Too terrified of needles

February 25, 2011 6:30 AM

Blood test failed due to needle phobia - what to do now?

I have had a strong fear of needles for as long as I can remember. I had an appointment to have some blood drawn earlier today - beforehand, I did all my research for the test to go as smoothly as possible: I read some previous threads (with some difficulty), I ate beforehand and drank plenty of water, I took some clonazepam left over from my last set of injections, I brought my boyfriend along to distract me.

It was to no avail. I freaked out anyway, and after 20 minutes of the nurse getting increasingly exasperated, and me in tears, I left feeling humiliated, defeated, exhausted and weak-willed.

I've had injections before and been okay (very anxious, but I still went through with them), but the last time I've had anything stuck in my inner arm was an IV when I had some teeth pulled in elementary school - and that didn't go well the first time, either. The idea of having the inside of my arm exposed and the possibility of them not finding a vein, in addition to my fear of needles (both the pain and just the penetration of the skin), leaves me terrified.

I need to go through with the blood draw, but I know I can't have something like this happen again. What steps can I take, beyond what I've tried, to increase my confidence and lessen my fear, especially after a failed attempt?

posted by Gordafarin to health & fitness (41 answers total)

They don't have to place the needle in your inner arm. The blood draw can be done from any one of several locations, including the back of the hand.
posted by 517 at 6:33 AM on February 25, 2011 [1 favorite]

A long shot, maybe: I don't know if they have nitrous oxide available, but that might help. You lie down, they give you nitrous for a few minutes, then they draw the blood. They'll charge for it.
posted by carter at 6:35 AM on February 25, 2011

Is it possible for you to NOT try to prepare for it and just go? I have a lot of anxiety about having blood drawn as well, and I've found if I go in thinking it won't happen it helps. Then, by the time I'm in the chair, it's over so quickly I've not had time to get all worked up.
posted by ACN09 at 6:38 AM on February 25, 2011 [1 favorite]

What steps can I take, beyond what I've tried, to increase my confidence and lessen my fear, especially after a failed attempt?

You have to do the thing you're afraid of doing before you stop being afraid of it.

It's really hard, and you've got to dig pretty deep to find the will to go through it even though you're terrified, but it's the only thing that works.
posted by mhoye at 6:38 AM on February 25, 2011 [1 favorite]

Are you watching what's going on? Close your eyes.
posted by something something at 6:39 AM on February 25, 2011 [4 favorites]

I haven't got major fears of it, but it still kind of freaks me out. What I always do is I imagine myself being outside of my body and just observing what is going on. Even if I feel some pain or am squicked out, I try to just look at the situation and think "ok, yes, so that is the sensation of having a needle in my arm, interesting". (I never actually look at the needle, btw - I think I would probably faint). I used the same psych-out when I had a chest-tube. That was seriously painful and far more freaky than a needle.
posted by molecicco at 6:48 AM on February 25, 2011

I got over this problem as a child by listening to a Walkman while chewing Starburst and looking in the opposite direction.

The needle is so small you won't even feel it and your mind will preoccupied doing other things so your brain doesn't start over thinking and blowing up the situation.

So I prescribe iPod -> candy -> and look the other way.
posted by zephyr_words at 6:54 AM on February 25, 2011 [5 favorites]

It sort-of makes me feel better to know that breaking the skin is so universal a human fear/concern that it appears in tons of holy books with strong admonitions about the dangerousness of skin lesions, bloody sores, leprosy, sex, eating the wrong things, etc. Anything entering past the skin zone is breaking your bodily integrity and it's a terrifying taboo in much of the ancient world. (Even when it occurs in the right places, like the mouth, you risk pollution! Anything could get in there!)

So, first, it's one of the oldest and most human of fears. Sometimes just sitting there and pondering this, intellectualizing it, can help me get through the blood draw.

But second, FOR THE LOVE OF GOD, DON'T LOOK. Don't think about whether they'll find a vein. It's their job to find a vein. They will. Keep your head turned firmly in the opposite direction, keep your eyes shut if you must (or open to watch a TV or something to help distract you), bring an iPod or other media if that distraction would help, etc.

