by Deborah Aragon
U.S. Air Force Installation and Mission Support Center
August 6, 2018
PART ONE - Living With PTSD
Post-traumatic stress disorder carries him into the depths of fear and pain; reliving images of death and destruction. Closing his eyes to night terrors at sundown and fighting through daily anxiety attacks eventually pushed him to the brink of suicide so he could put an end to the never-ending cycle.
It wasn’t until his second suicide attempt that Air Force veteran and Air Force Installation and Mission Support Center support agreement manager Ryan Kaono took steps to face his invisible scars and reach out for help.
It was 2010 and he hadn’t slept in more than four days, knowing he’d get flashbacks of what he’d experienced during deployments to Saudi Arabia and Iraq.
“They were terrible,” Kaono said. “I would wake up screaming and my wife would be scared. Out of desperation, I decided I was going to end it.”
Kaono’s wife, Alessa, said it was very difficult for her to watch her husband suffer with no real diagnosis.
“You feel helpless,” she said. “I described it as having an animal or child unable to speak yet you know they’re feeling something. You see a look in their eyes that they’re suffering but you don’t know what you can do to help them.”
Exhausted and going through myriad feelings, Kaono swallowed numerous prescription drugs in the hopes of not waking up. Something inside him, however, made him reach out to his commander for help, letting her know what he’d done.
He was admitted to the Los Angeles Veterans Affairs hospital for a few days of observation and diagnosed with PTSD. This began his journey of living with the disorder instead of being a slave to it.
His diagnosis came with some relief but angst as well.
“I was scared yet relieved at the same time,” Alessa said. It was a roller coaster of emotions. I was happy he was finally diagnosed but both he and I knew it would be a long and difficult journey at times.”
Even today, two deployments replay in the mind of the former security forces military working dog handler and logistician.
Khobar Towers, Saudi Arabia
In June 1996, Kaono was working a gate at Khobar Towers, Saudi Arabia, when a vehicle-borne improvised explosive device detonated on the other side of the compound, killing 19 and wounding countless others.
“When the actual blast went off, it was chaos everywhere,” Kaono said. “I had to stop and put that part behind me. I needed to focus and ensure that the folks who had been injured or disoriented … were taken care of.”
For years, he continued pushing the many visions of pain and suffering he’d seen there to the back of his mind where they festered.
In total, the Hawaii-native had 11 deployments as a security forces defender by the time he found himself at Ramstein Air Base, Germany, struggling with anger issues.
“I would quickly get frustrated; I would have bouts of just frustration and real anger,” he said.
While on a smoke break outside of central security control one day, Kaono lost consciousness and fell to the ground. Controllers inside the building were able to see what happened and his officer-in-charge ran to his aid.
When he regained consciousness, his captain was leaning over his chest, trying to wake him.
He was quickly taken to the hospital where he suffered with partial paralysis in his legs for about 10 hours and the inability to use his body from the base of his neck to his fingertips for three days.
His medical team diagnosed him with syncope; the uncontrollable loss of consciousness with no real explanation.
“From that, they determined I couldn’t deploy, I couldn’t carry a weapon so I couldn’t really be a security forces member anymore,” Kaono explained. “I was force retrained for medical reasons into logistics.”
Balad Air Base, Iraq
Fast forward to 2005 when Kaono served as first sergeant and deployment manager for the 93rd Aircraft Maintenance Squadron in Balad, Iraq.
As a dual-hatted logistics planner and first sergeant in the Reserve, he was responsible for making sure unit members arrived safely at their deployed location, were able to get their jobs done and would return home to Homestead Air Reserve Base, Florida, when their deployment was over.
While in a meeting with senior leaders, the base began taking mortar fire that impacted closer and closer to Kaono’s trailer and two fully-loaded F-16s nearby.
“They were trying to walk (mortars) up our runway to our loaded aircraft,” Kaono said, with the expectation that they’d be able to hit the aircraft causing secondary explosions with more damage.
While everyone in the room was running for cover, Kaono gathered up classified materials to stow in a safe.
“It wasn’t my first mortar attack so I really didn’t think anything of it,” he said.
With the sensitive documents in the safe, Kaono turned to leave to seek shelter when a mortar pierced the aluminum trailer and exploded, sending him 15-20 feet in the air before slamming his head and right shoulder into a concrete Jersey barrier.
