Saturday, November 27, 2010

Healing: Harder Than One Might Think

The thing about having an incision that goes all the way down your stomach, is that you cannot use any of those stomach muscles while the stitches are healing. For me, when ever I am going from a laying to a sitting position, or any time that I sneeze or cough hard, I have to hug a pillow to my stomach to support the stitches from pulling apart. I never realized just how much I use those stomach muscles on a daily basis. It is definately hard not to use them.

The other part about healing from surgery is getting my appetite back. Until last night, I had not eaten more than a couple bites of anything, because nothing tasted good at all. However, I craved a hamburger, so my mom went and picked a couple up from Chilis. Surprisingly, I ate more than half. I did not necessarily care for the taste, but I was so hungry from not really eating that I ate as much as I could stomach. The nurse in the hospital said that he had a lot of patients whose taste buds had changed after surgery. It is also known that after going through something like this, a person's body gets a negative nitrogen balance that makes them not really have an appetite. A person has to work towards changing it to positive. Which, believe it or not, is harder than you might think.

Since I got out of the hospital I started emailing with Courtney (from the newspaper article). The last email I received from her was on Thanksgiving day and she was telling me about a Facebook page that is all about MALS. This page, called MALS Gals, has girls telling their stories about what they went through and how they are doing now. It is pretty interesting and it was comforting to hear the "after" stories of how the girls are doing now that they have been through the surgery and the recovery.

My next step to moving forward in this recovery process is to stay active and out of bed. This goal seems to be pretty hard for me because I get worn out from walking or sitting up for a couple of minutes. I guess we shall see how I do on this next step. Hopefully I will be back at school on Monday.

Wednesday, November 24, 2010

Just Laying Around

I am now back at my home in Lake of the Ozarks. I got back around four yesterday afternoon. I was in a lot of pain yesterday and the ride home was not one of my favorites but I made it home. We had to stop in Jefferson City because I hadn't felt up to eating at all and by the time we reached Jeff City it was three in the afternoon and I had to eat something.

Once home, I sat down in a chair and did not move the whole night. The bed situation was the biggest issue I had because it was definately different than the hospital beds I had been using with the hand rails. It was so much easier with those available. I slept in a bedroom close to my parents, in case I needed help. Then, it just worked out that my mom ended up sleeping in the same bed to help me if I needed it.

My day today is going to consist of laying around, which I can tell you gets old really quickly.

That is all that is new for now. I will post another update later.

Tuesday, November 23, 2010

Going Home

It is official!!!! I am going home to Lake of the Ozarks TODAY!!!! I will be released from the hospital between ten and twelve this morning. Dr. Thompson said he does not let his patients going through this type of surgery go early, but he is letting me because I am recovering so quickly. I am beyond excited about going home.

Last night was a bad night all around. I kept trying to do what the doctors wanted and still be comfortable, but it was just not working out for me. However, I have been taken off of my IV pain medicine and I am now taking it by mouth. I still have the IV in my arm, but it is capped and not being used unless needed.

Now, the next step is the three hour drive home from St. Louis and being able to sit up the whole way. But, that all still beats staying in the hospital any longer. I am ready to be home and celebrate Thanksgiving with my family, even though I most likely won't be able to eat anything.

Monday, November 22, 2010

Good News!!!!

This morning I feel pretty good. The doctors came in around six and told me that I am doing well and that my incision looks good too. Originally I was told I would go from clear liquids (jello, broth, popsicles), to full liquids (ice cream, pudding, cream soup), to solid foods. However, I am doing so well, that I can skip the full liquids and go straight to solid foods. That made my day, and it is still early!

Yesterday, I got a bath and changed into my new pajamas that my sister bought me to wear during my stay at the hospital. Then, my cousin, Barb and her three year old daughter, Mia, came and visited me.Mia brought me a stuffed cat and some word search books to keep me busy while I layed around here in the hospital. Today I am expecting my best friend from high school, Ashley, to come visit me. I am ready to see her, this may not be our usual meeting place when we are home on break, but atleast we will still see each other and she will take my mind off of everything. She has a special way of making me laugh, when I do not even think it is possible. My sister and Felipe are also coming to see me today. Anna has been here a couple times but everytime Anna Marie has been here, I have been exhausted and just wanting to sleep. This will be Felipe's first chance to get to come see me, and I am feeling great, so I am glad I will actually get to talk with Anna Marie and Felipe. I seem to be very popular lately, everyone is always wanting to see me. :-)