And tell the phlebotomist or nurse that you're terrified of needles, you can't look, and you might freak out. You're hardly the first person to do so (see #1). If you're there after lunch, you probably won't be the first person TODAY to do so. The phlebotomist will ensure you're looking away when you need to be looking away and will often try to go faster and more smoothly for your sake. They'll also be ready to catch you in case you faint.

Sometimes it also helps me to think about WHY I'm doing this. I recently had to go to the ER for IV fluids when I got very dehydrated while pregnant and ill. So I had no veins and the nurse who placed the IV was great but it still wasn't super-pleasant. But focusing on the fact that I was doing this for my baby made it much easier to handle. A little needle seemed like nothing compared to his health and safety. So if you can focus on, "I'm doing this so I'll be healthy for my family" or "I hate this but knowing that I don't have disease X will allow my doctor to treat me appropriately so I can get back to jogging" or whatever, it may go more easily. (But I dunno, it's only during pregnancy, when I'm doing it for someone else, that I can manage to talk myself into it not being as bad. When it's just me, it's like, "WHO CARES WHAT MY CHOLESTEROL IS???")
posted by Eyebrows McGee at 6:55 AM on February 25, 2011 [1 favorite]

I'm a type 1 diabetic and I took shots for years. Now, those needles are a lot smaller than the needles that are used to draw blood but they are still needles. Given that, I am still truly scared of getting my blood drawn. I hate it, but I have to do it because it's so important for my health.

The only thing that helps me is to close my eyes and turn my head. Maybe try putting something over your head like a shirt or something. You should be okay as long as you don't know when it's coming. I would also suggest ear plugs.
posted by bobber at 6:55 AM on February 25, 2011

I can't speak for calming the anxiety. That's not something I've been able to nip in the bud yet. I can suggest that you need to have the staff work with you. Make an appointment. Let them know it won't be a 10 minute in-and-out visit. Have them work with you, so you don't leave until it's done, meaning you might have to be the last appointment of the day.

This means, the anxiety doesn't win next time, cause next time you are getting that blood drawn. You know that going in and so do they.
posted by Syllables at 6:58 AM on February 25, 2011

I was deathly afraid of needles as a kid, doctor-avoidant and the like ... then I had an allergy test. One of the old school ones where they have twenty-plus syringes, injecting dilute samples of each potential allergen into your skin, one at a time. I was doing alright on the first, badly by the fourth. By shot number eleven, everything had started to go gray and I was in the process of a good faint as I started swaying over. They stopped, I took a breath, and the world came back.

Ever since then, starting at allergy test shot number twelve, I could care less about shots. Blood draw? Let me pump up the vein for you. I'll slam an insulin needle in my arm just to demonstrate how to give a cat a shot, I don't care. I believe they call this "flooding."

So, allergy test.
posted by adipocere at 6:59 AM on February 25, 2011

something something's suggestion will really help. I don't even mind needles really, but even I can't actually watch what's going on -- I have to make myself look away. So if you're not doing that, definitely try it.
posted by rabbitrabbit at 7:01 AM on February 25, 2011

See if they can apply lidocaine or some other numbing gel to your arm about 10 minutes before the blood draw. This will decrease the initial "prick" sensation.

Lie down if possible, or at least elevate your feet. This prevents you from getting too woozy.

Explain to the nurse beforehand that you do NOT want to hear anything about what she is doing or the equipment she's using. Some nurses think it's helpful to narrate their every move, when really it's the last thing I want to know.

