Greatest medical inventions of all time? Needles would rank right up there. They deliver everything from vital vaccinations and blood transfusions to strong antibiotics and chemotherapy. They help numb us before dental drilling and put us into a painless surgical sleep. They save lives in a thousand ways...and yet, it's tough to be grateful when you're about to get poked.
Most of us experience a moment of dread when faced with an injection or blood draw, but we manage to keep our composure. Research suggests that more than 11 million people, however, have an outsize fear of needles—that's more than are scared of flying—and some of them admit they've avoided medical treatment as a result. The anxiety runs in families: Many needlephobes have a first-degree relative who feels the same way.
An excessive fear of an object or situation is considered a phobia, and needle phobias can wreak havoc. Balk at a procedure requiring a needle stick and your doctor may miss a serious disease diagnosis or fail to treat a medical condition. Avoiders have even lost jobs and insurance coverage or been barred from school for putting off shots.
Wherever you are on the spectrum, from a tiny bit squeamish to so afraid you faint, you can learn to cope better with preparation and a few strategies. "People everywhere worry when they feel they have no control," says David Ropeik, author of How Risky Is It, Really? Why Our Fears Don't Always Match the Facts. In the face of a needle, you have more control than you think. Worried about pain? There's more
than one way to tame it. Feel like the needle-wielding technician has all the power? You can ask for special care. "The very act of figuring out how to make it less onerous can reduce your fear," says Ropeik. Between setting up that appointment and walking out with a Band-Aid on your arm, these ideas will take you from "Help! Get me outta here!" to "OK, I got this."
Whether you're facing a simple injection or a tougher needle experience, like a blood draw, we've got you covered.
1. Set Your Own Schedule
You'll have more fear-calming control if you decide on the date and time you'll get an injection or test (when possible). Rather than take "first available," agree to a time when you're likely to be less rushed, more relaxed. Or plan way in advance, say, for your fu shot, writing it down in your calendar months ahead. "Spring the idea of a tetanus shot on me out of nowhere, and I'll panic. But I've been fine with elective procedures involving needles because I had time to mentally prepare," says Rebecca Lehmann, 39, of Chicago. "Doing it on my time line gave me a sense of being master of my own destiny."
2. Strategize with Your Doctor
If you have major willies, she can help make a needle experience easier with a few different prescriptions. For pain, a cream or patch containing lidocaine can numb the stick site. (Just be aware that patches take roughly 30 minutes to work, and creams require about an hour, so start early.) For anxiety, your doc can prescribe a single dose of a drug like Xanax, Valium, or Ativan. This can reduce the activity of overexcited nerves in the brain, leaving you calmer about the process.
3. Make Your Veins Easier to Find
Being well hydrated makes your veins plumper and more accessible—and helps a test go faster because "the blood will flow more quickly," says Kara Lusk Dudley, a spokesperson for the American Red Cross Biomedical Services. Drink plenty of fluids starting as early as 48 hours before your scheduled blood draw, and keep drinking water right up to your appointment, unless your medical team has told you to stop eating or drinking by a certain time.
4. Keep Your Arm Warm
If people are very cold, their veins will constrict," says Helen Maxwell, president of the American Society of Phlebotomy Technicians. This makes them harder to access with a needle. Wrap your elbow in a scarf or sweater, or ask the clinic for a heat pack (most facilities will have them). "I bring one of those little hand warmers and put it in the crook of my arm," says Jeannie Evanchan, 36, of New York City.
5. Say You're Scared
"The tech should ask if you've ever had any problems having your blood drawn," says Maxwell. But if no one asks, you absolutely need to tell them, especially if you get light-headed or feel faint. It doesn't mean you're a wimp. "My dad is a super-tough Vietnam vet, and he's passed out getting shots too," says Evanchan. The clinic might have you lie down for the procedure, which makes fainting less likely and less dangerous.
Being clear about your fears also helps technicians turn on the TLC with sympathetic eye contact or a comforting pat. Even that touch can help a patient's veins relax and open up, says Maxwell.
"Once they tell me their concerns, I say, 'It's OK. I'm going to help you through this,'" says Renee Thompson, D.N.P., R.N., a nurse in Pittsburgh. "Then I reassure them. I tell them, 'I'm very good at this and have done it thousands of times. You're going to be just fine.'"
6. Ask about a "Buzzy" or a "DentalVibe"
Buzzy is the cute name of a palm-size electronic device. Studies have found that placing this little plastic gadget right next to the site significantly lowers the pain of a shot or stick. It confuses your nerve cells by cooling and vibrating the skin so they don't transmit the hurt to your brain. The device is used in more than 5,000 hospitals and clinics, but if yours doesn't have one, you can buy it yourself and bring it with you. ($40, buzzy4shots.com)
If it's the dentist's numbing shot you're fearing, a tool called a DentalVibe performs a similar trick: vibrating your gums as the needle goes in. Your dentist can do this the old-fashioned way if she doesn't have the tool. "My dentist holds my cheek and shakes it before giving me the anesthetic," says Susan Bender Phelps, 62, of Beaverton, OR.
