Me and my Aspen collar

Keeping my head and neck as still as possible was extremely important for my cervical vertebrae and ligaments to heal properly after Surgery No. 2 back in September 2015. Enter Neck Brace No. 3 – my Aspen Vista collar.

The Aspen collar is plastic with front and back panels lined with removable padding. It provides comfort and keeps sweat away from your skin. Openings on the front and back panel of the collar allow your skin to breathe. (Source: University of Virginia Health System)

October 2015: Halloween at my French immersion school

Despite having to wear it 24/7 for the next three months (removing it only after I showered), I spent a rather productive and fun time in that neck brace.

Cooking classes

Rohit and Adhelly’s Mexican party

Parc de la Chute-Montmorency

In class!

For one thing, I enjoyed relatively more freedom and felt more confident going out in public compared to when I wore that horrid halo brace and awkward Minerva jacket.

Honestly, I still feel so disturbed knowing that I endured that halo for three and a half months.

Doesn’t it feel heavy just from looking at it?!?

The Minerva jacket wasn’t so bad as I wore it only for a month… the worst part was just sleeping in it.

Oh, what joy to reminisce about the neck brace days.

But I digress. Let me share the nitty-gritty about how I dealt with having foam around my neck at all hours of the day. Sure, it sucked, but it was peanuts compared to my previous neck braces.

The various aspects of living with the Aspen collar

Head/neck movement

While the halo kept my head and neck 100% immobile (recall that it was physically screwed into my skull… ugh), the Minerva jacket allowed for several degrees of movement. I was surprised to feel that the Aspen collar, despite it being much smaller and lighter than the Minerva jacket (no thoracic component), didn’t allow for much movement at all. I estimate perhaps a window of less than 5º of movement in flexion or extension of the neck, and barely any in all other directions (lateral and rotary).

It may look flimsy but it controlled my neck movement so much better than the Minerva jacket. I wish my neurosurgeon just gave me the Aspen collar to wear after my halo (note to self: write a letter to Minerva jacket manufacturer TruLife about this!).

Application

The initial application was done during my surgery and since I was obviously asleep then, I have no idea how they did it. I came in to the surgery wearing my Minerva jacket:

With my husband before being wheeled into the operating room

And then poof!

Aspen collar!

Waking up post-surgery with the Aspen collar was bizarre. After wearing padding against my torso for so long, it was the first time I felt my real back against a bed in four and a half months!

I’ll come back to how I removed and put it back on a bit later.

Cost

I honestly don’t know how much the collar cost, since all my medical costs were covered by public health insurance in Ontario, Canada. On Amazon, a set with the collar and replacement pads costs $55 USD.

Skin care, hair care, and brace reapplication

Did I mention this was my favourite part of my neck brace life?

Ha. Right.

To refresh your memory, here was my skin and hair care regimen while in the halo brace:

1. Shower waist down only (with a removable shower head)
2. Wipe my neck and upper body with baby wipes
3. Wash my hair using buckets

Visual:

What fun that all was. Not.

In the Minerva jacket:

1. Remove all padding that could be removed (those attached with Velcro straps)
2. Cover padding/straps with Saran wrap and tape if possible
3. Shower fully (that first complete shower after three and a half months felt LIBERATING)
4. Dry myself for AN HOUR using a hair dryer
5. Put padding back on
6. Remain damp for half the day

Sigh. This process was so taxing that I had to cut my hair so drying wouldn’t take so long… but it still did.

Now, this is what I did whenever I showered with my Aspen collar (my neurosurgeon told me to keep it on as I could easily trip or fall in the shower). I didn’t make all these steps up; I was instructed by the nursing staff on how to do this before I was discharged from the hospital.

1. Have WASHED and DRIED replacement pads ready (more on this later)
2. Shower head to toe
3. Dry myself with a towel; press foam pads against towel to get as much water out as possible
4. Dry my hair using a hair dryer
5. Call my mom/husband to help me
6. Sit down
7. Remove the collar with the Velcro straps
8. Keep my head up and avoid moving my neck (I usually stretched my painful shoulders and raised my arms up during this time)

Then, this is what my mom/husband did. Basically, she/he positioned the collar on me while I was sitting and then adjusted it properly while I was lying on the bed. I never adjusted the collar while seated or standing as it was too loose. From my experience, lying on the bed ensures that the neck is in the proper position and allows for a tighter fit of the collar.

Positioning the collar (ambulatory – sitting or standing):

1. Remove the foam padding from the plastic part of the collar and set aside for washing later
2. Wiped the plastic part of the collar with a towel (I did it myself sometimes… WHILE NOT MOVING MY NECK!)
3. Attach and insert the replacement pads into the collar (more on this later)
4. Place the front part of the collar on my neck (chin piece directly under the chin)
5. Place the back part behind my neck
6. Strap both parts together with the Velcro straps

From Chaneco UK

Adjusting the collar (supine):

1. Have me lie ON THE BED (BY LOG ROLLING ONLY)
2. Adjust the position of the collar (for example, the sides of the front part must be tucked into the back part)
3. Strap both parts together TIGHTLY
4. Have me get up and check the fit in front of a mirror (see below)
5. Adjust the collar and the straps WHILE I LIE ON THE BED if necessary

From Chaneco UK

Front part of the collar removed so that the dressing on my surgical incision could be changed

Our “neck brace removal sessions” were literally the only opportunities I had to let my neck breathe for a few minutes. I wiped my own damp neck while my mom/husband would insert the replacement pads into the collar.

