sensation to a light touch.

We’ll see how it goes……

Onward

I’m home from installation of a Spinal Cord Stimulator, aka HDX Device. Post installation, there is minimal discomfort from the device. However, the back brace is very uncomfortable. Perhaps it will get more comfortable.

Although it could be a placebo affect, I do seem to have more feelings in my lower legs. Time will tell.

It Didn’t Happen

So there I was, completely prepped for the HDX procedure, when we noticed several nurses flying by outside the curtain of my hospital bed. Finally, the HDX representative, who was very friendly, stopped briefly by and told us that there had been an incident. This was followed by not one, but two nurses coming into our curtained-off enclosure to inform us that the surgery had been called off. Upon this news, the second nurse, who was the charge nurse, unhooked me from the drip and other stuff and left so I could get dressed.

On the way back, while in the normal DFW traffic, we received a call from the doctor’s scheduler to reschedule our procedure. My wife, who was driving, told her we would call back when home and had access to our calendars, which we did. My HDX install is now at noon on Wednesday, with a follow-up on Friday at 1130. These times are much better as I won’t be required to cut into my dialysis duration.

See, even in the worst times, there is a God.

Uncharted Waters

Today, at least for me (us), I’m entering uncharted waters. By the time this is posted, we will be driving toward a clinic in Euless, TX, to have the HDX device implanted along my spine. Along the way, we will drop Dickens, our Golden Retriever, off at a doggie day care after I wake up at 0545, which cuts time off my dialysis schedule. Sometimes you have to do what you have to do to adjust to “normal” workflows; there is no way around it.

It took a lot of pieces to fall together to get this to happen. The psych eval was completed last Thursday evening. The clearance from my cardiologist didn’t arrive until late Friday. The script for my meds didn’t get posted until Saturday. I’m still getting text after text from the clinic, the doctor doing the work, the antithesoglist, and on and on.

In the face of such uncertainty, rather than getting uptight about it, I fall back on the US Navy SEAL ethos. See the embedded guideline below. Herein, we will never ring the bell.

In the Doldrums

Refers to a region near the equator with calm winds, making it difficult for sailing ships to move – a metaphor for being stuck or unable to make progress. That’s the way I feel at present. As if waiting for the other shoe to drop, given procedures queuing up. Of course, the “biggest” one is the insertion of the trial HDX device along my spine. Because of this, I have put off going to the dermatologist to have some more cancerous spots taken care of. I want to minimize open places on my old body in the face of opening others.

Our domestic is presently churning away at squaring our yard away. She can squat while she weeds in a manner that I have never been able to achieve and really moves out. We are blessed to have her working for us.

In the summer heat here, where every day in August is in the mid-nineties or higher, we are having to water frequently. Even then, some of our new trees are showing signs of stress. Speaking of new, Linda and I harvested our potatoes today that we grew in buckets. Did not turn out all that great probably because they were not watered enough. Also planted three of our volunteer tomato plants in smaller cloth buckets to give to a neighbor. We still have plenty of tomatoes from the 13 we have planted along the back of our large garage, and the 4 we have in buckets alongside our single garage. In this respect, God is good!

A Week From Yesterday…

I am scheduled to have the test version of the HDX device implanted into the spinal area of my back. We have to travel approximately 50 miles through the heart of Fort Worth to get to the clinic, which is located in Euless, TX. Not looking forward to that.

I received a call from Trinity Medical, the consortium that is behind my forthcoming procedure, to arrange a psych appointment online. I find it interesting that a shrink is involved in this treatment. Haven’t been subjected to such an interrogation since applying for a top secret/crypto clearance in the US Navy.

I have embedded below a brochure on the HDX device so readers, if so inclined, can delve deeper into the subject. Be advised that the brochure is about pain, which in this instance also means numbness of the feet and legs.

The Week Ahead

.Finally, after two weeks of seemingly constant doctor appointments, this week we have some slack. The only physical contacts are that my wife has a hair appointment on Friday at 1500, and we have a dialysis team meeting at 0920 on Friday. I do say ‘we’ because, until the situation with my legs going to sleep gets resolved, no pun intended, she has been driving me to all my appointments.

Speaking of my wife driving me, if I haven’t elaborated on her now being my “official” VA Caregiver, it is worth noting that we have heard nothing further from the VA. Not that we expected to be overcome with aid and attendance. I’m certain that all will come in due course.

Now that we have physical appointments out of the way, that’s not to say we don’t have several follow-ups to make. We received a bill from Pentec for two weeks of IPN. That’s all well and good. It was in the neighborhood of less than $800 for our share after estimated payments by Medicare. That said, there is no evidence that Pentec billed our secondary payee, Tricare for Life, which generally picks up whatever Medicare does not. I called Pentec this past Friday and pointed this out, and was told they would check it out and get back to us.

The second hanging thing is we are supposed to have the temporary back device installed on 8/18. We have received no word on the exact scheduling of this procedure. If we don’t hear anything by Wednesday, it’s off we go seeking answers.

Our Joint Hobby

My wife and I enjoy growing, and by association, eating, homegrown tomatoes. When we had our farm in Indiana, we grew them by the bushels. Here in Pecan Plantation, we no longer have the same real estate options we once did, but we can still easily meet all our culinary needs.

