Insulin Injections and Buzzy the Bee ®: Working Together to Alleviate Pain
Today I write about practical matters: the association of pain with multiple daily injections, especially in young children, toddlers, and infants. I am always looking for any "magic bullets" to alleviate as much discomfort as possible to enhance adherence. When I heard about "Buzzy the Bee ®," I was intrigued.
Who is "Buzzy the Bee ®?" According to Dr. Amy (a Pediatric Emergency Medicine physician and the CEO inventor of Buzzy4shots.com), the "bee" is a handheld device, that approximates the size of a computer mouse which through a " combination of vibration and ice, minimizes pain from shots and other needle sticks like IV starts, blood draws, and finger pricks." According to the website, it works immediately, is reusable and FDA compliant. It may be purchased online for $34.95.
According to buzzy4shots.com, Buzzy is a small vibrating toy bee with a special ice pack. When Buzzy is placed against sharp, itchy, or burning pain, it apparently desensitizes the body’s nerves, thus dulling the injection discomfort. According to the website, Buzzy "crowds out pain by sending stronger motion and temperature sensation down the nerves instead." Upon drilling further into the website, the basis for this desensitization is called the "gate control theory." The Gate Control Theory states that the decreased pain is caused by production of sensations other than pain and then sends these sensations through the same pathway. The final common pathway for sharp pain can be blocked by the nerves that transmit cold and vibration senses. Hence, stimulating "cold receptors can dull needle pain." The Gate Control theory also has been applied successfully in physical therapy by using a special device that scrambles sensations to alleviate back pain.
How does it work?
To decrease the pain of the injection directly on the spot, one puts an ice pack behind Buzzy, and Buzzy is placed above the shot site "between the brain and pain." Buzzy is turned on for about 15 seconds and left in place while the injection is given.
Although I wanted to avoid scholarly research today, there are actual evidence-based reports from reputable institutions attesting to its effectiveness. According to the 2011 poster presented at the University of Pittsburgh Trauma Symposium, "Buzzy in the Emergency Department: A Novel Pain Relief Device for Children," by Miller et. al, "Buzzy was able to decrease pain assessment scores from 3.9-4.6 (based on Wong-Baker Face Scale) to 1.2-3.4. According to the authors, "Buzzy appeared to reduce veni-puncture pain in a pediatric emergency room based on pain assessment score trends, patient report, and family comments." There have been other positive reports noting pain reduction. Since discontinuation in production of the shotblocker ®, there are few items on the market to help with pain of injections. Of course, "Buzzy the Bee, ® is just an aid to assist in diabetes management especially in small children or any child that is needle-phobic. One might start using the bee with the ice pack and then hopefully move forward in effort to desensitize the pain by transitioning to the ice pack alone and then eventually just give shots without any anesthetic aids.
Keep in mind that parental behavior helps in getting your child accustomed to insulin injections as children model parental attitudes in many cases. If the parent or caregiver conveys fear of needles and injections, that anxiety will be transmitted to the child. I suggest that all caregivers proceed with a positive attitude initially and then, if necessary, attempt to alleviate anxiety and pain by other methods. Buzzy the Bee ® is one of such methods.
I would love to hear of other ideas that have worked for families of children with diabetes. Please send in comments
Fran Cogen, M.D., C.D.E., is the director of the Childhood and Adolescent Diabetes Program at Children’s National Health System. She wrote about diabetes for HealthCentral.