Possibly one of my most self indulgent works yet, as I'm a sucker for medically based TFs and the possible application of transformation with real therapies. Many of the manipulation procedures in the story are real techniques that I enjoy preforming. HEENT work is really fun.

Asked for a photomanip to go with this story and they provided handsomely. Please enjoy!

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“May I come in?” Dr. Harper knocked on the door and his patient responded in the affirmative. “Macie Chapman?” She appeared as her stated age, about mid-thirties with bushy eyebrows and deep brown hair tired into a bun. A bulky beige neck brace sat around her collar, with notable red irritation over her clavicles. The way she set her hands on her legs and held her back straight gave the impression of a discomforting posture.

Macie tugged at the bottom of the blue gown draped over her chest. “Yes.” she said again.

“We’ll I’m Dr. Harper and I hope we can get you some help for that neck pain, alright?”

“Yeah.”

“Hmm.” Dr. Harper took out a pen from the pocket of his white coat, noting his patient’s curt replies. Either she was being snippy with him or, more likely, it was just painful for her jaw. “Are you ok with speaking Ms. Chapman? I don’t want to cause you any more discomfort. But I will need to ask you some questions. Is that alright?”

She withheld herself from nodding. “Sorry, it’s fine.” Talking wasn’t that much of a problem, more she’d been getting inpatient with the nurses taking all her information for the umpteenth time. “Go ahead doctor.”

“You sure? And please, I can help you lay down if that would give you some relief.”

This time Macie nodded instinctively and felt the sharp electric burn arc down her right arm. “Nhn! Yeah, sorry.” She scooted on the table and Dr. Harper moved to her side to assist her in leaning back onto a pillow.

“Better?”

“Uh huh.”

He pulled the stool over to sit beside her. “Alright. So, I read over everything you’ve given to the nurses. Do you mind if I just relay some of it back? And you let me know if there is anything you want to add.”

She stared up at the Styrofoam-like surface of the clinic’s ceiling. “Sure.”

“Ok. So about 7 months ago you started having neck pain and it’s continued to get worse. Hurts more when you flex forward, but when you received a steroid injection from Dr. Bayer a few weeks ago, you said it didn’t help? Is that accurate?”

“Yeah. Well, it helped for a little bit but then the pain came right back after I woke up the next morning.” Not to mention the injection itself hurt like hell.

“I see I see. So very brief relief. And there was no traumatic event that brought this on?”

“No.”

“Ok. Can you describe the characteristics of the pain for me again?”

She creased the corner of her mouth to find the words once more. “Uh, just really sharp and electric, like someone stabbing a knife in there, slicing into my arm. And then after the pain it’s just numb for a while.”

“Alright. Have you had any trouble walking, or issues with balance?”

“Not really. It’s hard to get up with this neck brace, and sometimes that makes me feel like I’m going to fall over, but that’s it.”

“Hmm. And could you trace on your arm where you feel the pain radiate down when it spikes?” Macie pulled her eyes to the side slightly, reaching across her chest with her left hand to trace a line on her hand arm from her anterior deltoids down to her ring finger. “I see.” The doctor stood up. “Do you mind if I feel over the back of your neck? You don’t have to move, I promise to be very careful, ok?”

She pushed her lips together and shut her eyes tightly. “Yeah, go for it.” Dr. Harper carefully removed the Velcro clasp of her neck brace while holding her head at the occiput. His touch was ghostlike, exceedingly light over her cervical ridges with minute fasciculations playing between his fingers as he gingerly teased each spinal column. Macie winced when he moved over where the pain was worse, but the doctor had already pulled his hands away and gently lowered her down.

Dr. Harper didn’t need to palpate that deeply to confirm his diagnosis. “Ok thank you Ms. Chapman, that gives me a much better idea.” Her condition was nothing exceptional to his years of practice, though the resistance to conventional therapies was always a complicating factor.

She peered back over at the doctor. “You have the x-rays too, right?” No way would she let another clinic force her to retake those images without a good reason.