If you have an iPad or some other portable video player, you could watch a brief cartoon or TV show clips while the blood draw is going on. It will give your brain something else to focus on. (some clinics now do this for kids who need shots). And I agree about chewing on candy. The idea is to give your mind as many distractions as possible: taste, smell, sound, sight, touch...so you can't focus on the blood draw.
posted by castlebravo at 7:01 AM on February 25, 2011 [1 favorite]

I would try and call the office ahead of time and ask if it is possible to arrange your blood test for a time when the best phlebotomist in the place is available, and ask them if they could use the smallest gauge needle possible. Blame it on your severe phobia, and tell them how much you appreciate their flexibility. A skilled phlebotomist and a narrow needle make all the difference in the world.
posted by Rock Steady at 7:14 AM on February 25, 2011 [2 favorites]

You could try practising calming yourself down, which would go something like this:

1. Establish a calming routine, which perhaps involves deep breaths, deliberately relaxing all your muscles one by one, and imagining sunning yourself on a beach somewhere. Remember, when you are on a beach, nothing else matters; all manner of crap could be kicking off back at home but you are on holiday and whatever problems you have are thousands of miles away. You may need some trial and error to find out what relaxation tricks work best for you. Maybe reciting your times tables will help to stop thoughts running in your head. Maybe something connected to spiritual practices will help you.

2. Practice your "calm down" routine over and over again. Every now and then, run through your routine, then carry on with your day. Do this in bed, on the bus, at work, and especially in any kind of annoying or stressful situations you find yourself in.

3. Try winding yourself up by thinking about needles before running the "calm down" routine. Practice thinking about needles until you are mildly agitated and then going through the Calm Down thing. If it doesn't work, go back to step 2, or at least wait to try again until you really are calm again. If you get better at calming yourself down, try getting even more worked up and then calming yourself down. For extra bonus points, go and sit in the doctor's waiting room and practice.

4. When you're using it for real, try to apply the Calm Down routine as soon as you detect yourself being even a little bit worried. The more you get into Ultra Freakout mode the harder it will be to talk yourself down again - freaking out can be very self-reinforcing.
posted by emilyw at 7:17 AM on February 25, 2011 [3 favorites]

As you doubtless know, there's no real pain involved. Pinching your skin with your fingernails hurts more. It's purely a psychological phobia, which makes it harder to get over.

I had this issue, and to some extent still do. I gave up on donating blood because it just made me feel too woozy. I completely passed out several times in doctors offices before, during or after getting shots. These days I'm OK with it, as long as I look away or close my eyes, and wiggle my toes. You need to develop your own distraction. It will be over before you know it.

Seconding, augmenting and summarizing what's been said
--don't do too much prep. I'd recommend eating something salty a half hour before, to get your blood pressure up, but that's it.
--tell them not to talk; and put on headphones/music if you want.
--look the other way. Do not ever look at the needle and stuff. If there's a poster or something to read on the wall, read it, slowly, word for word. Backward. And try to make sense of it.
--continuously wiggle your toes from the moment you sit in the chair or lie on the table. This keeps your blood pressure up also, but more importantly it distracts.
posted by beagle at 7:18 AM on February 25, 2011 [1 favorite]

(self-)hypnosis can be a powerful tool to deal with phobic reactions. Regardless of what you think about the various claims surrounding hypnotism (there's certainly a lot of exagguration and misinformation out there), at its core is a set of techniques to make you very relaxed and focused on a specific sensation of your choosing, while ignoring other sensory inputs. A hypnotic "trance" is basically the same as if you've ever been caught up in a book or TV show to the point that you completely lose track of the time, don't notice your foot going to sleep, don't hear the doorbell, or whatever: it happens to all of us occasionally, and hypnotism is just a set of techniques for deliberately inducing that state and controlling what you're focused on.

It might take a bit of practice, but you should be able to get yourself into (or have a hypnotherapist guide you into) a state in which you're either oblivious or indifferent to the injection itself. I can't comment on the veracity of claims about long-term cures of phobias, but distracting you from a specific event should be simple.
posted by metaBugs at 7:25 AM on February 25, 2011

They should be able to anesthetize your skin, as castlebravo mentions. I used to have a similar anxiety about needles and this got rid of it. You don't feel a thing, which for me worked wonders psychologically.
posted by slow, man at 7:41 AM on February 25, 2011

Maybe buy one of these? http://www.buzzy4shots.com/

I assume you could approximate the effects with an ice pack and any vibrating device.
posted by charmcityblues at 7:42 AM on February 25, 2011

I feel for you, I have difficulty even reading this thread. Sorry if I repeat advise given above.

