neck class

This morning my primary care physician had me attend "neck class" on the theory that the neurological complications I've been experiencing for the past year are the result of mixed signals not so much from my brain as from my cervical spine. At least that's how I like to spin my presence in neck class. It's entirely possible that my PCP sent me there because he couldn't think of anything else to do or any more specialists for me to see and he's trying to distract me. "Look, over there, something shiny!"

I wouldn't call Kaiser's physical therapy department shiny. In fact, when I arrive at 7:15 a.m. it’s fairly dark. When I was admonished to arrive early for my 7:30 session my admonisher hadn't mentioned that the department wouldn't open until, well, 7:30. So I sit in the waiting room and read by the dim ambient light of the hall, something I wouldn't do in an ophthalmology department for fear of reproof. Here I merely sit up straight, with exceedingly good posture, my book held at an ergonomic angle to my sightline.

I think about these things when on the campus of my health maintenance organization, especially since my physical compromise has been so cagey, hiding its source from GPs and neurologists, plus one wacky ENT and a rheumatologist so freaky I prayed he wouldn't find anything just so I wouldn't have to see him again. Since doctors like to know things, my case has been a little irksome to mine, and I think they'd love to be able to write me off as a head case, someone who's making herself sick. I don't think anyone's headed down Munchausen Way: I saw a neuropsychologist in July who conducted eight hours of testing and determined that I seemed to have some subcortical brain damage consistent with stroke activity, so that cleared me of a broad spectrum of factitious-disorder allegations. Neuropsychologists are trained to sniff out fakers.

Still, none of my imaging backs up the stroke theory. More important, my symptoms relapse and remit, and stroke-injury complications should be constant. That note of discord might make any number of doctors peer longingly down Munchausen Way, thinking about how lovely it would be to send me down yonder, out of their exam rooms. I can't say as I blame them. I'm really the only one who should know for sure whether I'm the cause of my own symptoms, and even I wonder sometimes, when I'm in remission, whether I can just concentrate really hard on remaining able-bodied and thus make it so. I have a friend who's been known to insist that all illness is mental, that even wearing glasses is a sign of personal weakness—us myopic types only THINK we can't see that far horizon where cancer is cured by fairies playing hornpipes.

So I sit up straight, lest anyone think I'm subluxating my spine and have only myself to blame for whatever nerves are severed as a result. God knows I don't like having my integrity called into question.

Receptionists arrive and check folks in, after which a sunny PT named Sherry comes to fetch me and my three neck-class schoolmates, all of whom are women of a certain age, conjuring an image in my mind of a swimming pool full of seniors doing light aerobics. We're taken to a room full of padded exam tables—with pillows! Unfortunately, we're asked to sit in the chairs between the exam tables instead. Then Sherry rolls over on her doctorly stool and begins to engage us, three of us anyway; one woman is perversely resistant to any of this poppycock about minimizing disability and is bitterly rude to my sweet, sunny Sherry. Unless this woman can prove that Sherry has directly caused her pain—say, by misapplying a choke hold to her in a previous neck class—I am so ready to kick her ass at Sherry's bidding. Sadly, Sherry's too nice to ask for such a thing, so the rest of us are braced to cringe every time Ms. Acrimony opens her mouth.

Sherry explains that we find ourselves thrown together here not because Kaiser is in the habit of conducting cattle-call physical therapy but because a first session with any one of us would involve a brief explanation of the structure and physics of the CNS and an introduction to home exercises. After all, she says, necks (like happy families) are all alike. I can tell by the way Ms. Acrimony rolls her eyes that she very much doubts her neck is anything like ours. Nevertheless, Sherry notes that she'd be delighted to work with any of us individually after this initial visit.

So we go over some exercises, the kind my chiropractor has shown me any number of times while I'm waiting for him to get to the fun part, when he torques my head like a pneumatic wrench attacking a stuck lug nut. Gentle Sherry, as you may suspect, doesn't recommend chiropractic medicine, but she adds that she doesn't want to get in the way of any existing relationships we may have with our chiropractors. She's diplomatic that way.

It's when Sherry gets into discussing examples of spinal abuse that I experience a moment of horror. She's likening our heads to bowling balls—but that’s not the horrific part—and reminding us that the farther we hold a bowling ball from our body the less support we can give it. Likewise, a 13-pound head exerts more stress on the cervical spine as it moves away from its center of gravity. Then Sherry cranes her neck forward and cocks her chin upward, calling this position the worst possible combination of stresses. She means to demonstrate an office worker in a nonergonomic computing posture, but I see something else: road cyclist.

No! Mean Sherry can't make me quit cycling. I won't quit cycling. She and her fascist anticycling physical-therapist friends can go to hell if they think they're going to take that away from me. I slump in my chair and resolutely fold my arms over my chest while evil Sherry natters on about the use of home traction for headache and pain relief. She's dead to me.

At the end of class I politely thank her, because I'm like that—I can love my enemies. Now if you'll excuse me, I think, I need to catch up with Ms. Acrimony. We're going across the street to Coco's to talk smack about you over pie and coffee. Sherry gives me her card and asks if I think I'd like to come back and do some one-on-one work. "Perhaps," I lie, "but I'm afraid I may know what the problem is from listening to you."

"That's wonderful," she says. "Is it something you can correct?"

"Yeah," I pouted. "But I don't particularly want to. I do a lot of cycling, and the position you described as being the worst possible for your neck—that's pretty necessary to cycling."

She mimics a riding position to test my theory. "Yeah, you're right," she says. "But that doesn't mean you need to stop cycling."

"No?"

"Not at all," she says gamely, beginning to melt the icy wall I hastily erected at her first intimation of attack. "Moving is good,” she says, “even when it puts stress on the body. What's terrible for the body is having poor posture while being sedentary. Do you work in an office?"

"Yes," I say, the earnest student returning.

"When do you get your migraines?" sweet Sherry asks.

"At work."

"Never while riding?" she asks.

"Never."

"Keep riding," she says, smiling.

"Does this mean I should quit my job?"

"If you can afford it," she winks. "Otherwise, just make your company buy you some cool back stuff. Do you need me to write you a note?"

Sherry is my friend, my very good friend.