The Get Healthy Tampa Bay Podcast

E97: Eliminating Needle Anxiety, Thimble Health’s Solution to Needle Fear with Dr. Manju Dawkins

• Kerry Reller

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Welcome to the Get Healthy Tampa Bay Podcast with Dr. Kerry Reller! This week, I’m excited to sit down with Dr. Manju Dawkins, a board-certified dermatologist and the founder of Thimble Health. In this episode, we tackle the growing issue of needle fear and explore how Thimble Health is changing the game. Dr. Dawkins shares her journey from dermatology to entrepreneurship, creating innovative solutions to alleviate the pain and anxiety surrounding needle procedures. From numbing patches to a psychological support app, we dive deep into how these tools help patients and healthcare providers alike. Tune in to discover how these simple, yet powerful solutions are reshaping patient experiences and making healthcare a little less scary for everyone!

Dr. Manju Dawkins of a board certified dermatologist who  received her B.A. from Columbia University and  her M.D. from the University of Maryland. She completed her dermatology residency and served as Chief Resident at Albert Einstein College of Medicine in the Bronx, NY. She was Assistant Professor at Mount Sinai School of Medicine where she was twice named Teacher of the Year.  She has practiced in academic, private, hospital based, and group practice settings in New York and Los Angeles. 

She is also the creator and co-founder of Thimble, the first easy, safe, and comprehensive solution for alleviating needle pain and stress. 

0:28 - Introduction: Meeting Dr. Manju Dawkins
1:21 - The Journey to Entrepreneurship: From Dermatology to Thimble Health
3:29 - The Impact of Needle Phobia and Why It’s Often Overlooked
4:17 - The Role of Thimble Health in Alleviating Needle Pain and Stress
6:41 - The Emotional Side of Needle Fear: How Thimble Health Tackles Anxiety
7:09 - Why Needle Fear Is Rarely Discussed in Medicine
9:25 - The Impact of Needle Phobia on Public Health
11:24 - Addressing Needle Fear: Thimble vs. Traditional Approaches
15:17 - The Science Behind the Prepare Patch: How It Works
19:54 - The Recover Patch and Its Benefits for Post-Procedure Pain Relief

Dr. Manju's Website:
www.thimblehealth.com

Connect with Dr. Kerry Reller
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Kerry:

All right. Hi, everybody. Welcome back to the Get Health Tampa Bay podcast. I'm your host, Dr. Kerry Reller. And today we have a very special guest, Dr. Manju Dawkins. Welcome to the podcast.

Manju:

Thank you so much for having me.

Kerry:

I'm excited to hear all about you and how you got to where you are, because this is a very unique path. So go ahead and tell us a little bit about who you are and what you've done before, and then kind of where you've gone now.

Manju:

Sounds good. So I grew up in Maryland and it turns out we went to the same medical school, University of Maryland. Yay. I am a board certified dermatologist, also mom of two girls and what ended up happening I never wanted to be an entrepreneur. It was just not ever something that was on my radar, but kind of fell into it because there was a problem that seemed like it could use some solving. So I started a company called Thimble Health and our whole goal is to alleviate the pain and stress of needle procedures.

Kerry:

Yeah, I mean, I think this is very interesting to our listeners. So our practice, if my patients are listening, you know, we do a lot of allergy injections and other people, maybe I'm doing obesity medicine as well, and they would be doing maybe some home injections for weight management medication. So I know that listeners will be very interested to see how you came up with this idea and the journey to it. So can you tell us a little bit about that? Like what inspired you to tackle this issue?

Manju:

