I need a shot in the arm... FIGURATIVELY.

October 10, 2007 3:24 PM

How can I learn not to fear needles?

I am near phobic of all things injection-related. I say "near phobic" because I don't lose my mind right away, but if I were forced to watch an injection in a movie or even listen to people talk about having blood drawn for any length of time, I would get highly anxious and nauseated. I haven't had any injections for five years and then screamed and shook quite a lot. It was embarrassing and uncool hospital behavior. That was one tetanus shot.

So far, I've refused an IV twice and declined bloodwork a few times, and survived. But, there will be times in my life I'll need to accept a needle in the arm, but that thought sends me up a wall.

Broken skin, scrapes, or blood alone don't bug me. It's the thought of pressure on my delicate and violable membrane. How can I get okay with the thought of blunt things pushing and popping through my skin, turning my flesh into rotty, bruised, plumlike mush? Do I have to resort to sedatives?

posted by Ambrosia Voyeur to health (40 comments total)

Exposure and the resultant lack of ill effect.

Find yourself a good* phlebotomist and have them draw blood from you a buncha times.

*that's the important part; I can draw 50mLs of blood from someone and if they weren't watching, they wouldn't even know I had finished
posted by porpoise at 3:29 PM on October 10, 2007

When you've gotten injections/had blood taken, did you look at the needle at all? It can be easier if you aren't watching what's going on, especially when the needle has to go into a vein.
posted by needs more cowbell at 3:30 PM on October 10, 2007

I have the same problem, AV. Frankly, and I'm kind of embarrassed since I keep recommending anti-anxiety drugs, but I take a klonopin when I have to have blood drawn. I still got the vasovagal reflex after a few minutes but I was able to handle it much better. This, from having a full-blown panic attack the last time I'd had blood drawn. Like, even thinking about it now is causing me to wig a little.
posted by sugarfish at 3:32 PM on October 10, 2007

not looking is good. also, tell the phlebotomist--they are professionals and probably have a few tricks up their sleeves. finally, bring a friend to distract you.
posted by thinkingwoman at 3:39 PM on October 10, 2007

Well, I think -- to state the obvious -- that you need to try to alter your mental/verbal patterns that conjure up such elaborate, vivid, negative images like this: "blunt things pushing and popping through my skin, turning my flesh into rotty, bruised, plumlike mush." Honestly, as long as you think in these terms, I think you're going to be primed to freak out -- christ, it freaks me out a little, and I get bloodwork done on a regular basis.

For me, the key is not to think about it in any terms at all (graphic or not) and to look away. I don't think about the needle, I don't think about the vein, I don't think about the bruise. I just turn away (I don't close my eyes; I pick something else to stare at, such as a clock, a tree outside the window, etc.), breathe slowly and evenly through my nose (yoga breath!) and hum a specific song that has very positive connotations for me. By the time I hit the first chorus, the whole thing's over.

And I second the suggestion about asking for the most experienced nurse or phlebotomist, if you can. The difference between a skilled and a not-so-skilled blood draw is extraordinary.
posted by scody at 3:42 PM on October 10, 2007

Lord, I wish I knew. I loathe needles, and exposure has done basically nothing to lessen my anxiety. For a while, I was on a truly wretched medication that I had to have injected with a harpoon once a month, and I really hoped that the sheer frequency of facing my fear could make that cold sweating, weak-kneed, utterly embarrassing fear easier to bear. This did not happen.

I'm actually much better with having blood drawn than I am with injections. I don't like it, but as long as I get a good phlebotomist and l don't watch when they put the needle in, I don't feel like it hurts very much and thus I don't panic as much. Injections, however, just slay me. They hurt, I dread them, and have super fun panic attacks ad near swoons.

I've found a couple of coping strategies, for what it's worth. Like sugarfish, I'm fond of the anti-anxiety medications. Also, for blood draws, I make sure I'm really hydrated and I make a point of mentioning, as calmly as possible that I am. not. good. with needles. a number of times. If they know you're liable to freak, I think they're gentler and more careful with you. I also tend to listen to music and really thoughtfully practice the deep breathing, body awareness, and general mindfulness that I use to help manage my anxiety problems day to day.

Alas, I find none of this stuff helps very much for injections. In those cases, I continue to make it clear that they should be as careful as possible, since I'm entirely likely to run away and cry. I get whatever I can in the butt instead of the arm. It's nice and meaty back there, it's not super full of nerve endings, and generally, you're kind of bending over and leaning on the table, which I find makes me less likely to pass out. Some of the easiest injections I've ever had involved the injector grabbing a big handful of butt and kind of firmly squeezing it. I think it sort of confuses the nerve endings. I think for either injections or blood draws, technique has a lot to do with it. Some people just seem to be more skilled at sticking needles into others with a minimum amount of pain and distress.

