Today, we will talk about the holes in my head.
I was going to tell you about pinsites anyway, but thanks to a last minute doctor’s appointment yesterday, the story just got exponentially better.
So as a quick reminder, the Halo brace is screwed into my head at four points. The bolts, or “pins”, that are used are screwed directly into my skull to a depth of just a few millimeters and tightened to 8 lbs of torque. After the first couple weeks of a somewhat-annoying constant tension headache, they honestly have not been terribly uncomfortable. As with anything, the body adapts and you just get used to the sensation of wearing a slightly-too-small hat 24/7. It always feels more like a band of pressure around the head as opposed to four distinct insertion points, and once I got used to it, it really has been hardly noticeable the last few weeks. I mean, as “hardly noticeable” as a Halo brace can be.
With four pins screwing directly into your skull though, the Number One home maintenance practice required while in a Halo is what L and I affectionately refer to as “PinCare” - every night before bed we use q-tips and a syringe to clean around the pinsites with hydrogen peroxide or an antibacterial cleaner. Risk of infection at those pinsites is one of the only major “complications” of the brace, so we’ve been religious about cleaning and care on our daily schedule.
Of course, the best laid plans of mice and men, etc, etc.
A couple weeks into this whole debacle, Lindsay noted that she was still seeing a lot of active discharge from around the back pinsites. The front ones (in my forehead) - no problem at all, clean as a whistle with no issues. But the back ones were still, well, just oozing pus from what appeared to be still some active wound trauma right around/below where the pin inserted. (Did I mention this post might not be for the faint of heart of you out there? Read on at your own risk). At no point did the back pinsites ever HURT - which is still my primary metric for “is there an infection / is something seriously wrong” - for all their weeping and oozing they never got red or inflamed or started being painful. We dithered for a while on if this was normal vs severe enough to call the doctors about - we finally did make a few calls and I was given an antibiotic prescription. At my first xray follow up a few weeks ago the PA checked out the sites and said to keep taking the antibiotic and let them know if it got any worse.
It never got much worse, but it really didn’t get much better, either. We continued to clean and pull a multitude of crumb-sized chunks of dried discharge out of my hair every night. Lindsay could show me pictures of the sites but of course I couldn’t see them - and still there was no discomfort or pain. I was scheduled to go in on Nov 3rd for my next x-ray shots, so we figured we were just holding on til then for the next in-person look. However, to my surprise, a couple days ago I got a call saying “Dr. Lynn has decided he’d like to see those pinsites in person so why don’t you come in this Thursday”. So into the car I was loaded (getting much better at that every time, for sure) and off we went.
I was delighted to see Todd the Orthotist again in the doctor's office. He checked out the sites and hemmed and hawed, then Dr. Lynn came in and took a look as well. He said it was a good sign that I was not having any pain or tenderness - that would be the sign of a more serious infection - but he did say that based on how “open-wound” the back sites were looking, it would be a good idea to go ahead and put in new pins in an adjacent spot and remove those current back two.
Oh, well, okay, today just got more interesting.
Dr. Lynn said it would be possible to schedule the procedure at the hospital and put me under general anesthesia, but in a moment of bravado (real or imagined, who can say), I suggested we go ahead and just do it right there in the office. No sense waiting, let’s just make it happen. So off they went to get the supplies they needed and I sat in a chair in the room wondering exactly what I had just agreed to.
In a way, it wasn’t unlike a dental procedure (if you’ve ever had that done). Dr. Lynn came in and injected local anesthetic into the sides of my head (very much when they inject the like into your gums - that sharp needle and then that flooding/burning sensation as the agent spreads through the area). After about 10 minutes it had gotten nice and numb and so Todd brought forth his Special Magical Halo Brace Pin Screwdrivers and the new pins. The whole thing took only between five and ten minutes - it was like having my own personal pit crew working on me. There are numerous holes in the halo part of the brace, so Dr. Lynn started on the right side and screwed in a new pin in the slot adjacent to the current one. There was a mild stinging pain that the anesthesia didn’t quite cover, but the primary sensation was just pressure - a ton of pressure. As the bolt enters your skull, the best way to describe the feeling is as if your head was in a vise being slowly squeezed tighter and tighter...and tighter...and tighter. For about ten seconds I did in fact begin to wonder if my skull was just going shatter- the pressure started at the site and then just slowly radiated across my entire skull in slow moving waves. Once the pin was “set” though, it seemed to stabilize and lessen slightly. The pin on the left side actually went in a little easier - it seemed to sort of “balance out” the pressure waves from the right side - and once they were torqued to the proper amount, they simply unscrewed the first set of pins. I didn’t even feel them coming out at all (probably thanks to the fun new sensations going on with the new ones).
And that was pretty much that. New pins in the back, two holes in my head where the old pins had come out. The skin there has enough elasticity to work to close itself over the old pin sites it seems, as no stitches or anything of that sort were required - Dr. Lynn said to just slap on the neosporin a couple times a day for a week and keep an eye on it. We’ll return back today (Friday) to have Todd check the back pins to make sure they are still at the proper torque (standard procedure after 24 hours with new pins). And then I go back for x-rays next Tuesday so that will be another chance to make sure all is well with the (new) holes in my head.
I wasn’t feeling too bad for the first few hours after the new pin installation, but into the later afternoon the local anesthetic wore off and I started having flashbacks to those hospital-pain-levels from The Early Days. Back to chewing ibuprofen on schedule for a few days at least, it seems. Thankfully I slept just fine last night. Seems like moving around actually starts triggering more pain, but Lindsay says everything looks as good as it can for now.
Oh and of course I have to share the two highest compliments received of the day. Both Todd and Dr. Lynn were MASSIVELY impressed with the shirt that Lindsay has custom cut for me to fit around the Halo that I wear when out in public. They both said in all their years of seeing people in similar circumstances, they've never seen something that cleverly constructed. All credit to Lindsay on that one - I'll show some more details in a future post on what exactly she's done to my shirts to make them wearable, but have to give her a shout out for that compliment.
Oh and they both also said that I smelled remarkably better then most people they see in Halo braces. So, uh...good to know that my current personal hygiene levels are above the mean.
Never a dull moment in this life, it seems. Dr. Lynn mentioned he had taken a look at the x-rays from a few weeks ago and he was very pleased, so hopefully we’ll get more of that good news next week. I also had a good chance to talk to Todd about the actual procedure of when they put the Halo Brace on, so I might unpack that a little more in a future post.
New update will come next week after the next x-ray report!
BONUS - For the Real Strong of Heart - Here's video of them screwing in the new pins as well as a link for pictures of the before and after of the infected pin sites
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