Taking the pain out of breast surgery

A Beaverton surgeon is using a new device that’s changing things for patients

By Christina Lent

The Times, Jun 17, 2009, Updated Oct 30, 2009

Jonathan House / Times Newspapers

Dr. Judith Richmond, a Beaverton surgeon, shows the new On-Q PainBuster Pump she uses to relieve pain in women after undergoing breast surgery. The small balloon pump delivers pain medication through a specially designed catheter.

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When Joanne Gulbranson had a mastectomy in March 2007 to remove cancer in her left breast, she knew that taking narcotics to manage her pain following the procedure was not an option for her.

“I had surgery before and was put on heavy narcotics that gave me such nightmares that I don’t take them anymore,” said Gulbranson, who lives in the Greenway neighborhood in Beaverton.

Instead, Dr. Judith Richmond, a surgeon who specializes in diseases of the breast at Oregon Breast Center in Beaverton, offered Gulbranson the option to use a new On-Q PainBuster pump.

The pain relief system consists of a small balloon pump that holds pain-numbing medication and delivers it through a specially designed catheter.

Richmond places the catheter under the skin around the surgical site during the operation. She then fills the bag with medication that will last up to five days.

“It delivers a constant, measured dose of numbing medicine,” Richmond said. “This takes the pain away following surgery.

“I can ask my patients, ‘How’s your pain?’ in the recovery room and they will tell me that they don’t have any. I think that’s really cool.”

Gulbranson used the pump for three days before a friend helped her to slip the tiny catheter out.

“I had virtually no pain, and it was simple to use,” she recalled. “I was uncomfortable because I had this big, honking incision in my chest, but I didn’t have pain at all.”

She also didn’t encounter the unpleasant side effects that come from taking narcotics like morphine that affect the entire body and can cause symptoms such as nausea, vomiting, constipation, grogginess and a slower recovery process.

“It’s a really wonderful tool, I think,” Gulbranson said of the PainBuster.

Richmond agrees and today recommends the PainBuster to all of her breast cancer patients.

“I’m in this business of cutting on people, and I cause pain,” Richmond said. “With this pump, I can do what I do and not cause that pain. That to me is a big deal.

“I have patients who underwent some kind of surgery as children, who are permanently scarred from the experience. People have lots of reasons to not come to the doctor – pain shouldn’t be one of them.”

The PainBuster system comes with a pack that can be strapped around the waist or carried over the shoulder. When the bag that holds the medication is empty, the catheter can be easily pulled out of the patient.

“Because everyone’s pain threshold is different, I can refill this,” Richmond said as she pointed to the medicine bag. “There is also an adjuster to allow patients to turn up the amount of medication if it is not numbing the area enough to ward off pain.

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