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Fear of Needles - I Want to Donate But ... (S2 E1)

Do you have trypanophobia? It’s the fear of needles and it’s way more common than you think. In fact, it plays a huge role in whether you donate blood or not. In this premiere edition of the Second Season of “Bloodworks 101,” John Yeager talks to those who suffer from a fear of needles, a phlobotomist who tries to calm down those anxious blood donors, who are afraid of the needle and finally with a clinical psychologist who helps patients face their fears head-on.

Listen below or read on for a full transcript.

Rachel: I turn my head and saw the needle with the vial of my blood sticking out of my arm. And for some reason, that really traumatized me.

Bill: It’s unnatural. I mean, why would you authorize something to just break the skin on your body, which causes blood to leak out?

John: Here’s a question for you. Are you afraid of needles? Join the club. Hi. I’m John Yeager, and welcome to season two of “Bloodworks 101,” a monthly podcast devoted to educating or inspiring you to donate either time, money or blood. Now, I won’t ask you what you did for the summer. You probably stayed close to home if you’re lucky enough to hold on to your job. It’s been a summer most of us would just as soon forget. Did you donate blood this summer? If so, thanks. If not, it might just be because you’re afraid of needles.

According to a recent Harris Poll that we commissioned, fear of needles is the number one reason why we don’t donate blood. As we planned our second season, we couldn’t think of a better way to get out of the blocks than to confront that fear of needles.

Okay. Come on. It’s just not that bad. But maybe for some people, it is.

Rachel: For me, it has a lot to do with the needle going into your vein.

John: Rachel Sparks used to work with us here at Bloodworks. She was deathly afraid of needles.

Rachel: With getting your blood drawn, getting the needle in the vein, there’s a lot of stress that goes around with that. If the phlebotomist doesn’t get it in the right spot, then there’s a lot of bruising, then there could be pain. The actual needle insertion itself is so quick and easy, and not painful at all. But there’s just something about the what could happen. And I think that that really messes with people a lot.

Bill: I mean, why would you authorize something to just break the skin on your body?

John: My colleague Bill Harper is the co-producer here on Bloodworks 101. And truth be told, Bill still has a thing about needles.

You’d think you’d be used to them. Bill, as you may remember from an episode in season one we called “When All That’s Left is Hope,” contracted leukemia a little more than 10 years ago. His recovery story is nothing short of inspirational, but during that fight back, he endured more transfusions than you can imagine.

You’ve had how many transfusions?

Bill: Two hundred sixty-seven, John.

John: You heard right, 267. And more surgeries that you can count. So, needles, he has been poked by plenty. And yet, Bill Harper still has a fear of needles, what the experts call trypanophobia.

Bill: When I am getting a needle stuck in, even though I’ve had probably thousands of needle sticks, is just…I feel myself tensing up.

John: Has it been busy in here today?

Man: Oh, yeah.

John: A little while ago, I went into our central donation center on Seattle’s First Hill to donate.

Brandon: Just going to mark the vein. I got a Q-tip here. No needles yet. Squeeze it whole making a fist.

John: To authorize Brandon Connor, then a phlebotomist at our central location to break the skin of my body with a needle and find a vein.

What’s the secret to doing it right?

Brandon: You’re doing it right if the folks… I find typically just applying some pressure, what we call anchoring, on the arm. We’ll press our thumb onto the donor’s arm a little bit. That just makes the skin nice and taut, pulls it up, makes the vein more visible. And we could see where the pressure is. And the increased tension makes it easier for the skin to give to the needle.

And hold still. All right. Three squeezes, and then squeeze and hold for me.

John: I always tense up just before the needle goes in. Just can’t help it.

Brandon: If you don’t like needles, now is the time to look away.

John: It’s our practice here at Bloodworks to say that.

Brandon: Deep breath in. Slow exhale.

John: You’ll be happy to know that phlebotomists here go through a lot of training before they take your blood.

Brandon: Relax your hand. I’ll let you know when to start squeezing again.

Bloodworks has a…really have great training program where they actually pay for your licensing and take you through a two-month training course to teach you how to poke, how to do everything from A to Z.

John: Oh, and Brandon Connor tells me that there 126 numbered steps that a phlebotomist goes through during the donation process for each donor at Bloodworks.

Brandon: It’s mapped out from when we put what stickers on what bags, what we write on what bag, when we put what’s called a hemostat to clamp up the line. Even to the instructions that we give you on when to squeeze your hand is all written out in an SOP. I was more sweating about keeping all those in order than the actual poking of the needle. They always say like, when I ask which arm they prefer and they say neither. But it’s just what we got to do.

