Author Topic: Eligibility questions  (Read 765 times)

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Offline jennyhunny

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Eligibility questions
« on: May 08, 2017, 02:01:29 AM »
Hi, I'm Jenny. I have POTS - Postural Orthostatic Tachycardia Syndrome. It's a type of dysautonomia. I know of people with POTS who got service dogs in the past, but I'm not sure whether I'd be eligible since I have a more mild case. A lot of people with POTS deal with fainting spells, which is why they get dogs, but I don't usually have to deal with that. I have dizziness, but it's usually manageable, and lots of fatigue, but that can't be helped much. My main issue is tachycardic episodes - episodes in which my heart beats upwards of 160bpm (it can get up to 212bpm - at least that's the highest I've ever been able to measure it. I may get higher and not know). They happen about once a month, for anywhere from 5-15 minutes at a time, and they've been getting worse. Plus, even after they're over, I have to be super careful for at least a few hours to not exert myself so it doesn't come back. But I'm not sure exactly what causes them, and whether a dog would be able to help. Ideally, an SD would be able to warn me an attack is coming, so I can prepare and hopefully make it last shorter (some things can help - breathing exercises and sitting/laying down when I'm affected sometimes get them to last shorter), and then an SD would help me afterwards since I get really dizzy and can't exert myself (like I just said). Do y'all think a dog could be trained to tell if an episode is coming, the way they can for epileptic seizures or diabetic sugar drops? And do you think I have a case to get a dog if it could be trained to do what I need?

Offline Ariel

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Re: Eligibility questions
« Reply #1 on: May 08, 2017, 08:15:48 AM »
Hi Jenny, welcome to SDC! Have you talked to your doctor(s) who treat you for POTS about whether you are disabled? This may sound like a redundant question, but bear with me, many people do not realize disability is a necessary prerequisite. Are you currently undergoing any treatment for your POTS? I know several people with POTS, and of those who utilize a service dog for it, it's generally because of mobility issues with syncope as you've mentioned. Some dogs will naturally learn to alert to heart rate changes, but that's generally a bonus behavior. Unless you already have a pet dog who naturally alerts to your HR changes AND has a suitable SD temperament, health (and to a degree age), it will be difficult to get a SD for HR change alerts.

Diabetic alert, and at least one known case of Mastocytosis alert are the only trained alerts I'm aware of. Dogs can still pick up these changes naturally and alert too, but these can also be trained. These can be trained because these are scent based changes and that scent can be replicated in training. Dogs who alert to seizures, migraines, HR changes - it's impossible to know what they're cueing off of to alert. Since it's currently unknown what dogs may be alerting to, it's impossible to isolate and replicate it for training purposes outside of attacks. Obviously when one is in the middle of a disabling attack, it's often quite difficult to do training or reinforcing.

If you and your doctor have not yet talked about it, I'd suggest you have a discussion about whether your POTS is disabling and if you are in mutual agreement, what tasks may be beneficial to you. I'd strongly suggest not trying to find a dog and hoping that dog has a natural alert in hopes of training an alert behavior . If a dog does, that's great, but there really should be other tasks that are also assistive in the statistically likely event that the dog is not one who ever learns to alert. Definitely worth the talk with your doctor. Once again, welcome!
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Re: Eligibility questions
« Reply #2 on: May 08, 2017, 11:28:26 AM »
First off - like Ariel said, your issues must be disabling according to the ADA. Some people don't realize that the ADA offers a broader definition of disabled than Social Security, and it is also broader than what Joe Average generally thinks that it means. So I would talk to your doctor, but make sure that they do understand the ADA's definition of disabled. If they understand it, then talk to them about whether or not you are disabled and then from there what they think about a service dog.

We can't answer for you if you qualify for a service dog. However, the 1 qualification is to be disabled according to the ADA, which means "substantially limited in one or more major life activities". Major life activities include things such as walking, sleeping, eating, breathing, thinking, hearing, seeing, taking care of oneself and so on.

