I’m sorry you are suffering again with symptoms from SMA. My 19 year old daughter had surgery for this. I took her to an ER due to weird uncontrollable vomiting when she stood up. she was admitted and they diagnosed her with SMA. They scheduled laparoscopic surgery for her. She was in hospital for 1 day and it fixed the problem. I don’t know why they wait with some people for so long to surgically fix this. She feels much better and no more vomiting. There were some doctors not agreeing on treatment. One said to put in feeding tube one said to do surgery right away. She was of normal weight, so feeding tube seemed like it would not help in the long run. The surgery was done at the American Center which is part of UW Health in Madison WI. No more issues with SMA. I hope you can get some good treatment for the SMA syndrome. I was so pleased with the way my daughters problem was handled and fixed.