My kid on Xanax for needle phobia
September 28, 2020 6:08 PM Subscribe
My 17 year old son needs to get his blood drawn. He has a major needle phobia. The doctor prescribed Xanax, with the directions for him to take one pill 15 minutes before the draw. Can you help me know what to expect and how I can help all this go better? I'm feeling stressed myself now (ugh) and want to work through that so I can be chill for both of us.
My son has been dealing with some mental and physical health issues for a few years. He was supposed to get blood drawn a few years ago but walked out of the medical building and just refused. He's had a needle phobia for years and his last blood draw, when he was about 5 or 6, was super traumatic for him (and really upsetting for me to watch), and he's always hated shots. "Needle phobia" is actually noted in his medical charts.
Lately he's been taking some great positive steps for his health, and he's accepting that he needs to get the blood draw done. It's a big deal for him to be up for this (he also struggles with social anxiety). These are all good things!
I'm normally pretty relaxed around doctors and medical facilities for myself and for my kids, but I have no idea what the Xanax will do and how he might feel. And this is on top of general pandemic-related stress. I'm hoping that you all can give me some ideas of what the Xanax will do to him and for him, and that information well help me be a supportive parent through this.
If you have any other general input on being supportive of a teenager who has situation-specific stress, I'd love to hear that as well. Thanks!
(Yes, I realize that me being stressed won't help him, so that's why I'm asking all this.)
My son has been dealing with some mental and physical health issues for a few years. He was supposed to get blood drawn a few years ago but walked out of the medical building and just refused. He's had a needle phobia for years and his last blood draw, when he was about 5 or 6, was super traumatic for him (and really upsetting for me to watch), and he's always hated shots. "Needle phobia" is actually noted in his medical charts.
Lately he's been taking some great positive steps for his health, and he's accepting that he needs to get the blood draw done. It's a big deal for him to be up for this (he also struggles with social anxiety). These are all good things!
I'm normally pretty relaxed around doctors and medical facilities for myself and for my kids, but I have no idea what the Xanax will do and how he might feel. And this is on top of general pandemic-related stress. I'm hoping that you all can give me some ideas of what the Xanax will do to him and for him, and that information well help me be a supportive parent through this.
If you have any other general input on being supportive of a teenager who has situation-specific stress, I'd love to hear that as well. Thanks!
(Yes, I realize that me being stressed won't help him, so that's why I'm asking all this.)
Did the doctor prescribe multiple pills? Could you have him take one pill a week or two before his blood draw on a Saturday so if he gets sleepy he can nap or go to bed early, as a test run? This will help him (and you) know what to expect and help you calibrate whether 15 minutes before is a good estimate or if he needs less or more time for it to kick in. He might feel light-headed, detached, sleepy, or he might just fall asleep; your pharmacist can probably speak to other reactions.
posted by stellaluna at 6:16 PM on September 28, 2020 [6 favorites]
posted by stellaluna at 6:16 PM on September 28, 2020 [6 favorites]
Risking stating the obvious, but have him look away from the side where they are drawing blood. Don't look at the needle, his arm, any of that.
posted by exogenous at 6:36 PM on September 28, 2020 [9 favorites]
posted by exogenous at 6:36 PM on September 28, 2020 [9 favorites]
My 20-year-old daughter has a massive blood phobia, which definitely comes into play when she has to have a blood draw. When she was 11, she had to have surgery on her foot and was in the hospital for 3 days. The Child Life staff at the hospital were wonderful and taught us techniques to distract her that we still use today. The first is deep breathing whenever she starts getting anxious about the blood draw. This can start days before the actual event. It slows the heart rate and gets them out of that immediate anxiety feeling. It's good that need phobia is listed on your son's medical chart; it was listed on my daughter's as well. For good measure, though, before she was brave enough to do it herself, I'd tell the nursing staff beforehand that she had a very serious phobia and we would be doing some distracting methods during the draw so they would let us get on with it. Now that she's older, she tells them herself. During the draws, we talk. We talk about places we've visited, funny family stories, anything we can think of to get her talking. The most recent one, I had her tell me again about the college classes she was signed up for in the next term. It gets her mind of off what's happening in front of her. She used to faint during blood draws. Now she just gets really really pale but gets through it. She's also had some therapy related to the blood phobia and plans to do more.
Good luck!
posted by cooker girl at 7:10 PM on September 28, 2020 [4 favorites]
Good luck!
posted by cooker girl at 7:10 PM on September 28, 2020 [4 favorites]
Xanax slows my racing thoughts down to a gentler stroll.
Ask for a butterfly needle.
Ask the nurse to talk to you the entire time about something completely unrelated to getting your blood drawn. Once a nurse sang a lullaby to me. I've never had a better experience.
posted by Kitchen Witch at 7:13 PM on September 28, 2020 [10 favorites]
Ask for a butterfly needle.