Sure. Yep. Like most things, it starts with your own problem, having to solve your own issue. When I had my first daughter I was a resident in dermatology at the time. And and I just will never forget her face, you know, they're a month old. So you don't really expect that much, but she really, it was like a very specific, like pain and, bewilderment and betrayal. Like, how could you let that happen to me? And I was like, Oh man, yeah. I just felt like I'd failed as a parent and, and as a doctor. And so I ended up being able to hack my own solutions because I had lots of friends who could prescribe me the prescription numbing creams and and they're not that easy to use. Like you need a lead time of a couple hours and you've got to occlude the, the medicine with saran wrap and leave it in place and it melts at skin temperature and it has these side effects. But I was in a position of privilege that I could, I could do it. And it was really, game changing. Like it was so, it was such a better experience for everyone involved. So, you know, for obviously for my daughter, but also for me as the mom and for the person giving her the injection, which happened to be the pediatrician at that time. So that was the kind of first moment and then started to kind of realize like, wow, this It's not just a me problem, it's, it's not only an every parent problem, but it's like an every patient problem. And then looked into the problem and it's just been growing. It's like 60 percent of adults now has some fear of needles and we never really talk about it. Like we never got taught anything about it in med school in training. It's just kind of something that people had to get through. And even the language that we use around it is like pretty cold. And when we're inflicting this much. pain on a regular basis. People, I think we just have to have a little bit more care and compassion and see what we can do to make things better. So that's kind of how it started and then the journey began.

Kerry:

Yeah. Yeah. I mean, I remember doing like my pediatric rotations and I mean, even now still, like when we have to order an injection on a kid, I'm just like, okay, you're the medical assistant do it. So I don't look like the bad guy. Right.

Manju:

Exactly!

Kerry:

it's hard. Yeah. Luckily, personally, I have three kids and I think they're just, they take it pretty good. So I, I mean, yes, they cried a little bit, but like, They're, they're pretty good. So I haven't had that personally too bad, but you know, family members wise, my brother, will see a needle and pass out. So does it help for, I mean, we'll probably get to this, but it does, does it really help for those kinds of situations, what you are doing, or maybe I should save that question for later, but versus just like the pain of the injection.

Manju:

And no, it's a, it's an excellent question because, yeah, needle fear is super variable, like, and it's certain parts of the experience that bother certain people, like sometimes it's seeing the needle, sometimes it's the pain of the injection, sometimes it's the pain after, sometimes it's the fact that you faint, or feel lightheaded, you know, so there's all these aspects to it. And we need to like look at the problem for what it is. And so what we try to do is create like an over the counter, accessible, ultimately affordable solution that everyone can get to that tackles each parts of those and people can use the whole system or pick and choose what works. So I'll just tell you kind of what it includes. So it's like not like this abstract thing, but. So basically we have a patch that you put on before that contains lidocaine and it's specifically designed and formulated for needle procedure. So it looks like this. It's just a, it looks like a sticker and you put it on before any vaccine, blood draw, medication injection. you apply it before, so it prevents the pain of the stick. And then for after we have the recover patch and it looks like this, it's a plant based patch. So it's powered by turmeric and arctica. And you put it on right after the injection and you leave it on for 48 hours of targeted relief. So tackles the bruising, soreness, ache. And then because we know that pain and needle fear. All of this is not just physical, it's also emotional and psychological. And so that's why we have an app that puts together all the research backed tools to ease the kind of psychological sides of things like, you know, things like breathwork, applied muscle tension, progressive muscle relaxation, distraction, cognitive behavioral therapy techniques just to help get people through. Like it's, it's a real emotional journey for a lot of people. Like the anxiety starts at a certain point, it rises, and then it falls, Falls. And even that after portion, I think is something we really need to start paying attention to. Because that's when our brains are processing that event. And we start like, I think about the movie Inside Out. I was just thinking about it this morning. You know, like there's the core memories that like get stored away. And so right now we've got a whole lot of people with a lot of core memories that are very negative centered around healthcare. And just like you kind of pointed to like, A lot of people dislike us now because we're, you know, inflicting a lot of pain and there's a lot of negative association, so I, I think if we take kind of better care of these little moments of pain. Then hopefully we can kind of shift the attitudes around health care and the kind of like you know, there's a lot of distrust and it's, it's understandable in many ways. And so, yeah, I hope we can make a dent in that.

Kerry:

Yeah, I definitely want to come back to this whole package with this app that you can kind of help ease and prevent anxiety. And I think that's, that's amazing to even, I, that's not something I thought you were going to come up with. So I'm excited to hear, you know, a little bit more about that. But you mentioned before that it's this needle phobia is like rarely discussed. Do you have any idea why you think that is or it's so prevalent but not really discussed at all?

