Support from the Inner Circle: UCSF Department of Neurosurgery Accommodates Disabled Patient's Service Dog

Manish Aghi, MD, PhD, assistant professor, UCSF Department of Neurological Surgery (left), and Ivan El-Sayed, MD, assistant professor, UCSF Department of Otolaryngology–Head and Neck Surgery, co-directors of the Minimally Invasive Skull Base Surgery Program, remove a pituitary tumor from Ana Aureoles.

Ana Aureoles has a constant companion in her four-legged friend Henry, who has steered her in the right direction for the past 12 years. Recently, their special relationship reached a turning point. Their story unfolded last week at UCSF Medical Center, where Aureoles, who is legally blind, had surgery to remove a tumor from her pituitary gland. Henry was beside her right up until the time she entered the operating room and rejoined her immediately after she came out. As a service dog, Henry opens doors, picks up the phone and guides Aureoles around town, among other tasks. Now at the age of 13, Henry is afflicted with arthritis and it’s Aureoles who takes care of the dog. “I’ve had him since he was 1 year old after adopting him from Animal Care and Control,” said Aureoles. “Henry gives me something to care for; I depend on him and he depends on me.” Aureoles was born in Mexico City and came to the United States as a youngster in the late 1940s. She lives in San Francisco with her dog and is an active member of the community. For Aureoles, the dog symbolizes independence and freedom.

Ivan El-Sayed, MD, assistant professor, UCSF Department of Otolaryngology–Head and Neck Surgery, and co-director of the Minimally Invasive Skull Base Surgery Program, checks in with Ana Aureoles before performing surgery to remove her pituitary tumor.

“It’s really Henry who has allowed me to live independently and enabled me to do my work as a community activist,” said Aureoles. “I’m able to reach out to other disabled people, promote animal welfare and just be more of an active member of society.” While Aureoles identifies as a disabled person, she believes it is important that society gain more awareness about disability issues.

Ana Aureoles and her service dog, Henry Miller, say goodbye before her surgery to remove a pituitary tumor at UCSF Medical Center as David Goff, CRNA, senior nurse anesthetist, and Jessica Deery, RN, nurse anesthestist resident, look on.

“People often only see your disability, and not your activism or your contribution to society,” said Aureoles. “It’s important to educate people that we have a common bond and that disabled people have a right to be an active member of society too.” UCSF Medical Center recognizes that follow-up care is a critical element in a patient’s healing process. The faculty and staff of the Department of Neurological Surgery made every effort to ensure that Aureoles’ dog would be treated as a part of her support system.

Inner Circle of Support

“Every patient has an inner circle that’s involved in their care, and we saw Henry as part of Ana’s inner circle, which would aid her in her healing process,” said Manish Aghi, MD, PhD, assistant professor of neurosurgery. “In fact, research shows that patients who have families actually fair better after the removal of a malignant tumor. Some of that same process happens with benign tumors as well.” While Aureoles’ tumor was benign, had it been left untreated, it could have negatively affected her vision even more. The spectrum of legal blindness runs from those who are unable to perceive any light – the most extreme case – to those who are unable to count the number of fingers in front of them. Aureoles’ vision lies somewhere between these two extremes. Aghi, who completed his residency training at Massachusetts General Hospital in Boston and attended Harvard Medical School, said he didn’t recall specific training about animals as part of a patient’s support system, but he found the experience of caring for Ana and Henry to be enjoyable. Aghi, who joined UCSF in January 2008, was quick to point out that in Aureoles’ case, Henry wasn’t just an ordinary animal. “While most people wouldn’t bring their animal to a meeting with their surgeon, it felt very natural when Ana brought Henry,” said Aghi. “The dog is her companion, but in a different way. You could feel that as soon as they were reunited in the recovery room following the surgery.” UCSF trainees and students on Aghi’s team did have the opportunity to be exposed to the idea of including animals as part of a patient’s support system.

Ana Aureoles recuperates in her room with her service dog, Henry Miller, after her surgery at UCSF Medical Center to remove a pituitary tumor two days earlier.

Following the surgery, Aghi and his team made efforts to accommodate the dog in the recovery room and in her hospital room, where the nurses were instrumental in caring for both Ana and Henry. After spending the weekend recovering in the hospital, the pair was discharged home and will continue their recovery with home services. “The hospital staff in the recovery room and 8 Long did a great job in caring for both Ana and Henry,” said Aghi. “It’s a bit more challenging than having family with a patient because someone needed to watch after Henry’s needs while Ana was recovering. But the nurses did a great job, and Ana and Henry both appreciated it. I look forward to seeing them both back in my office in a couple of weeks.” Photos by Susan Merrell

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UCSF Department of Neurological Surgery