First, dress warmly and have a long sleeved shirt or sweater you can put on after so you can hide the band-aid.

The only thing that works for me it I have to be flat on my back. And I need to be talking. The best nurses start talking to you about anything, weather, sports, vacations, and don't stop. They also don't talk about what they are doing. I don't want to be told "here comes a pinch", I just want to pretend nothing unusual is going on. Every thing should be out of view. Don't look at the tray ahead of time.

I tell them all this up front. If they don't have a bed or don't want to play ball, I leave.

Once it is done, remain lying down for a few minutes. Ask for a glass of juice.

I'd like to say it gets easier, but it doesn't, at least for me. The reaction is a real, physical reaction and don't let anyone minimize it for you.

Given all that, you need to do this, and you can.
posted by cosmac at 7:43 AM on February 25, 2011 [2 favorites]

Look into exposure therapy.

There was a TV show about it a while ago on ITV1.
posted by Solomon at 7:44 AM on February 25, 2011

Lying down helps me a lot, as does some fairly intense "I'm not even here" daydreaming. I just tell them I'm a fainter/puker and they're very helpful. I also warn them about my hard-to-find veins (I've had to have up to four people looking, whacking my arm, switching to another arm...) And I tell them I don't want to know about what's going on. The funny thing is: when I do all of this stuff, I feel silly because it's like I'm cured and it didn't bug me at all. Last time I hardly felt a thing, and was completely convinced it was the "Sarah is no longer afraid of needles" breakthrough I'd been praying for since 3rd grade, until the moment I nearly passed out on the way out the door.

Getting a blood draw will probably always be a 90 minute, take the rest of the day off thing for me, but it is survivable now, as long as I treat it like the invasion of Normandy.
posted by SMPA at 8:02 AM on February 25, 2011

I can get kinda squicked by this stuff, too. What worked for me was to directly compare the situation to some true-misery book I'd read. For a while, when I went in for blood draws or whatever squicky medical procedure, I'd turn off the anxiety by telling myself that what I was going through was nothing compared to insert-war-or-other-true-trauma-story-here. [Would Leonidas get squicked about this, Chaz? How about Jan Baalsrud? Joe Simpson? Al Swearengen? No? You can deal, Chaz. It will be over soon. You're not trapped on Everest.]

After a while I didn't need the explicit self-talk, and now I just take a couple deep breaths, relax as completely as I can, and look the other way. Sometimes I mess around on my phone.

Note: I do not in any way mean to minimize your reaction. This "Frank Miller Method" worked for me. Do not take this as "Hey, Gordafarin, you need to suck it up." It is most emphatically NOT THAT. This is an anecdote describing what worked for one guy.
posted by chazlarson at 8:07 AM on February 25, 2011

Lie down, look away, close your eyes. Lots of good suggestions here in terms of distraction and calming yourself. Sing?

Personally, I have a significant vasovagal response to having blood drawn (just this week actually). You might want to check with a medical professional, but I'd wonder if a mild work out just before might help, e.g. in keeping your veins dilated and your heart rate up.
posted by idb at 8:22 AM on February 25, 2011

I know someone who takes music with her, puts head phones one, closes her eyes, then lies back and sings to distract herself. Yeah, out loud. She said it distracts her enough that she doesn't have to focus on what's going on.
posted by phunniemee at 8:35 AM on February 25, 2011

Man I am sorry that the phlebotomist treated you so poorly. I would definitely call and ask to schedule with the best phlebotomist. If they say "all our employees are great" I would calmly tell them about your experience. Nobody should make you feel bad like that.
posted by radioamy at 8:48 AM on February 25, 2011 [4 favorites]

Seconding hypnosis (sort of). My wife had this problem really seriously (I've seen it in action and can speak to how bad it was). She finally went to a thererapist and got taught a calming routine and was given a little story about George the heroic needle that dies for you. She still isn't as calm with it as I am (I was a blood donor for years), but she can cope with it now.
posted by Logophiliac at 8:51 AM on February 25, 2011

I used to HATE getting blood drawn. Goes back to a bad experience I had at 18 months old. For many years afterward, I used to look away and talk about the bad experience whenever I got blood drawn. By the time I was done with the story, the draw was done. About 10 years ago, I got over it somehow, and now I *have* to look.