You also asked about tasks:

Generally, if a person will benefit from an alert behavior, they will also benefit from some response behaviors. For example, a person who has a diabetic alert dog who benefits from the alert, will also benefit from response tasks such as fetching a snack and drink, fetching medication, etc.

From what you described, besides the alert, it sounds like you might be looking for some mobility work? You said that the dog could help prevent you from exerting yourself. They might be able to help you with things like forward momentum, light bracing for dizziness, and retrieving.


As for the alerting...I don't know, I could see this one as being potentially trainable, actually. Though we don't know what the dog is alerting to, we do know when he should be alerting. One of the biggest obstacles in training seizure alert is that you don't know when seizures will happen. I don't know if this is safe for POTS, but an idea that I had might be that you could get a heart rate monitor or something (so that you can see the immediate and minute changes) and decide on a set high that isn't actually emergency high, but still above the preferred norm. That's how DADs (diabetic alert dogs) are taught to do it; the diabetic chooses a low and/or high number that the dog will alert to and when their blood sugar is at that number they do something like spitting on a cotton ball and freezing it to preserve the scent and the dog is taught to alert to that.

What you might do is something like this: let's say you pick a high of 130 bpm. Then, using the heart rate monitor, you could exercise to get your heart rate into that level and then cue the dog to do an alert behavior (i.e. nudging, licking, pawing, etc). I would exercise in a different room, wipe off sweat, and then approach the dog so that they aren't just going to pick up on the sweaty smell or the sight of you exercising. Eventually, offer them the chance to do the behavior first, and then cue the behavior. Hopefully, they will pick up on the alert.

However, like Ariel said, there is no concrete possibility. I wasn't saying that this was trainable. I said that I could see it being possible by using a method like this, not that I know that it is and not that, even if it is, that it will be possible for every/any dog. Like Ariel said, do not depend on alerting as your only legal task.
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Offline Ariel

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Re: Eligibility questions
« Reply #3 on: May 08, 2017, 11:38:29 AM »
Moonsong, I think it's premature to offer training advice when it's unknown what mechanism dogs that can alert are alerting on. If the primary need is an alert dog I think it gives false hope to offer training advice when you have relatively no training experience and none with training alerts. Experienced trainers will not attempt to offer advice not backed by scientific evidence because they know better than to explain how to shoot in the dark. Explaining how to do something when there is no base for it and you are equally baseless can only leave someone upset because they followed your hopeful advice and it steered them wrong, or worse, somehow screwed up other training they were working on. It's important to be exceedingly cautious when offering unsolicited, unprecedented training tips or advice because any fails fall on you. Better to not offer advice than offer smart sounding advice lest someone follow it and end up in an upsetting or worse, dangerous situation because of it.
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Re: Eligibility questions
« Reply #4 on: May 08, 2017, 12:01:53 PM »
You're right.

I'm just the kind of person where, when someone is looking for help/ideas/advice, I offer them ideas that I have so that the have as many options as possible to look at. It's just a habit, and one that I can see not being a good idea in this specific situation.

That is why, though, I had posted that paragraph at the bottom specifically saying "I wasn't saying this is trainable". Maybe I should have said it clearer there, but what I meant was "I'm not saying anything concrete or real, I'm just spitballing"

I agree, though, that I shouldn't have jumped the gun and starting thinking about training options at this point in time. Thank you for pointing it out  :smile:
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Offline EverConfused

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Re: Eligibility questions
« Reply #5 on: May 08, 2017, 01:27:45 PM »
have you tried a wearable heart rate monitor with continuous readout? i don't have time to find references now, but there's a group using them with cfs/me folks (as you'll know there's a lot of overlap between the cfs/me and dysautonomia populations).

these are sport type monitors with the chest bands that display the data on a watch. apparently some models can be programmed to alert you when your hr reaches certain levels.

if you haven't tried that already, it might be something else to discuss with your doctor. it's a relatively inexpensive, unobtrusive thing to try.
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Offline MusicTeach2013

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Re: Eligibility questions
« Reply #6 on: May 08, 2017, 01:52:35 PM »
Hi Jenny!

