Toward the end of summer break, when other teenagers are still on family vacations or loitering in Starbucks, all the band geeks go back to school to spend a week practicing music, marching, and field formations. As the saxophone section leader, band camp was always the highlight of my summer. I looked forward to bossing the other saxophonists around and hanging out with my friends all day long. The music part was fun, too.
Ask any member of a marching band, and they’ll likely tell you that their after-school activity is a real sport on par with football, track, or tennis. The true band geeks are willing to die on this hill (and die they would, from heat stroke induced by their thick wool uniforms and stifling, shiny shoes, which are called Dinkles). And yet, “pilates contests'' were by far the hardest part of my high school band camp. In a pilates contest, everyone laid flat on the band room floor—the same floor where the brass players regularly drained their spit valves—then on the count of three, lifted their heads and their feet into the air. Agony ensued as all the wimpiest kids in school tried to use their core muscles for the first time in a whole year. Within thirty seconds, most everyone collapsed to the floor with dramatic groans. To win, you had to hold this position for longer than the band director.
Band camp was my first encounter with pilates, and it’s still what I think of when I hear the word “pilate.” So when a friend recommended I meet a pilates and gyrotonics instructor who works with chronic migraine sufferers, I had lots of questions. Would I be paying this person to watch me lift my head and feet off the ground? Would I be expected to do other difficult exercises, like sit-ups, push-ups, or pull-ups? (Because if so, this idea was DOA.) And, most importantly, is a gyrotonic a Greek wrap or a drink mixer? My sister has done pilates for years and told me that because of it, she loves how she looks naked. So at least I had that to look forward to, I guess.
This pilates instructor works out of a studio in Mill Valley, California, home of the world’s first “wellness center” (founded in the 1970’s) and intellectual birthplace of wellness as we know it today. Wellness, at its core, is about preventing and/or treating disease by promoting not only physical health but also an all-around healthy lifestyle (whatever that means) and by prioritizing your mental, emotional, and spiritual wellbeing. Wellness culture is all about listening to your body, or as my tapping meditation app always says, “I accept myself, and honor how I feel.” Wellness culture, according to Amazon, is also all about super foods, CBD gummies, coconut oil, probiotics, self-care kits, therapy lamps, acupressure mats, sleep-inducing eyeglasses, aromatherapy devices, and weighted vests for calming anxiety.
Wellness, for some, involves not ejaculating. I discovered this when researching psoas muscle stretches, which were recommended to me by my therapist for recovering from trauma and medical PTSD. The practice of not ejaculating is called “semen retention,” and many men claim it gives them “mental, physical, or spiritual benefits.” Strengthening the psoas muscle, which runs through the pelvic bone, apparently helps both traumatized people and semen retainers who want to orgasm without…leaking. There is an entire subreddit devoted to the topic of semen retention, which I will not link to here. As for the women, the most-mentioned wacky wellness practice/product in my social-media-powered research was Gwenyth Paltrow’s jade egg. From the product listing on the goop website: “Insert the egg into your vagina and feel the connection with your body by squeezing and releasing the egg…Clean your egg after use and before using again. Keep it in or on a space that is sacred to you or has good vibes.” The runner-up to the jade egg in my survey was the practice of urine therapy, or drinking your own urine.
Pilates was not my first foray into the wide world of wellness in an attempt to improve my migraines. Some of my most helpful treatments, after all, have been things like acupuncture, massage, chiropractic, and dietary changes. Some of my least helpful treatment attempts have been in the wellness category, too: yoga, essential oils, various herbal concoctions and supplements, noise-filtering earplugs, mindfulness apps, and a powder made of cow immunoglobulins that tastes like spoiled, watery milk. I even once bought a neck traction pillow which claimed to CURE migraines or your money back! It didn’t do a darn thing, but I forgot to get my money back and now I think it’s too late. I investigate most every nontraditional treatment idea that comes my way, because I really don’t have a choice. When dealing with chronic pain, even swimming naked across the Bering Strait sounds worth a try if it helped your friend’s cousin’s mother-in-law with a hangover headache.