John: What was it like the first time you did it?

Brandon: The first time I did it, I wasn’t too nervous. I was pretty confident with going in there. The biggest concern is going through the back of the vein. But I knew about how much force it would take and just take it easy.

John: So, when you go to parties, you’re talking to friends, they say, “What do you do?” You say you’re a phlebotomist. And they may know what that is.

Brandon: Yeah.

John: How do you describe what you do, and what do they say?

Brandon: If they don’t know what a phlebotomist is, I just tell them I’m a vampire. They instantly make the connection with the blood. And so, yeah, I just tell them I’m doing this and working towards a future goal in the medical field, and that this is a great stepping stone with opportunities and advancement and lots of departments. You get to interact with lots of people and other hospitals. Good experience here.

John: What’s the worst case you can remember of somebody with a fear of needles?

Brandon: With a fear of needles…

John: Give me the worst one.

Brandon: Yeah. The worst one, I… It’s probably when people have a fear and their arms jerk back [inaudible 00:06:09]. I joke and say it’s like riding a bull but with an…you’re trying to keep the needle in the vein there. It doesn’t happen too often. Typical flinch. There are some donors that have had pretty big flinches. So, that usually…like, the biggest thing we’re trying to avoid is the needle coming out.

John: How do you reduce somebody’s fear, Brandon? How do you get them to feel at ease? They’re doing this important life-saving work.

Brandon: Yeah. I think the most important thing I do is I ask whether or not they have any… I just leave it broad. Like, any problems donating, if they have a fear of needles, they’ll bring it up and we’ll talk about it then. There’s also when we do the hemoglobin test for how many red blood cells you have, that’s a finger poke. That’s when usually people bring it out. And then quite honestly, I’d say that’s the worst part of the donation. That hurts more than the actual drawing of the blood. So, once I tell them that, that gives them some ease.

And then I have them look away if they don’t like needles, of course. I ask them if there’s anything that, like, would make them more comfortable with the needle. Like, we offer to cover the entire arm so they don’t see anything at all. And then I kind of adopted a technique just from watching doctors give shots and cortisone shots that are much more painful than a blood draw. They seem to all use a breathing technique where it’s just a deep inhale, a deep exhale. I think it just takes the mind off of what’s actually going on. You’re focusing on your breathing. And it’s not an exact cue of the needle’s coming, but it prepares them for it. It’s usually where I have the most success of just sliding it in.

John: Now, I don’t know about you, but these details make me squirm a little. I look away. It never hurts, but I just don’t like the thought of a needle, in Brandon’s words, just sliding in. Sure, I work here and I’m a regular blood donor and I really should tell you there’s nothing to worry about and that it really doesn’t hurt, and it really doesn’t, but I still have that fear of needles.

Dr. Michele Bedard-Gilligan is a clinical psychiatrist and assistant professor at the Department of Psychiatry and Behavioral Sciences at the University of Washington.

Trypanophobia, the fear of needles, is it real?

Dr. Bedard-Gilligan: It certainly is, yeah. So, I should say, in addition to research, I also do a lot of clinical work. And fear of needles is something I see in clinic on a fairly regular basis, I would say. So, it falls into the category of specific phobia. So, specific phobias are anxiety disorders that are diagnosed according to the DSM-5, which is the Diagnostic and Statistical Manual for mental health disorders. And so, it falls in the anxiety disorder category. And under specific phobia, there’s a number of different types of phobias that somebody could have. And basically, by phobia, we mean fear that’s problematic, that gets in the way, that’s impairing in some way. You know, fear of flying is a phobia. Fear of spiders is a phobia. And, certainly, fear of needles is also considered a diagnosable phobia.

John: All right, doctor, tell me how bad it can get.

Dr. Bedard-Gilligan: So, you know, how bad it gets kind of depends on the circumstances for the person. So, it is possible to live life with a fear of needles and not have a problem with that. Right? Maybe you don’t get the piercing you want. Maybe you don’t get the tattoo you want. Maybe you don’t give blood even though you really like to. But for other people, it can get really bad. So, generally, when I see someone and they’re looking for treatment for fear of needles, it’s because it’s causing some kind of problem. Usually, what that means is they have some kind of health condition where they need to get needles. They need to get IVs, they need to get regular blood draws and they can’t. And that’s getting in the way of them getting the care they need, and that’s a real problem.

John: Yeah. It gets in the way of life.

Dr. Bedard-Gilligan: Absolutely. Yeah. And sometimes, you know, it can get in the way of living a healthy life in that if you’re not able to get the medical procedures you need, you may not be managing your illness the way you need to.

