Dogs Paired With Providers at Hospitals Help Ease Staff and Patient Stress

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DENVER — Outside HCA HealthONE Rose medical center, the snow is flying. Inside, on the third floor, there’s a flurry of activity within the labor and delivery unit.

“There’s a lot of action up here. It can be very stressful at times,” said Kristina Fraser, an OB-GYN in blue scrubs.

Nurses wheel a very pregnant mom past.

“We’re going to bring a baby into this world safely,” Fraser said, “and off we go.”

She said she feels ready in part due to a calming moment she had just a few minutes earlier with some canine colleagues.

A pair of dogs, tails wagging, had come by a nearby nursing station, causing about a dozen medical professionals to melt into a collective puddle of affection. A yellow Lab named Peppi showered Fraser in nuzzles and kisses. “I don’t know if a human baby smells as good as that puppy breath!” Fraser had said as her colleagues laughed.

The dogs aren’t visitors. They work here, too, specifically for the benefit of the staff. “I feel like that dog just walks on and everybody takes a big deep breath and gets down on the ground and has a few moments of just decompressing,” Fraser said. “It’s great. It’s amazing.”

Hospital staffers who work with the dogs say there is virtually no bite risk with the carefully trained Labradors, the preferred breed for this work.

The dogs are kept away from allergic patients and washed regularly to prevent germs from spreading, and people must wash their hands before and after petting them.

Doctors and nurses are facing a growing mental health crisis driven by their experiences at work. They and other health care colleagues face high rates of depression, anxiety, stress, suicidal ideation, and burnout. Nearly half of health workers reported often feeling burned out in 2022, an increase from 2018, according to the Centers for Disease Control and Prevention. And the percentage of health care workers who reported harassment at work more than doubled over that four-year period. Advocates for the presence of dogs in hospitals see the animals as one thing that can help.

That includes Peppi’s handler, Susan Ryan, an emergency medicine physician at Rose.

Ryan said years working as an emergency room doctor left her with symptoms of PTSD. “I just was messed up and I knew it,” said Ryan, who isolated more at home and didn’t want to engage with friends. “I shoved it all in. I think we all do.”

She said doctors and other providers can be good at hiding their struggles, because they have to compartmentalize. “How else can I go from a patient who had a cardiac arrest, deal with the family members telling them that, and go to a room where another person is mad that they’ve had to wait 45 minutes for their ear pain? And I have to flip that switch.”

To cope with her symptoms of post-traumatic stress disorder, Ryan started doing therapy with horses. But she couldn’t have a horse in her backyard, so she got a Labrador. 

Ryan received training from a national service dog group called Canine Companions, becoming the first doctor trained by the group to have a facility dog in an emergency room. Canine Companions has graduated more than 8,000 service dogs.

The Rose medical center gave Ryan approval to bring a dog to work during her ER shifts. Ryan’s colleagues said they are delighted that a dog is part of their work life.

“When I have a bad day at work and I come to Rose and Peppi is here, my day’s going to be made better,” EMT Jasmine Richardson said. “And if I have a patient who’s having a tough day, Peppi just knows how to light up the room.”

Nursing supervisor Eric Vaillancourt agreed, calling Peppi “joyful.”

Ryan had another dog, Wynn, working with her during the height of the pandemic. She said she thinks Wynn made a huge difference. “It saved people,” she said. “We had new nurses that had never seen death before, and now they’re seeing a covid death. And we were worried sick we were dying.”

She said her hospital system has lost a couple of physicians to suicide in the past two years, which HCA confirmed to KFF Health News and NPR. Ryan hopes the canine connection can help with trauma. “Anything that brings you back to the present time helps ground you again. A dog can be that calming influence,” she said. “You can get down on the ground, pet them, and you just get calm.”

Ryan said research has shown the advantages. For example, one review of dozens of original studies on human-animal interactions found benefits for a variety of conditions including behavioral and mood issues and physical symptoms of stress. 

Rose’s president and CEO, Casey Guber, became such a believer in the canine connection he got his own trained dog to bring to the hospital, a black Lab-retriever mix named Ralphie.

She wears a badge: Chief Dog Officer.

Guber said she’s a big morale booster. “Phenomenal,” he said. “It is not uncommon to see a surgeon coming down to our administration office and rolling on the ground with Ralphie, or one of our nurses taking Ralphie out for a walk in the park.”

This article is from a partnership that includes CPR News, NPR, and KFF Health News.

KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about KFF.

Subscribe to KFF Health News’ free Morning Briefing.

