Pin Care - The pins are the main points of fixation that hold your brace to your body. The points are tightened against your skull and exert about six inch pounds of pressure per pin site. This is enough pressure to stabilize your head and neck without penetrating your skull. The pin's penetration of the bone is approximately one-eighth of an inch. Consequently, the ring is held in position by the pressure of the pins rather than by their depth. Care of the pins is necessary to prevent infection. In cleaning the pin sites, use a cotton swab soaked in half strength peroxide and normal saline solution. Clean each pin site with a separate swab to avoid cross-contamination. After you have thoroughly removed the excess crusting and ointment, take a clean swab and apply betadine solution to the base of each pin. Try to clean the sites daily. Be sure that your doctor or nurse explains this procedure to you prior to your discharge from hospital. You should also be told where extra supplies for this procedure may be obtained.

Pain - You may experience discomfort for one to three days following the application of your halo brace. This is normal during the adjustment period. However the pins should not cause pain once the initial headache has subsided. If a pin becomes unusually painful, it may indicate that it has become infected or needs adjustment. Call your orthotist or doctor to have this matter resolved. Always take all of the tools provided as they will be needed for adjustments.

Soreness and Oozing - If you notice that a pin site is bleeding or oozing it may be the onset of an infection. Call your doctor to let him know. He can probably advise you over the phone.

Painful Pressure - You may feel pressure causing continual discomfort or soreness under the vest. The brace fits snuggly to ensure stability for your neck. Loosening the buckles or straps without permission could disturb the alignment and cause problems. Pressure on your scapulas, ribs, clavicles or spine can be relieved with proper care. You may also experience tightness round the abdomen because you have gained some weight. Call your orthotist or doctor to have the pressure points relieved and the brace re-adjusted. Do not attempt to adjust these problems by yourself. The onset of pain could be an indicator that the brace needs to be adjusted. Do not ignore these signs as prolonged delays often compound a problem that could be cured with a simple adjustment.

Dirty Liners - If your liners begin to have an odor, become dirty or you spill something down the brace, call your doctor to have them replaced.

Bathing - Try to avoid situations where you are exposed to excessive dirt or dust. You cannot just take a shower or bath. Keeping your environment as cool and clean as possible will make life easier in a halo. Perspiration and oily skin can create itching under the brace. You may loosen one buckle at a time while supine to wash under the brace. After you wash, avoid using oil-based powders or lotions as they tend to cake-up and cause skin irritation. Corn starch is a better moisture absorbent and can be used in conjunction with alcohol which aids in drying oily areas. A shallow tub bath is permitted but avoid getting the liners wet as this will cause rapid deterioration of the sheepskin liner. The best method of bathing is by a towel bath, sitting in a chair beside the sink. No showers are permitted. If your liner should become moist, use a hair dryer to help dry it. Use the cold setting on the dryer to avoid burning the skin. Some people are allergic to the wool sheepskin liner and itching and a rash may occur. This problem can be resolved by changing to a synthetic liner. Call your doctor or orthotist if you experience any skin discomfort or irritation.

Itching - If you scratch an irritated area, use a blunt object and try not to scratch so hard that you break the skin. A break in the skin under the brace may cause further problems.

Swallowing - ALWAYS be upright when swallowing. Your head and neck will be fixed in a position that makes swallowing difficult at first. It will be easier to choke on  foods and fluids so precautions need to be observed. Cut your food into smaller pieces, take smaller bites, chew thoroughly and swallow carefully. Crush your pills and avoid taking more than one pill at a time. If swallowing or chewing continues to be a problem to you, or if you are having problems opening your mouth, please call your doctor.

Balance - Your center of gravity has changed due to being "top heavy"; consequently you will need to adjust your posture so that your head is tilted slightly forward and you are flexed at the waist. Sometimes holding onto the bars helps to provide extra stability and balance. Falling down can have disastrous after-effects. Practice bending over and dressing yourself with someone to spot you at first prior to attempting this procedure alone. If you do bang your head, examine the pin sites to make sure you have not jarred the pins loose.

Car Riding - Getting into a car is best achieved by sitting sideways on the seat, sliding your buttocks onto the seat and then swinging your legs inward. getting out is easier if you lean down, clearing your legs first. Please  wear seatbelts at all times when traveling in a car. Sudden stops could cause serious injury. It is inadvisable to drive a car during the time you are in your brace as the immobilization hinders your line of sight and peripheral vision.

Sleeping - The stress and added energy requirements upon you may cause you to need more sleep than you are used to taking. Do not be alarmed by this. Allow yourself a nap whenever you feel fatigued. Being well rested will help make coping easier. You may sleep on your side. back or stomach.