For Matthew Solan & James Davis at St John & St Elizabeth Hospital and OneWelbeck

For Martin Klinke at London Bridge, Cromwell Hospital, Chiswick Outpatients, New Victoria Hospital & One Welbeck

Pauline Moroney

Pauline Moroney, aged 45, from London has rheumatoid arthritis, a condition which can lead to a range of foot and ankle problems. Pauline developed a bony enlargement on the back of her heel, called a Haglund’s deformity.

This bony enlargement caused retrocalcaneal bursitis, the term for inflammation of the bursa – a fluid filled sac lying between the tendon and the bone. The deformity also caused extensive pain and inflammation in her Achilles tendon.
Describe your foot problem

I had terrible knee pain for many years, after fluid gradually built up around the joint. I had knee surgery and believed I had put it behind me, but then the same thing started to happen in my foot. My ankle suddenly erupted in pain and swelled up. My rheumatologist prescribed a large dose of anti-inflammatory steroids, which made my face swell up twice the size. I felt very self-conscious but the steroids didn’t help with the constant, throbbing pain.
Why did you choose to have surgery?

When I met Mr Mark Davies, I immediately trusted him implicitly. He listened and understood exactly the impact it was having on my life. I have three children and run our family building contracting firm with my husband. It felt like a desperate situation to be in so much pain and struggling to do the daily activities I needed to do. I was worried about the prospect of being out of action for six weeks after surgery and how I would manage. But it became clear that surgery would be the only effective way of treating the problem and I was booked in for my operation in February 2008.
Describe your operation

Mr Davies explained he had made a cut at the base of my heel and then removed the bony enlargement. He also helped my Achilles tendon to repair itself by making small cuts in the tendon, stimulating a healing response in the blood vessels.
How did you feel straight after surgery?

I was surprised how comfortable I felt. The day after surgery, there was a little throbbing, but no pain. I was immediately able to get up and out of bed and start using crutches. I went home by lunchtime, wearing a large healing bandage but fortunately didn’t need a plaster cast.
The first two weeks

I was so happy to be free from pain. For the first two weeks, I had to keep my feet up and not do any weight bearing. I found I was able to get up and down the stairs on my backside without any problems and my husband and children were fantastic. Thanks to email, I was even able to get a little work done.
Weeks two to six

At two weeks, I had my dressing changed and started to wear an Aircast Boot. I was flying by this stage! It was such an enormous relief to be free from constant pain. By week three, I was using my crutches much less and by week four, not at all. I continued walking with the Aircast Boot until my six week checkup and left it off more and more as I got confident to walk without it. I worked with a physiotherapist for a total of two months. It was all about balance – I had spent so long hobbling around in pain that my balance was not very good. I also did a lot of stretching and strengthening exercises daily and found it easier to do it to music.
Six weeks and beyond

By six weeks, I was feeling very positive. I had wanted to be able to do the activities which I enjoy – walking, cycling and yoga. Nine weeks after surgery I could comfortably walk for a mile, which was a very big step compared to how limited I had been before. Mr Davies told me to expect it would take 12 months to make a full recovery, but I felt very strong and mobile within three months. About six months after surgery, I was able to come off the anti-inflammatory steroids. It was very gradual, to reduce the risk of another flare-up, but it felt fantastic to be free from steroids. All I take now is regular calcium.
What would your advice be to anyone considering surgery?

I should have opted for surgery earlier. I had the misconception that surgery would mean being off your feet and out of action for six weeks or more. I was amazed and delighted with the speed of my recovery. The trouble is that if you are living in constant pain, you start to lose confidence in yourself because you don’t go out and do all the activities you once enjoyed. You constantly think – ‘I can’t do that’. My advice would certainly be to bite the bullet, have surgery, ditch the tablets if possible and enjoy your life being free from pain.