He nodded while stepping back to the stool to take up his pen and clipboard. “Yes, though I think an MRI would be more useful in this case. But let me tell you what I think first before we talk diagnostics or procedures.”

“Fine.” Were MRIs the ones where you had to get stuffed in a cramped loud tube for hours? Not like her cheap ass insurance would cover it anyway.

“So I’m fairly certain you have a herniated disk between your fifth and sixth cervical vertebra which is the source of your sciatica. That’s pain from a pinched nerve which is supplying sensation over your arm. Now, like I said, we could get an MRI to confirm that, but I’d rather save you the unnecessary stress and costs.”

“Thank you.” She sighed. “Will you be able to do the stuff with your hands?” OMM or something, her friend Becky had said Dr. Harper fixed her lower back pain with a massage thing, so she was wiling to try getting some chiropractor magic stuff.

“Osteopathic manipulation?”

“Yeah.”

He chuckled softly. “Yes, I think you would get good relief with a few articulatory techniques which I could try. However, I’d need to be very careful with that region and I’m worried about possible progression to permanent nerve damage. That’s what we want to avoid at all costs, so I’m afraid these hands might be beat, Ms. Chapman.”

It was refreshing honesty at least. “What are the other options?”

“Surgery is always an option.” Macie’s eyes shifted back to the ceiling. “But there are too many risks, and given you had poor results with the injection, I wouldn’t recommend it. There are analgesics I could prescribe you, but again, that’s just relief of symptoms and you need a long-term solution. I do have one other idea though.”

“What is it?”

“Have you heard of RTT?”

She tried to reach a memory of hearing about that on her newsfeed. “No, what’s that?”

“Rehabilitative Transmutative Therapy. Think of it as something between medication and manipulation. It’s been very effective with treating chronic bone and nerve diseases like this.”

“Ok. Will my insurance cover it?”

“You’d have to pay out of pocket I’m afraid.” Unsurprisingly the insurance companies were diametrically opposed to any treatment that might actually cure patients and not keep them chronically ill. “But this clinic uses a sliding scale payment method. We’ll be able to make it affordable to you Ms. Chapman, I’m certain.”

That was a bit of a relief to hear. Heather lifted her waist slightly and readjusted her back against the table. “Ok, how does it work?”

“It’s mainly delivered through topical application, but right now it can only be administered with medical supervision. I can give you a dose here, and if you feel some improvement, I’ll reschedule you for another treatment in a week.”

“How long do I do that for?” So much for a long tern solution if she was coming to the clinic regularly.

“It depends. RTT exhibits reverse tolerance in most patients. Often the relief is exponential with each treatment. I’ve seen full recovery in just three appointments.”

“Hmm. Ok.”

The doctor smiled and tucked the clipboard under his arm. “Great. Hang on right there and I’ll be back.” Macie slowly blinked as Dr. Harper scooted out of the room. He seemed like a nice guy but every clinic visit just tired her out with stress. A doctor who couldn’t help her pain wasn’t very useful no matter how good their bedside manner was, only more time and money wasted on people leading her along. Sinking her sore neck into the pillow, she let her lungs deflate with a steady exhale.

Dr. Harper retuned after twenty minutes, carrying a pack of gloves and a large plastic vial filled with a light orange cream. “Sorry, I was pulled away to help other patients. Really sorry about that.”

Macie just looked back at the ceiling lights. “Its fine.”

“Well, thank you for the patience.” He strapped on a pair of gloves and squirted the cream into a palm to mix it over his fingers. “I’m going to rub this down your neck, ok? Side effects are very rare but let me know if you feel any irritation or burning, ok?”

“Yeah.”

It was dry and cooling, with a fizzy tingle on her skin like hydrogen peroxide, though the doctor used a rougher touch then before which made Macie twitch her shoulder a few times. Closing her eyes, she did the best she could to relax and keep still. Each of her breaths felt like it was lasting for longer and longer, dragging her ribs outward.

“Better?”

“Hmm?” Macie pulled her eyebrows up to blink, feeling the doctors’ fingers tapping over the most sensitive part of her neck. There was still some tenderness, but no immediate stabbing pain like before. “Yeah…” She reached back to touch where the Dr. Harper was holding. “Yeah. It’s a lot better!”

