Goodbye Halo

My first follow-up appointment with the neurologist came about two and a half weeks after installation of the halo. At that time, the x-rays showed that the fracture was beginning to heal and everything was in its proper place. The doctor mistakenly thought I had been in the halo for about a month, so my healing was apparently a little bit ahead of schedule. I was nervous for that appointment because I thought for sure the doctor would whip out his shiny silver wrench and torture me by tightening my pins. He didn`t. In fact when I told him of my fears he said that they normally only tighten them once, about 24 hours after installation. The reason for this, he said, is because the bone tends to soften if you tighten the screws too often and then there is no longer any hold for the screws. Boy, was I relieved to hear that! In my case, it was a little more often than that, but that`s because I had infected pins which had to be moved. I had read about people having the pins tightened every week during their ordeal and had been doing a fair bit of obsessing about it. This news came as a happy surprise to me.

My next follow-up appointment was scheduled for about six weeks later. That put me at about nine weeks in the halo so I was expecting another three weeks before I was `released`. However the doctor surprised me by asking if I was ready to have it removed. I wasn`t about to say no, but he caught me off guard. I was shocked, scared and happy all at the same time. I wasn`t quite prepared for that scenario and I think he could clearly see it on my face. He said he was satisfied that the healing was almost complete, and that the halo could come off. A rigid cervical collar would protect my neck for the remainder of time it took for the fracture to finish healing.

As usual, the legs began to shake, shake, shake, as soon as I was told to lay down on the bed. A resident started to disassemble the supporting rods from the halo, one at a time. As soon as he unleashed the last one from the vest, I felt the sudden release of my neck. Although I didn`t move my head at all, I could instantly feel the difference. It no longer felt like my head was in a vice. I felt relief, but I also felt very vulnerable. Once I was disengaged from the halo, the vest was removed. After that, we waited for the neurosurgeon to return.

He soon returned and asked me to sit up. I tried but I felt alot of pain on one side of my neck and it felt so weak I had to actually hold my head with my hands. It was the oddest sensation. It is something that is difficult to describe and probably hard to imagine unless you have experienced it yourself. We are so used to holding up our heads, we don`t realize how heavy it is until we lose the muscle strength to do it. He put me back down, put the brace on and we tried again. The brace helped and I was able to sit up.

Now only the halo remained around my head. He began to unscrew the pins while I clutched the sleeve of his jacket. By the way, I couldn`t help but notice that my doctor looks exactly like the actor Tim Robbins.. Not that that`s relevant or anything :). He said I wouldn`t like him very much after this was over. And it was painful. I felt tremendous pressure in my upper teeth as he unscrewed one of the pins in my forehead and he said it was because I was clenching my teeth too hard. I don`t think that`s the reason though. I was clenching my teeth because of the pressure I was feeling, not the other way around. Thankfully, it was all over quickly. If it`s any reassurance to anyone, the pain and pressure you feel stops as soon as the pins are out. After that, there is a bit of soreness at the pin sites, but it`s nothing like when they are first put in.

The nurse cleaned the pin sites, showed me and my husband how to change the pads on the collar, and gave us information about what to do and what not to do. Basically, I was under the same restrictions for another month and I had to wear the collar at all times, including while taking showers. I asked if I could start walking on the treadmill but was told no :(

The next day, I removed the two little bandaids the nurse had put on the pin sites on my forehead. I was disappointed to find that one of the sites had alot of hard adhesions underneath. I allowed a couple of days for the wound to close and after that I began to massage the area a few times a day. Although the solid mass underneath has diminished quite a bit, there are still adhesions and this is causing a bit of puckering at the pin site. I don`t think there is much more I can do myself to resolve this and will discuss it with the doctor at my next appointment. It`s not a huge deal in the scheme of things, but if I can make it better somehow, I would like to try.

In hindsight I think I could have avoided this by massaging the area once in a while. I had a bit of skin overhanging that pin, probably due to some pulling of the skin during installation. And, curiously enough, that pin site was always a bit more crusty than the others. I think the bunching up of the skin in that area caused adhesions to settle in underneath. It is too late for me, but might be a good lesson for others. Check with your doctor or nurse first, but my advice would be to keep the skin moving around your pins if you care about how it is going to look afterwards. The other site on my forehead is slightly depressed, but is fine. The ones behind my ears are healing well, and as long as they`re not infected, I am not concerned about what they look like.

Although I am now wearing a rigid collar, I am feeling much more normal than I have in a long time. Almost there.. :)