INTRODUCTION
This is a medically challenging case report of a 65 year old male with past medical history significant for uncontrolled type II diabetes mellitus atrial flutter status post pacemaker implantation, PCI ×3 on lifelong anticoagulation who presented with complaint of bilateral upper and lower extremity sever peripheral neuropathy. Untunately, given patient's complex cardiac history and the imperative need for anticoagulation, his cardiologist did not recommend holding anticoagulation for spinal cord stimulation trial. Through the formation of a personalized plan of care with the main goal focused on improving his quality of life the decision was made to explore peripheral nerve stimulation in the hope of managing his debilitating peripheral neuropathy.