--- In morelife@yahoogroups.com, Paul Wakfer <paul@...> wrote:
>
> On 07/15/2009 01:14 AM, David Thomas Jackemeyer wrote:
>
> > --- In morelife@yahoogroups.com, Paul Wakfer <paul@> wrote:
> >
> >> On 07/01/2009 10:51 PM, David Thomas Jackemeyer wrote:
> >>
> >>> This is a response to a portion of message 1964.
> >>>>> An example involving a physical-psychological phenomenon: I have
> >>>>> never enjoyed drawing blood, even for a small sample used for
> >>>>> determining my blood content and their respective
> >>>>> concentrations. I
> >>>>> would like to respond differently, more focused on the benefits
> >>>>> (rather than the sickening feeling of being sucked dry) and less
> >>>>> likely to steer away from opportunities to learn more about my
> >>>>> body.
> >>>>
> >>>> I think it is unlikely that *anyone* actually enjoys the direct
> >>>> process
> >>>> of having blood taken from hir body. It is slightly painful (as
> >>>> is any
> >>>> puncture wound), but that should be all the harm that you
> >>>> physiologically receive. If the phlebotomist is competent, then
> >>>> that should be the only negative of the process.
> >>>
> >>> I can recall only competent blood draws, yet I've always
> >>> experienced some sort of "shut down" by my body.

I can now recall one incompetent phlebotomist...more about this near the
end of this message.

> >> Since most humans do not experience this and it is hard to even
> >> imagine
> >> any physiological cause for it, the experience is almost certainly
> >> a
> >> psychosomatic (literally mind-body) result of your mind and the
> >> anxiety
> >> within it. But such mind generated causes are ultimately under your
> >> conscious and reprogrammed subconscious control.
> >
> > I understand that my "anxiety attack" is something I am creating in
> > subconscious, likely as a response to avoid pain or suffering.
> > More below...
>
> Its intensity may be connected to some of the vividly recalled
> experiences that you relate below. You do not have to continue
> creating it, particularly when you do want to experience the minor
> pain of the blood draw in order to gain its major benefits.

This last sentence is what I have been "taking ownership" of through
daily reminders of Paul's statement and by listing the potential
benefits along side the costs.
As a physical animal, the pin prick hurts! But as a big-brained animal,
I have abilities to look past the pin prick and generate a strategy that
supports participating in a blood draw in anticipation of future benefits.

> >>>> Any "sickening feeling of
> >>>> being sucked dry" is merely your own emotional (psychological)
> >>>> baggage
> >>>> (it is a very tiny amount of your total blood, so the whole idea
> >>>> of
> >>>> being "sucked dry" is simply nonsense) which you can and would
> >>>> best work to eliminate.
> >>>>
> >>> I have tried lying in bed at night and envisioning the mechanics
> >>> of the
> >>> draw, and to date I have been surprised at how anxious I get right
> >>> there in the bed, tensing up, breathing shallow and quickly.
> >>>
> >> First, quit even imagining the "mechanics" of the draw. Simply
> >> dwell
> >> on all the peripheral events involved and the benefits of the
> >> whole.
> >
> > OK, I'll start here, but do you mean altogether?

meta
<changed from "all together" to altogether>
/meta

> > I planned to continue learning the "mechanics", only stopping before
> > or during a draw. I have enjoyed reading about and envisioning how
> > the skin organ and vein are disturbed by the entry of the needle,
> > followed by platelet plug formation and blood coagulation at the
> > vessel walls, etc.
>
> Jack, why is it that if I leave any detail out you always miss my
> meaning? (This is a rhetorical question, not requiring an answer, but
> merely for you to think about.)

Very little was missed -- I came to the same conclusion as you describe
below, that I should continue learning the application to humans in
general, and stopping when the blood draw was on myself.
I asked the question above in case your suggested method began with a
period of temporary but complete refrain.

> Perhaps the following written above would have enabled you to
> understand:
> "First, quit even imagining the "mechanics" of the draw *on yourself*.
> When you are having blood drawn do not think of the physical procedure
> with respect to yourself, do not watch the needle, tubes, etc, rather
> dwell on all the peripheral events involved and the benefits of the
> whole."
>
> Yes, it is always beneficial to learn about any physiological
> operation of the body. But when you are doing the learning, approach it
> as if it applies to humans in general not yourself.
>
> [When I was learning to start intravenous infusions, I practiced
> getting the feel of lower arm and hand veins on others and myself. But
> I did not imagine inserting the needle into my own veins. Even now I
> can view and palpate the veins on my arms and note which ones are good
> for IVs (if that were ever needed - last time was when I had the
> ureteral stone Jan 2003). But I do not envision the puncture of skin
> and vein. I do not see any point in getting this graphic on *myself*
> and I do not think it is a good idea for you to do it for *yourself*
> either. **Kitty]

Understood.

