Shanna M 00:11
It's time to be well with your health. It's a party on the pawcast today. We have a couple special guests. So everybody knows I'm Shanna and I have a special cohost today. Zuleika. Welcome Zuleika!
Zuleika 00:27
Hey! Thank you. Thank you.
Shanna M 00:29
Thank you, and Zuleika, you help support our Adventist HealthCare Rehabilitation and Post-Acute Services team, right?
Zuleika 00:35
Yes, ma'am!
Shanna M 00:36
All right. Well, we are excited and we have a pawsitively exciting episode about facility dogs, if you hadn't guessed it yet, and how they help our patients here at Adventist HealthCare and Adventist HealthCare Rehabilitation. So let me introduce our special guests. We have Dr. Heather Tropiano, who is a rehabilitation psychologist at Adventist HealthCare Rehabilitation. Welcome, Dr. Tropiano.
Heather Tropiano, MD 01:01
Thank you. Thanks for having us.
Shanna M 01:02
Thank you. And we have Colette Calomeris, an occupational therapist, also with Adventist HealthCare Rehabilitation.
Colette C. 01:09
Hello, hello. Happy to be here.
Shanna M 01:11
and not that I wasn't super excited to have you, but we also have Peru, our facility dog.
Shanna M 01:11
Good job Peru! We're happy to have you, i'm super happy to have you! I am a dog lover, I have two dogs, also I guess I have to claim the cat too. But I have two dogs and i'm really excited to learn more about Peru and what she does and how you all work with her. Zuleika, do you have a dog?
Zuleika 01:19
I had. And I have to say I love dogs as well.
Peru 01:19
Woof
Shanna M 01:35
Nice. Let's just dig right into it. I was doing some research before the podcast and learning about facility dogs and the benefits that they provide to patients emotional support, pain reduction, improved moods, enhance socialization, even motivation for therapy. So Dr. Tropiano, you are Peru's owner, handler, how does that work?
Heather Tropiano, MD 02:10
Yes, I'm her handler
Shanna M 02:11
Okay. Tell us what you do here and how you use Peru.
Heather Tropiano, MD 02:14
So, i'm a rehabilitation psychologist and work in the department of neuropsychology. So as a rehabilitation psychologist, I help individuals with chronic health illnesses and disabilities, help them to regain independence and return to the community. So both Colette and I work on inpatient rehab units, i'm at White Oak, and she's at Rockville. And we see patients who are recovering from major life events like strokes or traumatic brain injuries, spinal cord injuries, amputations. And we're often trying to get them to do the things that are going to help them be able to discharge home, like walk, stand, be able to take care of themselves. And so there's a lot of, you know, pain and anxiety and fear that kind of comes from that. And sometimes it's really hard to kind of get patients motivated and engaged to do the really difficult and painful things that we're asking them to do.
Shanna M 03:16
Yeah.
Heather Tropiano, MD 03:16
And that's where Peru kind of shines and that's where she helps. So some of the benefits that you noted are absolutely true. But one of the really cool things about Peru is that she is trained as a service dog, which means that she's tasked trained to perform different activities to help an individual with a disability to mitigate the negative impact that a disability has on someone. So we use her interactively in physical therapy sessions, occupational therapy sessions and speech to work one on one with patients toward specific goals that they have during their rehab stay.
Shanna M 03:58
Okay. Peru is stationed or worked at our White Oak, worked at our White Oak Medical Center facility. So I know you're at Rockville and Colette, so we don't yet have a facility dog there. But I know you've been interacting with Peru in anticipation maybe of potentially getting one at Rockville.
Colette C. 04:20
Yes. So we are on the waiting list to get a facility dog at Rockville. So we are all very excited to kind of ease the transition and get people used to having a dog on the rehab floor. We've been bringing Peru over to work with various patients and various disciplines to get you know the staff ready and kind of show the benefit that this facility dog will be able to have and kind of start to educate everyone on the proper interactions and the benefits and what not to do what to do, and just kind of how things are going to work once we have this dog here because it will be a big change and we want it to go as smoothly as possible.
Heather Tropiano, MD 04:58
Yeah, and it's you know, she interesting as well, because she is a working dog. So the rules of engagement are much different, right? So usually when you have the therapy dogs that come up on the unit, anyone can say hi, anyone can go over and kind of get snuggles and things like that. But with Peru, she's they're doing a job. And so it's very hard sometimes to navigate, you know, staff and other patients who see all of the cool things that she can do with a patient. But it's really important to educate people that, you know, she's doing her job, and when your coworkers are doing their job, you don't go over to them and just kind of start a conversation, right? Yeah. And so giving her the space and the rest breaks. And also, you know, giving her, you know, just that time, one on one with the patient without any distractions, so that she can really kind of focus and do the job that she was trained to do.
