Misty and "her sister", Sarah, wearing the Canada Day colours and sharing The Love...
WELL AREN’T YOU THE BEST BLOOD-PRESSURE-TAKER-DOWNER? As Misty and I walk the halls of the hospital, people passing in the opposite direction reflexively run their fingers through the fur on her back and offer smiles and comments but... “blood-pressure-taker-downer” was a first. It did get me to thinking, however... how DOES the act of stroking a dog – even someone else’s dog (say, for example, a therapy dog) work to decrease one’s blood pressure? The picture is a complex one:
In 2002, Allen and Blascovich reported there was a greater reduction of cardiovascular stress response for subjects in the presence of a dog when compared to that of friends or even spouses.[i] The “stress hormone”, cortisol, can be lowered in as little as five minutes of interacting with a therapy dog.[ii] In addition, a number of hormones come into play: the neurotransmitters associated with happiness and well-being, dopamine and endorphins, have been shown to increase following a quiet 30-minute interaction with a dog. [iii] More recently, researchers in Japan found that dog owners who were bonded to their pets experienced a spike in oxytocin -- a neurotransmitter that helps us cope with stress -- from simply meeting their dogs' gazes.[iv]
Hey! There’s Misty! Come ‘ere, Girl! Nurses at the station push their chairs away from the desk to welcome their Pet Therapist with big hugs and...
“Misty! Where are the cookies? Huh?” One nurse pushes her chair toward The Drawer That Has The Treats. “Wait a minute,” chimes one nurse. “She’s not supposed to get her cookies until she’s finished her work.”
“So give her a cookie when she’s done...” The first nurse reaches into a cookie box withdrawing a fistful of cookies (it’s why Misty gets half rations for supper on the night we visit the hospital). Misty drops to the floor in a well executed Down-Stay.
“Oh, what a good girl!” The nurses love Misty. Cookies are forthcoming. Misty loves the nurses.
“Ready to see some patients now?” I shook her leash and off we went with our list of people to see that evening.
Misty pulled me in the direction of Babs, the delightful, little Scottish lady we’d met the previous week. The sign outside her room said it all: THIS IS BABS’ ROOM... as she sat in her wheelchair but used her legs to “walk” the halls, Babs needed some help to find her way home. But her face was perpetually smiling. Misty made happy little grunts as we approached Babs.
“Wheesht, Boy!” Her hand trembled slightly reaching for Misty’s ear. I’d told her last week that Misty was a Girl... but Misty didn’t care – she was busy wagging her tail and laying some smooches on Babs. A sweet, wee start to our evening.
The first room we entered held the scene we’ve encountered so often on the Palliative Care Unit. The curtain separating the two men in the room was pushed all the way back so there could be interaction (and shared experience) between the men and their ring of family members... except one man was now apparently comatose. Nonetheless, there was a feeling of warmth, comfort and many smiles, even from the family of the departing man. People, strangers, arrive in a room where they do not wish to be, awaiting the Hand of Fate. And there they encounter other humans undergoing the same events, sharing the same feelings, questions, fears. Then they find each other and bond, at least in that exquisite moment. Then in walks a Therapy Dog...
“Oh, how wonderful!” “Bless you for doing this work!” “What a beautiful dog!”
Misty wove her way through the amassed chairs and planted her front half on the bed where the alert and nervous-looking man sat up. This man’s face was disfigured from surgery and given his hair loss, likely radiotherapy, as well. One eye bulged slightly and his misshapen mouth rendered his speech difficult to comprehend. I believed he’d asked where Misty was from.
“She’s from Prince Edward Island – that’s why she’s so friendly.” Then I went into the story of rescuing Misty from the highway – always a crowd-pleaser. For her part, Misty nuzzled under the man’s arm and gently wagged her tail. He smiled. His family smiled. The family next to him smiled. Then Misty decided it was time to back off his bed and after paying attention to his family, we moved to the next bed.
Wife held up her hands and said, “It’s okay. He wouldn’t really know.”
“Misty’s here for family, too” I said walking toward her.
Wife’s arms shot out toward Misty and shared a number of hugs with the Pet Therapist. There was glad “ahh-ing” and quiet laughter from the family next to her.
“It’s so wonderful for you to do this work,” Wife said, straightening up.
Several beds of people on our list from the morning, now were empty... we moved quickly through the ward.
“Babs! Uh, what are you doing?” Babs had managed to undo the belt that kept her seated in the wheelchair. She was “walking” her wheelchair into the Visitors’ Washroom.
“Och! I’ve just got to use the toilet before I run to catch my train.”
