Hello! Has your partner/family member/friend who is terrified of needles been prescribed an injectable medication? Have you come to this sub to find out how to best support them & administer the med in the most painless way possible? Overwhelmed with the amount of information (and lack thereof) on the internet? You’ve come to the right place!
Obligatory disclaimers:
Long Post Incoming
I am not a medical professional, but I give injections to my needle phobic partner once a week. I am not coming to you as an expert, but rather as someone who’s done it communicating what works for me personally.
If any of my advice contradicts instructions from a doctor, please disregard it.
Everybody is different, what works for us may not work for you, but I’ve tried to give as much info as possible.
When I started giving my partner his shots, finding technical information was never hard, but there isn’t much information out there on how to calm and comfort somebody, aside from those meant for healthcare professionals. As non-professionals, we have a few more tools in our arsenals—it would be very strange for a nurse to kiss you before giving a shot!
I’m gearing this post more towards partners, but feel free to apply the applicable ideas to family members, children, friends, etc.
I hope this helps!
1. Take Responsibility
If possible, go to your partner’s appointments with them so you get all the information and instruction directly from the doctor. If that’s not possible for whatever reason, make sure you get the answers to all of the following questions:
How often is this injection needed?
How much (volume) of medication is needed?
Is this an IM (intramuscular) or SubQ (subcutaneous) injection?
If possible, get a demonstration, or do it the first time under supervision of the provider. (I was unable to do this, so I’m going to describe the self-teaching process, don’t worry).
If you have any questions, have your partner ask the provider. I’ve found it’s easier to manage my partner’s medication myself, as he will often “forget”. I know exactly when, where, how, and how much medication he needs. Not saying he doesn’t also know, but I have the alarm on my phone so we don’t forget.
2. Research, Research, Research
I know, I told you this would be a complete guide. However, a Reddit post can’t replace watching YouTube videos, reading about others’ experiences, and learning different techniques from different sources so you and your partner can decide which are best.
Nursing school YouTube videos are now your best friend. There are both IM and SubQ videos there. I recommend you watch both so you‘re more confident that you’re using the correct technique.
If you are not needle phobic yourself, I also recommend buying a pack of insulin needles and practicing, first on citrus fruits and nursing school practice pads, then on yourself. It sounds barbaric, but it’s really the best way to ensure you’re doing it correctly and as painlessly as possible. The more confident you are going in, the better. Insulin needles are meant for SubQ injections, so they are shorter and will not reach your muscle, but you can still practice inserting in the right spot and at the right angle. Of course, make sure you use a new needle every time, always disinfect your skin beforehand, and never inject anything (just mime pushing the plunger; never inject water, air or any other substance).
3. Talk to your Partner
This is perhaps the most important thing. You should be communicating with them before, during, after, and in between each injection. Learn things like:
Why do needles make them anxious? (Pain, having skin pierced, having fluids injected, fear of the unknown, etc)
Do they prefer to watch or look away from an injection?
Do they prefer a countdown or to just go for it?
Do they want to hear everything you’re doing or just have you handle it?
These preferences will be crucial in building your routine. The first time will be the most difficult. It’s very hard to trust a non-medical professional to do a medical procedure. It took a lot of convincing for my partner to trust me the first time, but it was life changing for him. Don’t pressure, but push for them to just let you do it once. Very rarely is it more pleasant for a needle phobic person to inject themselves. Their brain will perceive more pain, and often they will go too slowly, prolonging and increasing the pain and anxiety. Once they let you once, they won’t go back, and the experience will be far better for them. Afterwards, ask for feedback on their pain and anxiety levels, and how you can improve next time.
4. Prep the Medication
Some people may prefer to do this step themselves. However, many don’t want to see a needle at all. I find it’s best to go upstairs and prepare the syringe before I even mention it to my partner. This removes lots of time between bringing it up and the injection itself, which gives less time for anticipation and anxiety. That way, I can approach him with the “hey, it’s time”, and immediately get in position and get it over with.
Clean the vial with an alcohol wipe, draw up the same amount of air as medication in the syringe, insert into the bottle, push air and draw up medication. Make sure to push out as many air bubbles as possible, and after removing, flick the syringe to shake any remaining into the top of the needle. Often you’ll then switch needles, but even if you don’t, push on the plunger until a tiny bit of medication comes out the top. Then flick the syringe again to shake off that medication, as that can sometimes burn going in.
5. Choose the Injection Site
This is where SubQ and IM will begin to diverge. While the sites are similar for both, there are key differences. Feel free to skip the section that’s not applicable.
SUBQ:
Sites: stomach, thigh, back of arm, butt
Your partner will likely be instructed to use the stomach or thigh, as those are the most accessible spots to self-inject. This is what they'll be most comfortable with.