Shanna M 05:54
Yeah
Zuleika 05:55
What kind of trained specific tasks or exercises are tailored to individual patient needs?
Heather Tropiano, MD 05:59
Yeah, no, that's a great question. So I mentioned that she was trained as a service dog. So service dogs are usually trained in tasks to help people with a disability, right. So if we're talking about a person with a disability, which impacts their mobility, service dogs are trained to pick items up off the floor on command. Things like keys, things like a wallet, a cell phone, even something as slender as a credit card, they're also trained to help with access. And so she knows how to press the button on an elevator to summon an elevator or to open a door. So all these kinds of different things, we've been able to kind of shape and mold into tasks that she can do with our patients. So a classic example that I like to give us because she's trained to push the button on an elevator with her nose, I'm able to then use that command and shape it into her pushing or hitting a balloon back and forth to a patient, who's you know, working on X amount of different areas, things like standing balance, hand eye coordination, visual tracking, use of their upper extremity. So that's one kind of, I think, simple example.
Shanna M 07:14
Yeah. How long was Peru's training? And then, what's, what's the training like for you all as as handlers to?
Heather Tropiano, MD 07:21
Yeah, so it's her training. So I mean, she was born and bred for this work. So she was bred out in California, so I like to say she's a West Coast gal. At eight weeks old, she was then flown to a volunteer, that they're called puppy raisers. And these amazing individuals volunteer their time and their energy and their heart to basically raising the dog for the first 18 months of their life. So they socialize them to all different types of environments, and sounds and sights and places. And teach them basic obedience. Right? Then when the dog is 18 months old, they're turned back to Canine Companions. Peru is from the training facility out in Long Island, New York. And so she's a native New, she is also kind of a native New Yorker, too. But then when they're turned back into the training center there, they undergo nine months of professional training, where every single day they're working with a trainer to be able to learn the behaviors to perform the tasks that a service dog would need to be able to do.
Zuleika 08:30
And I have to say that that campus, or the facility itself is so intriguing, because I think that they have taken so much care into figuring out so many different scenarios. And they even have a cat present on site where while the dog is training, so that way, there's something to what's supposed to be a distraction, something that just becomes normal behavior to them, you know, this is just something that that they experience. So that way when they are actually at a facility doing their job, they're not distracted doing something else. They they will flick on a light, they will turn off the light, they'll flush the toilet, they'll do everything.
Heather Tropiano, MD 09:08
Right, all these things that would help an individual living with a disability. So you asked about our training too, so Colette will hopefully be going through this in a couple of months. But so the dog then goes through professional training, they either kind of pass or they fail. It's called a change of career if the dog is like doesn't hack it.
Shanna M 09:29
I've always heard it's called fabulous flunky.
Heather Tropiano, MD 09:37
So the dogs that then are suited for service work and show that you know they're interested in this is something that they want to do are then professionally matched with either an individual with a disability or healthcare professional that wants to use the dog for more than one person. Right. And so if you think of us on the rehab unit, she's not helping one person every day but she's helping multiple people with multiple different types of disabilities. So then they contacted me, I had to go down to Long Island for a two week in house training. So I stay there and I even boarded there, and they were basically teaching me how to use her.
Shanna M 10:10
Oh, the commands.
Heather Tropiano, MD 10:12
Yeah, all the commands. And then you know, canine learning theory, how to train new commands, how to use her in certain ways. So it was it was a really, really great experience.
Shanna M 10:25
Well, here, I thought my dogs were geniuses when they go outside and I call them and they come back. I'm like, oh, they're so smart.
Heather Tropiano, MD 10:33
They are, they are smart.
Shanna M 10:35
I think Peru puts them to shame, but I still love them. Sounds like Canine Companion offers a lot. Is there anything else about them that we can add?
Heather Tropiano, MD 10:47
Well, I think just in general, they're such an incredible organization. And the work they do is just so above and beyond. They provide service dogs for individuals with all different types of disabilities, for free of charge. And so that's a big thing, too. So I like to tell people that Peru is a gift. She's a very expensive gift. And she's worth about $50,000. By the time she's placed with someone like me, who is a handler, because of all of the
Shanna M 11:15
the training.
