Fight the ! Fear of needles Can be conquered. By Gary Scheiner MS, CDE

Needles, and syringes and lancets, oh my! For diabetes, your health and well-being depend on many people with diabetes, the fear, anxiety and your ability to deal with sharp objects. Try aversion to sharp objects that prick the skin can some of the suggestions below: set the heart racing and shoot blood sugars through the roof. Treatment for diabetes is  Accept that fear of needles is normal and hampered when you reject your doctor’s commonplace. You are certainly not alone. suggestions to complete diagnostic blood tests, One in 10 of people share your fear of when you avoid the use of lancets to perform needles. They may not talk about it, but blood glucose monitoring, or when you refuse they are out there. Realize that your needle treatment that involves the use of syringes. phobia is most likely an inherited condition, Clearly, needle phobia is not to be taken lightly. and that your reaction to needles is involuntary. It’s not ‘all in your head.’ Trypanophobia is name for the extreme fear of medical procedures involving injections or  Practice some sensible techniques to lessen needles. For some, the fear is so extreme that symptoms and pain: the very sight of a needle can cause fainting or vomiting. For most, the anxiety is not nearly so 1. Use topical at the needle site extreme. In fact, a certain amount of needle (ice, ethyl chloride spray, or topical anxiety can be healthy, and probably has a anesthetic creams). Only the surface of hereditary component. From the stone ages the skin will be numb but the initial through the middle ages, without antibiotics or shock of the puncture may be decreased. proper first aid, survival depended on avoidance of wounds from thorns, splinters, teeth, claws, 2. For additional pain relief, explore the use and man-made weapons such as axes, spears of iontrophoresis, a process that drives and swords. Not surprisingly, men are more anesthetic through the skin by using an prone to needle phobia than women, and about electrical current. 10% of all Americans suffer from some form of this disorder. 3. Avoid the sight of the needle puncturing the skin. Place cloth between needle A nervous system reflex is responsible for some point and skin when injecting of the symptoms associated with needle phobia. medications; use pens, syringes, and You may feel clammy or cold, turn pale, feel lancing devices that have covered caps. nauseaus, or have difficulty breathing when in Try devices such as the Autoject (Owen the presence of a . You may Mumford), Inject-Ease (BD), Instaject feel sweaty or tingly, and your (Medicool), and NovoPen Penmate may drop. To make matters worse, the skin (Novo Nordisk). surface may become hypersensitive, making injections seem ever more uncomfortable. 4. If you take rapid-acting insulin at mealtimes, speak to your doctor about So, what’s a needle phobic to do? First and using an inhalable insulin or a jet injector foremost, don’t just give up. As a person with for spraying the insulin through the skin

BD Diabetes (BD.com) Diabetes Learning Center: first posted March, 2007 © Copyright 2007, Gary Scheiner MS, CDE – Integrated Diabetes Services LLC Page 1

(albeit with some discomfort). You may  Avoid unnecessary needle procedures still need to take one or two daily that may condition you to excessive fear injections of long-acting insulin, but you and anxiety. Reserve needle procedures may feel more comfortable knowing that for health care treatments or diagnoses a needle is not necessary at every meal. that really matter.

5. Reduce pain when injecting insulin by  During a needle procedure, elevate your pinching the skin (avoid inserting the legs and feet while lying down or needle into muscle) and using fine guage reclining to avoid lightheadedness or and short needles. Penetrate the skin fainting. quickly with minimal hesitation.  Participate in densensitization therapy by 6. Minimize the pain of lancing the finger a qualified health care practictioner. tips by using fine guage lancets, using the You may be able to “unlearn” the sides of the fingertips, or switching to nervous system response and extinguish alternate site testing. irrational fears by using a combination of relaxation techniques and pain For those with extreme fear of needles (fainting, relievers. vomiting, etc.), more intensive treatment and action may be necessary. For instance:  Try behavioral therapy. This treatment is most effective when provided by a  Learn all that you can about needle trained therapist who has experience in phobia. Talk to your doctor or diabetes diabetes. educator. Go to websites such as the Needle Phobia Information Site  Watch others inject themselves or lance (www.needlephobia.info ) and The their finger for blood glucose testing Needle Phobia Page whenever possible. Seeing others face (http://www.webcom.com/cfsc/needles.h needles effortlessly may help lessen the tml) Read all you can about this fear and anxiety when your turn comes. disorder.

References:

http://www.findarticles.com/p/articles/mi_m0689/is_n2_v41/ai_17276569 (landmark review article by Dr. James G. Hamilton on needle phobia)

http://en.wikipedia.org/wiki/Trypanophobia (classic definition of needle phobia)

http://www.diabetesselfmanagement.com/article.cfm?aid=1702 (great article on children with Type 1 diabetes and needle phobia)

BD Diabetes (BD.com) Diabetes Learning Center: first posted March, 2007 © Copyright 2007, Gary Scheiner MS, CDE – Integrated Diabetes Services LLC Page 2