“Great, great. Now you still might want to wear the neck brace, but hopefully the improvement lasts for a while.” Macie sat up on the table quickly, pulling her neck forward. The familiar and painful electric jolt jammed through her spine and Dr. Harper caught her sides where she was frozen mid spasm. “Careful, please. I never said you were cured yet.”

“Ghh, shit.” She put the brace back on, curiously feeling an increased space between the padding and her chin. “Can I come in sooner if it gets really bad?”

“Of course. Of course. You let me know if anything come up.”

- - 7 days later

“May I come in?”

“Yeah.” Macie smiled and stopped bouncing her knees.

Dr. Harper was wearing the same blue tie under his white coat. “How are you doing today Ms. Chapman?” She was holding herself much better with her legs crossed and leaned back on the table. The neck brace was still on but there was no chaffing erythema on her collar.

“A lot better.” Her neck brace twisted to the side as Macie perked up and she readjusted it. “Well, pretty good. I still get the pain once and a while.”

Dr. Harper nodded and scribbled a note on his clipboard. “Good to hear, good to hear.”

“Will we do another course of the RTT?” She’d found herself looking forward to this visit for the past few days.

“Of course. Anything else to note?” He looked over Macie for a moment and they both shared a confused pause while she was unsure of what she was expected to say.

“Uh, no, I don’t think so.”

“Alright.” The doctor tilted his clipboard. “Sometimes patients experience odd side effects, like other sources of pain or muscle changes. Nothing like that?”

“Oh.” She swung her leg up and then let it fall back down. “I guess a few things. I think my neck grew longer?” The neck brace no longer fit as snuggly around her chin and even her daughter had commented on it. “And there’s been some pain on my forehead and around my mouth… but like, nothing serious.”

“Any characteristics too it, the pain on your face?”

“Huh?”

“Is it dull or sharp? Anything like that?”

“Hmm. Dull, not bad or anything. I guess more of an ache. And like, a tugging feeling too?”

“I see.” Dr. Harper set the clipboard down. “That’s all expected. Those will hopefully lessen with another treatment, but as long as it’s helping your neck pain, I think you’re safe to proceed.”

“Great.” The cream was already on the counter and the doctor pulled on some gloves while Macie turned around on the table. This time she took off the neck brace on her own and pulled her hair up with a scrunchie. “Can you do it while I’m sitting?”

“Of course.” She could hear the cream smushing between Dr. Harper’s gloved fingers from behind her. “Do I have permission to touch you?”

“Yes.” His hands guided down along the groove of her cervical oblique muscles, pressing deeply with his thenar that made Macie lean backwards into his force. “Mmmmm.” Her chest filled with air as he built up motion to her occiput, and then let it escape when he dragged the cream downwards again.

“You’re a natural Ms. Chapman.” She was doing respiratory assistance without him even asking.

“Hmm?” Macie didn’t hear it, she was too focused on the tension flowing away into her shoulders. It wasn’t just her imagination; her neck was growing by inches with every stroke of the Doctor’s hands and she loved it. His fingers wrapped around to her anterior neck in alternating waves that strummed over her hyoid.

Dr. Harper cupped a hand under her chin with a downwards tug. “Can you extend your head back and try to lift against my force?”

“S-sure…” She did as he directed, clenching her jaw and tilted her head backwards while jutting out her lips. The doctor provided a counter force that resisted her motion, stretching her sternocleidomastoid till it was drawn taught on her lengthened neck. “Ohh that feels good…”

“Relax.” Macie let her head sink forward again. “A few more times.” He repeated the muscle energy technique while continuing to rub over her posterior neck, adding an upwards force under her chin with each cycle. On the third time, there was a smooth ‘pop’ and Macie saw her vision bounce upwards.

“Hnn! Was that it?” There was no pain, just a void of tension as the sensation slowly returned to her spine.