Heather Tropiano, MD 11:16
Veterinary, right and the food and the boarding and the professional training for so long. Yeah, but they are a nationally known organization. They've been around for a very long time. And they have just been so incredibly supportive, and so phenomenal to work with
Shanna M 11:31
Well amazing work being done there. And in our very own facility. So thank you. Are you excited Colette for to enter in this journey? What does it, what does it mean for you? And how does it take how you help patients to the next level?
Colette C. 11:47
I am extremely excited. I have been at Adventist for almost five years now. And I've loved my time here. And I feel like this will just solidify, you know how much I love my work even more. I never imagined that I'd be an occupational therapist with a dog. But I am so excited. I think even you know, the few patients that Peru comes over to get to see, you see such a difference in the patient's ability to stand for longer, or their arm is functioning in a way that I couldn't get it to. So I think it will really make a big difference. And you know, like Dr. Tripiano was saying everyone comes over and stares and I get 10 message requests of can my patient work with Peru? And it's so hard to say no. But you know, i'm just trying to encourage our dog is coming. If the patients are still here, we'll try and set up a time with Peru. But I think it will be really beneficial. And I think it will really be a good morale boost for everyone around.
Shanna M 12:46
Yeah. How does it affect the staff and just the general mood when Peru comes around for for the patients and everybody?
Heather Tropiano, MD 12:53
Yeah, I think she's just kind of like a ray of sunshine. And she, but she's so, she's just like,
Shanna M 13:01
She's super chill like, she's so our, for our listeners who can't see she's just laying right by Dr. Troiano take, you know,
Colette C. 13:09
I'm pretty sure she's gonna start snoring soon.
Zuleika 13:11
She, it was a long day. It was a ruff day!
Heather Tropiano, MD 13:16
She, I think brings levity. And I you know, I think she also brings a lot of humanity to the hospital, which is interesting, because lots of our patients have dogs at home. And so they're in the hospital recovering from this, you know, horrible thing that just happened at the drop of a hat. And it reminds them of home. She at the same time, she brings just kind of a lot of positivity to the unit. But she also like is, she's there to work like and she's very, very serious. And when she's going through a treatment session staff will try to say hi to her. And she's just like, she just keeps on walking.
Shanna M 13:53
She just keeps going.
Zuleika 13:55
I have work to do.
Heather Tropiano, MD 13:58
And you know, Colette had mentioned something interesting before about, you know, when she cotreats with Peru with her patients, how patients are able to do things for longer periods of time. We just wrapped up a research project using her that were in the late stages of but one of the statistically significant findings
Colette C. 14:18
was that task persistence, so patients engagement in a task with Peru versus without Peru, like they engaged in that task for so much longer when they were doing it one on one with the dog versus when they were doing it with another therapist.
Heather Tropiano, MD 14:32
So not to undermine what the therapists do, because they are very important, but she just adds another.
Shanna M 14:37
Adds like motivation or elements just Yeah.
Heather Tropiano, MD 14:40
Yeah. And a lot of them also, a lot of the patients in the study and we had about 69 patients in a three month time span had mentioned when they were asked about what their experience was like, was that she was a very good distraction from pain and anxiety. And so a lot of the things that I work on as the rehab psychologists too, so really kind of cool to see her be able to make that difference in patient outcomes and reaching their goals and progress. Yeah,
Shanna M 15:06
I love when you said, you know, she brings a level of humanity. And I've heard this a lot. And I think we might even have talked about this on past episodes on the podcast, where when patients go through something like you're describing, or just you know, they're in the hospital, and they don't feel like themselves, there's a loss of identity a little bit, they're not able to do the things that they normally do. And this brings that into a space where it can make people feel more comfortable connect with themselves when they just don't. And I think that's a beautiful thing.
Heather Tropiano, MD 15:36
Yeah, absolutely.
Shanna M 15:37
Yeah. That's how much I love the dogs. Love all the dogs, all the dogs.
Zuleika 15:42
Yeah. I do think that they had stated it statistically lowers their blood pressure there, if there's a high anxiety level, if they have high blood pressure, petting a pet creates that sense of safety almost. And it reduces anxiety, and I mean, if there's a threshold pain threshold, maybe looking at something more appealing and seeing what kind of, you know, what's the endpoint and seeing that pet there really makes a huge difference. I think they're just amazing.
Shanna M 16:13
How long can Peru work for?
Heather Tropiano, MD 16:15
That's a good question. I get asked that a lot. So she started working and she was two and a half, Canine Companions who I regularly keep in touch with and they, you know, constantly keep tabs on myself and Peru and how we're doing, they will start to check in at around seven years old, which for Peru is going to be next year, just to see if she started to exhibit any of the behaviors that they would look for in thinking about like, okay, maybe this dog should maybe go part time or start looking towards retirement.
