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03 Nov 2021

Case Study 2

MEDICAL HISTORY

Hypothyroidism (Under Active Thyroid)

  • Hashimoto’s Disease
  • Anxiety
  • Consistently Low Iron
  • Consistently Low Vitamin D

MEDICATIONS

Thyroxine 100mg daily

  • Escitalopram 30mg daily
  • Ferrograd C 1x daily
  • OsteVit-D Vitamin D3 7000iu 1x week

Note// For the past 2-3 has been on and off 30mg Duromine (currently not taking)

SUMMARY

  • Suffering from moderate-severe needle phobia
  • Adverse response to needles include: anxiety, fainting, sweating, nausea, crying, yelling, irrational thoughts and irrational and uncontrollable actions such as trying to get away from the needle and physical resisting
  • Impacting general health as not receiving regular blood tests to monitor health conditions
  • Avoidance of needles has meant that patient has never received a flu-shot or pre-travel immunisations prior to travelling to overseas locations which strongly recommend immunisations – Did not receive last 2 round of high school immunisations due to phobia meaning patient is not protected against certain diseases ect.

ATTEMPTED TREATMENTS/ RELIEF AND PHOBIA MANAGEMENT

  • 2 different psychologists trialled Cognitive Behavioural Therapy (CBT) as well as reducing general day-to-day anxiety to help improve ability to cope and manage stressful situations such as needle phobia
  • Valium has been prescribed numerous times by GP or hospital staff to take prior to injection with no success or calming effect and has not assisted with the procedure
  • Emla cream has been used and been inconsistently but somewhat successful at alleviating sensations or intensity of sensations felt during needle procedures however this has not provided much relief to the actual fear itself
  • Applying ice to the area to attempt to numb the area did not help and caused more stress trying to apply and hold for a period of time
  • Various calming techniques such as deep breathing, meditation, laying down to receive the injection, moral support, supportive and calming environment, distractions all only slightly assist however have never been enough to calm or provide enough relief for ongoing smooth needle procedures
  • Exposure to needles such as attending blood tests or immunisations with family members or friends and visiting the nurses clinic room and sitting in the chair or looking at the needles has not assisted
  • Ongoing regular support and encouragement from GP and family members

SIGNIFICANT EVENTS

  • Was hospitalised due to severe symptoms and dehydration from Influenza A in 2019. 
During hospital visit, a nurse insisted on placing a drip in arm to administer fluids however ignored patient and patients mother when informed of needle phobia and made dismissive comments. Patient ended up passing out and ever since this occasion has not been able to receive blood tests for thyroid testing
  • Psychologists and patient unable to identify root cause of phobia
  • Prior to surgery, has to have a gas induction and IV drip placed in afterwards
  • COVID and constant exposure to news related content explicitly displaying needles and people receiving injections of Covid-19 vaccination has increased anxiety around injections and caused severe general day-to-day anxiety due to being consistently exposed to phobia and topics related to needles. Feeling forced to receive the needle and being more fearful of the needle than the vaccine or virus. Had to increase anti-anxiety medication.
  • Vivid memory of receiving immunisations as a child some instances more traumatic than others

OUTCOME

The patient attended her regular GP clinic for a vaccination in October 2021.

The appointment was scheduled for late afternoon with a family member as a support person and a vaccination was given using the NeedleCalm device by a Registered Nurse experienced in using the NeedleCalm device and needle phobia management. The patient reported feeling no pain during the procedure.

During the day of the procedure the patient utilised self-care activities such as meditation,  hydrotherapy and rest.

OUTCOME

The patient has since been able to attend another appointment for a blood test and further vaccinations using NeedleCalm. The patient is now confident speaking about her experiences and providing guidance to other patients in a support group.

Bringing calm, comfort and ease to needle related procedures.