“Okay, let’s go to your room and someone can help you get to the toilet.”
“No, no, Dear, I’m fine, thank you.” She continued her wheeled creep into the washroom (every inch bringing her closer to a fall.)
As one half of a Dog Therapy Team, I’m not permitted to provide care. As a person witnessing an accident about to happen, however, I had to do something – but something that didn’t include letting go of Misty’s leash. That’s a real No-No. Then came The Cavalry – a man who was visiting another patient walked up to us.
“I know this lady. Her room is by the nurses’ desk.” He started pushing Babs’ wheelchair in the direction of the nursing station.
“Babs! How great is this? This man is going to help get you to your room so a nurse can help you get to the washroom.”
“Och! I’m alright.”
“I know but...” A nurse was walking down the hall toward us with “Huh?” written on her face.
“Babs undid her seat belt because she wanted to go to the washroom by herself.”
The nurse smiled, leaned over to do up the seatbelt and said, “Okay, Babs. I can help you now.”
Over Babs’ mild protests, the nurse mouthed “thank you” to the visitor and us. I exhaled and we went to see our last patient.
“Carey? Is that you? You’re back?”
“Hey! It’s Misty!” Husband strode up to us smiling hugely. I couldn’t believe he recalled Misty’s name with everything he’s had to deal with in the last several months. The last time I’d seen Carey (and blogged about her) was December 2012. She had suddenly disappeared from the P.C.U. – I remember walking into her room in January 2013, and breaking into goosebumps when I’d realized she was gone. The nurses quickly reassured me that Carey had been transferred to a wonderful institution for some rehab.
As Pet Therapist Handler, we only have enough information about the patient to help us understand how to approach the patient, for example: “hears better from left ear”, “pain in both legs”, “confused”, “daughter afraid of dogs so knock before entering”. With Carey, the information provided to us was: “startles easily.” She breathed through a tracheostomy, her pupils were of unequal size and eyes were opened widely, both her arms were in splints and she appeared to be paralyzed from the neck down. Her husband always smiled, even if sadly, and stroked her hair back from her forehead.
“Do you know how many times I’ve thought of Carey?”
Husband’s broad smile broadened further as he told me about the highly expert care Carey had received in another city. “Look! Here’s how we communicate – flash cards!”
Above Carey’s head was a metal rack with plasticized, highly colourful cards, each about 2” square, each bearing images.
“Honey, Misty’s here. Remember Misty the Therapy Dog?” He walked to the head of Carey’s bed so he stood behind her head, then he reached up to the cards and selected two. “This one with the big red ‘X’ on it means ‘No’ and this one with the green flower on it means ‘Yes’. I hold both of them up to her and she moves her right eye to the answer.” He positioned the cards about 6 inches away from Carey’s face. “Honey, do you want Misty to visit with you tonight?”
Carey’s right eye rotated over to the green flower.
“Well, that looks pretty definite!” He was triumphant. Months earlier I’d had the feeling that Carey was a prisoner captured by her body. She seemed alert and aware of what was happening to her. The nurses told me that when her children left, she cried. But now, with 2x2 cards, the world, external Life, could ask her questions and she could make her will known. A triumph, indeed.
I carefully placed Misty’s front paws beside her, noticing that Carey was far less twitchy than previously. “Carey, I’d like to have your arm feel Misty’s fur,” I said and Husband nodded then gently rotated one of Carey’s splinted arms so that the skin exposed between the Velcro straps could be touched by Misty’s fur. And then Misty licked her arm. Carey shivered slightly. Husband smiled. The brief visit was over.
I was steering Misty toward the elevator when she pulled me to the nurses’ station. Ooops! I’d forgotten about the Off-Work Cookies. Once Misty was treated, she agreed to leave. One of the nurses walked with us to the elevator, her shift now being over.
“How long have you worked on this floor?”
“How do you find the work?”
“It doesn’t get better than this.”
Misty and I agreed.
[i] Allen, K.M., Blascovich, J. “Cardiovascular reactivity and the presence of pets, friends and spouses: the truth about cats and dogs.” (2002) Psychosomatic Medicine 64:727-739.
[ii] Barker, S., Knisely, J., McCain, N., Best, A. “Measuring Stress and immune response in healthcare professionals following interaction with a therapy dog: pilot study.” (2005) Psychologic Reports 96:713-729.
[iii] Odendaal, J. “Animal-assisted therapy - magic or medicine?” (2000) J Psychosomatic Research 49(4):275-280.
[iv] Miho Nagasawa and Takefumi Kikusui, Azuba University, Japan. As reported in firstname.lastname@example.org: January 14, 2009.