After hearing the phrase “dead in bed,” the restful nights for Marc Bullion and his wife, Becki, are gone. Their daughter, Lelia, was diagnosed with type 1 diabetes (T1D) when she was 8 years old and her episodes of hypoglycaemia were unusually frequent.
Each night, the Brighton couple would take turns sneaking into their little girl’s bedroom, poking her finger while trying not to wake her. Often his blood sugar was low, adding more hours of treatment, monitoring and worrying.
“We would never sleep. It was like having a baby again,” Bullion said.
“They must also be consistent
with their diabetic care before trying
take care of something else. – Lelia Bullion
About Patients Considering Diabetic Alert Dogs
Today, insulin pumps and continuous glucose monitors (CGMs) help eliminate dangerous unknown drops or spikes in blood sugar, which play a role in the true but extremely rare “bed death syndrome.”
But the Bullions wanted more peace of mind. They found it – in a big fluffy ball of fur named Gizmo.
Get a life-changing diagnosis
Gizmo, an 80-pound cream-coloured golden retriever, hovers next to Lelia Bullion, now 17, as she shares her story around the kitchen table in her family’s suburban home. While happily hanging out with his other canine housemates, Gizmo keeps his eyes and nose on his special human, an athletic high school student.
A few days after her eighth birthday, Lelia went to the emergency room with symptoms of what her family had thought was the flu. But weight loss, thirst and excessive urination (in addition to fever, nausea and vomiting) alerted her mother, who is a nurse.
“They checked my blood sugar, and it was 688, which was crazy,” Lelia said (the normal range is below 140 mg/dL). Insulin injections lowered his blood sugar and relieved his symptoms. But her family returned home with a diagnosis that changed her life.
With T1D, a person’s pancreas produces little or no insulin, a hormone needed to transport glucose from the blood to cells for life energy.
The next day, the family spent 10 hours at the Barbara Davis Center for Diabetes (BDC) at the University of Colorado’s Anschutz Medical Campus to learn about the disease and the care it involved.
“They were so heartwarming,” Lelia said. “They said: Everything will be fine. It will be a long process to get used to, but we will help you. We will be there for you.
Fulfill mission #1: bind
When Lelia’s mother heard about Alert Service Dogs for Kids, a program of the Foothills Kiwanis Club in Boulder, the family researched the program and Diabetic Alert Dogs. The dog-loving family decided a four-legged helper was what they needed.
“I was overwhelmed, but kind of in a good way,” Lelia said of the first time she held her new 8-week-old pup, whom she quickly named Gizmo. “I was like, Wow, I have a service dog now, and I have so much to take care of.”
Lelia meets her new puppy at the airport.
For the first few months, Lelia and Gizmo’s only mission was to bond. Since Gizmo would play such an important role for her, Lelia had to establish “alpha” status with him and take the lead as a caregiver.
With guidance from the Service Dog Program, then 11-year-old Lelia fed, walked, groomed, groomed and loved Gizmo.
While some service dog organizations train puppies and then deliver them to their new handlers, others consider early bonding time crucial for training.
Kerri Rodriguez, PhD, a postdoctoral fellow with the Human-Animal Bond in Colorado program at Colorado State University, studies the aspect of bonding between handlers and diabetic, epileptic, and mobility assistance dogs.
“Alert (related to dogs’ sensitive noses) also matches the link,” Rodriguez said. Basically, as handler and dog get to know each other, they pick up on each other’s dyadic responses, she said. “Alerts are more effective and stronger as the bond grows stronger.”
Mission n°2: train the nose
Once the bond was solid, Gizmo and Lelia began training.
Several times a day, Lelia would command Gizmo to “look at me,” then prick her finger and measure her blood sugar as the pup looks on curiously. “He was focused. If my blood sugar was low or high, I would have him feel (and lick) the blood off my finger.
If her level was low, Lelia would ask Gizmo to speak,” Marc Bullion said. “Then treat, praise and love,” he said, touching on an essential part of dog training.