Ask the nurse to talk to you the entire time about something completely unrelated to getting your blood drawn. Once a nurse sang a lullaby to me. I've never had a better experience.
posted by Kitchen Witch at 7:13 PM on September 28, 2020 [10 favorites]
If your concern is medicating a teenager when it seems like there should be alternative ways to manage the fear, a couple non-medication alternatives for phobias include hypnosis and biofeedback.
posted by aniola at 7:14 PM on September 28, 2020
posted by aniola at 7:14 PM on September 28, 2020
I also have an extreme phobia of having blood drawn. Shots aren't so bad but there's something about hving blood drawn and omg I'm cringing just typing that ewwww. I actually kicked a doctor in the stomach when I was a kid to try to get her away from me. I did not have blood drawn between when I was in high school (1995 maybe) and five years ago. I just flat out refused every time the doctors asked.
For me, the anxiety about the upcoming draw is almost as bad as the draw itself. If I could plan it, I would have as little time possible between learning that I need it to having to give it. Cutting down on the anticipation is best for me. No amount of planning and practicing would help - it just needs to be done so that I don't dwell on it.
Also: making sure that the nurse/tech/doc really does know that it's a phobia and doesn't just brush it off as "oh nobody likes having blood drawn." I told the last tech that I have a needle phobia and it needs to be done quickly or I begin to panic. He kind of went "okay, sure, don't worry" and then took forever. I began to clench my teeth and have trouble breathing just as he finally got started and I grew faint and panicky, and wound up on the floor crying barely able to breathe. The Tech said, "you should have said something!" and I shouted "I did fucking say something!!" Next time I will have to spell it out for them.
posted by Gray Duck at 7:19 PM on September 28, 2020 [3 favorites]
For me, the anxiety about the upcoming draw is almost as bad as the draw itself. If I could plan it, I would have as little time possible between learning that I need it to having to give it. Cutting down on the anticipation is best for me. No amount of planning and practicing would help - it just needs to be done so that I don't dwell on it.
Also: making sure that the nurse/tech/doc really does know that it's a phobia and doesn't just brush it off as "oh nobody likes having blood drawn." I told the last tech that I have a needle phobia and it needs to be done quickly or I begin to panic. He kind of went "okay, sure, don't worry" and then took forever. I began to clench my teeth and have trouble breathing just as he finally got started and I grew faint and panicky, and wound up on the floor crying barely able to breathe. The Tech said, "you should have said something!" and I shouted "I did fucking say something!!" Next time I will have to spell it out for them.
posted by Gray Duck at 7:19 PM on September 28, 2020 [3 favorites]
I don’t like needles. I’ve gotten better and worse about them at varying times. Funny enough, I’m a big fan of vaccines and tend to get ones that might not come up very often just in case (like yellow fever and typhoid). Last year I also started doing allergy shots in hopes to one day get a dog. So I’ve had a lot of shots this year and of varying kinds. I’d rank them from worst to easiest as follows: finger needle prick to test for iron at a blood donation, flu shot, Novocain shot for dental work, COVID19 vaccine trial (could have also been placebo, but either way, easy), blood draws, allergy shots.
Allergy shots were so easy that I would barely realize they were doing them. I got my blood drawn last week and even though they had a little trouble at first finding a vein (which then made me nervous for multiple pokes) it was wayyyyyyyy easier and less painful than expected.
I realize this might not manage the anxiety, but I know I appreciate being honest about how bad something will be and also not wanting to lie to a loved one about how much something make suck or not. A blood draw with someone experienced is not bad at all (also drink water beforehand to make it all go easier)
posted by raccoon409 at 7:23 PM on September 28, 2020
Allergy shots were so easy that I would barely realize they were doing them. I got my blood drawn last week and even though they had a little trouble at first finding a vein (which then made me nervous for multiple pokes) it was wayyyyyyyy easier and less painful than expected.
I realize this might not manage the anxiety, but I know I appreciate being honest about how bad something will be and also not wanting to lie to a loved one about how much something make suck or not. A blood draw with someone experienced is not bad at all (also drink water beforehand to make it all go easier)
posted by raccoon409 at 7:23 PM on September 28, 2020
My experience with Xanax is similar to jessamyn’s, but it takes longer than 15 minutes for me to feel the effects. I second the recommendation for a trial run if you have enough pills.
posted by The Underpants Monster at 7:27 PM on September 28, 2020 [9 favorites]
posted by The Underpants Monster at 7:27 PM on September 28, 2020 [9 favorites]
One thing that hasn’t been mentioned and has been studied in adolescents for exactly this kind of situation is playing immersive virtual reality games during blood draws and other procedures. Depending on where you live, you might call around to your local hospitals etc. and see if any of them have child life specialists or this kind of technology available. I don’t think there’s any reason you couldn’t combine these non-pharm interventions with the Xanax.
posted by MadamM at 7:27 PM on September 28, 2020 [2 favorites]
posted by MadamM at 7:27 PM on September 28, 2020 [2 favorites]
I have needle phobia. I was given Ativan, another benzo, to try to help me through a draw when I was sixteen. It was the best way to do it then, and it helped me calm down enough to not *refuse* to do it, but it wasn't enough to prevent me from freaking out as it was done.