“It felt essentially like The Matrix … I’m floating through the air and everything is going in slow motion. I see shrapnel and dust and everything just going around me,” he said.
Once he hit his head, he was snapped back to reality and felt the severe pain of what would later be diagnosed as a traumatic brain injury.
“I went to the hospital there at Balad and they checked me out and told me I had a concussion but that was about it; nothing really life threatening so I didn’t get sent home,” he said.
When he eventually rotated back to Homestead, he went through a standard post-deployment physical health assessment where he initially struggled with discussing what he’d endured. When he was able to talk about it, the doctor said he entered what was considered a fugue state – a complete loss of what was going on around him.
“I essentially was staring off into nothingness for a period of time suffering a flashback,” he said.
“From there, they said I had a possibility of PTSD and they sent me on my way.”
Five years later, after his extreme cries for help, his PTSD diagnosis came.
PTSD - The Daily Struggle
“PTSD and living with it is a daily struggle,” Kaono said. “We’re always cognizant of it. Those who are around us may see us and see absolutely nothing’s wrong. We don’t typically have external signs of our disability but emotionally and mentally, we still have to deal with it.”
In the years between 1996 and today, Kaono said there were times when he would just shut himself away because he didn’t want to be a burden on anyone. There were also times when he could go to work and feel that people would think there was nothing wrong with him because he looked fine.
“That just reinforced the issue that I had,” he said. “To me, one of the main issues of dealing with PTSD is that people don’t (realize) … they don’t see you missing a limb, they don’t see you scarred, they don’t see you burned and so to the outside world you look like you’re no different -- you’re not special, you have no issue, no disability to really claim.”
In order to live his life, Kaono has to acknowledge his PTSD and what caused it every single day.
“If I continued down the path that I was on previously, where I just let it consume me, I wouldn’t be here today,” he said.
The U.S. Department of Veterans Affairs estimates 31 percent of Vietnam veterans, 10 percent of Gulf War veterans, 20 percent of Iraqi war veterans and 11 percent of veterans from the war in Afghanistan live with PTSD.
To be able to help them, Kaono recommends people educate themselves on the disorder.
“Find out what post-traumatic stress is, see what it does, look at the studies that show why there are 22 people per day committing suicide because they can’t handle the stress anymore. Don’t just pass us off as being fine … that’s the worst thing that people can do.”
On top of everything else, dealing with the stigma of having PTSD is a struggle for the Kaono family.
“When people hear the word PTSD they think of the negative news articles out there. Ryan may have PTSD, but it doesn’t make him any less of a human being,” Alessa said.
“We’re not asking people to walk on eggshells around us," Kaono said. "Treat us as if you would treat anybody else … we are still people. We still hold jobs. We still have families. We still have responsibilities and if you don’t give us the opportunity to meet those responsibilities, you’re not helping us.”
PART TWO - Service Dog Rescues From Despair Of PTSD
After battling night terrors and the pain and anxiety of Post-Traumatic Stress Disorder for decades, an Air Force veteran found his lifeline at the end of a dog leash.
Ryan Kaono, a support agreement manager in the Air Force Installation and Mission Support Center, vividly remembers a few years ago when he would regularly find himself in the depths of fear and despair; reliving troubling images from deployments as a security forces military working dog handler and later as a logistics specialist.
Kaono’s wife, Alessa, said she felt helpless, with no idea how to help him.
“You see a look in their eyes that they’re suffering but you don’t know what you can do to help them. It’s a terrible feeling watching someone suffer through PTSD,” she said.
Those memories seemed so hopeless at times that Kaono attempted to end his life.
After taking numerous prescription drugs in 2010 in a bid to permanently end his pain, Kaono finally reached out for help and started receiving the support and understanding he needed.
“I had previously attempted (suicide) but this time I actually sought treatment,” Kaono said.
After being hospitalized for his suicide attempt, the veteran began a treatment program at the U.S. Department of Veterans Affairs hospital in Los Angeles.
“When I was first diagnosed, group therapy didn’t work for me,” the Hawaii-native said, “so I actually left the group and started volunteering at a (German Shepherd) rescue in California.”
Dogs had always played a part in Kaono’s life from when, as a toddler, his family’s old English sheepdog, Winston, picked him up by the diaper to deliver a wandering Ryan back to his front yard.
“I realized (while volunteering at the rescue) that the interaction with the dogs really made me feel better,” he said.