Manju:

oh, I think there's so many reasons. I mean, the first part of it is like, I think, you know, like in medicine, things don't really move with much ease. Like it's a lot of it is like, we've done things this way for so long and we all get trained by our seniors and attendings that have done this for many years. And so kind of a lot of the times the same way to think about old problems persists for longer than I think it sometimes in other fields. And then the other thing is that the problem has really grown because if you look at the research, like a needle phobia in adults in 1995 was thought to be around 10%. And then by 2012, the number had risen to 25%, and now the more recent numbers suggest that it's around 60%, 63 percent is, I think, the official number from the last study. So, there's a real kind of steep rise, and the question is why. And one of the things is, we are all getting a lot more needles than we ever did. You know, like when I was a kid, I got six shots before the age of six, and I thought that was terrible. But my kids have gotten 36 shots each in that same time. Which is It's it is a great thing, right? Because we've made that many advances in medicine and science that we can protect that much better from disease. So it is a good thing. And all of that care is essential. But if we continue to ignore the pain and trauma, each of the procedures could cause then, then that's where I think the problem lies. And, and we were all exposed to it, right? Like the media is covering the rise of GLP ones. And, and there's so many amazing autoimmune medications, there's just a whole lot more needles that we're experiencing IVF, like, it's a lot. Yeah. And we just haven't caught up yet with how patients are feeling about it and how caregivers are feeling about it and frankly how we're feeling about it as the people doing the injections because I'll just share that like, I'm an empath. I really don't like to cause other people pain like it, it hurts me to see somebody else hurting. I do think that it contributes to the kind of like, You know, like the, the burnout and like the moral injury that happens when we're like kind of like doing the same thing and we get less and less time with patients and, there's no opportunity to build an empathic or compassionate relationship there when you only have like, you know, six and a half minutes to do everything. And so, yeah, tackling a lot of my own problems with one thing.

Kerry:

Yeah. Well, I mean, you kind of alluded to this, but how do you think this needle fear impacts public health on a larger scale?

Manju:

Oh man, it absolutely does. And so I've been working on this for a long time and you know, it was kind of hard to get people to believe that this was a real problem, but then the pandemic happened. And then more research started happening. Cause I think that's another thing, you know, like why haven't we addressed it in med school or in nursing school or anywhere? And it hasn't been studied very well at all. And we're not asking, we don't always ask open ended questions. We kind of give people a choice of like, what don't you like about this? Is it X, Y, or Z? Or why not? What don't you like about it? Period. You know, so that's one thing. But so pandemic happened. And then, of course, there were a lot of people that were concerned about getting another vaccine. And I think you know, the response, it was a very divisive time, right? And I think we all made a lot of assumptions about why people weren't getting the vaccine. And Humans have lots of different reasons for doing things. And it turns out that a fear of needles was a really big one that we just didn't pay attention to. And so there was this Oxford study done in 2021, and it suggested that if we had actually addressed injection anxiety, we could have increased COVID vaccines by 10%. And so that extrapolates to 300, 000 lives that could have been saved in the US alone. So there are real public health impacts that are being made by not addressing the problem. So I think we should try it. And that's just in the vaccine space, which I know is like a, a tricky subject for a lot of people, but You know, you can think about even just lab screening, right? Like, we all need to get our hemoglobin A1c check to know if, like, we're predisposed to the diabetes, and you can imagine what happens if you're like, I'm going to put that off. I don't really want to go through that blood draw. You put it off, you put it off, and suddenly you're a full blown diabetic, and now you have to take an injection. And then what happens? You don't want to do the injection, and then what happens? You know, so it's just this, you know, It's the spiral that I think hopefully we can tackle early on.

Kerry:

Yeah, I mean, you make such great points. Like if people aren't going to get their labs and you have no idea these things are an issue and then they may actually need more, you know, things going further. So some patients who are, I think, particularly anxious about it have even asked me for medication like oral medication, sometimes like a benzodiazepine, which is something that, you know, we don't like to prescribe very often before they have these kinds of procedures. How would you say, you know, just for public education, how would you say that thimble kind of makes it different from these kinds of ways of addressing needle fear or other ways?