As others have said, making sure you're suitably distracted will REALLY help. Also, ask if they can use a "butterfly"--if they need to take multiple vials, this will make it less painful than the normal way.

Good luck!
posted by luckynerd at 8:53 AM on February 25, 2011

The first time I had to have blood drawn as a child, I broke free from the first nurse who tried to do it and had to be chased through the doctor's office. Three nurses restrained me but I broke free again and fled into the waiting room. It ... didn't go well. And I was terrified of ever having to do it again.

Now I am explicit in asking for the very best nurse. I explain my ... history. For me, it helps not to have the tourniquet, but I am really pale have really visible veins and scrawny arms. Then I look away and think about something else. It took a long time to even get to that point. Definitely don't watch. But yeah, this is common, and asking for the best person should be no big deal. I found that making certain big rewards contingent on getting my blood drawn helped a lot. (Vacations, etc.)

Is there any chance you could have your blood drawn someplace like Labcorp and not the standard doctor's office? I had my very best ever blood drawing experience there. That's all they do all day long. It was seriously nothing, and the nurse was awesome. I know that may not be a universal Labcorp thing, but a really experienced person can make such a huge huge difference.
posted by ZeroDivides at 9:19 AM on February 25, 2011

ugh ugh ugh ugh ugh ugh ugh whyyy did i read this thread.

my advice is just cry as you need to, explain to the person drawing the blood that you're sorry that you're crying and just to do it, do it now and get it over with.
posted by cristinacristinacristina at 9:55 AM on February 25, 2011 [1 favorite]

As you live in England you can ask virtually any chemist for EMLA. Most are happy to sell you a single-use tube for this purpose. It needs to be applied one hour beforehand and then you need to wrap the area in clingfilm so that the EMLA is absorbed instead of evaporating. It works very well. If you're not actually looking at your arm at the time, you would be hard pressed to distinguish between the phlebotomist prodding your arm with a fingertip and actually putting a needle in.
posted by K.P. at 10:44 AM on February 25, 2011 [1 favorite]

I was really afraid of needles as a child. Luckily, one of the nurses I had taught me to get over it by singing to the wall.

Right before I was to get my shot, the nurse pointed to the wall in front of me.

"See that wall? It's that wall's birthday! I want you to go ahead and sing 'Happy Birthday!' to that wall!" I didn't want to get a shot, but I did like to sing. So, I sang to the wall. I was so distracted congratulating that wall on another blessed year on this rock we call home that I didn't even notice the shot. Haven't really been afraid since.

So. Go sing 'Happy Birthday!' to a wall and make that wall's day just a little bit brighter when you get your blood drawn.
posted by spinifex23 at 11:04 AM on February 25, 2011 [1 favorite]

I hate to be the bearer of bad news, but distracting yourself is only a short-term solution that will ultimately perpetuate your fear. I don't want to scare you, but flooding can be dangerous for people with injection/blood/injury phobias because it is often associated with fainting (i.e. rapid drop in blood pressure and decreased oxygen to the brain), which can be dangerous. If you must have your blood drawn before you can seek professional help, insist upon lying down to avoid injury from fainting (even if you've never fainted before).

Needle phobias can be very effectively treated with systematic desensitization. I strongly recommend that you try it. I also strongly advise against trying anything similar (i.e. flooding) without the help of a trained professional. Any licensed CBT therapist will know how to do it, but I'd put my money on a licensed clinical psychologist. A lot of people with phobias are very averse to the idea of desensitization because it requires exposing yourself to the very thing you're afraid of, but the technique is designed to ease you into it while building a repertoire of relaxation skills so that you can manage the feared situation. If you have a skilled therapist, the whole experience can be quite calming. Please memail me if you have more questions. I have personal experience with this subject.
posted by Mrs.Spiffy at 11:26 AM on February 25, 2011

I'm not sure this would help everyone, but I'll tell you what I do.