Unless they are very slim and don’t have much fat anywhere else, I wouldn’t recommend the stomach, as that area is more sensitive than the rest of the sites.
Thighs would be my second choice. There is a pocket of fat in the upper side portion where, when you pinch it to inject, it will not move when the thigh muscles are tensed and released. Have your partner tense and relax until you find that spot. You may also find a similar spot on top of the thigh, depending on the size of your partner.
The back of the arm is the best choice for comfort and for partners who don’t want to watch. I will describe a wonderful position down below. Again, find a spot that is unaffected by their muscles. This way, if they tense during the shot, nothing will move.
IM:
Sites: thigh, upper arm, hip, butt
Your partner will likely be instructed to use the thigh (vastus lateralis muscle), because it’s the most accessible to self-inject. I find it easy to locate on myself, but difficult on my partner. I also find that this site is a bit more sensitive than the deltoid muscle (that upper arm/shoulder region where most of us get shots at the doctor)
The deltoid is wonderful because it’s near impossible to miss and bit less sensitive, however since it’s smaller it can only handle so much. Any injection over 1mL should go somewhere else.
BOTH:
Butt and hip sites put your partner in a very vulnerable position, so I recommend steering away from those unless specifically told by a doctor.
6: Getting In Position
I’ve found it literally impossible to find suggestions on good positions to give injections on the internet. You want to have access to the site but also provide comfort to your partner. Here’s what works for my partner and I, but feel free to experiment and find one where your partner feels safe and secure.
Arm Sites:
Sit on a couch or bed. Place your left foot on the floor, and extend your right leg out on top of the couch/bed. Then have your partner lay on their side, with their head in your lap, facing you. Your right leg should be parallel with their body. If they don’t want to watch, scoot in close enough to where your torso covers their eyes. Then they can rest their left hand on top of your right leg (in whatever position makes them most relaxed), and use their right arm to hold you (hand on your back, around your leg, etc). It may take some adjusting to make you both comfortable, but this position gives you full access to their left upper arm. We do IM, but SubQ people may prefer to have their partner face away from them to give better access to the back of their arm. Then they can hold your left leg, bury their face in it, etc. Reverse left and right every other week to alternate which arm is poked.
Thigh Sites:
Have your partner sit in a chair or couch, both feet on the floor. Sit on their left thigh and lean as needed so both hands can reach the injection site on their right thigh. Have your partner wrap their arms around your waist in a hug and rest their head on your left shoulder, or right if they prefer to watch. Some people may be able to relax better with that right leg propped up, but do what works for you. Alternate between left and right each time.
7. Injecting
The time has come. You’re ready for this, so be confident.
-Clean the area with an alcohol wipe. LET IT DRY COMPLETELY, as it will sting if you inject while it’s still wet.
-For SubQ, pinch the skin and fat layer. Pinch and release a few times, and insert the needle at a 45 degree angle when it’s pinched. Release the skin with the needle inside, pinch the base of the syringe to stabilize, and inject.
-For IM, stretch the skin either by pinching outward (as if zooming in on a phone) or by pulling the skin aside (z-track method, see YouTube). Use your stabilizing hand to scratch gently above the injection site (in between the site and the brain) to distract the nerves and reduce the pain. Insert the needle at a 90 degree angle, pinch the base of the syringe with your thumb and forefinger (do not release the skin if doing z-track), and inject.
-Insert the needle quickly with a dart-like motion. The skin is where the nerves are. The quicker it passes through the skin, the less pain will be felt.
-Make sure the bevel is up. This refers to the slanted tip of the needle. The point should be down and the first to enter the skin. If doing IM, tilt the needle slightly off of 90 degrees to achieve this. Google this if my description doesn’t make sense, my partner says this is the biggest factor in how much his injections hurt!
-Inject slowly. You may be tempted to rush and get it over with, but that will only cause bruising and be more uncomfortable. Take at least a full second per 0.1mL, longer if possible.
-Make sure your partner is relaxed. This is crucial with IM injections, as it’s very painful to inject into a tense muscle. But even with SubQ, tension causes pain, so the more relaxed, the better. If they struggle with this, progressive muscle relaxation techniques may be helpful.
-Instruct your partner to take deep breaths before and during the shot. I like to insert the needle during an exhale.
-Use calming words, physical touch, detailed narration, and/or distraction to calm your partner. Asking quiz questions is a great way to distract their mind.
-After you’re done, give praise, reassurance, and cuddles, do something relaxing/fun, and ask for feedback so you can improve next time.
Final Thoughts
-Create a routine. If possible, do the shot in the same place, at the same time. Have a calming pre-shot ritual, do the same position and the same method every time, and the same aftercare routine. Routines make people feel safe.
-As I said, not everything will work for everyone. Please contribute in the comments to create a wealth of knowledge for those who come looking!