Surgery Options for Needle Phobics?

[Jess831]

Edited to say we DID find a solution! The oral sedative they use at the hospital is much stronger than the ones they can prescribe for outpatient procedure. Even if you are VERY needle phobic it will be ok to have oral sedation, then start an IV, then be knocked out for the surgery.

If you are needle phobic and need a surgery, tell your doctor and arrange to have it done in a hospital with an anasthesiologist, under full sedation.

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Hi, I'm writing to ask for your help with my son. He's 16 and for the past 5 years has had worse and worse needle phobia, to the point where now he's completely unable to have any injection. He just shakes, cries, hyperventilates and says No, no, no, no. He has needed outpatient surgery to fix an ingrown toenail for two years now.

He actually had the surgery about 6 months ago but it didn't work. Before that he had tried twice to have the surgery using anti-anxiety medications and both times completely panicked when it was time for the injections. That time he said to go ahead even though he was terrified, and it was very traumatic. After the surgery, nothing changed, so now he needs another and now the phobia is even worse.

The podiatrist wanted him to have it under general anesthesia but the anesthesiologist won't agree to put him under without starting an IV first!

Meanwhile he also has generalized anxiety and last summer started having depressive episodes which are now coming more and more often. I am sure the chronic infection/inflammation in his toe is making his mental health worse. It's also affecting his ability to participate in sports, hikes, even just going for a walk is sometimes too painful. He's in marching band and after a competition he has to wear flip-flops for days afterwards because he can't put a shoe on.

I am at my wit's end trying to get medical help for him. I can't understand how no one seems to see or care that he needs to have the toe treated in a way that also addresses the needle phobia. He is seeing a psychologist and getting hypnotherapy but so far it hasn't worked, or at least not well enough to allow him to be able to get an injection. Does anyone have any ideas for how to proceed? Do you know of a way to have surgery when you are needle phobic, or do you know of a truly effective way to treat needle phobia? The local anesthetic injections are no joke: they hurt! I think that's why the phobia got worse after the failed procedure last time.

[redbridges7diana]

One of my daughters is afraid of needles because of all the immunizations when she was a child, I used to have to tell people she is afraid be gentle and then the person giving the needle would reassure her,,, also they may find someone who is the best at putting iv in or taking blood whatever the case may be...... I don't think you want to trick him, it is best to be honest, ....I don't like needles myself, I don't like the sight of my own blood, but I know it is necessary sometimes so I have to look away and not see what's going on, .... Is there an anesthetic he can breathe in? Something like an oxygen mask, or pill form, or one of those steam makers you put medicine in that can be breathed in also,,,,

[Jess831 in reply to redbridges7diana]

Thanks for your reply! Your idea about finding someone to give him gas was a good one. He wants so much to have the procedure, but when he sees the needle he becomes completely terrified and he can't cooperate even though he knows intellectually that the pain of the needle is way less than the pain from stubbing the inflamed/infected toe! The phobia is just too strong. We are going to keep working on healing the phobia too, but right now he really needs to have the surgery ASAP.

The good news is that yesterday I took him to Stanford Lucile Packard Children's Hospital for a new-patient consult and they were wonderful! They have a team of pediatric anasthesiologists who use oral anti-anxiety medication, then they use VR goggles if needed to distract the patient, and they use a fruit-scented gas to put the patient to sleep. All of that is before they start an IV or give any injections. So if anyone else is reading this and their child has a needle or medical phobia, the answer is to take them to a good pediatric hospital. They work with phobic kids all the time and they have tools in place that an ordinary surgical center just doesn't have.

The local surgical center had refused to give him anything except oral anti-anxiety (which we already tried and it didn't work) until after they started an IV, so that was useless.

[redbridges7diana in reply to Jess831]

You're welcome

[lil-rose]

Hi, I know this is an older post but I wanted to let you know of a treatment that worked quickly for a child I know it's called EMDR- there is an EMDR Institute and trained practitioners are listed on there. I have used EMDR myself and it has calmed many triggers I have with anxiety and OCD mainly. I have used the ligthts (you watch them go back and forth with your eyes for a couple minutes while the practitioner guides you before and after the lights are turned on and off) and the hand held vibrating device. Both were extremely relaxing. What it felt like it did was help me process my triggers into a different part of my brain so it wasn't something that I felt I had to focus on so much. It was like it was filed in the back of my brain and I could think about it if I wanted to but I didn't have to.

I hope that helps. I enjoyed reading about the gal (Shapiro) who discovered EMDR, and it's use with Vietnam vets. It sounds very promising for the modern day and age.

[ol729392]

Hey I am a 14 year old girl and I have to have another toe surgery. The first one failed so my parents are insisting me to go and get another. They know that I have a phobia of needles. But they just tell me that 15 minutes and it will all be gone. I just about got through the first surgery, but now I have to get the second one and I am more nervous than ever. I have been thinking about this surgery 24/7 and I have had problems sleeping. I usually faint when I get the injection which doesn’t make me feel good! If there is anything that you may think of that could help me, I will really appreciate if you replied.

[Jess831 in reply to ol729392]

Hi, yes, the only thing that worked for us was to go to a hospital and have the procedure there under full sedation, instead of having an outpatient procedure at a podiatrist office. If your podiatrist has an agreement with a local hospital, they can do it, otherwise you will need a referral to another surgeon.

At a hospital they have anasthesiologists who can give you a very strong sedative, then start an I.V. (this is painless and you will be too sedated to notice). Once the I.V. is in, they can put you completely under during the procedure. You will wake up afterwards asking when are they going to start.

A few suggestions:

1) Emphasize to the doctor (your surgeon) to make absolutely sure the ingrown part of the toenail doesn't grow back. This may mean your nail will look weird for a long time afterwards but it also means not needing the procedure again.

2) Review all of your vaccination records with your pediatrician before hand and have the pediatrician office send a request to the hospital team (the podiatrist or orthopedic surgeon who will be doing the procedure) to please have all your needed vaccines and booster shots given while you are sedated for the surgery. Usually surgeons don't do vaccinations so they will need to make special arrangements ahead of time. This way you can get caught up on the vaccinations you will need for high school and college.

[NeuronerdDoaty]

We have always put my dad out. He was injured at work. He’s had 8 back and leg surgeries. I give him a pill the night before and another one in the morning is given by the nurse. He doesn’t care what they do to him. I don’t understand why the anesthetist didn’t come up with other options.

[Jess831 in reply to NeuronerdDoaty]

Podiatrists don't have anesthetists so they are limited to what they can do in an outpatient setting. People with needle phobia need to go to hospitals, where they can have an anasthesiologist on the team. Once we figured that out, it worked ok. The problem initially was that I didn't understand the anasthesiologist oral sedative would be different (much stronger) than one a podiatrist could subscribe.

[Jess831]

I want people to know we DID find a solution. Because the anasthesiologist at the hospital gives a much stronger oral sedative, it works fine to use the oral sedative, then start the IV, before full sedation for the procedure. So if you or someone you know is needle phobic and needs a surgical procedure, you CAN do it at a hospital.