“The pop is not diagnostic. Let me retest.” Dr. Harper felt over her neck with a more exploratory touch this time, poking little divots with his thumb along each vertebral process. “Any tenderness here?”

She squirmed a little with the hard press against her herniated disk. “Nnn, a little, still.”

“I see. Well you might need a third treatment, but let’s see how your symptoms improve as the week goes on.” He moved away from her and back to his clipboard while Macie reached up to explore her neck. It was definitely longer, though hard to tell without a mirror to examine herself. Also, her chin felt like it moved away from her face and there was an upwards point to her ears.

“What if I need to come in sooner?”

“Just call the clinic and we’ll find an opening for you Ms. Chapman. You have a good day, alright.”

- - 6 days later

“May I come in?”

“Yes please!” Macie was seated on the patient table without her neck brace. The nurses were adamant about her putting on the blue patient gown again, even though she said she’d be fine seeing Dr. Harper in her plain clothes.

“How are you doing today Ms. Chapman?” His eyes ran over the noticeable changes to her face and neck, giving her a satisfied smile before taking his seat on the stool.

“Great! I’m feeling so much better doctor. This treatment course is amazing.”

“I’m glad to hear it. Have there been any complications?”

Macie crossed her hands over her lap. “What do you mean?”

“I assume you’ve noticed some of the changes to your appearance?” He shouldn’t speak to patients like that, but it felt like she was playing dumb with him here. The woman’s neck was at over a foot long, her ears now noticeably pointed and splayed to the side. Two boney bulges were present on her forehead while her lips were jutting out from her face. Skeletal structural abnormalities were the most common side effect of RTT, but they were not an absolute contraindication on their own unless the patient showed concern for the changes.

Macie had called the clinic to move her appointment a day sooner, but she was not in acute distress at the moment. Dr. Harper just preferred to hear it in the patients own words rather then assume such things. “Is any of it concerning to you?”

“Concerning?” She tiled her elongated neck to the side slightly. “Uh, no, not really. It’s part of the treatment process, right?”

“It can be, but some patients do report those side effects as a source of stress. I only want to be sure.”

“Oh no no.” Macie shook her head gently. “I don’t mind it at all doctors. Really. If anything, I think I… mm, well, it’s been nice.” A little extra length on her neck wasn’t anything to complain about. She already got too many stares from strangers for wearing that stupid neck brace, but now all the glances were ones of curiosity and attention. The fact that her ex-husband had a peculiar thing for kissing her neck was just like the cherry on top. If only he could see what he was missing now.

“I’m glad to hear it.” Dr. Harper kept up his smile while making a few more notes on the clipboard. “At this point, I think a third course of RTT would be entirely optional for you.”

“You think so?” She blinked twice, reaching to drag her hand over the back of her neck. “Or optional meaning, I can still get it if I want, right?”

He had to hold back a small chuckle. “Of course. It looks like you’re already at a functional level, but a third course is still within the recommended limit.” There was some slight interest within himself as well, just to see how she would respond.

Oh thank goodness. “Then I’d like to! Please.” That’s what she was here for after all. The neck pain was secondary to how good it felt with Dr. Harpers hands stroking the cream over her neck and chin. Her body was begging for that feeling one more time.

“Alright, I’ll be just a moment.” He left to go retrieve the lotion while Macie waited eagerly, though thankfully not as long as before. Dr. Harper was back after just a few minutes with the usual dosage. “Would you like to stay seated again?”

“Sure.” His gloved hands lightly lathered by the lotion, he approached her from the font this time.

“Do I have permission to touch you?”

“Yes.” Dr. Harper cupped his palms around the back of her head, pressing deeply into her semispinalis muscles with the rows of his fingertips. His wrists held onto her shoulders to draw Macie closer and keep her tightly positioned in the groove of hic neck. She fell into the embrace easily, shudders creeping up her shoulder with every carful motion. “Nnhhh!” Tan furs spread under the doctor’s touch, lining her spinous processes with a pronounced stripe of brown hair like a miniature mane.

