persistent numbness, paresthesia, tightness, swelling and skin color changes post foot surgery

Dec. 17 I had plantar plate repair and bunionectomy surgery. Had an ankle block anesthesia. During procedure a fire alarm went off at outpatient surgery center, and I woke up in parking lot. Surgeon said he had to do emergency closure of 2nd toe and I had to be resedated to finish surgery. My healing since has not been normal. Had short bout of cellulitis. Foot has remained feeling partially anesthetized from ball of foot to tips of toes....lots of swelling, skin color changes (will turn splotchy purple if down too long, esp. in shower), very stiff big toe and 2nd metatarsal. Feels like I am walking on rocks when weight bearing and whole forefoot feels as if its full of chicken wire. Big toe and metatarsal are still floating off the ground. 2nd MRI showed some retearing of plantar plate so am being very careful with walking only in wide running shoes or ortho shoe. Am doing big toe ROM exercises at home. I wear a little eyebrow shaped pad under 2nd and 3rd toe. I am very frustrated as I am an avid athlete - distance runner and tennis player - and this has tried not only my patience but has made it difficult to do much of anything. I have most symptoms of CRPS but no real pain. Doctor keeps reassuring me that I'll get back to pre-surgery activities within a year, but am just wondering what else, if anything, I should be doing. Any thoughts would be tremendously helpful. I am a 48 y-o white female. H/O Hashimoto's hypothyroidism.

Hi,
Lets start off with the CRPS. If you think that might be a possibility you need to immediately see a pain management doctor or a neurologist who deals with CRPS. The problem with this condition is that it is usually under diagnosed and if you do have it, it can be a very crippling disorder.

Assuming you go to have it checked out and you are re-assured you do not have it, then I would suggest you talk to your surgeon about physical therapy. Physical therapy is a great way to move the healing process forward but it cannot really be done at home and must be done on a regular consistent basis.
I am wondering if during the fire drill if they had been using a tourniquet, if the tourniquet was deflated. My thought would be yes, but if it was not that might partially explain way you are still having problems. At over three months post surgery, although you may not be back to brand new, you should at least be far enough along with your recovery that you can see noticeable improvement.
Have the CRPS ruled out by an expert, then speak to you surgeon about ways to move your progress forward.

Marc Mitnick DPM

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