MALS Surgery & Update

A post from Leanne, to give Chane a break…

Time for an update and some more background info for the curious :-)

Last Tuesday, Chane had surgery to fix one of the two rare(ish) artery diseases she has. At this time, there has still not been surgical intervention for the dissection in her carotid artery caused by FMD. This surgery was to correct MALS, or median arcuate ligament syndrome. For those who love Google, it is also known as CACS, celiac artery compression syndrome. So what does all that medical jargon mean?

There is a ligament that runs close to the diaphragm (I haven’t quite been able to pinpoint how best to explain where it is, but this is a generalization, see picture below - it's the first item from the list on the right).

Retrieved 3 Feb 2011 from: http://www.imaios.com/en/Media/Images/e-anatomy/thoracic-wall-breast-illustrations/diaphragm-intercostal-muscle-e-anatomy-imaios

In MALS, this ligament is a bit off in one’s anatomy and it comes down to compress the celiac artery, which is one of the arteries that feeds the stomach & digestive tract. One of the best analogies of arteries is the “straw.” So think of a straw, now imagine this ligament coming down and squishing it. Might cause some blood flow problems right? Yep sure does. When your digestive system doesn’t get the blood flow it needs to function, well, stuff doesn’t function right.

So how exactly did this affect Chane? She lost her appetite. She had pain after eating, pain that continually got worse and was quite unbearable towards the end. She had near constant nausea. She lost weight, a lot of weight, especially for someone not actively trying to lose. In general she felt like crap. We didn’t test, but we believe that she was beginning to suffer from malnutrition because her digestive system was unable to effectively absorb nutrients from what little food she was able to keep down. By the time we suspected it was that bad, we knew the surgery was coming so there was no point.

The surgery itself was to snip the ligament so that it wouldn’t compress the artery. There was always a chance that they would need to do more work, such as an arterial bypass, if they got in there and found that things were worse than believed. But the surgery went well! Chane had a tag-team of surgeons working on her. The majority of people have an “open” surgery for something like this. Well, it’s been popping up more and more in medical literature that it is possible to perform the procedure laparoscopically. So there was a laparoscopic surgeon to attempt this method, but also a vascular surgeon who had performed this surgery many times before as a kind of “back-up” in case they were unable to proceed laparoscopically. It took 3 ½ hours, but laparoscopy was the way to go! Much shorter recovery period, and Chane has the distinction of being a pioneer. It was the first laparoscopic release of the median arcuate ligament done at Fairview. Pretty cool eh?

So. Now for the update, but I’ll be quick. Chane is recovering pretty well, had a bit of a set-back recently when a hematoma (build up of blood) formed near one of her incisions, compounded by a bruised muscle in the same vicinity, but doctor’s orders of heat, ice, and meds is getting her back on track. She has already had an increase in appetite, which is such a good thing! Time will tell how truly successful the surgery has been to ease her tummy woes, but so far so good. Once she gets past this “dumb bruised muscle” she’ll be feeling much better :-)

As a side note, I just want to say that this does not fix all of Chane’s medical conditions. Unfortunately this does nothing for the FMD and she will still be affected by that. But at least she will have one less thing to worry about (as her mother put, which is so true!).

Thank you all for the well wishes, prayers, cheerleading and support these past few weeks!