Still, it blows and the fact that I logically understand nothing tragic is going to occur has little or no effect on my emotional response to it. My fingers are crossed that someone in this thread comes up with a magical solution I've never heard of.
posted by mostlymartha at 3:52 PM on October 10, 2007

I was just like you. Then I got really sick and needed an IV and got over it.
Now when I have to get blood drawn, I just breathe deeply and count.
posted by k8t at 3:53 PM on October 10, 2007

Agree with above - (1) obtain the most experienced needle/blood person available; (2) distract yourself.

Here's a scenario: blood person hovers with needle at the ready. On the other side is your friend with whom you talk long enough to (with a little luck) forget about the needle. At random, maybe while you are laughing, the needle goes in.

Once I had an IV installed and didn't realize it because one of the nurses said something hilarious at just the right instant.
posted by Kevin S at 4:04 PM on October 10, 2007

I use Emla (that site's for Australia, but it's available in the U.S. as well). It's a prilocaine/lidocaine numbing cream you apply to the injection site beforehand, so you feel mostly just pressure (just writing that makes me feel a little oogy). You put it on an hour or two beforehand, cover it with an occlusive dressing, and wipe it off when it's time for the draw/injection. It's intended for pediatrics, but of course it works just fine on squeamish adults as well.

Beyond that, I tell them I have to lie down while they do it (nobody wants to risk injury from a fainting fall). And I get the arm they need as far away from my body as possible and do a little mental effort to distance myself from that arm. And I say "kittens kittens kittens kittens kittens" to myself - out loud if I need to - until it's over.
posted by jocelmeow at 4:07 PM on October 10, 2007 [1 favorite]

Forgot to note - you do need a prescription for Emla, but once you have a tube, you can keep it on hand for the future.

Also, phlebotomists always try to comfort me by saying, "But you have such good veins!" and I reply, "Uh, a good vein would have a little door and a spigot."
posted by jocelmeow at 4:14 PM on October 10, 2007

Get it done when there's little chance of a lineup, meaning less time to sit there and wait, and think about it. When it's your turn - Definitely don't watch. Have someone very experienced taking your blood. Keep the conversation going, while you sitting there with your arm outstretched. Before you know it, they'll be done.

Also, from personal experience - the fear that if you don't get blood drawn or your injections, the docs won't be able to figure out what the hell is wrong with you, and you'll have a stroke, or worse, will make it way way easier. Ativan helps, as well. I'm an old pro now :S
posted by cgg at 4:15 PM on October 10, 2007

Flooding worked for me.

I was horribly, horribly afraid of needles as a kid. Avoided visits to the doctor, didn't even like looking at sewing needles. Then I needed an allergy test. An old school allergy test. That means that they got a syringe, filled it with substance #1, injected a tiny under my skin, then went for substance #2 ... (there are much faster, less painful methods, I'm told). Well, around #11 (out of #32), I nearly fainted. Tunnel vision, cold, everything goes gray. I came out of it after a minute and I'm all "meh." The remaining shots didn't bother me in the slightest. To this day, I don't care a bit.

So, short of becoming a cenobite or a diabetic, I'd say that you should avoid "coping" for just this one shot and instead stomp your fear flat by demonstrating to yourself that, even if you had a dozen blood draws, it doesn't matter.
posted by adipocere at 4:16 PM on October 10, 2007

Hypnotherapy.
that is all
(well Emla cream works fine if your problem is the physical sensation but I've never met someone for whom that was the case. Most needle phobics fear the experience, the penetration, and just valium or Emla won't do it.)
posted by Wilder at 4:26 PM on October 10, 2007

I second jocelmeow's suggestion of lying down - I've never had any problems with that request.

Also, I've had the most luck just being upfront and honest with whoever is drawing the blood/administering the shot. I just say "Look, I had a bad experience with an IV a few years back, and I'm really skiddish with needles now. I'm going to do my best to work through it, but I may need some help staying calm." Nearly every time, this seems to flip the compassion/mothering switch in the tech's brain, and he/she is much more willing to talk me through it, use a smaller needle, etc. They may essentially treat you like a child (especially if you look young), but hell, if that makes the experience less of a trial I don't give a damn.