I got a roommate yesterday, which was fine, but the hospital policy says that no patient can have overnight visitors with a roommate. I really got nervous because I did not want to have to stay here by myself and need help during the night and have to wait for the nurse to come help me. My mom has been helping me throughout the night and I wanted her there with me. So, we ended up moving rooms again. Now, I am in a private room, 6485. It actually works out better this way,  because now there is room for mom to have a cot. So, last night, for the first time in four days, she got to lay down and sleep through the night. Which definately improved how she had been feeling as well.

I have also been taking some longer walks around the hospital halls. Yesterday, I walked about 600 feet and I did the same this morning. Even though I am still a little worn out from this morning's walk, I am getting ready to go on another one, but I am going to be going a little bit further than 600 feet. I am trying to keep moving forward but at the same time I have to remind myself to push myself but not past my limits. The doctor says that at the rate I am going, I should be home before Thanksgiving, but he will not promise anything.

Well, it is time for my walk. I will talk to you later!

Sunday, November 21, 2010

One More Step Forward

Yesterday afternoon I was moved to a regular room. They also removed my heart monitor. My good friend Chelsey and her boyfriend Jeff came to visit me. It was nice to see friendly faces and to talk about something other than what was going on with my health.

At present I am in a room by myself but there is another bed if needed. I still have the pumps on my legs to prevent blood clots and I am on the pain pump but they are talking about changing it to oral medication. I have been getting heparin injections in my belly 3 times a day since surgery. I still have daily blood draws. I have never liked needles but since surviving surgery I feel like I can handle the needles. I am still doing my hourly breathing exercises. The Drs have made rounds and I now get to have ice chips and clear liquids. I was really excited to get that news, but after 2 bites of a popsicle I was full.

My mom's friend, Judy, who found the original newspaper article about MALS, called the news reporter who wrote the article and left her name and number to be passed to the patient, Courtney and her mom, Marsha. Judy received a phone call Friday night from Marsha. She was very excited to know their article had helped another girl. Marsha was very happy that I had my surgery done at Barnes Jewish Hospital with Dr Thompson  because after Courtney had laparoscopic surgery in Chicago, it reoccluded and the end result was Dr Thompson, my Dr, did abdominal surgery to fix it. It was the same procedure I had so I feel I chose the right path.
My mom and Marsha have visited on the phone and we both feel relieved and excited to have someone who truly knows what we have been going through as a patient and as a mom. We plan to keep in touch with them. Courtney and her mom increased public awareness of MALS by the newspaper article which I will be forever grateful for, and my mom and I are currently trying to think of a fundraiser to help increase public awareness as well.

Saturday, November 20, 2010

One Step at a Time

At present, I am sitting in a chair telling my mom what to type. Since Thursday night I have made alot of progress. I started sitting up in a chair yesterday morning,  my foley cath came out and my pain medication was decreased last night. I have walked twice already this morning, my nasogastric tube has been removed, my oxygen is now off, and I am presently sitting in a chair. I am doing a breathing exercise called incentive spirometry every hour to keep my lungs expanded and prevent pneumonia. I am hoping to transfer to a regular room today. The Drs who have seen me today already have commented on how much better I am doing.

Thursday, November 18, 2010

A Mother's Point of View

After 5 hours, Brittany Rose finally made it out of recovery when a bed became available. We were allowed to visit her 5 minutes every hour when it was convenient for the surgical waiting room staff to escort us into recovery. Right now I am sitting at her bedside waiting for Dr Thompson  to come talk to me. He did call and talk to me this morning on the phone after surgery. He said after releasing the ligament, the artery expanded making it unnecessary to perform a bypass. He said choosing abdominal surgery over laparoscopy was the right choice because there was so much scar tissue and  hypertrophy from damaged  nerves that they had to remove. He said they wouldn't have been able to get it all if they hadn't opened her up. She is awake complaining of boredom and  ready for the next step in her recovery. She is on bed rest tonight but tomorrow the plan  is to start getting her up and moving.

