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
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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.
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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.
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Self-Advocacy: Continue to advocate for yourself in your healthcare journey. Your health experiences and insights are vital in guiding your medical team.
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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.
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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.
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