Manju:

Yeah, so, you know, needle fear is really complex and there's a huge spectrum. So there are some people that have a mild aversion and there are some people who have a severe, severe phobia that requires treatment beyond treatment. What we're able to offer at thimble, right? So people with severe needle phobia should not be afraid to ask for help. You know, exposure therapy can be very effective and sometimes medications are needed because there are, you know, life saving interventions that need to be done. And and so, yes, sometimes anxiolytics are necessary to get people through. So what we try to do is, you know, offer solutions to, to the masses that hopefully everybody can start to use and ultimately prevent needle fear. You know, like I always think about like, you know, ultimately I don't want people to need our stuff. You know what I mean? I want people to move beyond the fear at a certain point, but sometimes it just starts with treating a problem with a little bit of compassion and understanding first, and that's how you feel safe and you can move beyond. But so. You know, the way we do that again is like we everything we make is available with available over the counter so that everyone can kind of get it for themselves and feel empowered. I think that's another tricky part of being a patient these days is like you feel a little bit lost and at the behest of like, whoever's in front of you, doing the thing. So, That's one thing is accessibility. And then we, we treat the pain at all points. And I think another important part of it is also just starting the conversation, like because it's a shift, right? And things are hard to shift in healthcare, but I think it'll hopefully inspire some curiosity. Like if a patient comes on with this patch and you're like, what is that? And I hope it, I hope it inspires curiosity and not Anger, you know, like sometimes we react to new things with kind of like, what is that? I can't, you know, Nope, Nope. But I hope it's like, Oh, what is that? Oh, actually, this is going to numb my skin before so that the stick doesn't hurt as much. Oh, well, let me learn more about that. And I think at the end of the day, I know I'm getting a little off target, but like, at the end of the day, it's the humans that are being hurt by what's going on in healthcare, like with the corporatization of healthcare and, and, and patients are suffering. People in healthcare are suffering. Like All of us, doctors, nurses, phlebotomists, like MAs, everyone, our jobs are getting harder and harder, and Instead of like the system has kind of divided us and pitted us against each other and it should be exactly the opposite, like we're all on the same team and, you know, I, I kind of hope these things bring us closer and more in conversation and kind of like remind us that like, Oh, we are on the same team. And like, Hey, me, the patient treating my pain and anxiety is actually going to help you healthcare practitioner, do your job with more ease and safety and confidence, you know

Kerry:

I mean, I think that's totally true. I agree. It'd be much better to have a cohesive front instead of, you know, doctor against me and know that patient's going to like one better than the other. But I think hopefully things like this, allowing the curiosity and allowing, you know, Oh, what's that? I think in being open to it is definitely would help move things forward for sure. So you, you were explaining the patches a little bit and I wanted to go back to that. So the prepare patch you mentioned is first of all, you said they're available over the counter, right? Oh, very exciting. Okay. So prepare is like lidocaine base. Is that what you said? Okay. And

Manju:

like the package. Yes, contains lidocaine. And the tricky thing is like this was the, the R and D was, how do you get lidocaine to penetrate through the skin more quickly, because You know, my background is in dermatology, and skin is kind of like an umbrella. It's very good at keeping things out, whereas your oral mucosa, for example, is like a sponge. Like, it's part of your digestive system, so it wants to absorb things, which is why, when you go to the dentist, that numbing medicine is able to work so quickly. Which is great. Like, isn't that a one? I mean, going to the dentist is so much better now. But with the skin it's a little bit harder, so that's what we were trying to develop, and so we shortened the time that this needs to be left on the skin to be effective. And so, and I'll just tell you a little bit more about it, like, so you just stick it on like a sticker and then you leave it on for about 30 to 90 minutes and then, and that's the key to be, to it being over the counter, so you can, you know, order it yourself. On thimblehealth. com and then have a pack ready at home for whenever you need to go in for anything like you can, even if you have to go to the emergency room, you could slap one on because by the time you get there and get triaged, it's, it will have been there the correct amount of time. So what you probably can't see very easily is, but there's a central circle. And when it's time for the procedure, you peel out that central circle and it so that it leaves this kind of ring. And the reason for that is it outlines the site of treated skin because. I don't know if you've ever used Emla in practice, but it's a prescription numbing cream that is kind of tough to use because it's wonderful. It's a great, great medication, but you have to put a big glob of the medicine on. You need to occlude it with Saran Wrap or a Tegaderm, leave it in place for two to three hours for it to work its best, for true its best. And then it melts at skin temperature, so it moves away from the site. And then a lot of the times You know, people will be like, you know, they're trying to get ready for the doctor and they'll be like, okay, I've wiped it off. I'm ready to go. But then the problem is like, but where did you numb? Right? Like, so that's why we outline the site with the patch itself so that it's clear for everyone. Like, okay, where do I, where do I go? So

Kerry:

it need to be cleaned first in that area?