I've since developed a paradoxical reaction to benzodiazepines - they make me agitated instead of calm. I've also developed a chronic illness that means I've had a lot of blood draws over the years. So benzos are not an option for me now.
For a long time I used EMLA cream (lidocaine/prilocaine) beforehand. It's prescription. You apply it an hour or so in advance, apply an occlusive dressing over it, and so the area is pretty numb and you feel a little poke instead of the full pierce. I found that the long preparation tended to rile me up, though. It's better for me to choose a moment when I'm feeling up to it and go do it right then. It helps me feel more in control.
When I get to the lab, I make it known I have the phobia and they choose someone who they think is most likely to be able to get in and out without an issue, even if I flinch. I ask to be able to lie down while they do it, which helps me to stay still and prevents me from getting so faint. I ask them to use a butterfly, even though it takes longer, because the sucking feeling of the syringe is a major issue for me. I ask them to keep the paraphernalia they're preparing out of my sight beforehand and to keep the drawn blood and equipment out of my sight afterward. I do my best to mentally distance myself from the arm they're going to draw from. I remind myself to relax my muscles all over. Of course I never look - I cover my eyes with my other arm. I tell myself that it will hurt a little but it only lasts a minute and I'll get to be excessively proud of myself when it's done. And they'll give me a juice if I want.
It's been a long time since I made an ungodly scene - I'm sure the phlebotomists who were working that day at Kaiser 25 years ago are still talking about the woman who yelled KITTENS KITTENS KITTENS! at the top of her lungs. (My mother had thought it'd be a calming thing to repeat to myself. I failed to keep it to myself.) Admittedly, a lot of inadvertent exposure therapy from being chronically ill has helped, and I have times when I'm better and times when I'm worse about the whole thing. I still dread it and put it off sometimes, but I can get through it with all the tactics in the preceding paragraph in place.
posted by jocelmeow at 7:32 PM on September 28, 2020 [9 favorites]
I've since developed a paradoxical reaction to benzodiazepines - they make me agitated instead of calm. I've also developed a chronic illness that means I've had a lot of blood draws over the years. So benzos are not an option for me now.
For a long time I used EMLA cream (lidocaine/prilocaine) beforehand. It's prescription. You apply it an hour or so in advance, apply an occlusive dressing over it, and so the area is pretty numb and you feel a little poke instead of the full pierce. I found that the long preparation tended to rile me up, though. It's better for me to choose a moment when I'm feeling up to it and go do it right then. It helps me feel more in control.
When I get to the lab, I make it known I have the phobia and they choose someone who they think is most likely to be able to get in and out without an issue, even if I flinch. I ask to be able to lie down while they do it, which helps me to stay still and prevents me from getting so faint. I ask them to use a butterfly, even though it takes longer, because the sucking feeling of the syringe is a major issue for me. I ask them to keep the paraphernalia they're preparing out of my sight beforehand and to keep the drawn blood and equipment out of my sight afterward. I do my best to mentally distance myself from the arm they're going to draw from. I remind myself to relax my muscles all over. Of course I never look - I cover my eyes with my other arm. I tell myself that it will hurt a little but it only lasts a minute and I'll get to be excessively proud of myself when it's done. And they'll give me a juice if I want.
It's been a long time since I made an ungodly scene - I'm sure the phlebotomists who were working that day at Kaiser 25 years ago are still talking about the woman who yelled KITTENS KITTENS KITTENS! at the top of her lungs. (My mother had thought it'd be a calming thing to repeat to myself. I failed to keep it to myself.) Admittedly, a lot of inadvertent exposure therapy from being chronically ill has helped, and I have times when I'm better and times when I'm worse about the whole thing. I still dread it and put it off sometimes, but I can get through it with all the tactics in the preceding paragraph in place.
posted by jocelmeow at 7:32 PM on September 28, 2020 [9 favorites]
My life right now is blood draws all the time, you would not even believe.
In the hours before the appointment, get him to HYDRATE This will make it easier for the phlebotomist to find an easy vein that will make the whole thing go really smoothly. Personally, I'd take the Xanax 20-30 minutes beforehand so it can settle in a bit more before he enters the lab.
The blood draw itself will be pretty quick. You check in and wait your turn to be called. Your son should mention at some point that he's needle-shy and a bit nervous. The technician will have him take a seat, then look for a suitable vein. He might be asked to make a fist to help reveal the vein. The tech will clean the area with an alcohol pad. Butterfly needles are fantastic. Then there's a quick pinch of a needle (I can't watch and that's totally normal), the filling of however many vials, and then gauze and tape to keep on the site for 20 minutes or so. The technician can talk through the process before or during. It might be nice to do something more fun after, so the draw is not the Big Event of the day.
posted by mochapickle at 7:59 PM on September 28, 2020 [7 favorites]
In the hours before the appointment, get him to HYDRATE This will make it easier for the phlebotomist to find an easy vein that will make the whole thing go really smoothly. Personally, I'd take the Xanax 20-30 minutes beforehand so it can settle in a bit more before he enters the lab.