This article first appeared on KFF Health News and is republished here under a Creative Commons license.

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  • The SharpBrains Guide to Brain Fitness – by Alvaro Fernandez et al.

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    We say “et al.” in the by-line, because this one has a flock of authors, including Dr. Pascale Michelon, Dr. Sandra Bond Chapman, Dr. Elkehon Goldberg, and various others if we include the foreword, introduction, etc.

    This is relevant, because those who contributed to the meat of the book (i.e., those listed above), it makes the work a lot more scientifically reliable; one skilled science writer might make a mistake; it’s much less likely to make it through to publication when there are a bevy of doctors in the mix, each staking their reputation on the book’s content, and thus having a vested interest in checking each other’s work as well as their own.

    As for what this multidisciplinary team have to offer? The book covers such things as:

    • how the brain works (especially the possibilities of neuroplasticity), and what that means for such things as memory and attention
    • being “a coach not a patient”; i.e., being active rather than passive in one’s approach to brain health
    • the relevance of physical exercise, how much, and what kind
    • the relevance (and limitations) of diet choices for brain health
    • the relevance of such things as learning new languages and musical training
    • the relevance of social engagement, and how some (but not all) social engagement can boost cognition
    • methods for managing stress and building resilience to same (critical for maintaining a healthy brain)
    • “cross-fit for your brain”, that is to say, a multi-vector collection of tools to explore, ranging from meditation to CBT to biofeedback and more.

    The style is pop-science without being sensationalist, just communicating ideas clearly, with enough padding to feel casual, and not like a dense read. Importantly, it’s also practical and applicable too, which is something we always look for here.

    Bottom line: if you’d like to be given a good overview of what things work (and how much they can be expected to work), along with a good framework to put that knowledge into practice, then this is a great book for you.

    Click here to check out The SharpBrains Guide to Brain Fitness, and optimize your brain health and performance!

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  • Managing Chronic Pain (Realistically!)

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    Realistic chronic pain management

    We’ve had a number of requests to do a main feature on managing chronic pain, so here it is!

    A quick (but important) note before we begin:

    Obviously, not all chronic pain is created equal. Furthermore, we know that you, dear reader with chronic pain, have been managing yours for however long you have, learning as you go. You also doubtlessly know your individual condition inside out.

    We also know that people with chronic health conditions in general are constantly beset by well-meaning unsolicited advice from friends and family, asking if you’ve heard about [thing you heard about 20 years ago] that will surely change your life and cure you overnight.

    It’s frustrating, and we’re going to try to avoid doing that here, while still offering the advice that was asked for. We ask you, therefore, to kindly overlook whatever you already knew, and if you already knew it all, well, we salute you and will not be surprised if that’s the case for at least some readers. Chronic pain’s a… Well, it’s a chronic pain.

    All that said, let’s dive in…

    How are you treating your body right now?

    Are you hydrated; have you eaten; are you standing/sitting/lying in a position that at least should be comfortable for you in principle?

    The first two things affect pain perception; the latter can throw a spanner in the works if something’s not quite right.

    Move your body (gently!)

    You know your abilities, so think about the range of motion that you have, especially in the parts of your body that hurt (if that’s “everywhere”, then, our sympathies, and we hope you find the same advice applies). Think about your specific muscles and joints as applicable, and what the range of motion is “supposed” to be for each. Exercise your range of motion as best you can (gently!) to the point of its limit(s) and/or pain.

    • If you take it past that limit, there is a good chance you will make it worse. You don’t want that.
    • If you don’t take it to the limit, there is a good chance your range of movement will deteriorate, and your “safe zone” (i.e., body positions that are relatively free from pain) will diminish. You definitely don’t want that, either.

    Again, moderation is key. Yes, annoying as the suggestion may be, such things as yoga etc can help, if done carefully and gently. You know your limits; work with those, get rest between, and do what you can.

    For most people this will at least help keep the pain from getting worse.

    Hot & Cold

    Both of these things could ease your pain… Or make it worse. There is an element of “try it and see”, but here’s a good general guide:

    Here’s How to Choose Between Using Ice or Heat for Pain

    Meditation… Or Distraction

    Meditating really does help a lot of people. In the case of pain, it can be counterintuitively helpful to focus for a while on the sensation of the pain… But in a calm, detached fashion. Without judgement.

    “Yes, I am experiencing pain. Yes, it feels like I’m being stabbed with hot knives. Yes, this is tortuous; wow, I feel miserable. This truly sucks.”

