It’s nothing unusual to be nervous about needles: around 25% of adults report fearing them. Fear of needles, or trypanophobia, can make living with a chronic condition like systemic mastocytosis (SM) even harder than it already is. When frequent blood tests, injections and biopsies make needles a regular sight, learning to manage this fear will make receiving treatment easier.
How does a fear of needles arise?
Needles are easily associated with pain, stress and bad experiences or trauma; this can develop into a fear or phobia. An early experience like receiving childhood vaccinations from an unsympathetic doctor can easily lead to a long-held fear of needles. So can watching a parent who was visibly nervous about injections receive one. People who are more sensitive to pain might develop a fear of needles later in life.
When do patients with systemic mastocytosisMastocytosis Rare disease caused by the buildup of mast cells. Cutaneous mastocytosis primarily affects the skin and is more common in children, while systemic mastocytosis affects internal organs and is more common in adults. encounter needles?
Most people living with SM are regularly confronted with needles. Some of the most common times are:
- Diagnostic testing, which usually means a bone marrow biopsyBone marrow biopsy A procedure to collect a sample of bone marrow using a needle. Often used to examine the characteristics of mast cells and diagnose SM. and multiple blood tests.
- AnaphylaxisAnaphylaxis A severe allergic reaction that can turn fatal without treatment. Patients with SM are at a higher risk of developing anaphylaxis., which requires urgent epinephrineEpinephrine Also called adrenaline, this hormone is used in emergency situations to reverse symptoms during a severe allergic reaction (anaphylaxis). injections and potentially follow-up intravenous treatment.
- Allergy testing conducted via skin pricks or intradermal injections.
- Ongoing monitoring, which often means regular blood tests.
These frequent encounters aren’t the only reason to work through a fear of needles: if you have SM, the emotional stress of a needle phobia can act as a symptom triggerSymptom trigger The symptoms of SM may become worse when certain triggers activate mast cells. Common symptom triggers in SM include exercise, insect bites, stress, scented products, alcohol and spicy foods., making you feel even worse (and in some patients, even lead to anaphylaxis).
Read more about SM testing and diagnosis
Strategies for managing a needle phobia with SM
There are two approaches to dealing with a fear of needles in SM.
The first technique, intended for those at risk of anaphylaxis, involves premedication with H1 and H2 antihistaminesAntihistamines Medications that block the effects of histamine, the chemical found in mast cells that is responsible for many of the symptoms of SM, as well as many allergic reactions. and corticosteroids. This can help prevent the triggering of mast cellMast cell A type of white blood cell produced in the bone marrow. They help defend against infections and play a key role in allergic reactions. In SM, mast cells become overactive and build up throughout the body. activity as a result of the stress and anxiety associated with needles.
The other approach focuses on strategies and techniques to soothe the fear of needles. Consider the following tips to help calm your fear:
- Make sure you have all the information you need to understand the steps of the procedure and its duration.
- Prepare yourself mentally for the procedure. Remember that the needle is not very painful, and any discomfort passes quickly.
- If they are not symptom triggers for you, ask if a numbing cream, freezing spray or ice cubes can be used at the injection site beforehand to help dull any pain.
- Inform the medical personnel of your fear, so they can provide extra reassurance and care. You won’t be the first patient with a fear of needles they’ve helped through an injection or blood draw.
- Have a support person with you to give reassurance and support if you feel faint.
- Breathe deeply to calm your anxiety and focus your mind.
- Try distractions, like playing a game on your phone, listening to music or chatting with your support person.
Since SM symptoms may have a delayed onset, after the procedure keep a close eye on any potential symptoms and alert your healthcare team if necessary.
If a fear of needles significantly impacts the medical procedures you need to monitor and treat SM, you may want to consult a therapist. Cognitive behavioral therapy (CBT) and exposure therapy using technology such as virtual reality have shown success in treating phobias.
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