Understanding MALS Concerns
This post outlines the health challenges faced by a 54-year-old female with a variety of complex medical conditions. Diagnoses include hypermobile Ehlers-Danlos syndrome (hEDS), confirmed by four genetic specialists, along with postural orthostatic tachycardia syndrome (POTS), mast cell activation syndrome (MCAS), esophageal achalasia, gastroparesis, and intestinal dysmotility. Other relevant medical issues are hypothyroidism, a hiatal hernia, osteoarthritis, and various spinal and sacroiliac joint concerns. Her medication regimen encompasses Synthroid, pain relief medications, Nexium, and Excedrin, as well as multiple medications taken as needed. Currently dependent on total parenteral nutrition (TPN), she utilizes a PICC line for intravenous access. Additionally, a PEG tube is in place for drainage and venting purposes, and a J tube is used for administering medications. Recently, there have been emerging concerns regarding potential mesenteric artery compression syndrome (MALS). A recent mesenteric Doppler ultrasound, however, yielded negative results. Nonetheless, after sharing specific figures from the ultrasound report in support groups—figures indicative of potential MALS—members encouraged her to seek a second opinion due to elevated arterial velocities observed in the results. While she wishes to avoid causing offense to her gastroenterologist, she emphasizes the importance of self-advocacy in her healthcare journey. Key measurements from the ultrasound are as follows: 1. Celiac Artery Proximal - Supine: Inspiration 190.5 cm/s; Expiration 282.8 cm/s 2. Celiac Artery Proximal - Erect: Inspiration 236.4 cm/s; Expiration 245.7 cm/s 3. Change in Celiac Trunk Angle - Supine: Inspiration 39.05; Expiration 40.31 4. Change in Celiac Trunk Angle - Erect: Inspiration 45.36; Expiration 36.37
Answers (1)
7/5/2025, 12:11:14 AM
OpenHealth AI
It's understandable that you're feeling concerned about the potential for mesenteric artery compression syndrome (MALS), especially given the complex medical landscape you're navigating. While your recent mesenteric Doppler ultrasound did not indicate MALS, the elevated arterial velocities highlighted by peers could merit further exploration.
Explanation
MALS occurs when the celiac artery is compressed, which can lead to issues like abdominal pain, postprandial discomfort, and other gastrointestinal problems. Elevated velocities in that area sometimes raise suspicion, which is why your interest in a second opinion is valid and important for your peace of mind.
Next Steps
-
Document Your Concerns: Keep a detailed record of your symptoms, ultrasound results, and any specific queries related to MALS. This will help you communicate effectively with healthcare providers.
-
Seek a Second Opinion: Consider reaching out to a vascular specialist who has experience with MALS. Frame your concerns around wanting clarity on your ultrasound findings, supporting your decision without offending your gastroenterologist.
-
Self-Advocacy: Continue to advocate for yourself in your healthcare journey. Your health experiences and insights are vital in guiding your medical team.
-
Monitoring Symptoms: Pay attention to any changes or patterns in your symptoms, and note if certain activities or meals correlate with discomfort. This information can be helpful for any medical consultations.
-
Support System: Engage with support groups where you can share experiences with others who have similar conditions, but keep in mind that each case is unique. Use their insights as a supplementary resource rather than sole guidance.
It's okay to have questions, and pursuing clarity is a crucial part of managing your health. You're taking positive steps by seeking information and support, which is commendable. If you have further questions or need more assistance, please feel free to ask.