    …it doesn’t sound like a good experience, does it? And it’s not, but paying it attention this way can paradoxically help ease things. Pain is, after all, a messenger. And in the case of chronic pain, it’s in some ways a broken messenger, but what a messenger most needs is to be heard.

    The above approach a) is good b) may have a limit in how long you can sustain it at a time, though. So…

    The opposite is a can be a good (again, short-term) approach too. Call a friend, watch your favorite movie, play a video game if that’s your thing. It won’t cure anything, but it can give you a little respite.

    Massage

    Unless you already know this makes your pain worse, this is a good thing to try. It doesn’t have to be a fancy spa; if the nature of your pain and condition permits, you can do self-massage. If you have a partner or close friend who can commit to helping, it can be very worth them learning to give a good massage. There are often local courses available, and failing that, there is also YouTube.

    Here’s an example of a good video for myofascial release massage, which can ease a lot of common kinds of chronic pain:

    !

    Some quick final things to remember:

    • If you find something helps, then it helps, do that.
    • That goes for mobility aids and other disability aids too, even if it was designed for a different disability. If it helps, it helps. You’re not stealing anyone’s thunder (or resources) by using something that makes your life easier. We’re not in this life to suffer!
    • There is no such thing as “this pain is not too much”. The correct amount of pain is zero. Maybe your body won’t let you reach zero, but more than that is “too much” already.
    • You don’t have to be suffering off the scale to deserve relief from pain

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  • Castor Oil: All-Purpose Life-Changer, Or Snake Oil?

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    As “trending” health products go, castor oil is enjoying a lot of popularity presently, lauded as a life-changing miracle-worker, and social media is abuzz with advice to put it everywhere from your eyes to your vagina.

    But:

    • what things does science actually say it’s good for,
    • what things lack evidence, and
    • what things go into the category of “wow definitely do not do that”?

    We don’t have the space to go into all of its proposed uses (there are simply far too many), but we’ll examine some common ones:

    To heal/improve the skin barrier

    Like most oils, it’s functional as a moisturizer. In particular, its high (90%!) ricinoleic fatty acid content does indeed make it good at that, and furthermore, has properties that can help reduce skin inflammation and promote wound healing:

    Bioactive polymeric formulations for wound healing ← there isn’t a conveniently quotable summary we can just grab here, but you can see the data and results, from which we can conclude:

    • formulations with ricinoleic acid (such as with castor oil) performed very well for topical anti-inflammatory purposes
    • they avoided the unwanted side effects associated with some other contenders
    • they consistently beat other preparations in the category of wound-healing

    To support hair growth and scalp health

    There is no evidence that it helps. We’d love to provide a citation for this, but it’s simply not there. There’s also no evidence that it doesn’t help. For whatever reason, despite its popularity, peer-reviewed science has simply not been done for this, or if it has, it wasn’t anywhere publicly accessible.

    It’s possible that if a person is suffering hair loss specifically as a result of prostaglandin D2 levels, that ricinoleic acid will inhibit the PGD2, reversing the hair loss, but even this is hypothetical so far, as the science is currently only at the step before that:

    In silico prediction of prostaglandin D2 synthase inhibitors from herbal constituents for the treatment of hair loss

    However, due to some interesting chemistry, the combination of castor oil and warm water can result in acute (and irreversible) hair felting, in other words, the strands of hair suddenly glue together to become one mass which then has to be cut off:

    “Castor Oil” – The Culprit of Acute Hair Felting

    👆 this is a case study, which is generally considered a low standard of evidence (compared to high-quality Randomized Controlled Trials as the highest standard of evidence), but let’s just say, this writer (hi, it’s me) isn’t risking her butt-length hair on the off-chance, and doesn’t advise you to, either. There are other hair-oils out there; argan oil is great, coconut oil is totally fine too.

    As a laxative

    This time, there’s a lot of evidence, and it’s even approved for this purpose by the FDA, but it can be a bit too good, insofar as taking too much can result in diarrhea and uncomfortable cramping (the cramps are a feature not a bug; the mechanism of action is stimulatory, i.e. it gets the intestines squeezing, but again, it can result in doing that too much for comfort):

    Castor Oil: FDA-Approved Indications

    To soothe dry eyes

    While putting oil in your eyes may seem dubious, this is another one where it actually works:

    ❝Castor oil is deemed safe and tolerable, with strong anti-microbial, anti-inflammatory, anti-nociceptive, analgesic, antioxidant, wound healing and vasoconstrictive properties.

    These can supplement deficient physiological tear film lipids, enabling enhanced lipid spreading characteristics and reducing aqueous tear evaporation.

