@jayhawk57 - You seem very miserable now- I’m sorry! It is confusing in your situation where you have more than one vascular issue.
I have had/have MALS- I was finally diagnosed 5 years ago after years of pain. My delay in being diagnosed was probably due to several confusing GI issues.
You ask if one could get MALS again. In a way- yes.
If the MALS surgery did not completely restore blood flow in the celiac artery, symptoms can return.
In my case, the celiac artery was quite a bit indented by the pressure of the ligament and symptoms returned. After placement of a stent it has opened enough.
I think your next step would be to see a vascular surgeon. They will be able to better define the extent of the stenosis and decide if something should be done.
FMD can also occur in arteries in the gastrointestinal system - probably less likely for you.