Halo Brace - Advice
Created | Updated Jan 31, 2009
The other "h2g2" guide article on Halo Braces has a huge amount of useful advice (to see it type "halo brace" in the search box above right). I'd like to add to that here with some further practical suggestions, some of which are especially important for women wearing halo braces.
I wore the halo for 4 months (ending 3 weeks ago) - I had C1 (Jefferson or "burst") and C2 ("Odontoid" or "Dens" type II/III) fractures. I was told to wear the halo for 3 months, but because of the nature of the C2 fracture, I had to wear it for 4 months in total (I understand that 3 months is "average").
So, let's start with T-shirts. As long as you're not too tight inside your halo vest, some people can slide a T-shirt up inside (and even wear a bra). Wearing a T-shirt is much more comfortable -- we all know how itchy the sheepskin can be on your skin -- but also it's better for keeping clean as you can change it frequently, and stops the sheepskin getting matted. I think it's much better for your skin condition under the halo also. I know this can be harder for men with bigger chest and shoulder muscles, as they their vests may be tighter.
T-shirts can be cut along the seam on the top of one shoulder. To put on the T-shirt, step into it, and wriggle it up through the bottom of the halo, gently tugging it upwards. You'll need someone to help you pull it up at the back, at least for the first few months. Put your arm through the un-cut sleeve before slipping this sleeve up on to your shoulder. Then the cut shoulder can be fastened with safety pins, (or sew in poppers before putting the t-shirt on). You'll need about 3 cut T-shirts, so that you can wear them in rotation.
Washing can be tricky. I found that sitting in a bath with a couple of inches of water in it worked fine. Just get a thin flannel and without soap, run the flannel under the halo at the front. After your bath, ask someone if they would do the same on your back. You may need to move the halo vest fractionally forwards or back and drop your shoulder blades a little to enable the flannel to get underneath. I remember this being painful at the beginning and I was cautious about moving much at all in the first month, so we just did what we could. But I could do total body washes during the final 2 months. I then use a cool hair drier to dry off the skin under the vest.
Next - hair washing. No problem if you're a guy with a crew cut, but not so simple for peopl with long hair (like me). We tried lots of methods here, but in the end lining up 3 chairs in front of the bath, then lying backwards with my head protuding over the side of the bath was the best. Obviously you need a friend or family member to help you with the actual washing. Then I think using a hairdrier around the pin sites at a minimum is important, as they're more prone to getting infected if they stay damp. (We found initally that a first wash around the pin sites using baby shampoo avoided stinging and irritation. We then did a second wash with my normal shampoo to clean the main section of scalp. After a few months, this wasn't necessary as my pin sites were less sensitive).
These tips should help your skin remain in pretty good condition. Just watch out for dry places developing where the halo rubs constantly (for me it was shoulder blades)- you can use simple moisturiser to treat these. Keep an eye on these dry areas as they can turn into little sores, particularly during summer. If sores develop, it's important to have these checked by your local doctor as pressure sores can become serious problems.
More about the pin sites. It's really important that they be kept clean to avoid infection. My nurses taught us to put a little saline solution on cotton wool bud to clean any seepage (usually it seemed to get quite "crusty", and needed gently softening and moving away on the tip of of the cotton bud). If you stick to this regime every day, it's possible to avoid infection. Certainly healing was remarkably fast after the halo came off, and I think scaring is reduced if you can avoid infection. I've also read that in extreme cases, infected pin sites can lead to the pins needing to be moved, so this is really worth keeping on top of.
Sleeping can be a real challenge for some people. The alignment of my halo was such that i couldn't lie on my back. However, my TOP tip would be to try a big squishy beanbag (the soft kind you can mould yourself into). I used this on the bed to lean against instead of pillows -- the halo moulds into the bag while supporting your back. Guess soft pillows would work too, but they're less pliable. After approx 6-8 weeks, I slept on my side without pillows. (Prior to that, I wasn't able to lower myself down or get up again this way, but it got much easier. If you use your legs by moving them off the side of the bed, it helps you to push up with your arms). A good trick is to put a soft little pillow between the halo bar and your cheek when lying on your side - it gives the impression of being (somewhat) on a pillow without affecting the frame.
Another thing that my consultant suggested was getting an exercise bike. I was really surprised, but I went ahead and got one. It worked out great, as my upper body hardly moved at all while my legs rotated. I was able to stay a little fit, it helped me avoid gaining weight, and I felt strong and stable on my legs. It really helped my mobility during the last month of my treatment, when I as able to walk (carefully) around my neighbourhood and visit friends. I'd suggest you check this with your doctor before going ahead, as it might not be suitable for very unstable fractures, or if you have other injuries.