John: You mean somebody could get to the point where giving blood would be a matter of life and death, and they couldn’t do it?

Dr. Bedard-Gilligan: Exactly. Yeah. So, someone who needs blood draws to check levels of things so that their medications can be adjusted or their procedures can be known…you know, we can know what procedures they need, that kind of thing. If they can’t get those blood draws, then that’s a real problem. It could be dangerous for them.

John: What’s the best treatment? Well, you may not believe this, but Michele says, don’t look away.

Dr. Bedard-Gilligan: So, what I say is that we have treatments. I mean, what I say is that we can fix this for you, that we have treatments for specific phobias, needle included, where we have success rates of 95%, if not higher. And they’re behavioral treatments. So, they’re therapies, they’re short-term therapies that really focus on changing thought and behavior patterns in order to help people face their fears. So, generally, we call these exposure therapies. And if people are willing to do them and are able to complete them, most people will see a significant reduction in fear, if not a complete remission of fear around whatever the phobia stimulus is.

So, you know, you might start out with looking at pictures of needles. You might start out with watching videos of blood draws. You might start out…you know, you might progress to accompanying somebody to getting a blood draw. You might do, you know, injections and small needles and shots and piercings, and then you might start with kind of actual blood draws themselves or move up to that, I should say. And so, usually, what it is, is this, like, gradual progression of kind of approaching the thing that elicits the fear so that the person can learn not to be afraid, basically, and learn that the bad thing most of the time doesn’t happen, that the distress doesn’t last forever, that they can tolerate it. And then kind of, with that process, generally, what happens is the fear goes down.

Well, you only think about phobias…I mean, there is definitely no doubt that some phobias are more likely to develop than others. We have kind of theories of preparedness, we call them, and basically this idea that certain things we are, as humans, more conditioned to be afraid of them than others. So, like, heights falls into that category and so does needles. Right? I mean, this idea that probably at one point, it was very evolutionarily good to be afraid of being stuck with things. It’s just, like, it’s evolutionarily good to be afraid of being on high places, to be afraid of certain types of spiders. Like, these are things that actually can keep us safe as humans. The problem is, when we don’t kind of catch up to the context in which those things are not dangerous. And so, certainly, that instinct to look away, to not want to look, is human. Right? I mean, we are programmed to not want to see those things, to feel threatened by something puncturing our skin, basically, right?

But the reality is, in situations where you are donating blood or in a hospital clinic giving blood, or even in a tattoo parlor, it’s not dangerous. And so, being able to actually do that process, yeah, of learning that again. Very few people look forward to the process of needles. Right? Because we’re just not built that way. I mean, it’s something that sort of is programmed to cause some kind of disgust or fear reaction. It’s kind of a natural tendency. And most of us, as long as we can withstand it, whether or not we look at it or don’t look at it, it doesn’t really matter. Right? Unless we’re a phlebotomist, we don’t really need to look at it. But sometimes, those kinds of behaviors can progress.

So, every time you don’t look at it, you are also sending yourself kind of a signal that maybe it’s dangerous, maybe there’s a reason to look away. And you know what that can build. And so, in some people, those kinds of behaviors can actually lead to problems down the road. And so, we often encourage people to face it, to really embrace it, and to kind of not be afraid of it, to sort of face up to it.

John: Okay. All right.

Dr. Bedard-Gilligan: And at the same time, it’s a very natural process.

John: I will look next time.

Dr. Bedard-Gilligan: You might find that the more you look, the less you have the urge not to. Right?

John: But you know what? I’m such a wimp. When I made my next donation, I looked away. I always do. Maybe one day I won’t. Maybe one day I’ll be able to take Michele’s advice and look my fear of needles right in the eye.

John: My thanks to Rachel Sparks and Bill Harper for their candid responses, to Dr. Bedard-Gilligan at the UW and Dr. Edie [SP] Phillips who advised me on this story by putting in touch with the right people. Thanks, Edie. And finally, to Brandon Connor who is now a COVID-19 research coordinator working on the Convalescent Plasma Project. He’s also pursuing his MBA from Seattle University.

One last thing: while we may have that fear of needles in common, I think it sometimes means more to me when I hear about a donor who overcomes that fear of needles to help somebody else and make a donation anyway. Every donation can have an impact on three lives. That’s a life-saving difference that you can make all because you made an appointment, answered some questions, squeezed a little rubber ball three times, took a deep breath, faced your fear, and did not look away. I’m John Yeager for “Bloodworks 101.” See you next time

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October 15, 2020 9:40AM

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