Manju:

that's a great question. So I know we on the healthcare side are also really sensitive about like I'm not going to change anything I need to do because that's, my risk, my license on the line. So nothing changes for the proceduralist. So that, that ring basically the outer portion of this patch will be left on the skin. Or you can take it off. Honestly. So you can leave it on, you can take it off, but then you do what you normally would do clean with an alcohol pad or HIPA cleanse or whatever you'd typically use. And then the procedure is the same, meaning you are not injecting through the patch at any point. Do you know what I mean? So yeah, we hope it creates more ease and, and no burden for the proceduralist.

Kerry:

Yeah, that's great. And then you said the, what is it called? The recover,

Manju:

Oh, yeah.

Kerry:

That is, I think I heard turmeric.

Manju:

Yeah. So it's got.

Kerry:

what, how does tell me about that one?

Manju:

So yeah, one of the other things that over the years have been like, man, we're, there's a lot of good stuff out there that we should be using, but we never really got taught in medical school. And so, Yeah, turmeric is widely used in Ayurvedic medicine and in traditional Chinese medicine, and it's an anti inflammatory that a lot of people know about now. Like, right, people are taking it for joints so I don't even need to explain probably, but it's anti inflammatory. It reduces swelling, Also can be helpful with pain. Arnica is used in actually traditional Western medicine. So it's a plant that grows in Western Europe and it's been used for bruising and pain. Also people know about it now. So I don't think it's anything new, but we combine them because together works even better to alleviate the bruising and soreness and ache that happens after these procedures. So like you can use it after a blood draw or a blood donation and it will help those bruises go away a bit faster. For me, what I love to use it for is like after the flu shot, after the COVID vaccine, like your arm feels awful and it really, really helps with that. So Yeah, and the reason I think that's important because like we never really thought about that like treating the pain of after vaccines or anything like that, but I always think about how pain is a teacher, like it is there to tell us something. And so what it's teaching us right now is that vaccine that I got. bad. Like it's it's it's pain means this is something I need to avoid. And so it shouldn't be surprising that there's so much hesitancy about about vaccines because there's there's literal pain involved afterwards, during and afterwards. So I'm, I'm hoping that if we address that part of it to you know, we'll kind of be able to shift attitudes. We'll see.

Kerry:

Yeah. I feel like with the Tdap vaccine, there's that deep muscular pain. Is it like penetrate the skin enough to help prevent or help it a little bit?

Manju:

that's what's been amazing. Yes, my experience is like my, we've had a few people who you know, got COVID and flu, like one arm, one arm, and I know it's not the same vaccine. And so the reactions are going to be different. But, you know, they only had one patch, they put it on one arm, one arm feels great. And the other one is like, so It's, it's remarkable. and it's so interesting, right? Like, there's so much we don't understand about pain. Like, how is that? Like, how is it tackling the, the, the muscular pain? We don't really know. We don't really know, but, but it works and that's why it's, these things have been used for, for hundreds and thousands of years and that's its own kind of randomized control trial. I mean, it's not randomizing control, but do you know what I mean? Like it is its own very long trial. So yeah, so I'm, I'm excited for people to try it and see for themselves,

Kerry:

Very cool. So is it available in stores or only you said on the thimble website?