The blood draw itself will be pretty quick. You check in and wait your turn to be called. Your son should mention at some point that he's needle-shy and a bit nervous. The technician will have him take a seat, then look for a suitable vein. He might be asked to make a fist to help reveal the vein. The tech will clean the area with an alcohol pad. Butterfly needles are fantastic. Then there's a quick pinch of a needle (I can't watch and that's totally normal), the filling of however many vials, and then gauze and tape to keep on the site for 20 minutes or so. The technician can talk through the process before or during. It might be nice to do something more fun after, so the draw is not the Big Event of the day.
posted by mochapickle at 7:59 PM on September 28, 2020 [7 favorites]
Oh! The actual draw site depends on the patient, but a regular go-to spot the technicians seem to like is the tiny hollow on the inside of the elbow. If it helps him visualize.
posted by mochapickle at 8:15 PM on September 28, 2020
posted by mochapickle at 8:15 PM on September 28, 2020
The comparison to a cocktail is accurate in my experience. For me, though, it takes closer to 45 minutes to feel the full effect; 15 minutes wouldn’t be nearly enough for me.
posted by Dip Flash at 9:39 PM on September 28, 2020 [3 favorites]
posted by Dip Flash at 9:39 PM on September 28, 2020 [3 favorites]
I always take Xanax for blood draws. It doesn’t make me high or loopy, just super chill, like things can happen and I don’t care, but not apathetic or anhedonic at all, just more chilled out.
posted by matildaben at 10:18 PM on September 28, 2020
posted by matildaben at 10:18 PM on September 28, 2020
Risking stating the obvious, but have him look away from the side where they are drawing blood. Don't look at the needle, his arm, any of that.
this very thing worked for me when I was fifteen or so, and now, over four decades later, it continues to be my tactic for dealing with the admittedly hideous experience of having a needle stuck deliberately into my arm.
posted by philip-random at 10:52 PM on September 28, 2020 [1 favorite]
this very thing worked for me when I was fifteen or so, and now, over four decades later, it continues to be my tactic for dealing with the admittedly hideous experience of having a needle stuck deliberately into my arm.
posted by philip-random at 10:52 PM on September 28, 2020 [1 favorite]
Is there the option to have it done laying down? I had every blood draw that way until my late thirties and they were always happy to accommodate me. It really reduced the line of sight of needle stuff and if I felt bad I was already flat. I only made a huge effort in my late 30s when I had to have them all the time and it was easier to deal but otherwise I'd still be laying down.
Definitely DO NOT LOOK AT THE NEEDLE. I'm still not there and don't plan to be. If he might be tempted, dark sunglasses/a blindfold / pulling a cap over his eyes might help block it out.
Can he listen to music through headphones the whole time? The more you can disassociate yourself the easier it is. if not, chatting non-stop about something really benign is great.
One thing, here they get us to cross check our personal details on the labels of the tubes. I'm ok with this now but holding tubes of my own blood was a major nope in the past. But mine was more blood than needle phobia. Just something maybe to ask about if it will be an issue.
posted by kitten magic at 11:30 PM on September 28, 2020 [1 favorite]
Definitely DO NOT LOOK AT THE NEEDLE. I'm still not there and don't plan to be. If he might be tempted, dark sunglasses/a blindfold / pulling a cap over his eyes might help block it out.
Can he listen to music through headphones the whole time? The more you can disassociate yourself the easier it is. if not, chatting non-stop about something really benign is great.
One thing, here they get us to cross check our personal details on the labels of the tubes. I'm ok with this now but holding tubes of my own blood was a major nope in the past. But mine was more blood than needle phobia. Just something maybe to ask about if it will be an issue.
posted by kitten magic at 11:30 PM on September 28, 2020 [1 favorite]
Xanax feels like particularly strong weed. You feel floaty and chill and happy. It should help. Also:Don't look at the needle, lay down if possible, take a phone and earbuds and listen to some chill music or a meditation during.
posted by Ostara at 12:05 AM on September 29, 2020
posted by Ostara at 12:05 AM on September 29, 2020
When I was a little kid it took two nurses to hold me down so a third could take blood. I am now a 50 year old man and unfortunately I still freaking hate it. This is embarrassing to me as a person who is normally calm and stoic about medical stuff.
