From Needle Phobia to Collecting my own Blood

My strategies to overcome fainting from needles

It’s commonly said that, in the face of fear, our bodies resort to a “fight or flight” response. Our somatic nervous system gets activated and animal instincts kick in. If we respond with “fight,” we may embody the lion and pounce toward our predator. If we respond with “flight,” we may flee like a gazelle, springing across the savannah. But some of us are neither the courageous lion nor the graceful gazelle. Some of us are the ferret.  

The ferret introduces a third response to our evolutionary playbook: “fight, flight, or freeze.” You don’t have to venture out to an African safari to witness this in action. My friend was walking her dog the other day. Envision a big German shepherd mix. Between some bushes, her dog ran up to a ferret. Its body stiffened. Sniffing it, the dog waited for movement, but lost interest. My friend’s dog presumed the ferret dead, but we could see its tiny little chest rapidly pulsing with adrenaline. The ferret response may not be heroic or dramatic, but it is effective.

Ok, now that I’ve redeemed the ferret in your eyes, I can admit it– I’m the ferret. And my big, scary German shepherd is needles. 

How far we've come:)

When I was a kid, I was terrified of needles. In fact, I hated the doctors’ office altogether, starting with that hospital smell that would hit you the second you stepped in the building. (I always thought Yankee Candle should release an extra spooky scent for Halloween that was “Haunted Hospital”-- some blend of antibacterial soap and rubber gloves.)  

Vaccinations were a shit show for me. And blood draws were even worse. As a teen in my pediatrician’s office, I’d look over at the younger kids with their lollipops and cartoon bandaids. If only it were that simple!

I experienced a whole range of physical symptoms leading up to and after getting jabbed. Before the needle would go in, I’d get hot and sweaty. My heart rate would go up, and my hands and feet would get clammy. As the phlebotomist rubbed my arm with the alcohol wipe and, in the case of blood draws, tied the rubber tourniquet above my elbow, waves of nausea would wash over me. As a kid, I didn’t know what these physical symptoms meant, so I’d panic.

Once the needle was in, the ferret came out. And by ferret, I mean vasovagal syncope. It’s the medical word for fainting. I wouldn’t faint every time; But if I did, there were tell-tale signs.

First my mouth would get dry and I would feel super thirsty. Then my breathing would get shallow, then it would be hard to see, and then… lights out. I’ve been told I’m only unconscious for a minute or two. 

I’ll spare you all my fainting stories. (Some aren’t even needle related– like the time I went limp on the Tatsu coaster at Six Flags.) Just trust that it’s happened enough times that I can consider myself a sort of expert. 

While anxiety contributes, vasovagal syncope isn’t all just in your head– it’s physiological. It’s caused by a sudden drop in blood pressure. It usually looks like fainting, but sometimes it can look like a seizure, too. In fact, I experienced one of these seizure-like episodes after a vaccine. 

A deep dive into vasovagal syncope:

Vasovagal refers to the vagus nerve. Lately, I’ve been obsessed with this nerve. In fact, I’m currently taking a course with the Polyvagal Institute (PVI) to learn techniques in modulating this nerve. I think a lot of those techniques could help with preventing vasovagal syncope in blood draws, but I haven’t found any papers investigating that. Once thought to be a woo woo fringe of science, vagus nerve research is really taking off now, especially in the autoimmune community. I’m looking forward to sharing vagus nerve tips I learned in the course!

Over the years, I’ve collected tips from friendly phlebotomists and haven’t fainted in years. In case you also faint easily, below are 5 steps you can take to prevent fainting from blood draws:

1. Drink enough water before, so your vein is an easy find.

2. Ask to lie down on a table. If they don’t have one, snag an extra chair to prop up your feet.

3. Cross your feet. Combined with lying down, this keeps the blood from rushing out of your head and pooling in your extremities.

4. During the blood draw, I find that talking a lot helps distract me. I also try to exhale on the jab.

5. Stay still for a bit after the draw. I wait a few minutes before getting up. (I’ve experienced delayed fainting after getting up and walking too soon.) If you’re sitting and feel dizzy, lean forward and put your head between your knees. (This keeps the blood in your brain.)

A lot of people avoid blood draws because of the discomfort and even traumatic memories tied to it. And some people debate how often we really need to do blood testing. If you ask me, it’s not much of a debate. Insurance usually covers one test a year. If it were up to me, I think once every quarter is more appropriate if you’re monitoring abnormal levels or worried about some chronic condition. The cancer incidence rates and the fact that 1 in 3 US teens is pre-diabetic suggests most Americans should consider more frequent blood testing. 

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So, how did I overcome my fear of needles? The annual blood tests my insurance covered wasn’t much exposure therapy. Luckily, I started working in the world of microsampling. (Microsampling is small sample collections. In the case of blood, we're talking 1 mL or less.)

Working at ImYoo, and jumping at the opportunity to be the team guinea pig, I had the chance to microsample a bunch and it really desensitized me to needles and blood. It was so exciting to collect my own blood and not feel that familiar head rush I'd get from the venous blood draws. I wished this technology was around when I was a kid! To bring this tech to more people, I became a founding board member of the non-profit, the Patient Centric Sampling Interest Group (PCSIG) in 2023. 

Microsampling deep dive for blood collections:

Check out the PCSIG website, if you want to learn more about microsampling. You can microsample any specimen, from urine to poop to blood. When it comes to blood, there are a few different designs. What they all have in common is they pull capillary blood from just below the surface of your arm, rather than venous blood draws which tap deeper into your vein. I don't think there are studies investigating the prevalence of fainting in microsampling, but I suspect that because the needles don't dig as deep, the vasovagal response doesn't kick in.

I’m especially eager to bring microsampling to more patients with sensitive nervous systems like me, and patients with learning disabilities are particularly sensitive. Special needs patients don’t get blood tested enough. In the UK, less than a quarter of these patients get annual bloodwork. Meanwhile, they die 20 years younger compared to the general population. Karen Perkins, a biochemist at the NHS, is using microsampling to solve this problem. Perkins successfully introduced microsampling to these patients. Check out her PCSIG webinar explaining her research study. 

Microsampling isn’t yet as comprehensive as venous blood testing, but it’s pretty close and it’s getting even closer as new technology develops. If you or someone you love struggles with blood testing, consider microsampling. 

If you’re eager to try microsampling asap, I’d recommend Rythm Health. I tried them and enjoyed it. (Video is in the works. Tell me what you want to know from that experience in the comments!) Rythm includes monthly testing for $79/mo and lets you skip months. If you want to try microsampling for free or get paid to do so, check out the research studies I’ve vetted.

If you’re a medical provider trying to incorporate microsampling into your practice, please send me a LinkedIn DM or leave a message when you subscribe to my blog. I’d love to connect you with the PCSIG community, so we can bring this technology to your patients.