First, I look in a different direction. Not in a forceful "I can't look!" way, but as purposelessly and zoned out as I possibly can.

Second, I dig my thumbnail into the tip of my index finger. The idea is to cause myself more pain that I can control than the relatively minor pain of the needle which I can't control.
posted by the jam at 12:33 PM on February 25, 2011

Go back to the psychiatrist who prescribed the klonopin and ask them for something else--more klonopin, or maybe a beta blocker, or something else. They'll have some ideas. If you need this test done quickly you might not have time to desensitize yourself, do hypnosis, whatever.
posted by the young rope-rider at 1:56 PM on February 25, 2011

I haven't ever had the fainting issue while getting stuck, but I have veins that are impossible to find (but apparently once they get it, it's a good one).

As always, ymmv:

Figure out if you have a better arm. (For most people, it's their dominant one. For me, it's not.)

Try to avoid the back of the hand draw because that hurts more than in the elbow.

Do not look. Not even when they're preparing it and swabbing.

Feel free to kick the chair you're sitting in and swear and cry if necessary. Explain this ahead of time. (Do try to not kick the phlebotimist. They get upset about that. (Sorry nurse who got it instead of the chair when I was 5!))

Go somewhere where they draw blood all the time. (In my case, I go to an independent lab and just have to show a prescription slip with the tests wanted on it. The one I go to that works with my insurance is called Labcorp, but there's tons of others out there. They stick people day-in and day-out and they're good and fast at it, whereas if you go to a GP or something, they might not be as practiced.)

Drink tons (of water) the night before and the morning of.

Good luck. I've never really gotten over this, but it's something that is going to be in my future for a while, so I just have to try and get through it, knowing that they don't want to have the damn needle in me any longer than they have to.
posted by sperose at 3:57 PM on February 25, 2011

Are you sitting in the waiting room for a long time before the draw before they get to you? It's not going to help you to sit there overanalyzing what's about to happen. Perhaps you can call ahead, tell them you have severe anxiety about blood tests, and get it arranged where you just walk in and go straight to the blood draw station without delay. That way, you won't have time to get worked up before they do the deed.
posted by wondercow at 4:41 PM on February 25, 2011

I've had to have a couple of blood tests recently after years of getting to ignore the whole thing. I'm nowhere near as bad as you, but I still get nervy about it. Definitely look away. I think the last time I looked away and kept my eyes closed, and zoned out sufficiently that I didn't even hear the phlebotomist ask me if I was okay the first time, because I had decided I was not really there, and not coming back until I felt the band-aid go one. And then, when she asked the second time after I had opened my eyes, I *was* all right.

Good luck. And don't be humiliated. A *lot* of us are freaked out by having blood drawn.
posted by Because at 7:48 PM on February 25, 2011

Difficult for me to read this still, but:

EMLA
Back of hand (I HATE having the inside of my elbow touched; this was a revelation)
Explain to the nurse
Hypnotherapy. Get a tape made of a session. Listen before you go in
Talk to the nurse while she's doing it

I managed one at the hosp the other week when I wasn't expecting it and didn't have time to get my hypno tape.

I was a real 45 mins of screaming person beforehand - if I can do it, you can too.

Good luck! And look how many of us there are!!!
posted by LyzzyBee at 11:46 AM on February 27, 2011

Nobody should ever feel bad about feeling the way they do, and I'm very sorry you're going through this.

Anyone reading this thread who ever wants some reassurance or just a handy person to freak out at can feel free to drop me a MeMail before the draw, and I'll do what I can to help. I'm a paramedic, and I see this kind of reaction a lot: I can't promise I'll make the phobia go away, but I can promise I understand what you're going through, and I can at least offer a sympathetic, nonjudgmental ear.

You are not alone, and there is nothing wrong with you. The best news is that you now know that you're not alone, and that there's hope.
posted by scrump at 8:58 AM on February 28, 2011

How did it do, Gordafarin? What was helpful?
posted by kellygreen at 11:13 AM on April 5, 2011