Our local Nextdoor has had several hits of people looking to purchase homegrown tomatoes. Due to our success in growing our own, I suggested via a post that they grow their own and made a short “how-to” video, which is embedded below. As of this morning, it has had 65 hits, so there is an interest in this subject. See video below:

It’s Offical

Yesterday, my wife and I traveled to the DFW area for an appointment with a neurologist namedhttps://www.pmrfortworth.com/physicians-and-staff/austen-watkins-d-o/ Austen Watkins. The purpose of the visit was for him to confirm through specialized tests that I suffered from neuropathy, and kinks did not obstruct my nerve paths in my spine. He conducted nerve conduction studies and electrodiagnosis. Indeed, he found neuropathy and no blocked nerve passages, which should clear me for the implanting of an electro device in my back on 8/18/2025. For those interested, I have included more about these tests below from Perplexity. He stuck needles in me and electro probes at various places and observed on a computer the nerve response via electrodes on my upper body.

Nerve Conduction Study (NCS), Neuropathy, and Electrodiagnosis: An Overview

What is a Nerve Conduction Study?

A nerve conduction study (NCS) is a diagnostic test that measures how fast and effectively your nerves transmit electrical signals. It’s commonly performed to detect nerve damage and to diagnose various conditions involving peripheral nerves, such as peripheral neuropathy, carpal tunnel syndrome, and other nerve compression syndromes.clevelandclinic+2

  • Procedure: Small electrodes are placed on the skin over specific nerves and muscles. A mild electrical stimulus is applied, and the resulting electrical activity is recorded. The test measures several parameters: latency (delay), conduction velocity (speed), amplitude (strength of signal), and waveform characteristics.wikipedia

What is Neuropathy?

Neuropathy refers to damage or dysfunction of nerves outside the brain and spinal cord (the peripheral nervous system). This can result in symptoms such as numbness, tingling, pain, muscle weakness, and lack of coordination. It has many causes, including diabetes, autoimmune diseases, infections, inherited disorders, toxin exposure, and trauma.yalemedicine+2

  • Types of neuropathy:
    • Sensory neuropathy: Affects sensation (tingling, numbness, pain).
    • Motor neuropathy: Affects muscles, leading to weakness or paralysis.
    • Autonomic neuropathy: Affects automatic body functions (heartbeat, digestion).
    • Mixed/combinations: Often, both sensory and motor involvement.yalemedicine

Role of Electrodiagnosis in Neuropathy

Electrodiagnosis involves using electrical tests—primarily nerve conduction studies (NCS) and electromyography (EMG)—to assess nerve and muscle function. It is a critical tool for:

  • Diagnosing the presence and extent of neuropathy: NCS can objectively confirm the existence of nerve damage and its severity.
  • Characterizing the neuropathy: Determines if damage primarily affects the nerve axon, the myelin sheath, or both. This distinction influences diagnosis and treatment.
  • Localizing the neuropathy: Identifies which nerves are affected and whether the problem is focal (one nerve), multifocal, or generalized (many nerves).
  • Monitoring progression: NCS and EMG can track changes in nerve function over time, helping guide treatment and prognosis.pubmed.ncbi.nlm.nih+3

Electrodiagnostic Findings in Neuropathy

  • Axonal neuropathy: NCS shows reduced amplitude of responses, indicating fewer functional nerve fibers.
  • Demyelinating neuropathy: NCS shows slowed conduction velocity, prolonged latencies, and temporal dispersion, suggesting loss of the myelin sheath.wikipedia+1
  • F-wave and H-reflex studies: Used for further evaluation of nerve pathways to and from the spinal cord.pubmed.ncbi.nlm.nih+1

Practical Applications

  • Peripheral neuropathy is frequently evaluated with NCS as it helps distinguish between different types (e.g., diabetic neuropathy vs. hereditary neuropathy) and guides clinical management.mayoclinic+2
  • Electrodiagnosis can also exclude mimicking conditions and uncover multiple underlying pathologies.

Summary:
Nerve conduction studies are essential for diagnosing, classifying, and managing neuropathies. They are non-invasive, provide detailed information on nerve function, and are often combined with other electrodiagnostic tools, such as EMG. Electrodiagnosis not only confirms the presence of neuropathy but helps determine its cause, exact location, and potential for recovery.ncbi.nlm.nih+2

  1. https://my.clevelandclinic.org/health/treatments/24821-nerve-conduction-study
  2. https://mdmercy.com/mercy-services/diagnostic-and-specialty-service/nerve-conduction-studies
  3. https://en.wikipedia.org/wiki/Nerve_conduction_study
  4. https://www.yalemedicine.org/conditions/neuropathy
  5. https://www.mayoclinic.org/diseases-conditions/peripheral-neuropathy/symptoms-causes/syc-20352061
  6. https://my.clevelandclinic.org/health/diseases/14737-peripheral-neuropathy
  7. https://pubmed.ncbi.nlm.nih.gov/11191927/
  8. https://www.sciencedirect.com/science/article/pii/B9780323901086000107
  9. https://www.ncbi.nlm.nih.gov/books/NBK563169/
  10. https://www.sciencedirect.com/science/article/pii/S0987705300002379
  11. https://medlineplus.gov/lab-tests/electromyography-emg-and-nerve-conduction-studies/
  12. https://www.youtube.com/watch?v=GalU9SWiYic
  13. https://pubmed.ncbi.nlm.nih.gov/31277849/
  14. https://livestrong.org/resources/neuropathy/
  15. https://www.neurology.org/doi/10.1212/WNL.54.1.40
  16. https://www.nhs.uk/conditions/peripheral-neuropathy/diagnosis/
  17. https://www.coxhealth.com/services/neuroscience/neurodiagnostics/nerve-conduction-velocity-emg/
  18. https://www.semmes-murphey.com/emg-and-ncs
  19. https://www.nhs.uk/conditions/peripheral-neuropathy/causes/
  20. https://www.ninds.nih.gov/health-information/disorders/peripheral-neuropathy
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