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My endocrinologist Dr. Govender said the word "amputation" to me at my appointment last month. He said it casually. He wasn't trying to scare me. He was laying out the timeline of what happens when diabetic neuropathy progresses untreated, the way doctors do. Flatly. Like he was reading the weather. I haven't been able to unhear it since. I'm 58. I was diagnosed with type 2 diabetes nine years ago, in 2017. The neuropathy started about three years ago — pins and needles in my toes that I ignored, then a tingling that came and went, then a burning across the ball of my left foot that started waking me up at night. By the time I went to a specialist in Pretoria, my reflexes in both feet were already reduced. He told me, that day, that what I was feeling was the early stage. That what came next was reduced sensation, then numbness, then the kind of complications you read about in the pamphlets they give you in the waiting room. Ulcers. Infections. Nerve damage that doesn't come back. Eventually, in some cases, surgery. He gave me lifestyle adjustments. Better blood sugar control. Specific shoes. Daily inspection of my feet for cuts I might not feel. He gave me a prescription for nerve pain medication. He didn't tell me there was anything I could actually do to stop the progression itself. Slow it, maybe. Stop it, no. I left that appointment feeling like a passenger on a car heading somewhere I didn't want to go. The thing that nobody warns you about with neuropathy is how quietly it advances. You don't notice until it's already won ground. One month you can feel a coin under your big toe. The next month you can't feel it as clearly. Six months later you don't notice the coin until you actually look down. You start checking your feet visually because you've stopped trusting them to tell you the truth. My mother had diabetic neuropathy. She lost two toes at 64. I watched it happen across about five years. Since my appointment with Dr. Govender last month, I've started doing the maths. I'm six years younger than she was when she lost the first one. That's the calculation that's been keeping me awake. I tried the things I was told to try. Each with its own little story. In 2023 I bought R2,400 worth of proper diabetic shoes from a specialist shop in Centurion. I check my feet every morning under the bedroom lamp before I put on socks. I've been checking for nearly three years. I started the prescription nerve pain medication in 2024. It helped a little. Made me drowsy in the morning. Constipated. I stayed on it because the alternative was the burning at night. I cut my carbs more aggressively than I ever had. My HbA1c is the best it's been in five years. My GP was pleased. I bought a foot cream the pharmacist recommended. R280. It smelled strongly of menthol. It did nothing for the pins and needles. I tried magnesium oil that a friend at church recommended. R350 a bottle. I sprayed it on every night for two months. Same result. I tried the compression socks the diabetic forum recommended. R420 for two pairs. They felt nice. They didn't change the burning. But the burning across the ball of my left foot still wakes me up at 1am about three nights a week. The pins and needles still come and go. And on a Tuesday afternoon two weeks ago — at 2:42pm, I remember the time because I'd just sat down with a cup of tea — I went completely numb in the ball of my left foot for about eleven minutes. Eleven minutes of nothing. Like the foot wasn't there. Then the feeling came back. I sat at the kitchen table at 9pm that night and tried not to cry, because I've been telling myself for three years that I have time, and that day I felt time pulling forward. I went back to Dr. Govender last week and told him about the eleven minutes. He listened. He nodded. He told me this was the kind of progression he'd warned me about and that we needed to consider the next stage of management. Then, almost as an afterthought as I was getting up to leave, he said something he hadn't said before in any of our previous appointments. "Are you doing anything for circulation specifically?" I sat back down. "What do you mean?" He sat back down too. He explained something I'd never heard from any of the doctors I'd seen in three years. The reason diabetic neuropathy progresses the way it does isn't only because of high blood sugar damaging the nerves. It's also because the small blood vessels in the feet — the ones that feed the nerves — get narrower and stiffer over time. The nerves don't only need glucose control. They need oxygen and nutrients delivered through circulation. When circulation drops, the nerves starve. Starved nerves misfire — the burning, the pins and needles. Then, eventually, they stop firing at all. That's what numbness is. That's the ground neuropathy wins. Every medication I'd been on was managing the pain signal. None of them were restoring circulation. The specific shoes prevent injury but they don't push blood into starved nerves. Even my much better blood sugar control was buying time — it wasn't repairing the damage that had already been done. He said something else that I hadn't heard from a doctor in three years. "There's growing evidence that consistent, deep stimulation of the foot — the right combination of heat, controlled pulses, and compression — can do something specific. It can force blood flow into the small vessels of the foot, deliver oxygen to the starved nerves, and over time, reduce the nervous system's amplified pain signalling. It doesn't reverse damage that's already been done. But it can slow the progression. Sometimes meaningfully." He told me about a specific kind of wrap his patients had been using. He didn't push it on me. He just told me what he'd seen. Heat, to open the small blood vessels of the feet. Pulses, to push oxygen-rich blood deep into the tissue where the nerves live. Compression, to drive circulation through the very vessels that have been narrowing for years. Fifteen to twenty minutes a day. I bought one the next morning. Week one I used it for 15 minutes after dinner. I didn't notice anything. I'd been told this was a slow process and I was prepared for that. Week two I noticed on a Friday night that the burning at 1am was less intense than it had been. Not gone. Less. Week three I had a night where the burning didn't wake me up. First time in months. I lay there in the dark at 5:30am realising I'd slept through. Week four the pins and needles were down to maybe twice a day from five or six. Week five I went numb again — but for about 90 seconds, not eleven minutes. I sat with that for a long time. 90 seconds was still 90 seconds. But it wasn't eleven minutes. Week seven my GP looked at my latest blood work and at my notes about the symptoms and said, "Whatever you're doing, keep doing it." I didn't tell him exactly what it was. I will at my next visit. I'm into my eighth week now. I don't know whether the rate of progression is genuinely slowing or whether I'm just having a better stretch. I'll know more in another six months. Twelve, ideally. But I'm not a passenger anymore. For the first time in three years, I'm doing something specific that targets the actual mechanism of what's happening to my feet, and not just managing the symptoms. I'm 58. My mother was 64. If you're somewhere on this same road — if a doctor has used the word "neuropathy" with you, or "progression," or worse — please read this. It's the page Dr. Govender mentioned. The doctor on it explains the circulation piece in a way I hadn't heard before, and which I think is the most important thing I've learned about my own feet since I was diagnosed. → https://archify.co.za/pages/new-breakthrough-in-foot-health You may not be able to reverse what's already happened. But you don't have to keep losing ground while you wait.