No matter how gracefully I walk into a neurologist’s office for an evaluation, the dreaded heel-to-toe test invariably punctures my façade.

As soon as I place one heel directly in front of the other foot, I start to sway. My arms float up, like a gymnast…a gymnast on the Titanic. I tilt toward the left. I regain my balance…for one brief hopeful moment. I tilt toward the right. My legs start to buckle. Then twist.

It’s all very suspenseful.

Inside my atrophied little brain, I’m reminding myself of all these tricks I’ve been taught at yoga. I press into all four corners of my front foot. I root down into my tail-bone. I lengthen my spine. Oh yes. I breathe.

I lift my back foot. Gently swing it around my front foot. Start to set it down…


Not again.

I tilt toward the right. A little too far. I break my fall…by breaking out of heel-to-toe.

Inside my atrophied little brain, I’m thinking that losing my balance is all my fault. I wasn’t…yogic enough. I didn’t make the right mind-body connection. Of course! Mind-body connection! Why didn’t I think of it sooner? What I should have done was visualize myself walking down the hallway. Visualization. That’s the ticket.

I request another try.

This request typically inspires a panic.

“Oh, no, no, no. That’s fine. You don’t have to do that one over. I’ve seen enough.” And I wind up feeling like an out-of-work actor who has just asked for a re-try on a crappy audition.

The first time I took the heel-to-toe test, I made a lame joke. “I guess my tightrope walking days are done.” The joke fell flat. My stand-up comedian days were dead-on-arrival. Fine. I don’t want to play the role of the wisecracking patient with multiple sclerosis. I don’t want to be in that sitcom. Or even on that channel. I’d rather be on the yoga channel, floating two feet above the gleaming wooden floor without even noticing, a tiny, enigmatic smile on my placid face.

Yeah, right.

Has my practice of yoga been based on unrealistic expectations? Or has my practice of yoga been the only reason I can balance at all? Without yoga, would I be in a wheelchair by now?

I cannot say. I don’t have a control group; a clone or a twin sister with multiple sclerosis who thinks yoga is a complete waste of time.

What I can say is that my expectations for my balance are consistently higher than my performance in the heel-to-toe test.

My performance in my normal daily routine can be fairly convincing. Contrary to what my blog posts may have you believe, I pass for a relatively fit healthy woman at least 90% of the time. In public. Before 8 pm. But still. I’ve got a good façade going. I’m fond of it. I don’t want that façade punctured. Which is why I don’t like the heel-to-toe test. Not one bit.

I never thought I could ever meet a person who could make my objections to the dreaded heel-to-toe test seem petty. That was before I met Dr. X.

I wasn’t supposed to be meeting Dr. X in the first place. My appointment was with Dr. Y. It so happened that Dr. Y was running behind, so she sent in a resident: a black man in a wheelchair. To see me: a white woman who felt irked every time she was asked to take the dreaded…never mind.

When Dr. X had me take the dreaded heel-to-toe test, I failed it, as usual. But this time, failing the heel-to-toe test felt fairly privileged. At least I wasn’t stuck in a wheelchair. Without a doubt, Dr. X would gladly trade places with me in a flash.

Or would he? Was Dr. X’s life really all that bad? Is mobility, or lack thereof, the decisive factor in anyone’s quality of life?

As we chatted, I came to see that Dr. X’s life was actually pretty good. He was nearly done with medical school. He was on the verge of a lucrative career. He had a job lined up for him in his home state, where he could live near his beloved family of origin. His upcoming move wasn’t all he was looking forward to; he was getting married in a few weeks. His honeymoon plans included snorkeling in the Caribbean.

My atrophied little brain thought it appropriate to mention a book I’d just read, The Body Has a Mind of Its Own. I enthused about the data showing that visualization could improve sports performance, and shared my plans to visualize walking down my staircase without using the banister.

Dr. X’s response? “Use the banister.”