Not content to just help himself, Kaono worked with the VA hospital to help other veterans interact with the rescue dogs and promoted animal therapy.
“The VA does equestrian therapy where they’ll take veterans to horse ranches and they get to ride horses … same premise, animal therapy works wonders,” he said.
It wasn’t long before Kaono, with a wealth of dog training knowledge from his time as a MWD handler, had veterans asking for help to train dogs so they could have their own service animals.
This support was especially important to Kaono since the average wait time for a VA-trained service dog can exceed two to five years.
“By then, we’ve already lost between 9,000 – 20,000 people due to suicide in a five-year period,” he said.
That’s based on a 2013 Department of Veterans Affairs study that showed roughly 22 veterans were dying by suicide every day from 1999-2010.
“That’s just way too many,” he said.
During this time, while helping to train dogs for other veterans, Kaono decided to add his name to the list for a VA-issued service dog.
After a two-year wait, he was notified they were ready to pair him with a dog. During the interview process, however, he was denied an animal because he already had a couple of dogs as pets and service dogs can’t be added to a home unless it is pet free.
“I was disheartened,” he said, but he continued to help train animals for other veterans.
Under the Americans with Disabilities Act, there is no mandated certification for a service dog and it allows people to train their own animals. So three years ago, when Kaono moved to San Antonio, his wife encouraged him to work on training his own service dog.
“I thought I’d just take one of the dogs we had at our house and train it to be a service dog,” Kaono said, until Alessa pointed out a Chihuahua probably wasn’t the best choice for his particular needs.
He then decided to work with San Antonio’s Quillan Animal Rescue to find a potential service dog. The rescue suggested a Doberman at first but Kaono wasn’t interested in such a large animal. One of the workers then recommended a mixed breed animal named Romeo that was in need of rehabilitation after being hit by a car. The only drawback was Romeo had already been promised to another family in California after his recovery.
“I said yes because that would give me the opportunity to work with a dog again,” Kaono said.
That was February 2016 and by May, he and Romeo were inseparable, Kaono said.
By June, Romeo had recovered and he was sent to California. Kaono said he was heartbroken.
“I secluded myself. I didn’t want to go to work. I took sick leave … I just didn’t want to be around anybody and make connections with people like I did with him and have them shattered,” he said.
"Romeo was kind of a fluke,” he added, because the California family decided they couldn’t keep him so Romeo returned to San Antonio.
When Romeo arrived back in Texas, Kaono had a trainer from Service Dog Express assess him. The local organization works with veterans to train service animals. Romeo passed the evaluation and was accepted as a service dog in training.
Kaono and the trainer then used techniques from Assistance Dogs International, considered the industry standard for dog training, to ready Romeo. Two months later, Romeo took the organization’s public access test, the minimum requirement for service dog training, and “blew the test away,” Kaono said.
He’s been going to work with the AFIMSC employee every day since passing his assessment on Aug. 1, 2016.
For Kaono, Romeo is much more than a four-legged companion. He’s a lifesaver who is trained in various disability mitigating tasks to help the veteran cope with PTSD.
These include deep pressure therapy where Romeo climbs into Kaono’s lap when he can sense anxiousness, agitation or frustration. He then applies direct pressure to the veteran’s body, considered a grounding technique, to bring focus to him instead of what’s causing the anxiety or agitation.
“Before him, I would have to sit there through it until it essentially went away,” Kaono said. “Now within two minutes I’m back to normal. I’m back to being productive again.”
Romeo also applies blocking techniques when the duo are in a group or crowded space to create a buffer between Kaono and those around him.
“People are cognizant of him being there so they give me the space to actually feel comfortable,” Kaono said.
The service dog also fosters personal interaction, Kaono added.
“I don’t make solid relationships with people,” he explained. “I would prefer to be and work alone. Having Romeo actually forces me to interact with people on a regular basis. He causes people to talk about things that aren’t necessarily work related. He’s a calming factor, not just for me.”
Romeo has completely changed Kaono’s life to allow him to better “live” with PTSD, Alessa said.
“I’m sure many people say this about their dog or service dog but Romeo’s truly a godsend,” she said. “He has changed and impacted our lives in so many ways.
“He’s gotten Ryan out more when it comes to crowds,” Alessa said, and Romeo is Kaono’s “sidekick and stress reliever at work.”
When the duo get home, Alessa added, Romeo “is just like any other dog … he loves to play and loves treats, especially ice cream.”