Coping things I have learned: be lying down when they do it. Have something else to look at, preferably something engaging. Maybe it's different for your son but for me it's watching the syringe fill that really gets to me. Thank god for smart phones and tablets. And talk small talk, don't talk about what's happening. Ask him about something trivial but complicated to explain, like how to play some game you've never played before. Something that he cannot answer without concentrating somewhat. And stay lying down after it's all over until good and ready to get up and go.
posted by i_am_joe's_spleen at 12:37 AM on September 29, 2020 [1 favorite]
Coping things I have learned: be lying down when they do it. Have something else to look at, preferably something engaging. Maybe it's different for your son but for me it's watching the syringe fill that really gets to me. Thank god for smart phones and tablets. And talk small talk, don't talk about what's happening. Ask him about something trivial but complicated to explain, like how to play some game you've never played before. Something that he cannot answer without concentrating somewhat. And stay lying down after it's all over until good and ready to get up and go.
posted by i_am_joe's_spleen at 12:37 AM on September 29, 2020 [1 favorite]
Definitely have him hydrate for *at least* a day before, if not two. It 'plumps' the veins and makes it much easier. Insist on the butterfly needle and make sure he's not cold (cold veins are hard to find). I don't know how you feel about it with the whole Covid thing, but they CAN have a phlebotomist come to your house to draw blood. It is a Thing, and it may make it a hell of a lot easier on your son than sitting in a waiting room surrounded by people freaking himself out. Your doctor would probably have to order it, but it is real and can be done.
See if you can bring one of those squishy stress balls where the goo stretches out of the holes when you squeeze them (last ditch effort, a tennis ball). Kid toy stores usually have them. Tell him he needs to hold it in his opposite hand and you'll give him $20 if he can pop it open before the draw is over. It will completely distract him and keep the draw arm loose. You might be out a $20, who knows? BTW, you're an awesome parent for going out of the way to do this!
Oh, and if you do choose to go to the lab, call ahead and tell the *lab manager* the situation. Depending on whether or not you have an appointment, they usually have somebody there that's good with hard sticks - infants, chemo patients with bad veins or older people. If you just walk in, you can end up waiting a long time, especially if you go on a weekend and he needs to be fasting.
posted by dancinglamb at 2:15 AM on September 29, 2020 [2 favorites]
See if you can bring one of those squishy stress balls where the goo stretches out of the holes when you squeeze them (last ditch effort, a tennis ball). Kid toy stores usually have them. Tell him he needs to hold it in his opposite hand and you'll give him $20 if he can pop it open before the draw is over. It will completely distract him and keep the draw arm loose. You might be out a $20, who knows? BTW, you're an awesome parent for going out of the way to do this!
Oh, and if you do choose to go to the lab, call ahead and tell the *lab manager* the situation. Depending on whether or not you have an appointment, they usually have somebody there that's good with hard sticks - infants, chemo patients with bad veins or older people. If you just walk in, you can end up waiting a long time, especially if you go on a weekend and he needs to be fasting.
posted by dancinglamb at 2:15 AM on September 29, 2020 [2 favorites]
I take Xanax for flying, which is my personal super-anxiety-inducing event. I take it 45 minutes before takeoff and have physically noticed the effect. It just sort of shuts off my anxious thoughts. Full stop. And lasts until I am in the air long enough that I am no longer terrified and simply bored.
Have you considered having him view this as an experiment? This might be his go-to solution for future blood draws so maybe he can analyze the process this first time. When does he notice the slow down of his heart rate? the quieting of the anxious thoughts? It gives him something to focus on that is not THE NEEDLE and gives him data for future similar situations.
posted by eleslie at 3:34 AM on September 29, 2020
Have you considered having him view this as an experiment? This might be his go-to solution for future blood draws so maybe he can analyze the process this first time. When does he notice the slow down of his heart rate? the quieting of the anxious thoughts? It gives him something to focus on that is not THE NEEDLE and gives him data for future similar situations.
posted by eleslie at 3:34 AM on September 29, 2020
This doesn’t address the Xanax question but rather how I dealt with some minor needle issues. I have never liked blood draws as it feels like something is going into my body that shouldn’t be there. I would consistently pass out and sometimes become sick afterwards from my nervous reaction, whether it was a blood draw, IV or having small dermatological procedures. As I explained this to my specialist amidst something in my twenties that required frequent blood draws and MRIs with IV infusions, she prescribed a numbing cream for me that doesn’t interfere with the blood draw. It worked for me as it distracted me from the procedure and as long as I wasn’t watching, I was none the wiser as to when it was happening. Between that and the frequency over a few years, I’m mostly over it. I still warn the medical team and don’t use the cream anymore, but have only passed out once in the last ten years.
posted by icaicaer at 5:05 AM on September 29, 2020
posted by icaicaer at 5:05 AM on September 29, 2020
Long-time as-needed Xanax user for panic disorder here. I agree with the other posters that 15 minutes might not be long enough to fully feel the effects. Xanax is one of the fastest-acting drugs in its class, but it definitely takes me longer than 15 minutes to feel it... probably closer to 30 min. Your son's metabolism may be different, of course, but in my experience I find the effects last for 2-3 hours once they kick in, so taking it just a little bit earlier than 15 min prior to the procedure should give you plenty of margin for error in case it takes longer. You won't be running the risk of it having worn off by the time the procedure is done; it lasts long enough. (I'd also encourage you to share your concerns with your son's doctor around the timing, just to get informed professional input.)