Technology, of course, claims a sizable slice of the $450 billion US wellness economical pie each year. There are fitness trackers, meditation apps, electronic vagus nerve stimulators, smart mirrors and scales, and, of course, Apple Watches. My husband, Cory, and his team at work recently gathered for a community service project, planting redwood trees in a local park. Afterward, they started talking about Apple Watch wellness features over lunch. Cory, the only person in the group with a plain-old, regular watch, was baffled by how many of his colleagues used the Apple Watch to track things like heart rate, steps, and blood oxygen content. It even monitors something called heart rate variance, an indicator of sleep quality.
“I use the heart rate variance tracking all the time” said Cory’s coworker, who I’ll call Jamie. Jamie wasn’t at the morning service project, but had managed to make it out for lunch. “In fact,” Jamie continued, “just this morning, I woke up and saw my heart rate variance numbers from last night were low, which led me to realize that I definitely felt a bit off. So, I went back to sleep for an hour, then decided to skip the service project in favor of a long, hot shower!”
I am, of course, a huge fan of people staying home when they’re actually sick. My immune system thanks you for not sharing your germs. But I also can’t help but imagine a plaque where Jamie would have planted a redwood tree that morning, had she shown up for the service project: Here is where a tree would have been, if Jamie had felt a little less off.
My private pilates sessions are part massage/rehab, part exercise. I didn’t get the point of massages before being in pain, but now, a massage is one of the few things that can get me out of a long migraine or through an extended time spent traveling. Massages are like pizzas: they’re ubiquitous, every place has their own take on the concept, and some are better than others (I recently paid good money for a “scalp massage” that was more like a vigorous head scratch). While on vacation in Florida, I booked a massage at a hotel with plush robes, a huge bathroom with showers and pre-pasted toothbrushes, and a private sun room with lounge chairs to relax in before/after. My massage in Glenwood Springs was in an old house that people may or may not have lived in. In New York City, the massage therapist was excited to show me his state-of-the-art massage table that made space for my boobs at the press of a button, and he spent twenty minutes rubbing cold, goopy “therapy balls” all over my head and neck. Up near the Oregon coast, it’s hard to find a massage therapist, whether male or female, without a beard. But all of my many massage experiences have had one thing in common: every massage therapist has migraine remedies to recommend. Have I tried fish oil? Marijuana? Sitting in a dark room? Homeopathy? Spinach? Relaxation? Advil? The pilates instructor’s recommendations were osteopathy and—of course—pilates. When I asked her what osteopathy is, her vague description left me imagining a doctor that asks for my blood type, Meyers-Briggs, and astrological sign before poking various spots in my head. I decided not to ask her what pilates are, though, because I didn’t want her to think that I had booked an appointment at a pilates studio without knowing what pilates are (even though that’s exactly what I’d done). And besides, I figured I’d find out soon enough.
The actual pilates portion of each pilates session is both difficult and baffling. It’s baffling because there are so many pieces of equipment involved, including a spring-loaded gliding table called a reformer, a stationary table that I don’t know the name of, a padded arch with a ladder, and a contraption with cables and spinny handles that I haven’t yet been allowed to use. Each of these devices can be modified in countless ways with springs, weights, boxes, pillows, rings, cables, exercise balls, foam rollers, etc, so the possibilities for stretches and exercises are near infinite. Most of the exercises (pilates?) are deceptively difficult. Take, for example, a recent one in which I was moving one leg back and forth on the glidey-table/reformer. I kept bending my arms, though I was supposed to hold them straight on the side bar, and the leg that was on the floor was supposed to bend at the knee, but not all the time. And my hips…oh, my hips. They are never in the right place. The instructor told me to imagine holding a cup of water on my hips as I moved back and forth. I was so confused, she ended up holding my hips in her hands and moving them where they were supposed to be the whole time. In the next exercise, in which I was laying flat on a table, she told me to tilt my sacrum upward. I was very proud of myself for remembering where my sacrum was located, as she had reminded me of this many times, but I really wasn’t sure which way was up for a sacrum. I guessed wrong, then wrong again, and now I still don’t know. Perhaps my sacrum is upside-down?
