Hello, I am a neurotypical GP. I have changed some of the details below to protect a patient's identity.
I saw a 21 year old today with autism. We had a long chat together with her mum about her fear of needles. She had a life threatening condition a while back which required her to have some blood tests and a cannula put into her arm.
She found that she was unable not to look at the vein etc. when they were going to try to take blood and could not stand the thought of anyone taking her blood.
She does not currently need any blood tests, but her mum is worried what might happen if she ever does need one in the future.
On the previous occasion when she did need the blood tests / a cannula, she had to be sectioned in order for this to be done.
She does not wish to try a local anaesthetic or counselling.
I have said I would be happy to work with her, for as long as it takes, to help her overcome her fear of needles. I have said she would never have to do anything she does not want to do, and that she can decide what we do when we have an appointment. I thought maybe I could gradually introduce the equipment at the first appointment and take it slowly from there.
Does anyone have any suggestions about how best to approach this?
I also have a needle phobia.
With time it gets easier as I realised it doesn't hurt.
The only way I can cope is not to see the needles or the blood in the tube.
Hello port moon,
I could be very wrong but it may not be anything to do with needles?
A while ago I had to give blood for various tests that were needed, it was my first time giving blood,
I have had many needles over my lifetime, mostly tetanus and local anaesthetic, , I am not brilliant with knowing a needle is being pushed into my body, I am not Squamish about blood, used to catch rabbits when a teenager to prepare and eat,
Before I gave the blood whilst sat waiting i kept thinking how wrong it was to take a part of me away, It was a strange thought which I couldn’t really reason with,
I was ok with the needle, the nurse took seven vials of blood, I sat looking out the window with my hand holding the cotton wool on where the needle had been, as she started to write the labels and fix them into each tube,I looked across at her I saw the quantity of blood and although I did not feel at all wheezy I did feel as if a part of me had for the first time in my life been taken. And would be lost, never returned,
I then came to hunched over in the chair surrounded by many staff!
I had passed out, I started sweating profusely, I felt hot, as they were attaching things to me I asked what had happened,
eventually they managed to get me into the couch, i then felt ice cold and turned a shade of blue, I had an oxygen mask on,they had cables all over me, a new canuler with saline going in, they monitored my oxygen through my finger, they did my blood sugar levels, I had two gp’s and three nurses all focused on me,
An ambulance was called, my wife was phoned, I got stretchered into the ambulance, rushed under siren and lights to the main hospital?
I had a single blood test there which involved a needle, no problem with that, the canuler didn’t bother me.blood sugar levels, blood pressure etc, new wires with new pads were added in the ambulance,
After a while I was released to go home.
When I revisited the doctors a few days later I asked why I had Fuentes?
I was told I hadn’t? I asked what they meant by that, the answer was it was not a fientvas they often deal with that, I had gone so deep that nothing would raise me, I was out for quite a period of time, many minutes, hence why they assumed I was in cardiac arrest.
They looked at all the results they the ambulance and the hospital had done, nothing was found to be wrong, everything normal.
So no reason why I had shut down so deep?
It does concern me, they couldn’t give a reason and behaved as ah well whatever it was you are ok now?
They admitted it had caused them much concern,
I have never Fiented or passed out before.
As I read your post it came into my mind that she does not want to give her blood, Maybe it is not the needle at all, but thevtaking away of something that is hers?
I think that gradually introducing the equipment, and letting her have as much time as she needs to become accustomed to it, is a good way to go but it might take some time - especially if it's the equipment itself that's scaring her. Being allowed to eventually pick up and examine the equipment, a little like self-directed exposure therapy, might eventually take some of the fear out of such appointments.
I say 'some' because I feel that the equipment itself isn't the only problem. Speaking for myself, it's the invasion that's the problem.
Having a person stand so close as to feel 'on' me is what makes me feel very tense. Having that person then 'take control' of me / a part of my body, is SO much worse. It's suffocating, I start to hyperventilate and have to consciously control my breathing - really concentrate on it to try to stay calm - and It's made so much worse when the person then demands my attention by asking questions.
I've found it helps if I'm able to swab my own arm with the alcohol wipe, even better if I'm able to apply the elastic band above the area. The more I'm able to do myself the better, really (without the doctor / nurse leaning right into my space while I do it). I don't like it when my arm is grabbed and / or manipulated either, even although I know that this is only being done to examine the area or look for a suitable injection site - it just feels like too much of an invasion. At the end I prefer to hold the cotton ball to the area myself and apply my own elastoplast.
I don't know how much help any of this will be but these are the things I experience and also the reason why I have to see what's being done during the procedure. I could never just turn away and let someone 'do' whatever it is. I've never found it painful and don't care about the sight of blood.
Greetings. I only post here because no-one has mentioned the term "Pain Threshold" yet...?
I myself do not "fear needles"... but I do fear (and feel) intense PAIN.
I just wanted to say, I wish my son with autism had such an interested and proactive GP. Your patient is very lucky. My son has a needle phobia too, I agree with all previous post, it is the pain he is scared of.
Thanks for all the helpful replies!
I have a fear of anything medical including needles. Been that way for as long as i can remember. I can only speak from my own experience but i would say the less waiting around the better. Sitting in a waiting room surrounded by people where there always seems to be a baby screaming and a phone constantly ringing, makes me hugely anxious in itself. So if there was a way that she could be seen quickly that might help a bit.
Information can be useful for some people, as it can give them the chance to focus on the details of something rather than the sensations. You would need to check with her though. She could do some of this herself if she wanted, such as reading about it online or looking at images. It's horrible but at least she can close it anytime she wants and it can't get her. (Someone else ought to source the material first though and check it)
If you could think about other sensory input too that could be helpful. Personally i hate the smell of medical environments as it is associated with bad things for me. So maybe she could bring a tissue with a scent she likes on for example, if that was relevant for her.
Being squeamish about such things is to do with pain but also other sensations too. A GP offered to put some numbing stuff on my arm but i actually hate the feeling of numbness and tingling, so it would just draw my attention to that area anyway. It's hard to explain but sometimes an unpleasant sensation or one that is new or unexpected can be just as bad or worse as something a bit painful (for me). That said i also have a pitifully low pain threshold. Other items could be bothering her as well as the needles, such as the feel of gloves or cotton wool (i can't even bear the sound it makes!) So you could check with her about little things which could be adding to her anxiety levels too.
Hope some of that was useful. Good luck with helping her, it's really nice to hear of a GP that understanding.
Many thanks everyone for all your very helpful comments
I hate needles too and i have Algophobia (the fear of pain) so i know how she feels.