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Median Arcuate Ligament Syndrome (MALS)

Digestive Health | Last Active: Oct 29 2:54pm | Replies (1225)

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@shawnsport

I was diagnosed a couple of months ago and my surgery was Oct 12. After a 6 day stay from hell at the Northeast Methodist Hospital in San Antonio, TX (which I wouldn't send my enemies there), I was released from the hospital Thursday of last week. Rough weekend but my main question is when does it start to improve. I want to take a painkiller but the downside of opioids is horrible. Any advice. I'm hardly able to drink fluids and still have no appetite. I'm close to checking myself back into the hospital cause I am not sure if I stayed long enough. Any help or advice would be appreciated. I'm a 43 year old Male.

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Replies to "I was diagnosed a couple of months ago and my surgery was Oct 12. After a..."

I have also been told that any surgery inside you will have a long recovery period, even if it is laparoscopic. 6-8 weeks to get less fatigued. I had pain swallowing too, since it connected with the diaphragm that held the ligament. I was given gabapentin that worked well. Took weeks though. I had immediate post op problem because I got too much IV fluid and got fluid in my lungs and low oxygen. Just rest and easy on eating. Our GI system is very sensitive and will go on strike! However- the major pain after eating is gone!

I’m so sorry to hear how hard this has been. MALs surgery is much harder than most surgeons realize. Most MALs patients have said similar things you said. Did you have open or lap? I’m guessing open by the length of stay in hospital. Also did the surgeon remove the celiac nerves or just cut the ligament?

I had lap 1 year ago with partial removal of celiac nerve plexus and am doing very well now. I eat without pain and am active and happy. So many unanswered questions are now answered after 40 years of stomach pain.
The recovery, however, even with lap, was way harder than I expected, 10 times harder than my C-sections were.
Pain was in front and, surprisingly, in the back. The doc said “We had to dig really deep”. So that kind of pain is normal. I took oxy at regular intervals the first few days, then alternated with Tylenol, then only at night, then stopped at the 1-week mark but continued with Tylenol for a month or so. Everyone (nurses and patients) says stay ahead of the pain, taking medicine before things start to hurt badly. Opioids are scary but helpful for the first week or 2, especially with open surgeries.

Nausea after surgery is pretty bad to severe for most of us, which I had not expected either. I was nauseated for 2 months, which seems average.
People who do not have nerves removed often have worse nerve pain because surgery “made the nerves angry”.
Sitting made my pain worse because sitting causes compression in surgical area. At 3 months post surgery, I got an elevating workstation so I could stand; that’s when I really started to feel better with less pain. Sitting caused pain even up to 8 months post surgery.
Fatigue was present for 10 months, which seems normal for most MALs pts.
Repeat CT is important post surgery (about 3-4 weeks) to be sure artery stayed open. Some people need a stent to hold it open.

Hang in there. Yes, it is much tougher than people realize but usually gets better. If you can’t eat or drink at all, it’s best to go back to docs for Eval and medical support. I hope things get better for you and hope you have supportive people to help you through this.