Mid to late January, the pain increased so much that I started eating less, the cramps forced me to go to my bedroom, curl in a fetal position and emotionally put myself to sleep. Honestly, I thought the pain was so bad that I wouldn’t be able to sit or stand for long periods of time. But yet again no one believed my symptoms and knew the cause of pain. I went to look for another doctor’s opinion and came upon the chief of vascular surgery, Dr Curi at University Hospital in New Jersey. I was pleased with his knowledge and response on my reports. He recommended a color duplex scan with inspiration and expiration. He measured my velocity levels and confirmed not only one compression disorder but rather four or five different compression disorders, such as MALS, Nutcracker Syndrome, Pelvic Congestion Syndrome, May-Thurner’s Syndrome, and possible mesenteric ischemia. As much as there is to tell, these compressions were found on a CTA with IV contrast. Based on a particular angle or viewpoint on the scans, the doctor found that my celiac artery (for the MALS diagnosis) had complete focal obstruction and was occluded. Way more than 80% as the other doctor told me a week before this test result.
To understand the compressions and issues I was diagnosed with such as Nutcracker Syndrome aka NCS abbreviated, I will provide here a definition. NCS is a rare vein compression disorder. It occurs when the abdomen’s aorta and superior mesenteric artery is squeezing the left renal vein. This becomes an issue as the left renal vein comes from the left kidney creating a compression where the blood cant properly flow normally through the vein. Instead, the blood will flow backwards into other veins causing swelling.
I waited another month or two until I saw the Dr in New Jersey again back in February. Did the tests he asked for which were the CTA and Abdominal / Pelvic US. Those were pretty helpful to my diagnosis. My velocity levels compared to the ultrasound Dr Hsu did were way off the charts. Holding my breath was above 300s and breathing regularly was above 400–500s range which explained the occlusion of my celiac artery.
By the way, I had the aortomesenteric angle to diagnose SMAS but wasn’t properly diagnosed yet. I was told I have mesenteric ischemia which is a blockage in an artery where it cuts off blood flow to a portion of the intestine. This type of ischemia occurs when narrowed or blocked arteries restrict the blood flow to my small intestine which can eventually damage it if not properly treated.
I was told to then follow up with a GI dr to rule out any other causes of abdominal pain and go through a series of tests like an upper GI study and HIDA scan. That was on my list after I got the Celiac Plexus block. The block was recommended as well as the other ones I just mentioned by Dr Hsu who’s in Connecticut. He wants to make sure there is nothing else I can look for after completing a bunch of tests for the pain I have.