Colette C. 16:43
PRN?
Heather Tropiano, MD 16:44
PRN
Shanna M 16:45
Maybe she should just do like, just like people dogs, dogs begin to age and slow down. And she's a working dog.
Heather Tropiano, MD 16:53
Right. And so there's you know, she, it's very taxing and it takes its toll and when we're in rehab, so she's doing lots of very physical interventions, like she plays soccer, she retrieves rings, she plays balloon volleyball. I mean, she's doing all these things. And so some of the behaviors that we'll kind of look for to see it, does she get excited to go in the car in the morning to go to work? What are her you know, reactions when we put the vest on? Is she looking like she's just really not interested, when she's at work anymore? So it varies is the short answer to your question. But usually, like around seven, they'll start to kind of ask these very specific questions so we can keep an eye on, is are we overworking her? Does she want to retire? Does she just want to be like a normal pet?
Shanna M 17:41
I think it's amazing that, you know, we're treating her like, I don't want to you know, she's a like she has her own ability, you know, her own thoughts and her own needs. And we're not ignoring that. And that's important.
Zuleika 17:56
She's a healthcare heroes.
Shanna M 17:59
Well you said she start? When did she start with?
Heather Tropiano, MD 18:01
Yeah, so she came September 2020.
Shanna M 18:04
Oh, so she started during COVID. She is a healthcare hero.
Heather Tropiano, MD 18:08
Which that brought, I mean, you're asking about the impact on staff before and we were at Takoma Park, which was an older hospital, we were getting ready to move out of it. And so this bright, new shiny building that we're at, at White Oak, and it was the pandemic, we had a COVID rehab unit, and like, there was just so much going on, and our staff were really burnt out. And facility dogs aren't there to help staff, they're there for the patients and to work with them to get better towards, you know, and to improve. But she helped the staff so much during that time. I mean, just like
Shanna M 18:40
Bringing a smile.
Heather Tropiano, MD 18:41
Yeah. And people would just be so tired from wearing their PPE all day and just be so drained. And, you know, we couldn't have patients family members come visit. And so it was a lot of like, back and forth over the phone, and people would just come into my office and just like hang out with her, and just take a breather. And yeah, she was really, really helpful at that time.
Shanna M 19:00
That's amazing.
Zuleika 19:02
And I think it's also really great to say and I don't know if we've discussed it, but she came in at three, and now she's six, and she's helped over 500 patients in the time of her career.
Heather Tropiano, MD 19:16
I'd say actually more like 1500.
Zuleika 19:24
But can you imagine 1500 patients that's,
Shanna M 19:28
She's made an impact, that's for sure. And you, and you Dr.Tropiano have been a part of that. So that's got to be amazing.
Heather Tropiano, MD 19:34
It's you know, it's humbling and it's just so like, I'm so honored to watch these patients interact with her and be able to do things that they weren't able to do before. But I do have to kind of laugh because no one knows my name. They just know me as Peru's mom. I know like i'm just the backup singer. I'm just here to help, you know, handle her. She's really going to do your, you know the bulk of the work today.
Shanna M 19:56
Did you work with a facility talk before?
Heather Tropiano, MD 19:58
No. So before I was at Adventist HealthCare, I was actually active duty Air Force.
Shanna M 20:05
Ok.
Heather Tropiano, MD 20:05
And I was a psychologist in the Air Force. So my exposure to working dogs or using dogs in terms of mental health purposes was when we would respond on base to different tragedies, we would get the therapy dogs to kind of come out and accompany us to go talk to the members of the unit, say if the unit had suffered a suicide or something like that. Because in the military, no one wants to talk to a psychologist.
Shanna M 20:32
The stigma
Heather Tropiano, MD 20:33
Yeah
Shanna M 20:33
We talk about mental health stigma in sort of regular community. But it's even worse I feel like in the military?
Heather Tropiano, MD 20:42
Absolutely. So I remember I was responding to a suicide on base and I had called one of the therapy dog organizations to come out. And before the therapy dog had gotten there, I was walking around myself and like, trying to talk to people.
Shanna M 20:55
Do what you can, yeah.
Heather Tropiano, MD 20:57
Just kind of give them a you know, like, these are the resources that are there. I'm here if you want to talk, this is who I am. And like no one made eye contact with me. But then the therapy dog who was a Leonberger, so if you know anything about that breed, they're gigantic. It was like a 150 pound dog.
Shanna M 21:00
Are those the ones that look like Bear, like almost like a bear?