    Studies reveal that castor oil applied topically to the ocular surface has a prolonged residence time, facilitating increased tear film lipid layer thickness, stability, improved ocular surface staining and symptoms.❞

    Source: Therapeutic potential of castor oil in managing blepharitis, meibomian gland dysfunction and dry eye

    Against candidiasis (thrush)

    We couldn’t find science for (or against) castor oil’s use against vaginal candidiasis, but here’s a study that investigated its use against oral candidiasis:

    Rosemary, Castor Oils, and Propolis Extract: Activity Against Candida Albicans and Alterations on Properties of Dental Acrylic Resins

    …in which castor oil was the only preparation that didn’t work against the yeast.

    Summary

    We left a lot unsaid today (so many proposed uses, it feels like a shame to skip them), but in few words: it’s good for skin (including wound healing) and eyes; but we’d give it a miss for hair, candidiasis, and digestive disorders.

    Want to try some?

    We don’t sell it, but here for your convenience is an example product on Amazon 😎

    Take care!

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  • Dates vs Raisins – Which is Healthier?

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    Our Verdict

    When comparing dates to raisins, we picked the dates.

    Why?

    There are benefits for each fruit, but we say dates come out on top. See what you think:

    In terms of macros, while they’re both dried fruits, dates contain more water (unless you leave them sitting open for a while), which will tend to mathematically lower the relative percentages of other components because they’re being held against water weight too. However, even though this is the case (i.e. dates are being mathematically disadvantaged), dates contain more than twice the fiber that raisins do (8g/100g compared to raisins’ 3.7g/100g).

    While we’re talking macros, dates are also lower in total carbs, as well as obviously net carbs, and have a much lower glycemic index than raisins (dates have a glycemic index of 42, considered low, while raisins have a glycemic index of 64, considered medium; their respective glycemic loads are even more telling: 13 for raisins and just 2 for dates!).

    About those carbs… For dates, it’s an approximately equal mix of sucrose, glucose, and fructose, while for raisins it’s 49% glucose and 49% fructose. Because sucrose is the only disaccharide here, this (as well as the fiber difference) is one of the reasons for the different glycemic indices and glycemic loads, since glucose and fructose are more quickly absorbed.

    That’s more than we usually write about macros, but in this case, both fruits are ones especially often hit with the “aren’t they full of sugar though?” question, so it was important to cover the critical distinctions between the two, because they really are very different.

    Summary of macros: dates win easily in every aspect we looked at

    In the category of vitamins, raisins get a tally in their favor. Raisins are higher in vitamins B1, B2, C, E, K, and choline, while dates are higher in vitamins A, B3, B5, and B9, giving raisins a 6:4 lead here. In dates’ defense, the difference in vitamin K is marginal, and it’d make it a 5:4 lead if we considered that within the margin of error (because all these figures are of course based on averages), and the vitamins that dates are higher in, the margins are much wider indeed, meaning that both fruits have approximately the same overall levels of vitamins when looked at in total, but still, we’ll call this category a nominal win for raisins.

    When it comes to minerals, dates have more magnesium, selenium, and zinc, while raisins have more copper, iron, phosphorus, and potassium. Nominally that’s a 4:3 lead for raisins, but if we consider that raisins also contain more sodium, it’s more like a tie here. If we have to pick one though, this is a very slight win for raisins.

    Adding up the sections, we have one huge win for dates (macros) with two very marginal wins for raisins—hence, we say that dates win out.

    Still, of course enjoy both; diversity is good for the health.

    Want to learn more?

    You might like to read:

    Which Sugars Are Healthier, And Which Are Just The Same?

    Take care!

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  • Are GMOs Good Or Bad For Us?

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    Unzipping Our Food’s Genes

    In yesterday’s newsletter, we asked you for your (health-related) views on GMOs.

    But what does the science say?

    First, a note on terms

    Technically, we (humans) have been (g)enetically (m)odifying (o)rganisms for thousands of years.

    If you eat a banana, you are enjoying the product of many generations of artificial selection, to change its genes to produce a fruit that is soft, sweet, high in nutrients, and digestible without cooking. The original banana plant would be barely recognizable to many people now (and also, barely edible). We’ve done similarly with countless other food products.

    So in this article, we’re going to be talking exclusively about modern genetic modification of organisms, using exciting new (ish, new as in “in the last century”) techniques to modify the genes directly, in a copy-paste fashion.

    For more details on the different kinds of genetic modification of organisms, and how they’re each done (including the modern kinds), check out this great article from Sciencing, who explain it in more words than we have room for here:

    Sciencing | How Are GMOs Made?

