Fears for Patients Navigating the Medical World
- A teenage girl died of sepsis and leukemia after her phobia of needles delayed tests that could have detected her cancer earlier.
- Acute lymphoblastic leukemia, or ALL, is a type of leukemia where the bone marrow makes too many immature lymphocytes, a type of white blood cell. It is an aggressive cancer and requires aggressive treatment.
- It’s important to overcome any fear of doctors or needles because doctor’s appointments and procedures involving needles can be life-saving. One of our experts offers tips on how to overcome a fear of the doctors, and the CDC provides information on how to manage needle fears/phobias.
Holgate had been battling a tooth infection and was being treated with antibiotics. But when she continued to feel unwell, doctors recommended blood tests to rule out anything more serious. Sadly, she refused because of her phobia of needles.Read More
She died from sepsis – an extreme bodily response to an infection – and leukemia, according to NottinghamshireLive. The paper also reports that a pathologist ruled she was more prone to sepsis because of leukemia, and that she died of natural causes likely because of her dental issue.
“She crossed our lives burning so bright but, like a shooting star, it was over way too soon,” her grandmother said.
Understanding Acute Lymphoblastic Leukemia (ALL)
Acute lymphoblastic leukemia, or ALL, is a type of leukemia where the bone marrow makes too many immature lymphocytes, a type of white blood cell. It is also called acute lymphocytic leukemia.
The American Cancer Society estimates that about 6,660 new cases of ALL will be diagnosed in the United States in 2022. The ACS also reports that the risk for developing ALL is highest in children younger than 5 years of age, with a slow decline in risk until the mid-20s. Then, the risk slowly rises again after age 50.
Dr. Olalekan Oluwole, a hematologist with Vanderbilt University Medical Center, previously talked with SurvivorNet about ALL’s effect on the body and the type of treatments that work to fight it.
“ALL is a type of cancer that is very aggressive,” Dr. Oluwole told SurvivorNet. “It grows very fast. Within a few weeks, a few months, the person will start to feel very sick. And that’s why we will have to give it an equally aggressive type of treatment to break that cycle.”
Dr. Oluwole also says the leukemia often resides in the bone marrow, and because it is an abnormal growth, it just keeps dividing.
“It doesn’t follow rules, and it doesn’t stop,” he told SurvivorNet. “Not only that, because this is part of the immune system, the immune system is sorta like the police of the body. So those abnormal cells that have now become cancer, they have the ability to go to many places. They go into the blood, and they often go into the tissue or the lining around the brain.”
Overcoming Medical Phobias
Many people do not like going to the doctor, but it’s important to address any sort of doctor-related fear because staying on top of appointments and seeking care when things feel off are crucial to cancer prevention, early cancer detection and successful cancer care.
In a column for SurvivorNet, licensed clinical psychologist Dr. Marianna Strongin shared her advice for one SurvivorNet community member who wrote in about her breast cancer diagnosis and fear of the doctors.
“I want to reassure you that being fearful of doctors and all medical settings is an extremely common phenomenon,” Dr. Strongin wrote. “Many individuals fear going to the doctor not because they are afraid of doctors themselves, but rather what seeing a doctor represents – the unknown and possibly bad news.”
She went on to explain that, in this woman’s case, seeing the doctors as well as the thought of eventually having surgery and undergoing treatment was, very understandably, putting her body “into reaction mode.”
“This feels scary, because it is scary,” she wrote encouraging her to acknowledge the reality of her situation. “Later, it’s important that we begin to change your association with doctors (bad news, more unknowns) to something less anxiety provoking. For example, ‘doctors are saving my life and giving me the information I never had.’ Rather than associating doctors with ‘bad news’ we can change it to ‘important news.’
“Once we can associate doctors with something more healing, you may be more likely to trust the medical setting. With trust you may begin to feel less scared.”
Then, addressing the woman’s tendency to avoid the doctors altogether, Dr. Strongin told her that avoidance will only prolong her panic symptoms.
“It will be important that you acknowledge your desire to avoid, but still follow through. Avoidance only feeds our fear and anxiety,” she wrote. “When you begin to feel panic symptoms such as the sensation of being ‘paralyzed,’ it will be critical that we calm your body and reorient your mind.”
One way to do so, Dr. Strongin says, it to use a technique called the “3-3-3 Rule” which invites a person to name three things you see, list three things you hear and finally move three parts of your body.
“By doing this when you notice your panic symptoms coming on, your body will begin to slow down and your mind will focus on the present,” Dr. Strongin wrote.
Looking more specifically at a fear or phobia of needles, it’s important to remember that vaccines, blood tests and other procedures involving needles can be life saving. So, doing whatever you can to overcome your fear of the doctors – as well as needles – is critical.
Fears and phobias can vary from mild to severe. For milder cases, things like preparation, support and pain management can help. According to the CDC, the following tactics can be used to manage more mild cases of needle fears/phobias:
- Giving the person information about the procedure so they can understand why it involves needles and how it will protect them
- Understanding the person’s causes of fear. These causes can include pictures, words or surroundings.
- If seeing pictures or videos of needles causes feelings of fear, it may be useful to avoid these images unless they are used by a trained mental health provider as part of therapy.
- If the person’s fear is related to the words commonly used with needle-related procedures, substituting words like ‘shot’ with ‘poke’ might help limit the fear response.
- If surroundings are an issue, making sure the person is in a private space can help. This is particularly relevant for people receiving vaccinations.
- Telling the person where the procedure will take place, who will be around and what will happen before, during and after can help reduce fears. Painting a realistic picture of the procedure – including whether or not it will involve pain – may also be helpful along with planning and practicing what will happen via role playing or using books and videos.
- Managing pain for the person with things like numbing creams and sprays, vibration or cooling tools, distractions or relaxation efforts may also help.
- Tailoring the fear managing strategies to each person is also important along with combining different strategies.
For extreme fears of needles, the CDC recommends the person affected talks to a mental health provider to understand the severity of the situation and create a plan to best tackle the phobia. Strategies for treatment can include:
- Exposure therapy – the person gradually faces their fears with the support of a mental health provider in carefully planned steps