The most difficult thing about pilates, however, is the breathing. You can’t just breathe like a normal person, you need to inhale and exhale at specific times. On the reformer, for example, you breathe in as you straighten your legs, sliding the table out, and you breathe out as you bend your knees to bring the table back in. Real pilates people, aka everyone else I see in the pilates studio, can do all sorts of complicated exercises on the strange equipment, breathe in and out at the right times, AND keep up a steady stream of chit-chat with their instructors. I’ve overheard all sorts of interesting conversations, including a debate over whether a salad is best eaten before or after the main course of a meal, and a story about a woman who was sensitive to every food except potatoes. My instructor tried to ask me a question about my life once, but quickly realized I couldn’t handle this level of multitasking and has since stopped talking to me.
In her book Run Towards the Danger, Sarah Polley tells her story of a severe concussion that gave her all sorts of troublesome symptoms, including migraines, for years. Her struggle with chronic pain forced her to stop burning the candle at both ends, and taught her to—you guessed it—listen to her body. But too often, her body told her to stop when she wanted to be present with her young kids, her husband, or her friends, and she grew discouraged. (This is a cycle that any person in chronic pain will find all too familiar.)
At the end of the story, Polley makes a remarkable recovery, due in large part to a doctor who recommended a form of extreme exposure therapy. For part of her treatment, Polley was instructed to do everything that triggered her symptoms, including sitting in bright or crowded spaces, working on the computer, etc, until her brain was forced to adjust. When I told one of my doctors (my integrative doctor at the ketamine clinic, who works out of a yurt) about Sarah Polley’s story, he didn’t seem nearly as shocked by it as I was1.
“The psychological burden of wellness can be enough to keep people sick,” he told me. “Now please pardon me while I go milk my yak.” (Ok, he didn’t say the last part. But I’m always half expecting him to say something like this, given the yurt.)
I was so intrigued by this exposure therapy approach, I ended up calling the concussion clinic Polley visited to see if one of their doctors would give me a second opinion. If this therapy could be modified to help people with plain-old, regular migraines, that would be a huge breakthrough! The patient intake coordinator at the concussion clinic was, unfortunately, not keen on the idea. I tried my best to explain to her that with my longstanding history of head pain and light sensitivity, I might as well have a concussion, plus isn’t amnesia one of the symptoms of a concussion? Maybe I do have a concussion, and I’ve just forgotten about it. But she was adamant that I needed to hit my head and remember doing so in order to schedule an appointment. I wasn’t near anything heavy at the time, so I hung up the phone. (To the UPMC Sports Medicine department: I forgive you. Call me.) Afterwards, I did a meditation, then biked to a chiropractic appointment, then micro-dosed some ketamine.
Four months into my pilates experiment, I’m still not exactly sure what a pilate is, and at this point, I’m afraid to ask. There has also been no mention of the gyrotonics, or how I can order one. But when not I’m not laser-focused on breathing, or what to do with my sacrum, I’m starting to question a lot of the things I do in my endless pursuit of better health. At the end of her essay, Polley says, “I [now] know to listen to my body, but not so much that I convince myself I can’t do things…not so much that I can use the concept of listening to my body as a weapon against my vitality.” Though not everyone would have Polley’s remarkable success with throwing wellness out the window, it does make me wonder if my body always knows what’s best for my life. Is there such a thing as wellness that makes people feel less well? And also, when do I get to try the spinny-handled machine? It seems like the sort of thing that could give me a concussion. 🧠
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This seems like a good time to remind you’re reading a funny newsletter, not a medical journal. DO NOT, I repeat, DO NOT consider anything I say to be medical advice, nor good advice of any sort. In fact, it’s probably best to do the opposite of anything I say, as I’m clearly not getting anywhere with my medical problems.
This was heartbreaking and hilarious. The wellness industry is big biz.
I know you’ve probably researched everything but have you ever heard of Arnold Chiari Malformation? My son had chronic migraines and he was diagnosed with ACM and had surgery to correct it. Just thought I’d throw that out there.
Sending healing hugs.
You had me at "room for boobs on a massage table." That is something!!!