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Hi,
Im wondering if anyone can offer me any advice please. I qualified last year so am still pretty new to this whole game!

I visited a lady at her home last week. This 65 year old lady was otherwise fit and healthy out gardening one day and the next critically ill. She had contracted MRSA and was hospitalised for 10 weeks, 4 weeks of this she was in a coma. She had significant swelling to her body, so much so that as the swelling subsided she lost over 9 stone in fluid. She has been left with pain to her shoulder blades and to both feet.

The pain is to both feet but worse in the right. Both feet are generally tender all over but the right foot is more tender around the lateral ankle and border of the foot. Her GP wants her walking around but at the moment it is all she can do to get to the toilet and back, so she is not very mobile. The pain is worse at night and is sometimes sharp and 'screaming' sometimes just a general tenderness all over.

On examination, there is absolutely nothing to be seen, no swelling, no heat, no redness. all pulses are palpable and biphasic. 10 grm monofilament 5/5 both feet vibration +ve both feet and pt is able to distinguish between sharp and blunt sensation positively.

Her GP has said he hasnt got a clue and to be honest neither have I. I suggested that maybe the the stress caused to the soft tissues internally from the sheer volume of fluid/swelling following the infection may still need further time to settle. Possibly some nerve damage from the pressure? but am otherwise at a loss. Any thoughts would be very welcome.