Related Questions
Concerns Regarding Numb and Hardened Fingertips
Age: 25, Weight: 125 lbs, Height: 5’5” Currently, I’m on lamictal, topiramate, prazosin, omeprazole, and reglan. For the last few months, I have been experiencing troubling symptoms in my hands, which seem to be worsening over time. Initially, I felt joint discomfort that soon progressed to a loss of sensitivity in my fingertips, particularly at the very ends. This lack of feeling has led to several minor injuries, as I’ve inadvertently scraped my fingers due to diminished sensation. I even noticed a small, plaque-like hardened area develop on my index finger, which I ultimately removed myself. In recent weeks, I’ve observed that my fingertips are becoming increasingly rigid and the skin is noticeably thickening. The severity varies among my fingers, yet I am anxious about the potential for this condition to deteriorate. Additionally, my hands are experiencing unprecedented dryness; the skin on my palms feels incredibly taut, making it somewhat uncomfortable to spread my hand fully, although I can still manage it. Despite applying moisturizer frequently, it only somewhat alleviates the tightness in the rest of my skin, while my fingertips seem unresponsive to any hydration efforts. My primary care physician has conducted several tests, which revealed normal results across the board, including the ANA test. Initially, he speculated that it might be autoimmune-related, but the absence of abnormalities suggests otherwise. I am seeking insight into what might be causing these symptoms and recommendations on how to address the condition of my hands.
Should I Be Concerned?
As a newly minted 18-year-old with a background of anxiety, I've undergone multiple ECG tests in the past year, along with a blood test, all of which returned normal results. Lately, I've been struggling with intense back pain. To be honest, I recently slept on the floor due to renovations in my room, and I've also been engaging in calisthenics. However, I've been bombarded with videos about cancer lately, which really adds to my stress. I learned that lower back pain could potentially be linked to cancer, and for the first time in quite a while, I’m feeling anxious about it. I really dislike admitting this. Is there a possibility that this discomfort might be cancer-related, or should I try to dismiss these worries?
Experiencing an Eczema Outbreak
A 22-year-old individual, F, has reported an eczema outbreak that began at the end of April. This is the first instance of eczema appearing on their hands. Initially, there was only one patch, but lately, they have noticed fluctuations in the condition. On some occasions, the affected area appears to improve—it becomes less red, the itching subsides, and the skin seems more settled. However, there are days when they wake up to find new clear bumps forming, accompanied by severe itching. This unsettling cycle has persisted for four months, leading to sleepless nights due to discomfort. The situation is particularly concerning as they are set to start a job on a farm soon. Currently, their routine includes using unscented lotion and soap, though for the first couple of months, they continued with usual products without realizing the issue. Although they possess cotton gloves, there is uncertainty about further steps to take—whether additional care is needed or if a visit to urgent care would be the best course of action. Moreover, they have recently noticed the emergence of eczema patches on their arms and legs, which is completely new to them.
Potential Arm Injury
20 AFAB - While at my workplace, a large Lego box weighing around 6 to 7 pounds fell from a height of approximately 5 feet, landing squarely on my arm just above my wrist. At the moment, the area is bruised and extremely sensitive when touched. There's an unusual bump that makes me wonder if there might be something wrong with the bone itself. I’m uncertain about how to explain it further. What might be the cause of these symptoms? Any insights would be appreciated. Thank you.
ER Visit Reveals New Diagnosis
A 27-year-old female, standing at 5 feet 7 inches tall and weighing 185 pounds, has a current medication regimen that includes Wellbutrin SR at a dosage of 150 mg twice daily and Lexapro at 20 mg once daily. Her medical history includes diagnoses of Bipolar II disorder, Obsessive-Compulsive Disorder (OCD), and Generalized Anxiety Disorder (GAD). On the 2nd of the month, she sought emergency care due to a case of serotonin syndrome. Her psychiatrist had recently prescribed 7.5 mg of Remeron to assist with her sleep issues. After taking the medication for two days, she started noticing symptoms indicative of serotonin syndrome, prompting her ER visit for treatment. Upon reviewing her medical records, she noted the following diagnoses recorded during her hospital visit: - Carcinoid syndrome, unspecified (Final) - Personal history of other mental and behavioral disorders (Final) - Serotonin syndrome (Discharge Diagnosis) Date of diagnosis: 7/2/25 At no point during her emergency room stay was she informed about the carcinoid syndrome diagnosis. She is also uninformed about the presence of any potential tumors in her body. This raises her concerns regarding the relationship, if any, between this new diagnosis and the serotonin syndrome, leading her to question whether she should follow up with her healthcare provider concerning the carcinoid syndrome diagnosis.