    (the above also offers tl;dr section summaries, which are great too)

    GMOS are outright dangerous (cancer risks, unknown risks, etc): True or False?

    False, so far as we know, in any direct* fashion. Obviously “unknown risks” is quite a factor, since those are, well, unknown. But GMOs on the market undergo a lot of safety testing, and have invariably passed happily.

    *However! Glyphosate (the herbicide), on the other hand, has a terrible safety profile and is internationally banned in very many countries for this reason.

    Why is this important? Because…

    • in the US (and two out of ten Canadian provinces), glyphosate is not banned
    • In the US (and we may hypothesize, those two Canadian provinces) one of the major uses of genetic modification of foodstuffs is to make it resistant to glyphosate
    • Consequently, GMO foodstuffs grown in those places have generally been liberally doused in glyphosate

    So… It’s not that the genetic modification itself makes the food dangerous and potentially carcinogenic (it doesn’t), but it is that the genetic modification makes it possible to use a lot more glyphosate without losing crops to glyphosate’s highly destructive properties.

    Which results in the end-consumer eating glyphosate. Which is not good. For example:

    ❝Following the landmark case against Monsanto, which saw them being found liable for a former groundskeeper, 46 year old Dewayne Johnson’s cancer, 32 countries have to date banned the use of Glyphosate, the key ingredient in Monsanto’s Roundup weed killer. The court awarded Johnson R4.2 billion in damages finding Monsanto “acted with malice or oppression”.❞

    Source: see below!

    You can read more about where glyphosate is and isn’t banned, here:

    33 countries ban the use of Glyphosate—the key ingredient in Roundup

    For the science of this (and especially the GMO → glyphosate use → cancer pipeline), see:

    Use of Genetically Modified Organism (GMO)-Containing Food Products in Children

    GMOs are extra healthy because of the modifications (they were designed for that, right?): True or False?

    True or False depending on who made them and why! As we’ve seen above, not all companies seem to have the best interests of consumer health in mind.

    However, they can be! Here are a couple of great examples:

    ❝Recently, two genome-edited crops targeted for nutritional improvement, high GABA tomatoes and high oleic acid soybeans, have been released to the market.

    Nutritional improvement in cultivated crops has been a major target of conventional genetic modification technologies as well as classical breeding methods❞

    Source: Drs. Nagamine & Ezura

    Read in full: Genome Editing for Improving Crop Nutrition

    (note, they draw a distinction of meaning between genome editing and genetic modification, according to which of two techniques is used, but for the purposes of our article today, this is under the same umbrella)

    Want to know more?

    If you’d like to read more about this than we have room for here, here’s a great review in the Journal of Food Science & Nutrition:

    Should we still worry about the safety of GMO foods? Why and why not? A review

    Take care!

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  • What I Wish People Knew About Dementia – by Dr. Wendy Mitchell

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    We hear a lot from doctors who work with dementia patients; sometimes we hear from carers too. In this case, the author spent 20 years working for the NHS, before being diagnosed with young-onset dementia, at the age of 58. Like many health industry workers who got a life-changing diagnosis, she quickly found it wasn’t fun being on the other side of things, and vowed to spend her time researching, and raising awareness about, dementia.

    Many people assume that once a person has dementia, they’re basically “gone before they’re gone”, which can rapidly become a self-fulfilling prophecy as that person finds themself isolated and—though this word isn’t usually used—objectified. Talked over, viewed (and treated) more as a problem than a person. Cared for hopefully, but again, often more as a patient than a person. If doctors struggle to find the time for the human side of things with most patients most of the time, this is only accentuated when someone needs more time and patience than average.

    Instead, Dr. Mitchell—an honorary doctorate, by the way, awarded for her research—writes about what it’s actually like to be a human with dementia. Everything from her senses, how she eats, the experience of eating in care homes, the process of boiling an egg… To relationships, how care changes them, to the challenges of living alone. And communication, confusion, criticism, the language used by professionals, or how things are misrepresented in popular media. She also talks about the shifting sense of self, and brings it all together with gritty optimism.

    The style is deeply personal, yet lucid and clear. While dementia is most strongly associated with memory loss and communication problems, this hasn’t affected her ability to write well (7 years into her diagnosis, in case you were wondering).

    Bottom line: if you’d like to read a first-person view of dementia, then this is an excellent opportunity to understand it from the view of, as the subtitle goes, someone who knows.

    Click here to check out What I Wish People Knew About Dementia, and then know those things!

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