Manju:

yep. Right now on the thimble website. So it's thimblehealth. com. And we are probably going to be expanding, but we are also available through a B2B distributor. And so one of the things we're really excited about is that some pretty big blood donation centers are interested in bringing it on because, man, blood donors are like angels on earth and they deserve a lot of things. And so, yeah. You know, to alleviate the pain of the of the donation and also the bruising afterwards. So we're excited about that. And then ultimately, and we're also available in some pediatricians office, IVF, dermatology offices and, and, you know, So, you know, if, if you or any of your listeners want to bring it into their offices, of course, we'd be happy to happy to make that happen. And then ultimately the goal is to, you know, change the standard of care for needle procedures. Like I always say though, you know, Anesthesia was only invented in the 1840s and that really wasn't very long ago, when you think about it. And before that, you know, it was like a shot of whiskey and they chopped your leg off. And, and there are these paintings of when that happened, right? Like they are holding the guy down and you can see his face. His face is one of, of course, it's like one of sheer terror. If you look at, you know, kids when they get vaccines now, a lot of the times, you know, they're being held down, restrained by multiple people, and it's exactly the same face, and I know it's kind of seems silly to liken those two things, but, like, fear is fear is fear, terror is terror is terror, so like, we have to, we have to pay attention to that, because it's impacting the way people kind of interact with healthcare. For the rest of their lives. So, so, yeah, so my hope is that ultimately, you know, hospital systems are giving it to patients and insurance companies are sending it out because it actually helps them. It helps them with their bottom line when people are able to stay adherent to. you know, their treatment plans and get their preventative care. It's good for everybody. So

Kerry:

Do you envision it like being available at like the pharmacies?

Manju:

yes, I forgot to say that we are available in some independent pharmacies. And yes, I think actually that's a great opportunity for pharmacies too. So they're doing a lot of vaccines now. All these, all these big retail pharmacies and small ones. And so it's a real offering to their patients that they're serving and then to be able to also sell it so that they can get it to their family. You know, PE people can get it for their family members and beyond is another opportunity I think, for the pharmacies too. So ask your pharmacies to carry us if you can. And yeah. And then that's how we'll shift things like. Another thing I think about is like, I mean, it's, it's like a very daunting thing, this whole thing, right? Because it's hard. It's just really, really hard. But like, what gives me hope is that change happens more quickly than it used to, like, you know I don't know if you've been following the IUD conversation at all, like for IUDs, it really hurts to get them placed and the pain experience is really variable. So some people are like, Oh my God, this is where it's in childbirth. And some people are like, I didn't feel anything. But it hurts really badly for a lot of people, but we've always placed IUDs without pain management. because that's just the way it's always been done. And, and basically a lot of people got vocal, I think on social media and, and then also in regular media. And, and things did change. Like the CDC changed the recommendation so that now women have to be offered pain management treatments options at least for IUD insertion. So it just gives me hope that like, maybe change can happen,

Kerry:

yeah, absolutely. I have only been following that a little bit, but I'm, you know, now more aware what about the app you were saying? So, I mean, you don't need the app to use the product, but I would say it sounds like there's a lot of, you know, like offering on that. Can you just tell us a little bit more about it?

Manju:

Sure. Like, so right now the app is in beta, so you won't be able to just download it on the Apple store or that other one that I'm forgetting the name of yet. But, and some of, some of the portions of it are available on our website for free because we just want people to have access to this information under the guide section if anybody's interested, just tips and tricks about how to get through with a little bit more ease. But we did a lot of research on when the fear was happening, when the anxiety was really triggered, like what are the things that help? And first of all, there's this there's actually this pharmacist out of Canada. Her name is Dr. Anna Taddeo, who has done really amazing research about what helps with needle fear and needle pain and what doesn't really help. And what she found is that multimodal therapy is what works, meaning different kinds of solutions utilized together are more effective than using one alone. And so that's why we treat the pain before and after. And that's why we treat the emotional and psychological side. So things like breathwork can really be helpful because what happens a lot of time with needle procedures is our body goes into fight flight freeze mode And when you take deep breaths, like diaphragmatic breaths it basically reminds, it's basically telling your body we're not in fight or flight. We are here and we are safe. Like, so it's very simple. But you know, just telling someone to take deep breaths sometimes feels you don't want to hear that, right? When you're in that state. So the app kind of puts it into these little modules that are kind of like little exercises. Like for example, right now it's designed for five to 11 year olds and their caregivers. And it's like, okay, we're going to blow bubbles. And then it has pictures and you're slowly blowing the bubble. And, you know, it's, so it's, it feels more like a game than like, okay, we're going to do diaphragmatic breaths now, you know, and we try to incorporate different parts of it. So, oh, I wanted to mention about applied muscle tension, because you mentioned your brother sometimes faints. And that is way more common than we realize, although you probably see it in the office a lot. Yeah, unfortunately, but but there are things we can do to, to prevent that. And applied muscle tension is a really easy tool that anyone can use. So basically what's happening is you're nervous about the thing. And so your blood pressure goes higher, but then your body basically goes into that panic mode and it's like we give up and then all your vasoconstriction it just everything vasodilates all the blood Runs out of your head and then you faint. So it's not because you're weak. It's not because it is just a physiologic response And so when you, when you use applied muscle tension, so simple things like pulling your arms apart for seven seconds like really hard and then relaxing, or pushing your hands together for something, or squeezing your thighs together like Suzanne Somers, and then relaxing. Like if you do those actions repeatedly, it increases the tone in your blood vessels and then you you'll keep that blood flow up there. So just simple things like that. And again, we put them into easy to use modules on the app and that can be really helpful. Distraction is a big one. So you know, sometimes listening to music can be helpful, but actually making music is even more helpful or like playing a game actively doing something active with your brain is more helpful than doing something passive, like watching a screen. So that's why we have like little games that are also on the app too. And then the last part of it is the after which I think sometimes we do a pretty good job of like, right? Like people get a lollipop afterwards or something like to at least, I mean, I think it should not just be the lollipop. The lollipop, the reward is a good thing, but we also need to talk about what just happened and reframe it in a positive light. Like you did something hard and you did awesome and congratulations. Like you overcame something that was really difficult and that's a different core memory that's like getting implanted. So that's, that's kind of the last portion. And then we want people to be able to share their wins. So hopefully use social media for good. Like, you know, people offering. sharing what they did and also offering tips to other people to be like, Hey, you know what worked for me? I don't know, make something up. Like anything, it could be anything. Cause there are probably so many things that we haven't thought about, but if we kind of crowdsource ideas for what can help other people, everyone wins, So,

Kerry:

Yeah, the things that are available that you're going to be putting or you have on the app or the website just seem like excellent resources to be able to use for all the different ways of, I guess, getting your mind off the shot or vaccine or blood draw or anything. So I think that's, This is exciting, really. I might need to look at it so I can give patients other tips and stuff. I mean, we definitely, like I said, in our office give lots and lots of injections. So I mean, I think this is a great role for our office in particular. So I'm, you know, excited to hear about it. Is there anything else you'd like to share with the listeners today?

Manju:

Hmm. Well, I guess I'll just tell you that the prepare patch the one for before it's been a labor of love for a very long time, and we're going to be opening pre orders in the coming week. So if you want, you can go on to the website and it's a limited supply. So if you want to kind of be the first to hear about it just drop your email in there and then we'll shoot you a message as soon as we open the pre orders and there's a discount code and all of that. And Yeah, I would just love to hear from people, again, like there are, I know there are things that I haven't thought of that we haven't thought of as a team. And so like, please share your ideas and feedback. we just want to learn and make things better. So we have an Instagram at thimble. health. We're also on TikTok, but man, I got to be better about that. Social media is not my game, but So yeah, just, yeah. Just any feedback always welcome. and thank you for being open to hearing about it.

Kerry:

Yeah, I think this is great exciting. We're definitely going to put all of that information in the show notes and hopefully our listeners will go ahead and seek out all the information that they need. And I mean, I'm hopefully would like to do a pre order so we can get it in our office for those that might need it. That'd be good. I don't know if we could do it for like an entire intradermal test because it's like such a large surface area. Maybe something to think about for like a test procedure, a larger option. I don't know. But yeah, this is great. Thank you so much for empowering, patients that they can have a better healthcare experience. Yeah. And doctors too, right?

Manju:

Yeah, exactly. Thank you. I really thank you

Kerry:

Yeah. Well, thank you so much for joining us today and thank you to the listeners for listening and tune in next week. And I hope you all enjoyed. Bye.

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Dr. Kerry Reller

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