By sharing with my sister Mandy, I have found out Brittany has a cousin in Texas who is presently searching for answers for her abdominal pain. She has the same signs and symptoms. She has such severe abdominal pain after eating, she curls up in a fetal position, she has quit any activities she used to enjoy and doesn't even want to go to school because of the pain. Jordon has recently gone through a growth spurt. Her belly is distended at times to the point if she was older you might think she was pregnant, and I can't remember if there was weight loss but I want to say yes. They are in the process of going to a GI Doc because it is abdominal pain. I informed my sister today they need a vascular surgeon. I had asked  Dr Thompson  at our initial  appointment it there were any familial tendencies and he said there weren't enough cases to do research to know. When he comes in I plan to mention my niece. Food for thought.

Out of surgery!

Anna Marie again, we just received the call saying Britt is out of surgery and into recovery.  The surgery went as planned, and it was a success! She should be awake within the hour. Thanks for everyone's support!! :)

-Anna Marie

A Sister's Perspective

Britt just went into surgery but she requested I post an update for the many people who've been helping her through this difficult time.

I'd like to say that we're all strong and confident and not the least bit worried but the lie is a little too much to stomach.  However, if there ever was a silver lining it was seeing my big sister, the one who could never get past the taste of any alcoholic drink long enough to get the slightest buzz, essentially drunk from the beginning of the anesthesia medicine...(In case you were wondering, she's a very happy drunk. She went from crying to giggling in less than a minute.)

That's all we know for now, but we'll post as we get updates.  Any thoughts and prayers are appreciated.
-Anna Marie

Wednesday, November 17, 2010

The Beginning of the End...of Pain

It is the night before the surgery and as I sit here in this hotel room I get more nervous and more scared by the minute. I am having trouble concentrating on trying to finish all of my homework due this week and trying to get my heart to stop pounding so hard in my chest. The only other time that I have felt this kind of feeling is right before I have gone on stage to dance for an audience. I have never hated that feeling, until tonight. It just keeps reminding me that the surgery is slowly getting closer.

I had my last meal tonight at the hotel with my parents, we ate at the restaurant where my sister works, she was actually our waitress. So, our whole family was together tonight...somewhat. Tonight was my last night of eating a meal and having to deal with the pain after filling myself. After tomorrow, I will (hopefully) no longer have to deal with the painful consequences of eating.

I have already done the prep required for tonight, which consisted of me not using lotions and using a special soap to decrease the risk of infection from the surgery. Tomorrow morning before the surgery I will have to use the soap again one more time, before heading to the hospital.

I just want to take the time to say I really appreciate everything that everyone has done for me these past few weeks. My professors have helped work with me on dealing with my medical issues and balancing my homework with it.I would especially like to thank Barbara Scott Dawdy for sitting and listening to me while I cry, and being there for me when I didn't even realize how much I needed it. My sorority sisters, have helped drive me everywhere, sat with me when I needed it, and gave me a shoulder to cry on when I have needed it (which, lately, has been almost everyday).  My family has stayed up late with me when I needed to talk on the phone, my mom has driven me to all of my doctor appointments and they have just been there for me to support me through everything I have been through these past couple of days, weeks and even months. Danny has also been there for me by driving an hour to sit with me while I slept, or to hold me while I cry. And I cannot tell you how much I appreciate all of this, without having you all to talk to, I am not sure how I would have handled everything.

I am going to wrap it up tonight. When I write to all of you tomorrow I will no longer have my median arcuate ligament, I will have normal blood flow to my digestive organs and I will have begun the long journey to recovery.

A Means to an End

November 16, 2010/ 10:45 PM
POSTED BY BRITTANY CURRAN
A SENIOR AT STEPHENS COLLEGE

As the day of surgery gets closer, I get more terrified. Since, Monday I have been on a roller coaster of emotions. One minute, I am fine and understanding of what needs to be done and why and the very next minute I could be hysterically crying because of the journey I am about to embark on.

I go into surgery at Barnes Jewish Hospital on Thursday, November 18, 2010 at 7:30 in the morning. I am not allowed to eat or drink anything after midnight the night before and I must arrive at the hospital at 6:30 to get checked in and prepped. I have already been pre-opped for surgery, which included having my blood typed and cross matched and being educated on how to prepare my body for the surgery and the day’s events that will take place tomorrow.