> >> Second, squelch any anxiety by strongly telling yourself what an idiot
> >> you are to feel that way and how counterproductive it is again because
> >> of all the benefits of the blood letting and the test results.
> >
> > "How counterproductive", agreed.
> >
> > I don't understood why you use "idiot" since the word does not apply
> > to me, since in present day refers to those with especially abnormally
> > poor intellects. The Greek "idiote" referred to one who was static in
> > hir learning of subjects outside of hir "private station". I could
> > become that idiote if I ceased to educate myself; for example, I could
> > move back to Indiana and live on my father's farm as a
> > Jack-of-all-trades.
> >
> > Why do you choose to use "idiot"?
>
> 1. Most important, please note that I was not calling you an idiot. I
> was telling you to say to yourself: "What an idiot I am to feel that
> way", "What a silly emotion to have." or "How foolish to be so
> concerned and have such a reaction to such a simple procedure which is
> both overall beneficial and has far less pain attached to it than many
> things that happen to me more often (stubbed toe, banged elbow or
> knee, other cuts scrapes, bruises, etc.)"
>
> 2. My use of the word "idiot" is always with the meaning 3b from
> /Webster's Third New International Dictionary, Unabridged/.
> Merriam-Webster, 2002. http://unabridged.merriam-webster.com ( 15 Jul.
> 2009)
> "a person who fails to exhibit normal or usual sense, discrimination,
> or
> judgment especially at a particular time or in respect to a particular
> subject <I don't know why I was such an /idiot/> <a perfect /idiot/
> about budgeting>
> Note particularly, the phrase "at a particular time or in respect to a
> particular subject". I never use the word for a person as a whole.

I did not conclude that you were calling me such nor using the word to
describe me as a whole. And if I were to witness your verbal use of
"idiot", I know well that you are likely in an emotionally charged state
and describing the irrational thoughts and behavior, rather than the
whole being.

> 3. I rarely ever use the word these days. I only did so here as a way
> to emphasis to you the message that when you feel the anxiety, your
> conscious part of mind should very *strongly* chastise the emotional
> subconscious part of your mind and tell it to: "stop being so foolish"
> and "stop acting inconsistently with what I (the conscious) knows is
> best for me". This is what I mean by squelching, denying, scolding
> and refusing to sanction your emotional response of anxiety.

In my experiences, once anxiety begins, I respond by reasoning that I do
not sanction further anxiety, yet it still comes (probably with less
power each time). I predict a long-term contribution with this practice.
Further, since beginning university studies in 1996, I've been reducing
strong chastising behavior because I understood there to be insufficient
quantitative or qualitative benefits:drawbacks ratios. Instead, my
practice has been to calmly address the problem through 1) timely and
time-consuming discovery/introspection of my thoughts and actions, 2)
determination whether the thoughts and actions conflicted with my
esteemed values, 3) estimation of whether the conflict (problem) was
severe enough to dedicate energy/time to, and whether the conflict was
easily addressable (probably due to prior "game plan" set up to address
that very problem), then 4) "self talk" in an effort to a) try again
using different thought process and actions or b) repeat reminders of
the idea enough times in hopes that desired future changes in thoughts
and actions would occur.

What are the benefits to strongly chastising and scolding the emotional
subconscious part over *or* in-addition-to diligently addressing and
redirecting the emotional subconscious part?

Without good data nor vivid experience (naivety), I suppose the former
would have a faster effect.

> 4. The Greek meaning to which you refer is effectively obsolete in
> current English language usage. However, since I do like to keep my
> word usages close to root meanings, I will try hard to replace all
> usages of "idiotic" with either "foolish", "silly", or, perhaps best
> of all, "irrational" - because inconsistent.

Increasingly, I too am curious about the root meanings, which is greatly
aided by my use of Merriam Webster's Unabridged Online Dictionary
http://unabridged.merriam-webster.com/
and the Online Etymology Dictionary.
http://www.etymonline.com/

> >> Think about all the times that you have cut, scraped or
> >> otherwise caused your skin to be punctured and bleed
> >> profusely and how these did not cause you
> >> to have this same shut down due to anxiety.
> >
> > Thanks for the suggestion of considering examples, of which I realize
> > if and only if I watched the puncture event did I react with anxiety.
> > All other times I react as you describe:
> >
> >> In fact, likely quite the
> >> opposite, your reaction was either to ignore it if small
> >> (sometimes not
> >> even to consciously be aware of its existence until much later,
> >> particularly if you were intent on a particular task while the
> >> cut/scrape occurred) or, if large, to immediately take action to stem
> >> the blood flow and patch the wound. Why should there be any difference
> >> (except from a foolish mind) between the exact same thing being caused
> >> by an intentional act rather than a chance accident or error of
> >> carelessness.
> >>
> > Great suggestions for consideration (intentional vs not).
>
> So use this fact also to remind yourself how foolish you are being
> when you feel anxiety before and during a blood draw. If you scold
> your emotional subconscious hard enough for long enough and tell to it
> to stop behaving this way, then it will eventually do so.