Okay, so here is a video that can help y’all visualize this:

The main difference between what I actually did in real life vs. this instructional video: I NEVER (EVER, EVER, EVER) adjusted the circular dial to change the neck height. Like I mentioned earlier, this was done for me initially during my surgery. I was too scared to change it and I don’t think I was supposed to.

So did I actually fully shower everyday like a normal human being, even if I had to deal with these Shower Procedures? Well… nope! Luckily my husband and I have a removable shower head so I could skip washing my hair for a few days (and thus, dealing with a wet neck brace) but still remain clean. But after two or three days when my hair would tell me Hey, it’s time to wash me, I would have to face the inevitable.

I didn’t remove the collar when I washed my face in the morning and before going to bed nor when I brushed my teeth. Like what I did while wearing the Minerva jacket, I simply inserted a small face towel between my chin and collar to absorb any water coming down my face.

General fit

I kept my collar on and properly tightened at all times (except when we had to replace the pads, obviously). Here are the guidelines I used to make sure that the fit was just right:

• My chin was centred in the chin piece, with it being flush to the front of the plastic
• I can swallow
• No plastic was touching any part of the skin (especially the piece of plastic positioned near the throat)
• My head was not wobbling around
• There was not much space between my chin and the chin pad:

October 2015: My first day of French school hehe. See my chin centred on the chin piece?

I had to tighten it (i.e., just adjust the Velcro straps with my husband’s help) every two days or so. I think it becomes a little loose while I sleep.

More about caring for the Aspen collar

According to opcare UK:

Keeping your Aspen Vista Cervical Collar and the skin beneath it clean is a very important part of your treatment. Proper cleaning will help prevent rashes and skin irritation.

I was discharged from the hospital WITHOUT an extra set of replacement pads. When I called the nursing station on my floor, they honestly didn’t have a clue where I could get extra ones and why I didn’t receive any in the first place.

I didn’t want to buy it myself (retails for $60 CAD) so I just waited until my follow-up appointment to see if there were any hanging around in the Orthopaedic Clinic. Luckily they had a set lying around! Never mind that my pads weren’t washed for three weeks. Huuu.

Here are the instructions that came with the replacement pads:

Removing the replacement pads

For the front part, you literally just remove the foam pads which are attached by Velcro. As for the back part, this manual from Aspen Medical Products does a pretty good job of explaining how to do it:

Washing and drying

All the manuals out there say to just HAND WASH the replacement pads with mild soap and water. I washed the pads using Cetaphil, my own gentle facial cleanser, in our bathroom sink and squeezed any extra water out of them after.

Although all the manuals also say to NEVER PUT THE PADS IN THE DRYER, I did. Hehe. I just put it on the low heat setting. The proper way is to leave them air dry overnight.

Inserting the replacement pads

I never did it myself, but my mom and husband said it was simple enough. Just do the opposite of when you take it off.

Despite all this washing and cleaning of the pads, I continued to develop this irritating, prickly skin rash from my collar (it started forming when I had my Minerva jacket).

November 2015: Rash just below my jaw

Now that I have my collar off, I am applying Triaderm 0.1% on it, a cream my doctor prescribed me. It’s not really noticeable now.

Pain management

My shoulder area bothered me a lot. I needed to lie on the bed at least once a day just to rest them. Raising my arms while on the bed usually made me feel better. I took Tylenol when needed, but it was not very often. I went for massages maybe only twice in three months – I wanted to go for more but I didn’t want to spend any more money on them.

I experienced aching, and at times sharp, pain in my neck from time to time. It hurt to yawn, as it engaged my tight neck muscles. Sometimes it hurt when I inadvertently took a huge step on the street. I heard some crackling ligament noises in my neck lying in bed on my back, perhaps once a week.

Everyday life in the Aspen collar

I carried on with my life, really making the best of it by learning and improving on my French and cooking. The only things I could not do were:

• Fall
• Lift anything more than five pounds
• Go back to work at the mine (my neurosurgeon said I would be fine to work in an office setting in Toronto if I did have a job there)
• Do any form of physical exercise except walk (I luckily moved to a very walkable city)
• Walk on the street by myself (a stupid rule my husband enforced… since I can’t turn my head and react quickly enough to cross the street or to defend myself from hobos that may harass me)

Other nuisances included having to tuck a napkin between my chin and my collar every time I ate and carefully putting clothes on (wide-collared shirts or dresses were okay now). Since I moved back to our apartment after my surgery, away from the hospitality of my parents, I had to become a real adult again and do *drum roll please* chores.

Adulting with my husband: Mopping the floor and doing the dishes

Sleeping in the collar was not bad at all. It was actually quite comfortable. I slept on my side 95% of the time.

Aspen collar manuals and guides

The following details how to fit, clean, and re-apply the collar, but it is important to note that I myself re-applied my collar in a supine position and put my replacement pads in the dryer.

• Aspen Medical Products (standard instructions)
• Chaneco UK (standard instructions with great diagrams)
• opcare UK (very detailed instructions)
• University of Virginia Health System (some information about daily activities)

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In retrospect, my time in the Aspen collar was not so bad. I’m just glad it’s all over! To anyone who is currently wearing or slated to wear an Aspen collar as part of your treatment, I wish you all the best. You can do it!

Fall 2015, Québec, Canada