Regarding walking, I'd again suggest that you ask your doctor for advice. I found as soon as I was able and confident to walk, I started doing so - albeit only a short way at first. Always keep a friend with you for the first few months. In my second month, I was walking alomst every day a few blocks (about 0.6 of a mile round trip) to our local park. I felt very "jarred" and obviously sore in my neck at first, and took a break when this happened. It was great for my body and mental state to get out. I would advise that you try to plan your rests on route e.g. a park bench, a low wall. I remember benefitting from regular rests in the early weeks. I was able to walk further with a friend during my 3rd month, and a mile on my own during my 4th month. (I took off my wedding and engagement rings, and felt less vulnerable walking around the urban streets). Obviously extra care if needed if crossing roads, I remember checking lots of time left and right -- tricky when you've got to move your whole body one way and then the other.
As for getting stared at, yes, it will happen constantly. But without exception people have just been curious, and a remarkable number of people asked about my injury. Children particularly stare but mean no harm. I consider it one of the positive outcomes of having gone through this "experience" that I will never ever feel self-conscious again having walked around in public wearing the halo!! But don't let any of this put you off. Getting out of the house, even if it's only for a few minutes on difficult days, can do wonders for your state of mind. Most importantly, there is an end to this, and very soon you will have your final scans, and your halo will be history :)
~~~~~~
When 3 months of wearing a halo is ahead of you, I know that it can feel like an awfully long time. I can honestly say that it gets easier. I read a pamphlet saying that I'd be able to go to restaurants, see friends (even go to the cinema?!!), and I didn't believe it at first - but it was correct. I have done some of these things without any major discomfort. I'd certainly recommend trying to stay sociable also. Let friends and family visit as soon as you feel up to it. They will understand if you can only manage a short conversation at first, and eventually you'll be able to spend longer with them. Wearing a halo can be an isolating experience, but it doesn't have to be. The pain and fear will reduce also, and your energy will start to return, so you may be able to pursue some quieter hobbies towards the end, and perhaps enjoy simple things at home that you usually don't get time for. For me it was a very challenging time, and extremely tough in the early weeks(I don't mean to suggest for a moment it is easy at any stage), but it did get easier to cope. And of course you will soon be free of it, and you can start getting back to full strength again.
PS. If you have further questions, you can "start a new conversation" by clicking on the link below. I will try to post a response as soon as possible. However, please note that I'm not a medical professional, and can only speak from my personal experience.
PPS. 12 months on, I've posted some responses to questions on the forum. Hope the answers will give you a sense of my post-halo experiences.
I wore the halo for 4 months (ending 3 weeks ago) - I had C1 (Jefferson or "burst") and C2 ("Odontoid" or "Dens" type II/III) fractures. I was told to wear the halo for 3 months, but because of the nature of the C2 fracture, I had to wear it for 4 months in total (I understand that 3 months is "average").
So, let's start with T-shirts. As long as you're not too tight inside your halo vest, some people can slide a T-shirt up inside (and even wear a bra). Wearing a T-shirt is much more comfortable -- we all know how itchy the sheepskin can be on your skin -- but also it's better for keeping clean as you can change it frequently, and stops the sheepskin getting matted. I think it's much better for your skin condition under the halo also. I know this can be harder for men with bigger chest and shoulder muscles, as they their vests may be tighter.
T-shirts can be cut along the seam on the top of one shoulder. To put on the T-shirt, step into it, and wriggle it up through the bottom of the halo, gently tugging it upwards. You'll need someone to help you pull it up at the back, at least for the first few months. Put your arm through the un-cut sleeve before slipping this sleeve up on to your shoulder. Then the cut shoulder can be fastened with safety pins, (or sew in poppers before putting the t-shirt on). You'll need about 3 cut T-shirts, so that you can wear them in rotation.
Washing can be tricky. I found that sitting in a bath with a couple of inches of water in it worked fine. Just get a thin flannel and without soap, run the flannel under the halo at the front. After your bath, ask someone if they would do the same on your back. You may need to move the halo vest fractionally forwards or back and drop your shoulder blades a little to enable the flannel to get underneath. I remember this being painful at the beginning and I was cautious about moving much at all in the first month, so we just did what we could. But I could do total body washes during the final 2 months. I then use a cool hair drier to dry off the skin under the vest.
Next - hair washing. No problem if you're a guy with a crew cut, but not so simple for peopl with long hair (like me). We tried lots of methods here, but in the end lining up 3 chairs in front of the bath, then lying backwards with my head protuding over the side of the bath was the best. Obviously you need a friend or family member to help you with the actual washing. Then I think using a hairdrier around the pin sites at a minimum is important, as they're more prone to getting infected if they stay damp. (We found initally that a first wash around the pin sites using baby shampoo avoided stinging and irritation. We then did a second wash with my normal shampoo to clean the main section of scalp. After a few months, this wasn't necessary as my pin sites were less sensitive).