7. Know Your Needles
A common piece of advice to the nervous is to ask for a wing-tip needle (a.k.a. a butterfly needle). These thinner, shorter tools do well in small veins, and the "wings" help the phlebotomist control them. They're usually used in adults' hands or in kids. The downside: They don't always reach the veins in adults' arms. Since they're more expensive, your lab may not have them or may be reluctant to use them for a standard draw. Give one a try if it's available, but know what to expect.
8. Look or Don't Look: It's Your Choice
Glance away from the needle, recommends the National Heart, Lung, and Blood Institute. Your brain reacts similarly to seeing a pinprick as it does to feeling one, and by averting your eyes, you can avoid the double scare. Yet some anxious people say the opposite works. "I read that it hurts less if you watch the needle going in," says Welmoed Sisson, 55, of Boyds, MD. "I was skeptical, but it's true for me, because there isn't that anticipatory dread of When will it stick me? Plus, if I don't watch, it feels like they're using a horse needle; the mind can really distort things. When I look, I see that it's tiny—and it also shows me that the technician is paying attention to doing a good job." Do whichever works for you.
9. Use Body Distraction
"To get your mind of the needle, you could concentrate on taking some sort of action," says Bernard Vittone, M.D., director of the National Center for the Treatment of Phobias, Anxiety and Depression in Washington, D.C. Physical distractions can help—he recommends pressing hard with your thumb on the leg opposite where the needle is.
If you're prone to fainting, fend it of by contracting your muscles—except in the arm being used—for about 10 seconds and then relaxing them for about 20 seconds. Start a few minutes before your stick and keep repeating the process until the procedure is over. Doctors call this "applied muscle tension," and it raises your blood pressure, which makes you less likely to pass out. It even works to just squeeze and release your calf muscles while you're sitting down, says Vittone. They're powerful muscles for pumping blood to the brain, which keeps you from fainting.
Another unconventional way to get your mind of things: "There was a time when I had to endure very painful shots in the bum," says Jennifer Bourgoyne, 49, of Austin, Texas. "One day, before the nurse stuck the needle in, she said, 'May I slap you?' I was taken aback. What? She said, 'Trust me, if I do, you won't feel it.' I told her to go for it, and as weird as it was, I was so shocked that she slapped my backside, I honestly didn't feel the needle. I can't say you should try it, but it worked for me!"
10. Get Chatty, or Sing!
Experts have long suggested making small talk with the nurse or phlebotomist. "I recently had a technician who found out I love movies and was amazing at distracting me with loads of questions about them. That helped so much," says Dawn Serra, 36, of Fredericksburg, VA. Conversation also prevents you from holding your breath, which can make you feel woozy.
"I take the process differently if the patient is afraid of needles," says Julie Seiler, R.N., a nurse educator at the Johns Hopkins Hospital. "I'll try to take their mind to a different place. I'll ask them about their family or what they did over the summer. I want them to think outside their medical situation."
If you're not the gabby type, try counting backward from 100—people who did that in one study reported less pain. Another idea: "I know it sounds kooky, but as soon as the needle comes near, I close my eyes and sing 'The Star-Spangled Banner' in my head," says Bourgoyne. "Focusing on the lyrics and pitches takes my focus away long enough for the sting to be over."
11. Nothing Working? Consider Therapy
In extreme cases, people who've tried everything else can have success with a course of exposure therapy. You'll work with a therapist, looking at pictures, videos, and eventually real needles, and learn to change your emotional response to them, says Jason Prenoveau, Ph.D., an assistant professor of psychology at Loyola University Maryland. The process can often take multiple visits. Find a therapist through the Association for Behavioral and Cognitive Therapies (abct.org). And think positive; it's a big investment of energy, but it could bring you a huge amount of relief.
The Anatomy Of Needle Fear
Most people start with a fear response—your body revs up to fight or flee what scares you. For some, the body turns on these actions, too:
- First, your blood vessels open. You release a chemical, acetylcholine, that makes your blood pressure drop and your circulation slow. This may have helped in caveman days: If cut by a sharp object or punctured by a claw, you'd want lower blood pressure so you'd lose less blood and it would clot more quickly.
- Next, your stomach churns. The acetylcholine causes you to release more digestive juices. Then the muscles in your intestinal tract clench and release, so you feel queasy and crampy.
- Then, you might feel woozy. The lack of blood flow to the brain makes you light-headed.
- Last, you could wind up flat on the floor. Fainting is your body's way of getting blood back into your brain—it has to work hard to do that if you're standing or sitting. If you're flat, the job is much easier. Gradually, your system normalizes and you're up on your feet again.
When to Say "Enough!"
Some people's veins are harder to hit than others. "Really thin people may have very small veins that can make for difficult draws," says Helen Maxwell of the American Society of Phlebotomy Technicians. "Heavier-set people will sometimes have deeper ones that are harder to reach. And as you get older, you lose muscle, and then veins can roll away from the technician."
Even if you're a tough case, you don't have to feel helpless. Here's how to keep control:
- Don't let the technician stick you more than twice, says Maxwell. "After that, the confidence of the phlebotomist is gone and so is the confidence of the patient. And when that goes, the patient's veins are going to constrict."
- Speak up. After a second miss, ask if you can take a break or see if another technician could give it a try. Something like "Can someone else start fresh here?" should get your point across without offending anyone.
This story originally appeared in the May 2015 issue of Dr. Oz The Good Life.