Heather Tropiano, MD 21:16
And his name was Aslan, which is like the perfect name for him right? And I was walking around the unit with Aslan. And suddenly everyone wanted to talk to me. Because I was like, there's something here that I need to harness. There's something here. So when I started working for Adventist, I had actually rescued a dog that I was training to be a therapy dog. Her name was Etta, and she had passed all of her tests, but then she had gotten diagnosed with cancer. And we lost her before she can, you know, start working. And then someone at Adventist told me about a facility dog and I didn't know the difference at the time. Between a therapy dog and a facility dog. And so then I applied and kind of the rest is history, but it took about two years to get her.
Shanna M 22:01
Okay, yeah, it's a long process. They do such special work that it really takes, takes the time. So we love Peru. She's a celebrity around here. We're excited for you Colette, what are you most looking forward to in welcoming a new facility dog hopefully fingers crossed, if we can get one
Colette C. 22:21
Yes, if Canine Companions is listening to this. I am most excited for I work a lot with the amputee population. And I am most excited to kind of see what the facility dog will really be able to do with that population. As an occupational therapist, I did not learn much about amputee care in school. So I go back every semester to do my guest lecture on you know, amputee care in the real world. And I'm very excited to kind of bring the dog into it and kind of see what this new path will will have for me.
Shanna M 22:58
Well, that sounds exciting. We want to have you back
Colette C. 23:01
and the dog.
Heather Tropiano, MD 23:04
Get used to it Colette, no one will care or know about you. Just know you're the dog's Mom.
Colette C. 23:09
I'm the dog person, it's fine. I'm the cat person right now. So,
Shanna M 23:12
Ah, okay.
Colette C. 23:13
I'm okay with the transition.
Shanna M 23:14
Well, it's been such a pleasure having you, is there anything else you want to add about the work that you do here, with patients with Adventist HealthCare?
Colette C. 23:23
I just really want to thank everyone who has supported the facility dog program, everyone who will support the facility dog program. I know, Dr. Tropiano, Dr.Fromm, Dr. Ricci have done a ton of work to make this possible. And I really feel so grateful for this opportunity. And I promise I will bring my dog to all of your events. Say hi and give kisses and all the fun stuff. So I really just have to thank everyone. And I'm really looking forward to it.
Heather Tropiano, MD 23:53
Yeah, I think it's great. I feel like I need to echo that too. It's, you know, we started this program from scratch. And now it's growing, which we're super excited about and super excited to have Colette specifically as the handler because she's such an innovative clinician, and I think she's gonna use the facility dog in amazing ways. But we've also had all the right players in place in terms of administration and support from upper level management, and so couldn't have done it without them. Yeah
Shanna M 24:22
I just, I'm amazed at the work that you do, but also that this is happening here at Adventist HealthCare. But this wonderful work doesn't have to happen in a big medical center and a huge place where it's right here in the community. So yeah, I love that story.
Heather Tropiano, MD 24:38
Yeah. Well, thank you so much.
Colette C. 24:39
Thank You
Shanna M 24:41
Would Peru like to add anything?
Peru 24:45
Ruff, Ruff, Ruff, Ruff, Ruff
Shanna M 24:45
We love it. Thank you, Peru.
Zuleika 24:47
Yeah, thank you.
Shanna M 24:49
All right. Well, thank you to both Dr. Tropiano and Colette and my special guest host here Zuleika, and to our listeners. We hope you enjoyed our tale from the dog side, the puns are off the charts today listeners. Not only do I get to do the dog and bring the dog in which I love, I also get to bring in my love of Star Wars. So there you go,
Heather Tropiano, MD 25:16
I think the puns are fetching.
Shanna M 25:19
Even better. All right, to learn more about our experts and services offered at Adventist HealthCare Rehabilitation, please visit AdventistRehab.com. And if you'd like to keep up with Peru, she has her very own Instagram page @PeruthePup. Information will be available in today's episodes show notes. We'll also put in some information about Canine Companions and all the different resources and things that we talked about today. And don't forget, we always love to hear from you our listeners, you can let us know if you liked the podcast by giving us two paws up with a rating or review or you can email podcast at AdventistHealthCare.com. And let us know what healthcare topics you want to know more about. Don't forget to subscribe to the podcast so you get new episodes, Dr. Tropiano and Colette we hope you'll come back?
Heather Tropiano, MD 26:08
I'd love to
Colette C. 26:08
We'll be here
Shanna M 26:09
and Peru, thank you as well, you were a very good girl today. Thank you and be well!