These tips should help your skin remain in pretty good condition. Just watch out for dry places developing where the halo rubs constantly (for me it was shoulder blades)- you can use simple moisturiser to treat these. Keep an eye on these dry areas as they can turn into little sores, particularly during summer. If sores develop, it's important to have these checked by your local doctor as pressure sores can become serious problems.
More about the pin sites. It's really important that they be kept clean to avoid infection. My nurses taught us to put a little saline solution on cotton wool bud to clean any seepage (usually it seemed to get quite "crusty", and needed gently softening and moving away on the tip of of the cotton bud). If you stick to this regime every day, it's possible to avoid infection. Certainly healing was remarkably fast after the halo came off, and I think scaring is reduced if you can avoid infection. I've also read that in extreme cases, infected pin sites can lead to the pins needing to be moved, so this is really worth keeping on top of.
Sleeping can be a real challenge for some people. The alignment of my halo was such that i couldn't lie on my back. However, my TOP tip would be to try a big squishy beanbag (the soft kind you can mould yourself into). I used this on the bed to lean against instead of pillows -- the halo moulds into the bag while supporting your back. Guess soft pillows would work too, but they're less pliable. After approx 6-8 weeks, I slept on my side without pillows. (Prior to that, I wasn't able to lower myself down or get up again this way, but it got much easier. If you use your legs by moving them off the side of the bed, it helps you to push up with your arms). A good trick is to put a soft little pillow between the halo bar and your cheek when lying on your side - it gives the impression of being (somewhat) on a pillow without affecting the frame.
Another thing that my consultant suggested was getting an exercise bike. I was really surprised, but I went ahead and got one. It worked out great, as my upper body hardly moved at all while my legs rotated. I was able to stay a little fit, it helped me avoid gaining weight, and I felt strong and stable on my legs. It really helped my mobility during the last month of my treatment, when I as able to walk (carefully) around my neighbourhood and visit friends. I'd suggest you check this with your doctor before going ahead, as it might not be suitable for very unstable fractures, or if you have other injuries.
Regarding walking, I'd again suggest that you ask your doctor for advice. I found as soon as I was able and confident to walk, I started doing so - albeit only a short way at first. Always keep a friend with you for the first few months. In my second month, I was walking alomst every day a few blocks (about 0.6 of a mile round trip) to our local park. I felt very "jarred" and obviously sore in my neck at first, and took a break when this happened. It was great for my body and mental state to get out. I would advise that you try to plan your rests on route e.g. a park bench, a low wall. I remember benefitting from regular rests in the early weeks. I was able to walk further with a friend during my 3rd month, and a mile on my own during my 4th month. (I took off my wedding and engagement rings, and felt less vulnerable walking around the urban streets). Obviously extra care if needed if crossing roads, I remember checking lots of time left and right -- tricky when you've got to move your whole body one way and then the other.
As for getting stared at, yes, it will happen constantly. But without exception people have just been curious, and a remarkable number of people asked about my injury. Children particularly stare but mean no harm. I consider it one of the positive outcomes of having gone through this "experience" that I will never ever feel self-conscious again having walked around in public wearing the halo!! But don't let any of this put you off. Getting out of the house, even if it's only for a few minutes on difficult days, can do wonders for your state of mind. Most importantly, there is an end to this, and very soon you will have your final scans, and your halo will be history :)
~~~~~~
When 3 months of wearing a halo is ahead of you, I know that it can feel like an awfully long time. I can honestly say that it gets easier. I read a pamphlet saying that I'd be able to go to restaurants, see friends (even go to the cinema?!!), and I didn't believe it at first - but it was correct. I have done some of these things without any major discomfort. I'd certainly recommend trying to stay sociable also. Let friends and family visit as soon as you feel up to it. They will understand if you can only manage a short conversation at first, and eventually you'll be able to spend longer with them. Wearing a halo can be an isolating experience, but it doesn't have to be. The pain and fear will reduce also, and your energy will start to return, so you may be able to pursue some quieter hobbies towards the end, and perhaps enjoy simple things at home that you usually don't get time for. For me it was a very challenging time, and extremely tough in the early weeks(I don't mean to suggest for a moment it is easy at any stage), but it did get easier to cope. And of course you will soon be free of it, and you can start getting back to full strength again.
PS. If you have further questions, you can "start a new conversation" by clicking on the link below. I will try to post a response as soon as possible. However, please note that I'm not a medical professional, and can only speak from my personal experience.
PPS. 12 months on, I've posted some responses to questions on the forum. Hope the answers will give you a sense of my post-halo experiences.