I have vasovagal syncope, which is very similar to POTS. Like you I haven't had the full syncope spells but my pre-syncope symptoms are bad enough to put me in the floor. Sometimes I can go nearly a month or so without an episode but sometimes I get them multiple times a day for days at a time. If I have an episode (mine usually happen in the morning but it can hit at other times of day) I am also exhausted and more prone to have another one.

An SD alerting for these episodes can happen, but from what I've learned it's not usually a trained behavior. Finding a dog who somehow notices something about you before it happens and then does something to alert you is like finding a needle in a haystack apparently. While it may be possible to trigger an episode and try to teach a behavior to go along with it, it's not really safe and not even guaranteed to work. It's not a method I would advise trying.

Response training a dog, however, is possible. For example a task I am looking into is having an SD fetch a phone when we are home alone if I have an episode. Or if we are in public take a card that says I am in trouble to someone like a store employee. If mobility is an issue after an episode (bending over to pick something up, or balancing) then training a dog for brace work and picking up items could be helpful.

I also advise talking to your doctor first, but I will say make sure they understand how your POTS affects your daily life activities. I had a cardiologist who was treating my vasovagal syncope tell me I wasn't "disabled enough" (his exact words) to use a service dog because I wasn't disabled all the time, just when I had an episode, and as I stated before I can have weeks at a time that they don't happen. However my general physician agreed that per ADA I am "disabled enough" because my episodes make me unable to complete daily life activities, no matter how often they happen. So... not all doctors know everything and every case is different.

Glad you are here! You will learn so much and meet some awesome people.
Don't worry, by the time I hit the floor I'm already on my way back up. (syncope problems)
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Offline Kirsten

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Re: Eligibility questions
« Reply #7 on: May 08, 2017, 03:53:42 PM »
Natural alerters can alert for multiple things.  What differentiates them from other dogs isn't the senses but their mental processing, how they process sensory input and what they interpret it to mean.  Cole did seizures, certain medications, low blood sugar and hyper or hypo thyroid because these are the conditions he was able to observe until he had found patterns to predicting them.

My sister's dog, whom I'm convinced is a solid natural alerter even though he's never alerted for me (not around me enough to have had the opportunity) never-the-less alerted for my mom when her oxygen saturation dropped too low.  She got up in the night to use the rest room and he fussed at her and followed her and then went and woke my sister.  And then she got dizzy from the low oxygen and so it was a good thing he went and woke my sister.  There was my mom's evil corgi in the house as well, who has lived with my mom for over a decade and adores her and yet he didn't have a clue there was a problem.  He's not a dumb dog and other than some cataracts his senses are in exemplary condition.

The difference?  How Loch processes his life experiences.  That he is prewired to be curious about or interested in finding patterns.  It's that processing that makes him an alerter and it's something that cannot be taught, but can be identified in candidates.

Coincidentally it appears that proper candidate selection for service work in some respects favors selecting natural alerters.  We know this because among programs that have rigorous selection procedures where they look for very specific characteristics, the rate of natural alerters in their dogs jumps from about 15% in the general population to about 50% in their selected population.  So figure you've got about a 50/50 chance of getting an alerter when you get a service dog from a very good program that breeds intentionally for service work and has a long track record of selecting suitable candidates. 

This does not mean that an owner-trainer has a 50/50 chance of finding an alerter.  They have a 15% chance, just like any other lay person. 

Nora and I have had many discussions on this and each of us are convinced we have a much better than 50/50 rate of identifying alerters in the wild (and we seem to be largely identifying the same characteristics as predictors).  That's why I say I was already convinced Loch could alert and had said so long before he ratted on my mom for walking around without enough oxygen.  Before she had pneumonia even in the first place.  I was eyeing him as a possible backup dog if Tardis ever had to go on crate rest or retire unexpectedly.
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