My final tip is to not worry as much about having "embarrassing" reactions to having your blood drawn. Part of what makes me so nervous is the concern that people will think I'm weak or weird for my reactions; it helps a lot to just go "Whatever, I'm probably going to wiggle and go 'ow ow ow,' that's how I deal with this best and it doesn't make me weird."
posted by sarahsynonymous at 4:30 PM on October 10, 2007 [1 favorite]

Basically, you just have to force yourself to do it over and over, and you'll get over it. I had a phobia due to getting a very painful cortisone injection for a severe case of eczema when I was five. I had subcutaneous allergy injections as a teenager, and I learned to tolerate those. I learned to tolerate blood draws because I became diabetic in my late 20's, and needed a lot of them. (My motivation for forcing myself to learn to tolerate the blood draws was to avoid kidney failure and therefore dialysis. My mother was on dialysis (although not from diabetes), so I knew just how awful it is, and the very, very large scary needles they use to do it with.) When I had my first baby in 1989, I was too scared of someone sticking a needle in my spine to get an epidural. By the time I had my second in 2004, I had conquered the phobia well enough to get an epidural, and that was a far more pleasant birth experience. I have even managed to give myself insulin injections while pregnant, and now I can do it with no fear-- although it's never going to be my favorite thing.

I second the not looking, at least at first, and finding a good phlebotomist. Try saying up front that you have a phobia and/or are hard to stick. There's usually one or two people in this type of setting that get called in if the normal person has a problem doing the stick-- ask for that person from the get-go. Find a logical reason to make yourself go through with being stuck. The more you do it, the easier it gets. I can do just about anything now, apart from donate blood. Last time I tried, I had a small panic attack. But, one can survive without donating blood, and the blood bank kind of brushed me off anyway-- because I'm type AB+, they said my whole blood wasn't really that useful. (ABs can accept blood from anyone, but can only give blood to the other 3% that are also AB.)
posted by Shoeburyness at 4:37 PM on October 10, 2007

Oh honey. I feel for you. I'm EXACTLY the same. My boyfriend loves watching House and even the SOUNDS scare me. Just THINKING of this makes me squirm. Urgh. Ow. And because of my unstable health, I've had to get needled too many times - can't avoid them! Exposure doesn't work unfortunately.

Something that helped a bit was to think that that part of the body will not feel pain. I visualized the point of the piercing being totally numb, able to withstand pain, and I visualize that as strongly as possible. Somehow that helps calm me down and it doesn't hurt as bad. My psychologist taught me this, and I've only managed to use this once so far, but it's helpful.

Someone to distract you is good, but note that in some places they don't allow other people in the same room. I needed bloodwork done and got my boyfriend to come with me, but they didn't let him in the same room as me. Bummer. Cuddles afterwards helped though - a LOT.
posted by divabat at 4:55 PM on October 10, 2007

Desensitization. My wife went to the UBC anxiety clinic for this very problem. She talked about needles, looked at them, held them, watched videos of people having injections, watched me having blood taken, etc. Worked for her.
posted by timeistight at 5:03 PM on October 10, 2007

Give blood if you can and think about how lucky you are not to have to be on the receiving end.

I don't mean that in a snarky way, by the way. I have the same problem, needlewise, better now than it used to be- first cut is the deepest and all that. Thing is, I have good blood, I'm easy to guilt out, and I give little enough else back in life.

Well, besides cheap advice here.
posted by IndigoJones at 5:21 PM on October 10, 2007

The sight of a needle bothers me, so I don't look. I'm very sensitive to pain, so I tell them that and ask them to be gentle. Then, yes, look away, but the best tips I can add to what has been said are (1) to take the attitude that I'm going to conquer this and rationally this is not a big deal, but something safe and simple and over in a few minutes and (2) I focus on resting my hands in an open position, trying to remain relaxed, but focusing on them and the sensation of them resting on the fabric or wherever they are, focusing on comfort and relaxation. And then it's over.
posted by Listener at 5:23 PM on October 10, 2007

This is going to sound strange and counter-intuitive, but hear me out.

Find yourself a good acupuncturist.

The needles they use to draw blood and give injections are bigger than acupuncture needles, but I assume your fear carries over.

