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.
Ryan Kaono, a support agreement manager with the Air Force Installation and Mission Support Center, shares a laugh with a videographer during an interview while his service dog Romeo keeps a steady eye on the photographer. (U.S. Air Force photo by Armando Perez)
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.
Ryan Kaono, a support agreement manager with the Air Force Installation and Mission Support Center, takes his service dog Romeo for a walk around his work center.(U.S. Air Force photo by Armando Perez)
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."
This article originally appeared on the United States Air Force. Follow @usairforce on Twitter.