How are the shells made?
The shells are made by specially trained personnel. The shells are made from a plaster of Paris mold so they will fit the contours of your body. To make the mold, special measurements are taken and then layers of plaster are applied over a soft lining material. A mold is first made of your front, then your back. Your shells will be constructed using this mold. This fitting procedure usually takes about thirty minutes.

How long will I need to wear the shells? You will generally need to wear the shells for 6 to 12 weeks, or sometimes longer depending on the extent of healing as determined by your doctor. When you are discharged from the hospital, you will be given an appointment date to return for an outpatient visit. This appointment is generally arranged for about 6 to 12 weeks following surgery or injury. At this clinic visit your doctors will examine you and obtain back x-rays. Your doctor will then advise you regarding further need to wear your shells, and you will be given another follow up appointment.

How to apply your shells.
Applying your shells will at first be awkward. During your hospital stay the nursing staff will assist you in learning home management of your shells. To apply your shells follow these steps:

1. Put on your cotton T-shirt.
2. Remain lying down and log roll to one side.
3. Place the back part of the shell next to your back and roll into the shell. Make sure the indentation on each side fits comfortably over your iliac crests, which are the top of the pelvic bone.

   

4. With the back shell now in place, apply the front shell and secure the two shells with the velcro straps.

   

   Prior to discharge, you or someone who will be assisting you, must demonstrate this procedure to your nurse.

How do I move in my shells?
Proper techniques of rising out of bed must still be maintained. First, log roll to one side and bend your knees.

Second, use your arm to push yourself off the bed from a side-lying position, and let go to the floor.

You may find sitting upright in your shells to be uncomfortable. A more desirable position may be to sit in a semi-reclining manner. This takes pressure off of the groin and under arm areas.

How do I remove my shells?
You may remove your shells once you are Iying flat on your back in bed. Do not remove your shells while standing up. Remove the top shell by releasing the velcro straps, then log roll to your side and remove the back shell. It is not necessary to wear the shells while resting or sleeping in bed.

Skin care
It is best that a cotton T-shirt be worn at all times under your shells. This will aid in absorbing perspiration and preventing skin irritation. The T-shirt should be changed daily, or more often if it becomes soiled or wet with perspiration.

Maintaining healthy skin while wearing shells is very important. Pay special attention to the areas where your shells are likely to cause pressure. Key areas would be the under arm areas, iliac crests and groin area. If you develop a blister or an open area, notify your physician immediately.

What clothing will I wear?
You may wear any clothing you wish. Loose fitting slacks or skirts usually fit comfortably over your shells. A shirt in a size larger than usual may be needed to fit over the shells. Keep in mind that the only clothing to be worn under the shells is your cotton T-shirt.

Activities
After you have received your shells your physician will meet with you to discuss physical activities or limitations. Walking for short periods of time is encouraged. Avoid twisting, bending and jarring motions. Instead of bending over, bend your knees and use the large muscles in your legs to avoid stress to your spine. An exercise program will be prescribed by your physician. Do not lift more than 10 to 15 pounds, which is the approximate weight of one grocery bag.

Care of your shells
Your shells are made of sturdy acrylic. If they become soiled, you may wash them using a clean wash cloth with warm soapy water. If the inner lining becomes wet you may dry it using a hair dryer. To avoid scorching the lining use a low setting and wave the dryer quickly back and forth, maintaining a distance of 6 inches or more from the lining.

Going home
Once you leave the hospital, it is up to you to follow the plan of treatment which your doctor has prescribed for you. Keep a positive mental attitude about your rehabilitation. You've come a long way in the healing process.

For any questions or concerns you have regarding your shells or your condition once you are home, contact the nursing staff in the Orthopaedic Clinic at 319-356-3844. Call immediately if your shells crack, break, or become loose.