I take it Dr. X doesn’t visualize leaping out of his wheelchair. Or passing heel-to-toe tests. Dr. X is more focused on what his brain and his body can actually do. I’ll be the first to concede, his brain and his body can do quite a lot. So much for visualization. Maybe there’s something to be said for looking around, and seeing the world clearly. The world is a beautiful place, from any perspective. I bet the world looks spectacularly beautiful while snorkeling in the Caribbean.

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Patient/Doctor Etiquette

Yesterday, I waited forty minutes to see a specialist. I didn’t particularly mind. I was ten minutes late, to start with. I had my Kindle with me. I was fine.

Finally, the specialist breezes in and asks, “How are you feeling?”

He sit down across from me, eye level.

As I open my mouth to answer him, the specialist breaks eye contact. He swivels his chair to face his computer, and begins to read my medical record. I continue speaking, but now to one side of his head.

How am I feeling?

I am feeling like I no longer have the specialist’s full attention.

When my kid pulls a stunt like that, I scold him. “Look at me while I’m talking to you.”

But I’m not the mother, here. I’m the patient. I follow the requisite etiquette.

I rattle off my current symptoms as the specialist reads up on my past symptoms. As I’m talking, I feel like I’m competing with my own history. I am no longer giving the specialist my full attention. Half of me is already planning to find a better doctor, a doctor who listens.

It only occurs to me later that I could have been a better patient, a patient who waits as the doctor is reading, instead of a patient who mindlessly speaks on cue.

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Negotiating Pain

Foot and Leg Pain
I experience “numbness and tingling” sensations in my feet and up my legs every day. This was my first symptom of MS, and it looks like it’s here to stay. Over the years, I have found a number of ways of reducing pain. Baclofen helps. There are also non-prescription alterantives that can provide pain relief. Here are my top strategies for taming the pain, in order of discovery.
4. Toe Socks. Yes, there are such things. And yes, they can help reduce foot and leg pain. They help me, anyway. If you  experience “pins and needles” pain in your feet and up your legs, read on:
The other night I was in intense pain; my legs were aching with bee-sting intensity. I don’t know why I asked for toe socks, but as soon as my husband slipped them on my feet, I felt instant relief. I think, in my case, my hyper-sensative MS-addled nerves got all rattled because my pinky toe tucks against my neighboring toe, which triggered a false neurological signal that confused proximity with pain. Once my toes were separated in the toe socks, the pain signals died down. From now on I’ll take my yoga teacher more seriously as she encourages us to spread our toes. (see 4.)

Has anyone else tried toe socks?

3. Vibrating Foot Massager. Technically, I have very little ability to perceive vibration in my feet and legs. The first time a neurologist whipped out one of those tuning forks at an exam, I didn’t know I was supposed to feel vibration; when asked how it felt, I said it felt cold. I don’t know why feeling less vibration translates into feeling more pain, but it does. Luckily, the converse applies as well; feeling more vibration translates into feeling less pain. I use an iJoy Equalizer I got from Sharper Image, which I believe has since gone out of business. There are other vibrating foot massagers out there, in prices that range from 19.99 to over $300. They shake things up, causing immediate relief.
2. Legs Up Against the Wall. My foot and leg pain literally drains away when I rest my legs up against the wall. To enter this position correctly: sit with your right side against the wall, knees bent; your leg and hip should be in direct contact with the wall. Lower your back onto the floor. Raise/straighten your legs, so that the bottoms of your feet are facing the celing. Now swivel 90 degrees, so your head is pointing toward the middle of the room, while the backs of your legs and your sitting bones are in direct contact with the wall. You should feel an immediate draining of pain. Hold this position, with your legs against the wall, for only as long as it is comfortable. For me, that’s about two minutes or so. Don’t worry; the soothing effects will linger a while.

1. Yoga. My first thought on diagnosis was that yoga could somehow cure me; that being a more spiritual person could make me a disease free person. Nonsense. I will never know how much yoga has helped; but I can say, without reservation, that yoga has made me more supple, which helps with spasticity, and has given me great joy, which helps with life generally. As someone who experiences a lot of pain by merely standing, I try to remember how it feels to stand in tree pose at the yoga studio when I’m stuck on a line in the store.

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