The Brace

The Brace
by James Richardson

I was having pains in my back so I went to see a physiatrist. He had me
start a regimen of exercises which stretched my leg muscles. After three
weeks my pain had not gotten any better. I went to see him again and he
prescribed a spinal brace.

"This brace will provide full-time stability for your spine," he said,
"and part-time traction." I wondered what that meant.

That day, I went to see the orthotist. He looked at the prescription and
said, "My, you must have quite a deformity in your spine. This calls for
quite a brace." Again, I wondered. "First thing we'll do is take your
measurements," he said. "Please strip down to your underwear and follow
me."

When I was ready, he ushered me into a back room of his shop. There was
a sink, shelves full of supplies, tools, a work table with a work lamp,
and a strange metal thing hanging in the corner. It looked like the top
half of a wire-frame mannequin with the horns of a bull. He gestured for
me to sit on the stool next to it. As I sat, he took hold of the frame
contraption with one hand and worked a control panel on the wall with
the other. Electric motors whined and the frame started moving downward.

"Please raise your arms. I'm going to guide the measuring frame over
your head." The frame descended over my waiting arms, and when it was
down far enough I threaded my hands and elbows through the arm holes.
Eventually the frame stopped, and after a few quick adjustments with the
control panel, I was inside.

He guided my hand to one of the bull's horns sticking out of the
"forehead" of the frame. "Okay, now put your hands on these bars and
hold them there. We want your shoulders positioned correctly for the
measurements." He started working on different parts of the frame,
tightening all the straps until they gripped my body firmly. One around
the hips, one for the waist, one for the ribcage and one just under the
armpits. There were secondary straps which wrapped around my shoulders.

He moved away to pick up some smaller contraption made of the same metal
and padded strapping as the frame. "Now hold your head up and back." I
arched my neck to look up and he slid the smaller part between my throat
and the cables which suspended the frame from the ceiling. He attached
the section of frame to the main body and also to an extra cable
dangling from above. The part snapped together behind my head.

"Now, sit up straight and tall. We want to measure how long your spine
really is." I adjusted my posture and he worked the control panel again.
A smaller motor took up the slack in the loose cable and I felt myself
being pulled upwards by the head and neck. Just before my butt would
have lifted off the stool, the motor stopped.

He said, "Okay, you can relax now." I slumped into my usual sitting
position, but nothing happened. "Try to wiggle around." I tried bending
my back, turning my head, nothing moved. I was held solidly.

He picked up a clipboard and stared making notes on it. He looked
closely at each strap on the frame and read the lines and numbers on the
straps. He reached over for a tailor's tape measure and pulled it around
my neck. He took measurements at the base of the neck, in the middle and
just under the chin, below the ears.

"Now, this frame pretty much gives you an idea of how it feels to wear
the brace. Is there any part which is uncomfortable or too tight or
chafes your skin?" I told him how I felt like I was choking. I have a
large adam's apple so the padding supporting my chin was partially
closing off my airway. It was difficult to swallow, too. "Hmm," he
muttered to himself. "Looks like we might have to use a halo."

He spoke to me, "Okay, we're done for today." He let me out of the
measuring frame, loosening all the straps and raising the frame so I
could extricate myself.

"Come into my office." I followed him into an adjacent room with a desk
and chairs and filing cabinets. We got on the phone and called the
physiatrist. Over the speakerphone, we discussed the need to use a halo.
As we spoke, the orthotist produced a small photo album and flipped
about halfway into it. He turned the album around to me and pointed to a
picture of a man wearing some kind of space-alien brace around his head.
The caption read, "Halo."

I got the willies. I wanted to call the whole thing off. My back pain
isn't bad enough for that! Isn't there some way to make my back feel
better without making me look like a freak? They thought about it,
discussing various options, and after a while the orthotist looked at me
with a smile. "I've got an idea," he said. "Let's use that new maxilla
plate." After a short pause, the doc agreed.

We got off the phone and the orthotist said, "All right, just one more
measurement and then you can go home." He sat me down on the stool again
and held a ruler to the side of my face. He held it vertically against
my shoulder and horizontally at the level of my mouth.

"Give me the name of your dentist so we can arrange some
'interdisciplinary cooperation.'" I gave it to him and went home.

The next day, the dentist's receptionist called me and asked me to come
in later in the week. I told her I had just had a cleaning two months
before and she said, "Oh, no, this isn't a cleaning. We need to take an
impression of your teeth." I didn't quite know what it was for but I
went anyway.

It was just like getting braces at the orthodontist's office so many
years ago. The technician mixed up a bowl of gritty, pink goo and spread
it on a plate. She shoved it between my teeth, even though it was too
big, and held it against the roof of my mouth with her finger between my
lips. I closed my eyes to try to relax and smelled the aroma of her hand
so near to my nose. My tongue inadvertently brushed her knuckle and my
eyes flew open. She was looking at her wristwatch with intense
concentration. I could almost see her lips moving as the seconds ticked
by. None too soon, she pried the quickly hardening paste out of my mouth
and told me to rinse. I did, gladly, and went home
Two weeks later, the orthotist called and said, "Your new brace is
ready." I went down to his office to pick it up.

"Before we see how this fits, let me explain how it works. Most braces
of this type have a cervical component which holds the head in position.
The component has a pad which contacts the back of the head and another
pad which cradles the chin. Since you need to be able to wear the brace
all the time, we made your cervical component detachable. When you go
out, you take the neckpiece off and nobody can see the brace because
it's entirely covered by your clothes. When you get home, you put the
neckpiece back on to get the full spinal traction."

"Most people who can't tolerate the standard chin support get a halo
component instead of a cervical component. A halo has four steel rods
which rise up from the shoulder section of the brace. The rods bolt onto
a circular piece of steel which goes around your head above the temples.
Metal pins are drilled into your skull and bolted on to the steel ring.
In this way, your head is supported from above. You still get the full
traction effect without any interference whatsoever with breathing,
swallowing or chewing. The disadvantage, of course, is that you look
like a lightning rod."

"The newest technique, which we're trying with you here, is sort of a
compromise. The brace's cervical component still contacts the back of
the head, but instead of trying to hold the head with the soft tissue of
the neck, it holds the skull in place with a plate on the roof of your
mouth. These steel parts here," sliding his finger along the smooth,
shiny metal of the brace, "extend from the rear head pad, around your
ears, across your cheeks and into the corners of your mouth. At that
point they connect with a dental component which holds your upper jaw.
The component has metal bands which run from the steel bars, between
the lips, backward along the upper gums, around the
rear teeth and into the molded plate on the roof of your mouth. In this
way, the skull is held in position, the neck and throat are not
irritated, and you don't look like a telecommunications receiver."

I couldn't wait to get the brace on. Immobilized spine, tightly gripped
torso, rigidly positioned shoulders, neck and head held still by a cross
between and headgear and a retainer, except that it was a spinal brace
giving me a lisp! With all those sensory inputs, I absolutely could not
forget that I had the thing on.

I started wearing my new spinal brace all the time. I went to work
without the upper section, of course, but otherwise, I wore it most of
the time, even out of the house. Occasionally I would come across
someone wearing an orthodontic headgear and they would look at me at
first with comradely recognition, and then with awe as they saw how
complicated my 'headgear' was. Once I saw a girl wearing a scoliosis
brace. She look at me and tried to do a double take, but of course she
couldn't move her head either. Instead, her eyes grew wide with wonder.

Oh, by the way, my back feels much better now, thank you.