The thing is, acupuncture leaves you relaxed and feeling good. Soon, you start associating the needles themselves with the good feelings, and your blanket fear of needles goes away. At least that's what happened to me, though I wasn't afraid of needles to the point of declining IVs.
posted by nadise at 5:28 PM on October 10, 2007

I got over my fear of needles by giving blood regularly in college. Everytime I saw one of the red cross vans I would walk over and give blood (assuming it had been the month required). I still practice that to this day. I think it became the necessary evil of knowing that I was helping those in need that did it. I was doing my part to save lives. Eventually I quit freaking out when they drew the blood.
posted by Tinen at 5:42 PM on October 10, 2007

Yep, that's me too - I would pass out, or feel faint, when faced with injections or blood draws. I smiled at divabat's comment above, because I recently discovered the addictive joy that is House...and I think it's helped! I had to go to the hospital to get stitches for a nasty cut recently, and I actually handled it much better than I had in the past.

But during that visit, something really interesting happened. I had to get a tetanus shot...I was stressed about it, and told the nurse that I'd fainted in the past. She said that she had a secret method of administering shots: when she counted to three, all I had to do was wiggle my toes. So, 1...2...3...wiggle! I did. And sure enough, I didn't feel the shot at all, or have any kind of panic response.

Now, most likely it was just the distraction, but when I asked the nurse, she said something about the nerves or part of the brain or something used to wiggle toes was the same that felt pain. Ah....right. But whatever it was, it worked. So, anyway, I hope you get past your fear. It can be done. Just tell the nurse or doctor about your usual reaction to shots, lay down, don't look, and get it over with. It'll get easier each time. (Maybe have a glass of wine first, too, if it's medically allowable.)
posted by TochterAusElysium at 6:07 PM on October 10, 2007 [1 favorite]

Start donating plasma. When you get paid almost $100 a week to have the needle stuck in you, suddenly it becomes worth it.
posted by sian at 6:12 PM on October 10, 2007

The only way I've ever been able to deal with it is by kicking something. So I always tell the blood-drawer to move to the side, just in case. And then I proceed to kick the table or whatever.
posted by sperose at 6:49 PM on October 10, 2007

Hydrate a lot beforehand. It'll pump your veins up and make them easier to get at the first time around -- and the only thing worse than getting stuck with a needle is getting stuck with a needle 4 or 5 times. That was a large part of my fear of needles (damn those tiny veins!), but I felt a lot less anxious about it once I knew there was something I could do about it (and I get IVs pretty regularly, so this eased a LOT of anxiety).

Don't look at it, and concentrate on something else. I squeeze my nails as hard as I can into the palm of my free hand and concentrate as hard as I can on that pain, rather than on the pain in my other arm.

Experience helped the most. I was terrified of getting blood drawn as a kid, but then I started needing bloodwork and IVs and there were just a TON of needles. You get numb to it after awhile. I agree that you should donate blood, since it'll give you numerous opportunities to figure out what method works best for you. Also, you're saving lives, which is always a bonus.
posted by lilac girl at 6:51 PM on October 10, 2007

Go get a tattoo. Worked for me.
posted by baphomet at 7:13 PM on October 10, 2007

Lilac Girl nailed it -- hydrate until you think your bladder will pop. But don't go and pee, just hold it and all that water will plump your veins like crazy. I did that when I was giving blood regularly; one experienced phlebotomist said she'd never seen anyone fill up the bag so fast. I got an extra sticker and T-shirt, too!

Also think of a loved one needing a transfusion of your blood or he/she will die. The thought of saving a life is my greatest motivator. (And I used to break out in cold sweats and start sobbing at the sight of needles.)
posted by Smalltown Girl at 7:41 PM on October 10, 2007

Yeah, I have to join the crowd saying exposure. I was scared of needles until I went on Accutane and had to get my blood drawn once a month. I had to fast so my mom let me stay home from school from morning until the blood was drawn - so I began to associate needles with getting to skip school. The pain was nothing in comparison to missing one half-Friday a month for almost a whole year.
posted by crinklebat at 8:15 PM on October 10, 2007

I cover my eyes and sing a really complicated piece of music to myself. The mental effort of breathing and singing makes it difficult to focus on the icky needle-related goings-on.

The needle-wielder has never minded the music. Or at least never admitted to minding.
posted by Andrhia at 8:18 PM on October 10, 2007

Sound reasoning tends to do it for me.

On the experience spectrum, I used to be wicked skeert of the needle, but then I had to start getting allergy shots regularly (and even more regularly later, 3x wk). Allergy injections use micro-needles, so you really can't even feel them most of the time.

