Sunday, January 28, 2007

I’ll Show You a “Little Pinch”!

You might be surprised to learn that medical professionals are some of the most needle-phobic people around. You should hear the whining in the line for the flu shots every year: “Which nurse looks like she hurts you the least?” “Is it a big needle?” “I hope I don’t faint!” Not to mention the ones who just avoid their shots. “But don’t you have to stick needles in people all the time?” you may be wondering. Well, yes. Into other people. Most (though not all) needle phobics don’t have too much trouble with a stranger’s blood or pain; it’s our own we’re concerned with. I have an (untested) theory that needle phobics may in fact be drawn to medical careers; there’s an aspect of phobia that involves deep interest in the object of fear. It’s invested with such power in your mind that it becomes fascinating.

There are different broad types of needle phobia (that site I just linked to is pretty good, by the way); I had a combination of the two most common, vasovagal and associative. The vasovagal type involves the symptoms typically associated with phobias: nausea, rapid heart rate, sweating, and a drop in blood pressure, resulting in lightheadedness and even fainting. A tendency toward becoming vasovagal seems to be just the way some of us are made, and usually we have more than one phobia to contend with. (A couple other phobias of mine are spiders and phones. I did have a fear of public speaking, but overcame this in quite a different fashion — maybe I'll tell that story too one day. Snakes, heights, and mice bother me not at all, so you never can tell.)

“Associative” needle phobia usually develops from an unpleasant experience with needles in childhood (whether your own trauma or something you witnessed). Mine probably started when I had two separate episodes of scarlet fever that necessitated very large injections of penicillin into my butt. They held me down while I screamed and fought. (Not the best way to go about it, one would think; I hope this isn’t a typical pediatric procedure anymore.)

From then on, anytime I knew in advance that I was going to have to get a needle of any kind, I would live in anxiety for days. Those who suffer from needle phobia often avoid necessary medical testing and treatment (some avoid pregnancy solely for this reason). I usually made it through, but not always, and I definitely delayed my infertility workup due to this. I vividly remember the days before my first bloodwork, wondering how I was ever going to be able to get through ART. That blood draw went ok, but the relief I felt after it was “It’s over with! Never again!” rather than “That wasn’t so bad!”

The first time I had to have an injection at home, I premedicated with an anxiolytic (the good stuff), but I was still so tense that I put my husband through a good half hour of “OK! — No, wait! Wait! — OK! No no no!” It ended with me in tears, though the injection was eventually administered.

Then I learned the first trick that helped me. It’s a simple technique for overcoming vasovagal reactions. Most people make the mistake of trying to relax as much as possible before and during the experience, but it turns out this makes things worse, because it allows your blood pressure to plummet, and makes your symptoms more severe. Whereas if you cross your legs hard and clench your fist on the side opposite the injection or blood draw, you help maintain your blood pressure, and then you don’t feel woozy, and the cycle can be (temporarily) halted. (Take care not to make it look like you are about to punch the phlebotomist; they can be touchy about this. I actually pinch my thumb really hard between my other fingers, and scrunch up my toes.)

The next trick I learned was visualization. Most people have categories of pain: some pain is ok, some is scary, and some is actually good. Everyone’s different, of course, but some examples of good pain might be: tweezing a stray hair; lancing a boil; popping a pimple; getting a tattoo; bikini waxing; digging out a splinter; having a newborn latch on to tender nipples … you get the idea: sudden pain that serves a worthy purpose. If you can pretend that the needle stick is actually one of the “good” pains, it seems to hurt much less.

The technique I learned that was most helpful for the “associative” part of the phobia was re-associating the procedure with something good instead of bad. What helped me the most for this was focusing on the goal: a baby. At the last infertility clinic I went to, they had pictures of patients’ babies up on the wall facing you as you had your blood drawn. Some people were offended by this, but if I could find a really cute one and focus on it, it went much better: it’s for a baby! Ouch! Not so bad!

A technique that helped with both aspects of my phobia was distraction. When my husband had to give me deep intramuscular injections of progesterone in oil—with the BIG needles—he developed what I called his “patter”: he would think of an interesting story to tell me, and right when it was getting to the good part, WHAM! he’d stick me. Sometimes he’d forget to talk (an amazing lapse, if you know my husband), and I’d have to yell “Patter! Patter!” as I lay on the bed with my pants down.

And finally, a great treatment for most phobias is habituation. This can be hard to achieve with needle phobias—playing with needles is not generally practical or savory. But infertility treatment was just what the doctor ordered, ha ha. Intramuscular injections daily—hell, twice daily, why not? Blood draws, let’s see—let’s do them every other day, just in case! It’s not clear why habituation works, but after a few days of this, most phobic people just chill out. (You will rarely see a really ill needle phobic in the hospital. Rather, you will see them, but you won’t realize they were ever phobic.)

The one thing I wondered was whether I would be back at square one once infertility treatment was done with, because habituation often fades if the stimulus isn’t continued. But not too long ago I came down with strep throat, and realized that rather than take pills for a week, I could just get a shot in the butt. I looked at the syringe beforehand, and it was the biggest, longest, fattest freaking needle I had ever seen. In addition, the quantity of liquid was prodigious, and was a disturbing milky white color. I gazed at it for a moment, then said, “Eh, stick me!” and dropped trou. It was only later, as I was limping around the office, that I realized that this was the very thing that had triggered the whole problem in the first place. And I finally felt cured.

Thursday, January 18, 2007


I'm sick (again) and in the middle of a shitstorm at work (again) and my precious assistant just went out on maternity leave (not again, and the baby is adorable, but I am near helpless without her), and I'm working this weekend.