Addressed and questioned above.

> >>> I have attended two blood draws within the past year, one where the
> >>> needle was very small and the phlebotomist very competent, one
> >>> where the needle was relatively large and the phlebotomist
> >>> new but fairly steady.
> >>>
> >>> I definitely had a greater physical response (much like the one
> >>> described above) to the draw with a larger needle.
> >>>
> >> You are making a major mistake by even looking at the needles or any
> >> other mechanics of the draw. I can do this with interest and without
> >> anxiety problems and so I do this to get added benefit from the
> >> procedure - partly to myself to be able to do a venipuncture for IV
> >> purposes, if I ever need to. However, Kitty, even though a former
> >> registered nurse, is still a little squeamish about having herself
> >> intentionally pricked and purposefully does not watch the mechanics of
> >> the procedure but rather keeps her eyes and mind on something else.
> >> Perhaps long after you have stopped this anxiety attack from occurring
> >> during blood draws, then you will be able to once more view the
> >> mechanics and gain the added benefits of doing so.
> >
> > Your last sentence is my hope!
> >
> >> [I agree with Paul. The best thing I would suggest under your
> >> circumstances, which are similar reactions to what I experienced in
> >> the
> >> past, is to *not* look at the phlebotomist preparing for or actually
> >> doing the procedure. I converse with hir on other or even related
> >> matters, but purposely do not look.
> >
> > Funny thing is that until recently, I thought this technique was my
> > evasion of reality, so I decided to cut the small talk, etc., instead
> > taking interest in the mechanics by watching with deep interest and
> > asking the professionals about the strategies/methods. Maybe I "took
> > too large of a bite".
>
> Yes, you tried to get your emotional subconscious (which has irrational
> behavior to this particular event) to run before it was even crawling
> correctly. Think of this way - if you are capable of rational action
> toward reality, then it should never be evaded, but rather faced head on.
> However, to the extent that you are not capable of facing the full
> reality of something then it may be necessary to circumvent, ignore or
> intentionally evade it until you are capable of fully facing it and
> reacting effectively to it. Note the difference between intentional
> evasion, which remains under your control and can later be altered
> when it is useful to do so, and unintentional habitual or subconscious
> evasion which is always negative (mainly because you don't even know
> that it is happening and therefore are totally missing whatever it is
> that you are evading).

Yes I agree, and until the very recent past, I naively placed both types
of evasion into [one negative category] which I think led me to "bite
off more than I could chew" in more than one area of my lifestyle.

> >> This method and the others that I took when
> >> I first joined Paul have enabled me to have venipunctures for
> >> multiple tubes of blood without any of the awful sensations - and even
> >> blacking out - that occurred in the past. I don't spend any time
> >> thinking about the actual procedure itself - I think that this too is
> >> important. Maybe sometime in the future I will look, but I'm not
> >> especially motivated to doing so. Everything goes quite well now and
> >> that is my interest.
> >
> > Do you think about the procedure when far from having a blood draw?
>
> [I think of it only in regard to planning what day and approximate
> time so that it fits appropriately with our eating. I do not at all
> think about the venipuncture itself. I know from experience that if I
> get it done with a butterfly and that even if the phlebotomist is not
> the best, the procedure will not be unduly uncomfortable. What really
> bothers me is the probing for a vein by a less experienced person or,
> if a butterfly is not used, the movement every time the test tube is
> changed out for another one. This last is many times when we have a
> large set of tests. But I've had no real anxiety episodes since using
> Paul's method. The blackouts occurred in previous years - I used to
> dread going to get lithium levels every 6 weeks and that was only 1
> tube. **Kitty]
>
> >> Another suggestion, is requesting that a draw, which will require
> >> multiple test tubes for samples, be done using a butterfly.
> >
> > Interesting, thanks for the suggestion -- I will inquire.

I decided to make a visit to the local Mesa, AZ LabCorp for my a.m.
blood draw (no caloric intake for 15 hrs, no exercise for 42 hrs), which
is to be assessed per LEF's $189-sale-price Male Panel:
http://tiny.cc/iJ03z

The night before, I had a stressful time falling asleep, taking over 1.5
hours to initially fall asleep, then waking throughout the night. I
actually did not think much about the blood draw that I planned to
complete in the morning; instead, my brain was concerned with EVERYTHING
else!

Without an alarm, I woke at 8:20am, shaved, showered, packed my bags for
work, and brought ice water and a book in case of a long line at the
LabCorp; I left the house at 9am.

