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. 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

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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/

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.

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.

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!

.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.

One of the hobbies my wife and I have is gardening. Even though it is getting more and more difficult to keep up with it because of my escalating conditions, we’re trying.

I have noticed on our local Nextdoor several different people on different occasions asking where they can purchase homegrown tomatoes. My suggestion to them and you is to grow your own. We have had ripe tomatoes from our gardens on the table since late March/early April, and continue to have an abundance. We have also provided select neighbors with the fruits of our labor. I made the short video embedded below to “show you how it’s done,” so to speak. Enjoy.

We have another almost full week of doctor’s appointments as follows for me:

1. Monday 8/4 dialysis labs at 1300
2. Tuesday 8/5 1115 postop catarac surgery plus new eyeglass prescription
3. Wednesday 8/6 1100 Dr Watkins Ft Worth Neurologis workup for neuropathy treatment 8/18

I have been doing more research into my lower extremity diabetic neuropathy. Below are twenty symptoms of it, with comments as to whether I am experiencing them: Graphic above and symptoms from this link: https://neuropathyjournal.org/top-twenty-symptoms-of-peripheral-neuropathy/

Each person’s experience varies depending on their type of Neuropathy, but in general, the following are the most common Symptoms of Peripheral Neuropathy:

1) Severe strange pains in your feet, legs, hands, and other parts of the body; including “crawling insects” under your skin; Mine come and go

2) Balance is difficult when walking, getting dressed, getting out of bed, or whenever you close your eyes; Yes, I have this. My wife has to help me get out of bed.

3) Numbness / heavy / cardboard / heavy cement feeling/ Novocain feeling in your feet and legs; Yes, bottom of my feet at times.

4) Tingling or “vibration” like feelings in your feet and hands; Just my feet.

5) Electric shocks starting at the bottom of your feet/foot that shoot up your leg(s) and on almost any part of the body; No, not my trip.

6) Bone pain, especially in the feet on walking or standing; No, not yet.

7) Painful muscle spasms/cramps; Yes, all the time; wakes me up.

8) Skin may become painful to touch or lose the feeling of touch, with Agent Orange skin rash; Yes, loss of touch

9) Burning sensations in your feet and hands; Very few times, but yes

10) Loss, or lessening, of sensation for hot and cold; Yes, plus cold feet.

11) Feeling like you are wearing socks when you are not; Nope.

12) The feeling you are walking on crumpled socks or stones; Yes, a few times.

13) Feet feel swollen or large; Nope.

14) Difficulty moving your hands or feet; Feet, yes.

15) A feeling of clumsiness, tripping (foot drop) or dropping things; Yes, as relates to feet.

16) Attacks of daily severe exhaustion with strange fatigue; Exhaustion, yes.

In more severe cases of Peripheral Neuropathy, you may also experience the following:

17) Problems with not sweating in the lower body with excessive sweating in the upper body; Yes, upper body.

18) Digestive (fullness; alternating diarrhea/constipation) and/or urinary problems (overflow incontinence); Yes, fullness but could be do to IPN

19) Sexual problems (loss of sensation/feeling/moisture); Yes, no feeling.

20) A tightening of your chest with an increased difficulty in breathing and/or swallowing; uncorrectable vision problems. Not yet.