I'm guessing the doctor gave you the Rx for whatever they thought was the lowest clinical dose (I'd guess somewhere in the neighborhood of 0.25mg?), since your son has no prior experience with it, so I doubt he'll experience huge effects. Xanax at a low dose is pretty gentle — my experience with it is that my racing thoughts slow down a lot, social anxiety eases, and I'm able to view things in a more cool-headed way. I agree with Jessamyn's cocktail comparison, though for me Xanax doesn't feel as "heavy" as alcohol does.
posted by Kosh at 6:44 AM on September 29, 2020
I'm guessing the doctor gave you the Rx for whatever they thought was the lowest clinical dose (I'd guess somewhere in the neighborhood of 0.25mg?), since your son has no prior experience with it, so I doubt he'll experience huge effects. Xanax at a low dose is pretty gentle — my experience with it is that my racing thoughts slow down a lot, social anxiety eases, and I'm able to view things in a more cool-headed way. I agree with Jessamyn's cocktail comparison, though for me Xanax doesn't feel as "heavy" as alcohol does.
posted by Kosh at 6:44 AM on September 29, 2020
My wife has pretty bad needle phobia. She once attempted to bolt when surprised by an injection. She was prescribed one pill of either xanax or ativan a few years ago before some surgery. I could tell when it kicked in after about 20 minutes because she started acting *drunk*. Being a lot more chatty than usual, slurring words, not being able to follow a conversation for very long, and so on.
posted by ArgentCorvid at 6:49 AM on September 29, 2020
posted by ArgentCorvid at 6:49 AM on September 29, 2020
Benzodiazepines like Xanax work on the same receptors (GABA) as alcohol. Benzodiazepines bind to a different place on those receptors, but cause a similar effect on those receptors as alcohol. (This is somewhat oversimplified)
posted by u2604ab at 7:24 AM on September 29, 2020
posted by u2604ab at 7:24 AM on September 29, 2020
As kitten magic said above, do not watch the needle: whyy.org/segments/why-blood-and-needles-make-some-people-faint/
I've got great veins. I've given blood via donation and tests tons of times. I've had some fairly gnarly injuries that were gruesome. I hammer chunks of metal into and out of the bones of cadavers as part of my job description. None of that has ever bothered me.
But if I watch someone stick the needle in my arm, I'll pass out. If I look away, even though I can feel it, I'm fine. Life is weird.
posted by spikeleemajortomdickandharryconnickjrmints at 7:25 AM on September 29, 2020 [1 favorite]
I've got great veins. I've given blood via donation and tests tons of times. I've had some fairly gnarly injuries that were gruesome. I hammer chunks of metal into and out of the bones of cadavers as part of my job description. None of that has ever bothered me.
But if I watch someone stick the needle in my arm, I'll pass out. If I look away, even though I can feel it, I'm fine. Life is weird.
posted by spikeleemajortomdickandharryconnickjrmints at 7:25 AM on September 29, 2020 [1 favorite]
My experience with Xanax is different than those above. I tried Xanax for panic attacked. It made me loopy, but still anxious. YMMV. I agree with the poster who said give it a trial run. I find Ativan works better for me.
posted by kathrynm at 7:36 AM on September 29, 2020
posted by kathrynm at 7:36 AM on September 29, 2020
Definitely do a trial run if at all possible; among other things, 15 minutes is awfully short for a pill to kick in.
For a lot of people, benzos are a bit like taking a full dose of Benadryl without the actual sleepiness. There can be a slight sense of being stoned, though there's not a serious effect on cognition for most people. Lots of people take it for things like public speaking anxiety, and proceed to give big scary presentations/speeches - but in a non-rushed, confident manner. In most people it's good at cutting that "nope" or "I can't do this" response down to "this will be fine even if I don't like it" or "this is a lot but I'm concentrating on the important parts".
It definitely shouldn't be the only intervention you're using. Aside from the xanax, you absolutely should pre-plan to ask for whatever mitigations the phlebotomist can offer (reclining chair or bed, for example), a distraction he can control (a video on a phone with earbuds, have whatever he likes queued up in advance), practice "box breathing" in advance so he can do it during the draw.
posted by Lyn Never at 8:03 AM on September 29, 2020 [1 favorite]
For a lot of people, benzos are a bit like taking a full dose of Benadryl without the actual sleepiness. There can be a slight sense of being stoned, though there's not a serious effect on cognition for most people. Lots of people take it for things like public speaking anxiety, and proceed to give big scary presentations/speeches - but in a non-rushed, confident manner. In most people it's good at cutting that "nope" or "I can't do this" response down to "this will be fine even if I don't like it" or "this is a lot but I'm concentrating on the important parts".