On the reasoning spectrum, I decided to try donating blood to the Red Cross (you don't get anything in exchange except the occasional Tshirt or promotional trinket). Soon they were after me to try donating platelets, so I figured I would give it a shot. They are always in super need of platelet donors, and so the fact that I was helping to provide a valued and renewable resource just from my body's natural function, the poking didn't matter even if the needles were a skosh bigger. However, I would not advise taking a close look at one of them xD
posted by Quarter Pincher at 8:30 PM on October 10, 2007

EMLA takes about 60 minutes to set in, so remember to apply/ask-for it early.
posted by porpoise at 8:51 PM on October 10, 2007

you do need a prescription for Emla

I had no problem getting EMLA from the drugstore, no prescription (US). It is, however, quite expensive. Two or three applications = ~$30.
posted by nakedcodemonkey at 10:57 PM on October 10, 2007

If you can't get Emla, you could always buy a lidocaine gel at the drugstore - they sell it for application after a sunburn. Don't know any names for it but I've used it before and it helps numb the skin.
posted by agregoli at 7:01 AM on October 11, 2007

I lost a lot of fear when I travelled overseas and needed about six injections. After the first couple felt like nothing, I was much more relaxed about it.

Two other things have helped : I had to have an antibiotic injection, and the doctor said `this is a rather painful injection, in fact the first bit of stuff in the syringe is an anaesthetic to try and lessen it'. I was sweating bullets, but felt almost nothing when he injected. After that I had little fear of the needle.

The remaining squeamishness left when I was asked by my partner to administer her nightly injections for MS. Horrified at first, I refused to do it, but finally got around to it. I even gave myself a small saline injection just to see what it was like. It felt like nothing. So, while I don't actively like injections, they aren't something that terrifies me anymore. It was really all about exposure taking away my fear.
posted by tomble at 7:05 AM on October 11, 2007

EMLA Cream online (from BMEshop)

I used to be deathly afraid of needles, but being in nursing school certainly helped me out. I also got a bunch of piercings and tattoos, which was good. Exposure therapy works pretty well for almost all people.

However, the longer you put off getting over your fear (by living through it) and the more you think about it (like posting here) the worse it will get. You have to *under-think* it instead, so it does not become a big deal anymore. I used to talk about my fear of needles with everyone I knew, but when I got to nursing school, that was kinda embarrassing. So I stopped, and my fear lessened.
posted by nursegracer at 7:16 AM on October 11, 2007

Previously.
posted by plinth at 8:10 AM on October 11, 2007

you're kind of bending over and leaning on the table
A nurse taught me if you lay down, it relaxes the muscles and it won't hurt as much, if at all. They always have a table handy, and if they seem reluctant to let you use it, threaten to do the vasovagal thing. (It's not really a lie; how do you know this won't be the time you hit the floor?) I've done it both ways, and it really makes a big difference.

Tell them anything they need to know. That's anything about your fears or your veins. Ask for the best phlebotomist they've got, and ask for the pediatric equipment if it is appropriate for the procedure. The little butterfly things are great. Depending on who it is, sometimes you can talk them into shooting the spot with a microneedle full of some kind of lidocaine. (They will do that before an IV if you ask, usually, and then after it's in, they will dump lidocaine into the line a few times until it settles down, if necessary.)

The long range cure is desensitization in one form or another. You can volunteer for expensive therapy (which would be way worth it if you had some challenge coming up that you needed to be ready for), or just donate blood until you get over it, or something in between. You know the principles involved here; you can look at pics of needles on the internet until you stop cringing, and then work your way up.
posted by unrepentanthippie at 8:43 AM on October 11, 2007

To pipe in about EMLA or the similar ELA-MAX cream, I know that in my experience it's available without an rx but you have to ask the pharmacist as they keep it behind the counter.
posted by radioamy at 10:51 AM on October 11, 2007

I have needles fears just like you, and a good distraction and the threat of death seemed to work for me:

I had a pelvic fracture from a car accident and was hospitalized overnight this past April. They wanted to draw blood from me every six hours to make sure I wasn't bleeding internally. Of course, you're allowed to refuse anything they do to you in a hospital, but I finally agreed to submit to the blood draws once they told me I could die if internal bleeding went undetected.

They were very kind, insisted I look away and talk to an assistant about how I met my boyfriend (who was holding my hand) while they did the needle work. It still hurt, but keeping me focused on talking about a subject that makes me happy made it very difficult to be fearful. For the subsequent draws I knew that if I just stayed focused on talking to the assistant I'd be just fine, and it still hurt, but each time I was less and less afraid.
posted by blackunicorn at 11:23 AM on October 11, 2007

I'm the same way, and my solution has been pretty simple. Look away from the injection site, breathe and tell them to not tell you when they are about to do it. I.E. Don't look and don't focus on when they are doing it. That way you just feel it and its over.
posted by Fidel at 12:08 PM on October 11, 2007