“Let’s lower you a bit.” The electric table hummed and sank Macie down so that Dr. Harper could more easily assess her face. Deep tissues first and now some articulatory techniques to help adjust her new features. “Is it tender here?” He tugged two fingers around each of the nubs on her forehead.

“Hnn, y-yeah…” The doctor began a slight twisting motion, guiding the hard tissue to push out of her skull into thumb-size horns. “HHnnnn…” It felt so good, like a dull headache sucked away into nothing. Macie closed her eyes to enjoy the sensation of her new protrusions as Dr. Harped rhythmically pulsed them in the grip of his palms.

Next was the lower face, applying a gentle effleurage motion that guided Macie’s chin to merge closer with her lower lip. Using his middle finger and ring finger, the doctor held traction over her cheeks that drew out her face into a solid snout. “Mmmm!” The feeling was sublime, bordering on erotic pleasure with how she could feel her nose reshaping under the physician’s touch.

With the flat of his thumb, Dr. Harper squeezed her nasal bone caudal and anterior, splaying Macie’s nostrils outwards while melding her nose into the extended muzzle capped by her lips. She could feel her tongue swelling thick and purple inside her mouth while the doctor made her last changes in smoothing the bridge of her nose down to a flat angle. Macie fluttered her eyes open to admire how narrow her new snout was, how far it extended between her eyes.

Her tissues were soft and prepped for a more active technique, but Dr. Harper wasn’t sure if that would suit her additional vertebra. The principle behind RTT was to use animal gene therapy to enhance the body’s natural capabilities, encouraging novel functions to pave over disabilities. In this case, the traits of a giraffe made helped widen Macie’s brachial plexus to release the pinched nerve. Her neck was stronger, but not necessarily as flexible. A little more extension should prevent any future nerve issue and resolve the herniated disk in full.

“Just a little more, you’re doing great.” Macie moaned softly, her breaths slowing to match the pulsatile rubbing force over the soft anterior of her neck. Dr. Harper’s touch was only a guide to show her body how to heal itself. With the firm pressure above her thyroid, Macie tipped her chin up, feeling her cervical spine shift all at once.

Inch by delicate inch, her neck angled higher until she felt that the doctor’s fingers were the only thing holding her head aloft. As she exhaled, he released the compression and Macie heard the cracking pops of her jaw loosening. “Ahhnn…” Her lips parted with a heavy breath, skin tingling with a fine layer of fur over everywhere Dr. Harper touched her.

“Alright, that should be enough.” There was now a solid two feet of neck laced with squarish patches of brown hair in a cobblestone pattern.

“Oh my gosh, this…” Macie petted of her snout while her other hand explored the tight skin from her collar to chin. “It’s incredible” She felt like a whole new woman, rediscovering her shape for the first time. “I really don’t know what to say doctor…”

“Happy I could help.” He took up the clipboard to glace at Macie and pen some closing notes. “If there is any trouble, anything at all, call the clinic alright?”

“W-wait!” The doctor stopped with his hand on the doorknob, and Macie’s fingers still cupping over her animalistic features with joy. “S-should I come back next week?”

“No need for that, but we could do a general checkup in a month or so. Whenever is convenient for you, sooner if it gets worse.”

“What if it doesn’t get worse.” Macie whined in a way that her flared nostrils turned into more of a whinny. “Can I come in to see you even if it keeps improving?”

“Ah.” Dr. Harper smiled tiredly. “How about a telemedicine appointment next week? Just so that I can see that you’re doing better.”

“Ok!” She rubbed her hands together over her lap, her shoulders wiggling nervously. “Um, I’d be happy to have you see me any time, doctor…” They shared a long stare till Macie had to look away with her rectangular cheeks turning a touch of rose red. “Do you…”

“Mm.” Increased sensitivity and sexual urges were another common side effect of RTT, one which posed little impact on the patient’s overall recovery. Still, Dr. Harper felt he had to say something more, urged to give the woman some final words of comfort or companionship. “I’m glad then.” No, the closure was in the treatment, and she was just another patient at the end of the day. She had her own life to live, and she’d live it just fine with Dr. Harper satisfied in his minor role. “You have a nice day, Macie.”