It definitely shouldn't be the only intervention you're using. Aside from the xanax, you absolutely should pre-plan to ask for whatever mitigations the phlebotomist can offer (reclining chair or bed, for example), a distraction he can control (a video on a phone with earbuds, have whatever he likes queued up in advance), practice "box breathing" in advance so he can do it during the draw.
posted by Lyn Never at 8:03 AM on September 29, 2020 [1 favorite]
Is looking at the needle seriously a thing people do? I’ve had hundreds of blood draws in my lifetime, and it honestly has never occurred to me even once that looking at the needle might be a thing I might want to do. Why would you look at the needle? Who is looking at the needle?
posted by The Underpants Monster at 8:57 AM on September 29, 2020 [5 favorites]
posted by The Underpants Monster at 8:57 AM on September 29, 2020 [5 favorites]
There’s always someone! The technicians I’ve asked tell me that yes, people do look at the needle. I think because knowing how it works was a way to gain control of the situation, perhaps? Back when I was on dialysis, some patients would watch or EVEN STICK THEMSELVES with those big ol’ 15 gauge needles, two every session. I never could!
Was thinking more about this question this morning. Another possible painkilling option besides the emla/lidocaine is what the dialysis folks called Freeze Spray. It numbs the site and when I used it, it really made a difference and most of the time I felt no pain at all, even with massive needles. It may be available — I’d call in advance to ask.
posted by mochapickle at 9:25 AM on September 29, 2020 [1 favorite]
Was thinking more about this question this morning. Another possible painkilling option besides the emla/lidocaine is what the dialysis folks called Freeze Spray. It numbs the site and when I used it, it really made a difference and most of the time I felt no pain at all, even with massive needles. It may be available — I’d call in advance to ask.
posted by mochapickle at 9:25 AM on September 29, 2020 [1 favorite]
1. have him lie down for the draw to avoid any danger of fainting/falling etc. there's an exam table in the room to lie on. obviously don't look at the needle. hydrating is a good idea.
2. does he run? could he? a run in the morning (before the stressful thing) tends to helps with anxiety all day.
3. xanax brings down the central nervous system. How it feels depends on a combination of how much you take and how keyed up you were going to be without it. Like if I'm going into something really heart-pounding, and I take a pill, I'll still feel objectively stressed/angry/scared whatever, but I'll be able to handle whatever it is: I won't cry; my voice won't break; my fight/flight reaction will be dulled enough to let me get through it, although I'll be aware that it sucks. But if I wasn't that keyed up to begin with, the same pill might make me dopey and sleepy-calm.
Think of it as, like, the pill takes you down by x amt. If you were keyed up by more than x, you'll be taking the edge off, but still be "with it." If you were keyed up by less than x, you might find yourself sleepy/stoned. Either way it's an improvement over going without.
Agree with doing a trial run beforehand -- get two pills.
posted by fingersandtoes at 10:10 AM on September 29, 2020
2. does he run? could he? a run in the morning (before the stressful thing) tends to helps with anxiety all day.
3. xanax brings down the central nervous system. How it feels depends on a combination of how much you take and how keyed up you were going to be without it. Like if I'm going into something really heart-pounding, and I take a pill, I'll still feel objectively stressed/angry/scared whatever, but I'll be able to handle whatever it is: I won't cry; my voice won't break; my fight/flight reaction will be dulled enough to let me get through it, although I'll be aware that it sucks. But if I wasn't that keyed up to begin with, the same pill might make me dopey and sleepy-calm.
Think of it as, like, the pill takes you down by x amt. If you were keyed up by more than x, you'll be taking the edge off, but still be "with it." If you were keyed up by less than x, you might find yourself sleepy/stoned. Either way it's an improvement over going without.
Agree with doing a trial run beforehand -- get two pills.
posted by fingersandtoes at 10:10 AM on September 29, 2020
The Underpants Monster, my spouse, el_lupino, always watches. He has asked more than once if he can do it himself. Thus far he has not been permitted to. Between us we average out to a normal person.
One thing I forgot about my tactics in my comment above: I have them put the tourniquet on *over* my sleeve rather than on the bare skin. They seem to think that works sufficiently and it spares me the pinches of the rubber material that can make me flinch and jump because of hyperawareness. Also, I know when they release the tourniquet that they're almost done, and use that happening to reassure myself.
Some MeFites have noted it's comforting for them to have the tech talk to them. For me, I prefer they not talk to me other than "okay, I'm going ahead" and "almost done." I don't want them to make conversation, because trying to pay attention to what they're saying keeps me mentally present in a place I'm trying my utmost to stay far away from. However, if there are three or four tubes, sometimes I ask them to please count them off as they're completed or have el_lupino do so, so I can calibrate how long I need to continue to hold it together and how much panic-quashing is necessary right that second. I hate to ask if we're almost done and find out we're halfway through tube two of four.
posted by jocelmeow at 12:01 PM on September 29, 2020 [1 favorite]
One thing I forgot about my tactics in my comment above: I have them put the tourniquet on *over* my sleeve rather than on the bare skin. They seem to think that works sufficiently and it spares me the pinches of the rubber material that can make me flinch and jump because of hyperawareness. Also, I know when they release the tourniquet that they're almost done, and use that happening to reassure myself.
