My son is on a trial pump with the saline solution, and when it was started, the nurse was in a hurry and didn’t use the Emla cream. She said it didn’t matter. Shouldn’t you always use the cream? He says it hurts, and we’re having a hard time getting him to even keep the set in.

My personal opinion is that this nurse seems to have been extremely insensitive to your son’s needs. If she was too busy to provide you proper instruction at the time your son started the trial insulin pump, the appointment never should have been scheduled in the first place. Often, the initial reaction to placing the catheter and starting even a trial pump, sets the stage for success or failure in the future.

Many people, especially children (and I don’t know your son’s age), complain about insertion of the infusion set. The needle is much larger than the one on a standard insulin syringe, and can be intimidating. The fear alone can result in tightening of muscles at the site making the insertion more traumatic and painful. EMLA� helps a great deal in minimizing that trauma. Some people always use it, while others can do without it after a while.

Nonetheless, the important point here is that now your son is “turned off” to using a pump. I think you should ask if he wants to try again (using Emla this time) or put the idea on hold for a while. I would also discuss what happened with your son’s physician and request that, if and when, your son is willing to try again, another individual (perhaps the pump company representative if appropriate) be assigned to do the training. I would not push things at this point, but allow your son to make his own decision. If he declines at this point, hopefully he will be willing to try again in the future.

SS