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Reducing Injection Anxiety and Pain

Sometimes what we think of as being intuitively obvious and “common sense” is dead wrong. Other times the researchers prove the truth of something we were sure we knew anyway. Those are the times I start saying things like “Well, that is a no brainer” and “Duh. No poop."

Anxiety and pain?

I had one of those moments today. I looked at my Healio newsletter and saw the title "Anxiety leads to increased perception of pain during intravitreal injections. All together now “Duh. No poop!”

The research behind anxiety and pain

It seems Matthew Weider presented a paper at the virtual Association for Research in Vision and Ophthalmology meeting held this spring. In his presentation, he reported pre-procedure anxiety is the best predictor of whether or not the client will experience pain during her eye shots.

More on this topic

Using measures of anxiety and quality of sleep prior to a shot, Weider discovered a significant correlation between anxiety and perceived pain. There was also a correlation between poor sleep the night before and pain but that correlation did not meet significance levels.

Increased perceived pain

No poop. I believe many of us could have predicted that. Weider goes on to suggest that people who are very anxious and thus at-risk for pain be identified earlier, given talk therapy, and treated with pain-modifying techniques.

Staying calm before the eye injection

Any other suggestions out there? Sandro LaRocca of the New Jersey Neck and Back Institute wrote a list of 17 tips on how to stay calm going into surgery. Some of them might apply to eye shots.

1. Trust your eye doctors

How about this one: Trust your medical team? If you don’t trust your team, I would suggest you find another team! “My” team works for the second-best eye hospital in the country. That is not too shabby. I suspect they are pretty much cream of the crop. Besides that, they are highly professional, knowledgeable, and nice.

2. Trust yourself and your decisions

LaRocca’s second point was to trust yourself. Trust your ability to decide on the course of action that will serve you best. You have made the decision to have these shots because you and your doctors did your research, looked at your options, and decided this procedure is the way to go.

3. Educate yourself on eye injections

Bringing me to another of LaRocca’s suggestions: educate yourself! Many of you grew up with Schoolhouse Rock (Conjunction Junction, what’s your function? Lolly, Lolly, Lolly, get your adverbs here? You remember!). Their motto is as true today as it was 50 plus years ago. Knowledge IS power.

My treatment routine

I presently go for eye shots once a month. I am part of a clinical trial testing an intravitreal treatment for dry AMD. I have had about ten shots and I have yet to have a “bad” one. I went into this armed with the knowledge I have a good team and this is my best shot at slowing down the progression of my disease. I know that because I did my research.

More tips on how to stay calm

Obviously, that is three points and not 17. Others include perennial favorites, distraction, relaxation and utilizing a support system. Not part of his 17, but worth mentioning - and he did! - are positive affirmations and positive visualizations.

So repeat after me...

“This will be a short procedure that I can and have endured easily...I believe in my doctor to do the best job possible; I chose well," etc.

Remember that reducing pre-shot anxiety reduces pain. It was researched.

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