MY Grandfather is having a pacemaker fitted soon. Is there anything he will need to do after surgery like this?

HAVING a pacemaker fitted is a routine procedure now and your grandfather should be out of hospital the same day.

He may get some discomfort for the first 48 hours but this will subside.

The hospital will provide him with all the care information he needs in regards to his pacemaker and he should avoid driving for the first week and strenuous activities for three or four weeks but after that he should be able to continue as normal.

I HAVE been having regular panic attacks for the past few months.

I have no idea why and I think this is making things worse as I am worried about having an attack whenever I go out. Do you have any advice?

The causes of panic attacks are not fully understood so the fact you do not understand why this is happening is not something you should worry about.

THE important thing is not to try and fight an attack.

This can make it worse and prolong the experience.

You rightly point out that worry can make things worse so try to relax more, many people with panic or anxiety issues benefit from therapies like massage to help them relax.

Exercise can also be a great way of releasing tension and stress.

If you do not feel your condition is improving, you can speak to your GP who may look at the possibility of medication.

Cognitive Behavioural Therapy can also really help. Call Living Life, free and confidentially on 0800 328 9655 for support. You can also look at support groups through charities like Anxiety UK ( as these can be a good way of meeting people with similar experiences and you can share help and advice.

WHAT is Morton's Neuroma?

Morton's Neuroma is a common, painful condition affecting the base of the toes, usually the third and fourth toes. The pain, which is sharp and severe (often described as like a red-hot needle), suddenly occurs while walking.

The pain happens because the nerve that divides between the metatarsal bones (toe bones) is irritated or compressed. The cause of this irritation is not exactly known, but it may be the metatarsal bones compressing the nerve when the gap between the bones is narrow. This causes the nerve to thicken.

It is rare for more than one nerve to be affected, and it usually only affects one foot. Anyone can develop Morton's Neuroma, but the condition is much more common in women. It tends to occur in women who wear high-heeled shoes, people who regularly do sports or those who have a particular foot shape, such as a high arch.

As the pain occurs while you are walking it may cause you to stop and remove your shoe. It makes some people with the condition anxious about walking or even placing their foot on the ground.

Keeping the weight off your feet or rubbing your foot can lessen the pain. The nerve pain can be made worse by wearing tight shoes.

Other symptoms include a numbness or burning sensation in the toes or the feeling toes are bunched up. It may also feel like there is a stone inside your shoe.

Your GP may refer you to a podiatrist, who will normally examine your foot and feel the toes to try to locate the irritated nerve.

Your GP or podiatrist may refer you for an X-ray, an ultrasound scan or a magnetic resonance imaging (MRI) scan, to get a detailed image of the inside of your foot.

Treatment for a Morton’s Neuroma depends on how long you have had the condition and its severity. Identifying the condition in its early stages will help to avoid the need for surgery.

Early treatments include a simple change in the style of shoes you normally wear. Wide-toed shoes that allow for width adjustment may be recommended. If the issue is with your foot type, padding to provide support for the arch of the foot, which removes pressure from the nerve may be recommended. Injections with anti-inflammatory drugs may also be tried.

Pain can be relieved by resting the foot and massaging the affected toes. You can make an ice pack by freezing a small bottle of water and rolling it over the affected area. In more severe cases, where early treatment options have not worked, surgery may be considered. This is normally done under local anaesthetic (the area is numbed).

Surgery usually involves removing the affected nerve, which often takes up to 30 minutes and can be performed on an outpatient basis (you go home the same day). There will be some numbness in the toes afterwards.

Alternative procedures are also emerging, such as releasing the affected nerve if it is trapped or removing the pressure on it. These other methods are in test phase because in about a fifth of cases, a nerve stump can re-grow when the nerve is removed and the symptoms may return.