When Gizmo was napping, the family would hide the jars of baby food from the freezer around the house. Inside the jars were positive test strips and bloodstained or rubbed gauze under Lelia’s armpit for a serious game of hide-and-seek.
“You would see his nose straighten out,” Marc Bullion said. “He would start looking. As he progressed, he smelled it and started barking.
Little Gizmo gets a lesson on blood sugar.
Smell plays a role in detection, as dogs have long served as detection dogs for everything from narcotics to explosives. Today, dogs are trained to detect diseases, from multiple cancers to COVID-19.
The general hypothesis is that dogs’ noses (capable of detecting at concentrations of one part per trillion) pick up changes in volatile organic compounds (VOCs) emitted from the body through, for example, blood, sweat and urine.
Many questions remain in the emerging field and more research needs to be done, Rodriguez said. “But so far the research has been extremely promising. Our research definitely suggests that these dogs have a very significant impact on the lives of these people.
Relieve family pressure
Gizmo’s first alert came about four months into training, Lelia said. “He was consistent at about six to eight months with me.”
Lelia has always had more than average glucose drops, in part because of her athletic lifestyle. A gymnast since she was 3, and now in athletics and volleyball, rigorous training and conditioning is burning through her sugar stores, she said.
She also suffers from “hypoglycemia unconsciousness”, which means that she often shows no signs of hypoglycemia. But Gizmo knows it, often alerting when his levels are just starting to drop, allowing him to reverse it before the drop becomes critical, causing a diabetic coma or seizures.
Easing pressure on family at night was the biggest benefit, they said. Gizmo initially tries to wake Lelia up by barking and licking her face when he senses trouble. But she’s a heavy sleeper.
If he can’t wake Lelia, Gizmo rushes to his parents’ bedroom. “He’s going to jump on the bed,” his father said. “Or he’ll put his head under the covers and grab my arm and pull me, then I know immediately something’s wrong.”
Disadvantages cited by surveyed service dog owners:
Source: Kerri Rodriguez, PhD, et al., “Mobility and Medical Service Dogs: A Qualitative Analysis of Expectations and Experiences.”
When a drop in blood sugar during the day leaves Lelia shaky, weak and confused, she’ll say, “‘Go get help,’ and he’ll bark profusely and ask someone for help.” He will find the closest person – be it my brother, my mother, my father… a friend – to come and take care of me.
Rodriguez’s studies of medical alert service dogs also looked at their benefits to family members, especially parents. “We found that having a service dog in the home was associated with fewer health concerns for other household members, including better overall psychosocial health and emotional functioning with less stress. ‘Total Family Impact of Chronic Illness.’
Find “incredible peace of mind”
Gizmo watches over Lelia nearly 24/7—in class, in the restaurant, at Avalanche games, on the volleyball court—he’s by her side wherever she goes. “He’s an extension of her,” her father said. “He’s her pancreas in that sense,” he said of Gizmo, who has a picture next to Lelia’s in the school yearbook and will be walking with her next year with her. in hat and dress.
Rodriguez’s research found that having a mobility or medical alert service dog was associated with better social, emotional, occupational, and academic functioning. The results are particularly important for people with invisible disabilities, which can be socially isolating and lead to anxiety, depression and low self-esteem, she said.
Lelia, inspired by the care she received at the Barbara Davis Center, is considering a career as a pediatric endocrinology nurse. At BDC, many of her caregivers had diabetes themselves, which she found extremely comforting, she said. She would like to return that feeling to newly diagnosed children and families one day.
Lelia knows that Gizmo is no substitute for her medical care and self-monitoring and advises that alert dogs aren’t foolproof and might not be right for everyone. “When we got it, the organization said, it’s never going to be 100% accurate,” she said of Gizmo, estimating it was probably between 85% and 90% accurate.
She advises people to research alert dogs and providers before choosing and to understand the enormous responsibility they carry. “They also need to be consistent with their diabetes care before trying to take care of anything else,” she said.
But for the Bullions, they couldn’t be happier. ” He is incredible. And we started getting at least six full hours of sleep at night when we had Gizmo,” she said, making her dad laugh. “He gave us incredible peace of mind. He is my best friend.”