Arriving to a mostly empty parking lot and only nine people in the
waiting room and no line for signing in, I did so, and within 5
minutes, was called; in fact I was the first to be called since I had
arrived. Fast service, a plus :)

{Anxiety creeps up to 5%}
A female named Joe P was assigned my draw. She left the door to the
room open, which felt good because in an 8 x 8ft room, I might have felt
restrained.
(On second thought, I might have enjoyed the enhanced focus that comes
with privacy.)
I requested a butterfly-style needle and tubing -- Joe hesitated and
said she was not well-practiced with the butterfly. I thought for a
moment, "fine, first and foremost, I want her to be confident and calm".

{Anxiety 10% -- things are not going according to plan}
So I suggested an ordinary needle and tubing would be fine, in fact,
that *her choice* of apparatus would bring me most comfort.
But she responded, "No, no, if you'd like a butterfly, then we'll do the
butterfly."

OK, whatever, just do your job and I'll do mine!

{Anxiety 15% -- can I trust this person?}
I stated out loud that I had a little trouble in the past controlling my
response to blood draws, but that I was more confident now that I was
thinking of the plethera of benefits of such a procedure coupled to a
small cost, the prick of a needle.

I avoided all visual contact with the apparatus as she neared and
strapped on the tourniquet, drawing from my right arm. Small prick and
an increase in {Anxiety 20% -- feeling the needle prick, but not
imagining entry}, so I continued to think about the relative gain versus
the small cost of minimal pain PLUS the fact that this was a controlled
situation, not some accidental puncture wound...

"You're all done", said Joe.

Wow, that was fast! Yippee! I am a champion!
I glanced over at the two tubes of blood and commented to Joe that in
the past, the tubes were a little smaller, and *five* in number.
Just as I was leaving the room, she called me back in -- oops, only did
half the draw!

{IDIOT! -- Oops! That slipped out... I'm angry and would like her to
step down. Anxiety bumps up to 25%}
So, I sat back down and requested the left arm, where she found a new
vein...and failed! I did not look, but I could not avoid her nervous
call to the supervising nurse -- "We have a bleeder" coupled with my
now throbbing left arm.

{This MUST be a joke! Why would she say THAT out loud? Anxiety up to
50%, doubling as I don't trust Joe to improve at this point and both
arms are throbbing.}

I'm getting pretty flustered, but before I can bolt for the door to
escape whatever wrath lay before me, the supervisor glides in, expertly
eyes the appropriate vein, and without more than a expert's nod, slips
the third butterfly almost perfectly between nerve endings -- I felt no
new pain.

Supervisor says, "Take care of this one -- I've got to go."

{No, please don't go... at least don't leave me here with her! Anxiety
caps at 50%}

Needless to say, my chest was full of anxiety. I kept breathing and
making small talk as Joe wrapped up the draw, without further incident.

I was out of there! I still managed to walk out with a smirk on my face
but only because of the unusual timing and circumstances surrounding my
experience, where I intended to simplify my blood draw to a few
manageable details.

Subsequent, I drove to work and really worked on my self to appreciate
the valuable information from this and future blood draws. I HAVE NO
NEED FOR THE ANXIETY! I am uninjured!!
Nevertheless, the anxiety took awhile to decrease as my arms pitifully
throbbed (slightly) painful reminders of the draw(s).

When I phoned Kitty, I described some of these details to her and shared
one of my heartiest laughs of 2009 while discussing the ridiculous
parts along with the important growth.
This was an important part of my experience, thank you Kitty :)

--Jack (David Thomas Jackemeyer)

> >> This is a
> >> very small bore needle attached to flexible tubing that enables the
> >> phlebotomist to change test tubes without disturbing the needle in the
> >> vein. I regularly request this since the sensation at the venipuncture
> >> site when the test tube is changed is not at all pleasant to me and I
> >> think it has in the past contributed to the anxiousness I have
> >> experienced. Phlebotomists do not want a patient to pass out, so if
> >> you firmly request a butterfly for that reason, they will almost
> >> always readily comply. Yes, this extends the time it takes to complete
> >> the withdrawal of blood - but not greatly - and a phlebotomist in a
> >> hurry may balk. But if you insist, s/he will not refuse to comply.
> >> **Kitty]
> >>
> >>> Since many years ago, I have always prepared myself with very
> >>> positive
> >>> thoughts about the usefulness of the draw along with the interesting
> >>> physics of pressure differences between vein and tube/needle, plus I
> >>> always watch the needle enter and leave.
> >>>
> >> At least for the time being until the anxiety has been eliminated, you
> >> would do best to totally quit thinking about and watching the
> >> mechanics of the draw.

<snipped remainder about living as a stranger in one's one experience>