Some MeFites have noted it's comforting for them to have the tech talk to them. For me, I prefer they not talk to me other than "okay, I'm going ahead" and "almost done." I don't want them to make conversation, because trying to pay attention to what they're saying keeps me mentally present in a place I'm trying my utmost to stay far away from. However, if there are three or four tubes, sometimes I ask them to please count them off as they're completed or have el_lupino do so, so I can calibrate how long I need to continue to hold it together and how much panic-quashing is necessary right that second. I hate to ask if we're almost done and find out we're halfway through tube two of four.
posted by jocelmeow at 12:01 PM on September 29, 2020 [1 favorite]
I find that I have a particular arm that's easier for me to deal with getting a blood draw from, but I think some of my issues are due to a childhood incident I've blocked from my memory where a needle hit my bone (that's probably the wrong term, but it's what I've been told). Might be a PTSD thing in my case rather than a phobia, dunno. I assume my preferred arm is the one that was not involved in that experience, and I tend to feel very protective about it even as my other arm is getting augh augh just augh I'm not going to type that out.
As you can see, it's not exactly easy for me to think about getting it done on the other arm either. But it's not AS bad. These days I usually go to one of the locations of the major lab test provider near me. Best to go when they are less busy if you have the choice, mornings are very busy as some tests must be done in the morning. The area is usually set up where it seems as though the phlebotomist would prefer to use a specific arm -- of course it's usually the arm I would rather they don't use -- but everyone has always been very accommodating when I ask them to use the other arm.
I like to get the phlebotomist to talk to ME when they do it if I can, that only really worked well when I used to go to a smaller clinic and always had the same person doing the draw, she liked to talk about her grandson. If I am going to talk to distract myself, I'd far rather get talking while they are still getting set up and just keep going -- in the beforetimes, I used to tour visitors around a thing, so I try to talk about that because I don't have to stop and think about it. Be sure to tell the tech you are going to talk out loud to yourself to distract yourself and let them know they can just ignore you.
I've sometimes had places want to put me in a lying down position when I tell them I am nervous about getting blood draws. Oh no no no. I guess it works for some people but if I have to have blood drawn I'd rather be sitting up where it feels like I have more agency in the process, not lying down helplessly while someone above me does... things to my reclined body. There's just an implied power differential about having to lie there helplessly knowing someone is going to stab you that inherently causes a lot of anxiety and even panic, a factor that's not present when both people are sitting in chairs. Plus it's also more prep time to have you lay down somewhere, and I just want to get it over with. I don't have an issue with passing out though, I hear that some people do. They REALLY want you to lie down if they think you are going to pass out so I've sometimes had to explain that I've never passed out, I'm just nervous.
Personally as a teenager I would have hated having a parent present for the blood draw, you might ask in advance what he would prefer, and also let him know that it's fine for that preference to change later, even to the point of asking you to leave the room after you are already there.
posted by yohko at 5:13 PM on September 29, 2020
As you can see, it's not exactly easy for me to think about getting it done on the other arm either. But it's not AS bad. These days I usually go to one of the locations of the major lab test provider near me. Best to go when they are less busy if you have the choice, mornings are very busy as some tests must be done in the morning. The area is usually set up where it seems as though the phlebotomist would prefer to use a specific arm -- of course it's usually the arm I would rather they don't use -- but everyone has always been very accommodating when I ask them to use the other arm.
I like to get the phlebotomist to talk to ME when they do it if I can, that only really worked well when I used to go to a smaller clinic and always had the same person doing the draw, she liked to talk about her grandson. If I am going to talk to distract myself, I'd far rather get talking while they are still getting set up and just keep going -- in the beforetimes, I used to tour visitors around a thing, so I try to talk about that because I don't have to stop and think about it. Be sure to tell the tech you are going to talk out loud to yourself to distract yourself and let them know they can just ignore you.
I've sometimes had places want to put me in a lying down position when I tell them I am nervous about getting blood draws. Oh no no no. I guess it works for some people but if I have to have blood drawn I'd rather be sitting up where it feels like I have more agency in the process, not lying down helplessly while someone above me does... things to my reclined body. There's just an implied power differential about having to lie there helplessly knowing someone is going to stab you that inherently causes a lot of anxiety and even panic, a factor that's not present when both people are sitting in chairs. Plus it's also more prep time to have you lay down somewhere, and I just want to get it over with. I don't have an issue with passing out though, I hear that some people do. They REALLY want you to lie down if they think you are going to pass out so I've sometimes had to explain that I've never passed out, I'm just nervous.
Personally as a teenager I would have hated having a parent present for the blood draw, you might ask in advance what he would prefer, and also let him know that it's fine for that preference to change later, even to the point of asking you to leave the room after you are already there.
posted by yohko at 5:13 PM on September 29, 2020
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posted by jessamyn at 6:16 PM on September 28, 2020 [3 favorites]