These are my excuses for this short post. I have the needle phobia one half-written, so that'll be out soon.

But today, one really cool thing happened: my son correctly used the word "since" in a sentence. This reminded me of how I once worried that I would be sad to see him leave babyhood behind. When in fact oh my god am I glad to leave his babyhood behind. Babyhood kicked my ass. He was a real HellBaby, but as a toddler, while he's still intense, he's a lot closer to the norm (if the norm encompasses channeling Bono, that is).

Thursday, January 11, 2007

Suck It Up and Run

Turns out I’m not the only quack out there who says that you can/should keep running even if it hurts! (Thanks to Elizabeth for noticing the article.)

As I said before: if something hurts and running on it is either too painful to do OR seems to be making it worse, then don’t do it; otherwise, get your butt out there.

Tuesday, January 09, 2007

Placebo Deficiency

Is the light therapy working?

I do feel less gloomy and more energetic than I did before. And when I think about how long it will be until the sun really starts making a comeback, that seems like a simple fact; I don’t feel it in my bones.

At first I was thinking it might just be a placebo effect. Then I remembered—I have a serious deficiency: I am immune to placebos. I used to be proud of this, thinking it meant I was less gullible than other people, but over time I have come to realize that it just means I don’t feel as good as other people. Because the placebo effect is a marvelous thing.

I always suspected that I was missing out. I get terrible post-viral coughs, and used to drink gallons of dextromethorphan without noticing the slightest decrease in the hacking. (I continued to take it mainly because the people I lived with got terribly annoyed if I didn’t—as if I were destroying their sleep on purpose.) I felt vindicated when I finally saw data that over-the-counter cough remedies are entirely useless aside from their placebo effect—but the knowledge didn’t help me cough any less.

My first attempt at (illegal) mind alteration was a dud. It was a pretty pathetic scene: three of us huddled around a tinfoil-and-tampon-applicator b0ng containing a tiny dried-up lump of h@shish. J, who supplied the stuff, was an anorexic who consumed only Tab and tiny, strictly measured mounds of trail mix. After a few minutes of inhaling hot cotton shreds, J said, “I feel it! I definitely feel it!” My friend S, a 2-pack-a-day smoker who was fluent in three languages, politely said, “Maybe?” And I said, “Nope. Don’t feel a thing. Let’s go get drunk.” (This non-starter led to unfortunate overindulgence much later on, on the suspicion that I just might need a higher dose; the result was not unlike that described by Feral Mom here.)

The real proof came one evening when I was staying at my sister’s house. She and her (first) husband went to a dinner event without me. I got takeout Mexican and happily sat down with a book and a beer. I didn’t much like the beer—some weird German brand I found in their fridge—but I really felt like I needed a drink that evening. Strangely, after I finished the beer, I still felt like I needed a drink. Must be really stressed, I thought, and cracked open another. But after draining that one, I still felt like I needed a drink. Am I becoming an alcoholic? I wondered. It was not until I pulled the third beer out of the fridge that I noticed the fine print on the label: non-alcoholic. I swore a bit, rummaged around and found a real beer, and was perfectly happy after drinking that one (though a bit bloated by that point).

While others are happily enjoying their buzz or being relieved of headaches and such, I’m moping in the corner wondering how I can get my hands on the good stuff.

I’m always a little amused when people get started on antidepressants and after about four or five weeks say, “You know, I’m feeling a lot better, but I don’t know if it’s really the medication—maybe I’m just snapping out of this!” Not that that could never happen, but it’s interesting that it almost always seems to happen right around the time when one would expect an antidepressant to kick in. And here I am, wondering the same thing about the light therapy.

So, I guess it works.

Sunday, January 07, 2007

What Would Miss America Say?

I was thumbing through the most recent issue of Glamour (a magazine I usually find sneakily feminist) and I saw a little filler article that made me want to smack approximately 1,750 women upside the head.

They asked 2,156 readers some “Would you rather” questions—for the most part silly things like “Would you rather go to a huge party naked, or never eat your favorite food again?” (66% would give up their favorite food). But two of the questions—or rather, the answers to them—made me dizzy with disbelief. The first one was, “Would you rather achieve world peace but never find a cure for cancer, or cure cancer but never have peace?” The majority (59%) answered that they’d rather cure cancer.

WHAT? What is it with the fear of cancer? Don’t people realize that they have to die of something? Most people don’t die of cancer as it is. And though I don’t like to scare anyone, there are plenty of diseases that are worse than most cancers. Give up the possibility of world peace to eliminate cancer? I know it’s just a silly poll that I’m sure most of the respondents didn’t take seriously, but come on.

The second question that got me riled up was, “Would you rather have a body like Heidi Klum’s but die at 40, or be morbidly obese but live to 100?” A whopping 81% said they’d choose Heidi Klum’s body.

All these women really believe that having a hot body would make their lives so special that it would be worth giving up 60 years of life for? (Or perhaps they’re so afraid of getting fat that they’d rather die? But since the vast majority of women in this country are already significantly bigger than Heidi Klum, I assume it’s mostly the former.) The question didn’t say you’d get her face, or her career, or even Seal; you’d just have her body. Just what do they think they’d do with it?

Even weirder, most of the women who said they’d give up world peace for a cure for cancer must also have said they’d die at 40 for Heidi Klum’s body. I guess they’d be okay with dying young as long as they don’t die from the Big C. Maybe they’d rather step on a land mine in the next world war?