The entire surgery will take about three hours. It is General Surgery, so I will be put to sleep and intubated. After the surgery is over, I will be placed in a room in Dr. Thompson’s version of ICU so that my family can stay with me. For two to three days I will have a Nasal Gastric Tube going down into my belly, to keep it empty while my digestive tract returns to normal. Once the tube is taken out I will slowly work my way back up to solid foods, starting with liquids. I should be released one week after surgery, which would be Thanksgiving Day. I will then go home and my parents will take care of me until I am ready to go back to my apartment. Dr. Thompson said that I should be able to go back to classes 10 days to two weeks after surgery. While I will be able to attend my classes, and get back to somewhat of a normal routine, my body will still be recovering for the next three months.

Writing this blog has made me relive the emotions I have been going through for the past 36 hours. At the same time, I have also understood more of what is going to be happening to me, whereas on Monday I was more stressed about that one word, surgery.

To Cut or Not To Cut: That is One Huge Question

NOVEMBER 16, 2010/ 2:34 AM
POSTED BY BRITTANY CURRAN
A SENIOR AT STEPHENS COLLEGE


To correct MALS  , a doctor has to cut the median arcuate ligament to relieve the pressure that it is putting onto the celiac artery and to increase the blood flow. However, cutting the ligament does not always automatically resolve the issue. Sometimes, the artery does not always re-inflate, so the doctor may also have to put in a stint to open the artery back to how it should be. Dr. Thompson also said, that he has realized that when trying to end the chronic pain caused by MALS, he also needs to remove the damaged nerves on the artery. These nerves are what keep sending messages to the brain saying that I am in pain.

After meeting with Dr. Thompson, I learned that I had one difficult decision to make on how to correct MALS. There are two options that are similar and yet so different to a person’s body. They are: 1) Laparoscopic Surgery; and 2) Open Surgery. Laparoscopic surgery consists of the doctor making five millimeter incisions in various spots on my stomach. These incisions would just be big enough for the doctor to get the tools necessary into the body to cut the ligament and possibly put a stint in if it is necessary.

The other option is open surgery, which is when the doctor will make an incision from a person’s diaphragm down to their belly button, and sometimes the doctor will even go a little further than that. This surgery is more of a guarantee that MALS is going to be corrected. This option gives the doctor the visibility to make sure that he has cut and removed the ligament, removed the scar tissue, and the damaged nerves. Then, if necessary, he will put the stint in if the artery does not inflate on its own.

The downside to laparoscopic surgery is there is no guarantee that the surgery is going to be completely successful. Sometimes, patients that have had laparoscopic surgery end up coming back later and have the open surgery because the laparoscopic surgery did not allow the doctor enough visibility to remove all the damaged scar tissue. Also, sometimes the celiac artery sits so high up on the aorta, if a stint needs to be put in; it is difficult to put it in the right place.  However, with the open surgery, you will have a scar going down your stomach forever, but you will only have to do this procedure once which is definitely a positive aspect.

When I was told that I had to have this surgery, I did not even comprehend everything being said to me because I was still stuck on the word surgery. It is definitely one of the scarier words in the English language. Just the thought of surgery is scary, but at the same time the thought of never having this stomach pain again, now that is pretty exciting. The scar I can live with.

I Have What???

November 15, 2010/ 7:25 PM
POSTED BY BRITTANY CURRAN
A SENIOR AT STEPHENS COLLEGE

For three years, I have been living with chronic stomach pain. Until recently I had grown accustomed to learning to work through the pain and had developed little techniques for lessening it.
This afternoon, I was officially diagnosed with MALS by Dr. Robert Thompson , a vascular doctor in St. Louis at Barnes Jewish Hospital.  MALS stands for Median Arcuate Ligament Syndrome. The median arcuate ligament is a ligament that is supposed to help support the diaphragm and the celiac artery is the top superior artery attached to the aorta. This artery is one of three arteries that supply blood flow to the digestive tract of a person’s body. The celiac artery is superior of the three arteries supplying blood to the digestive organs.  A rapid growth spurt can cause the median arcuate ligament to that wraps around the celiac artery to act as a “noose;” thus, choking the artery and decreasing the blood flow to the digestive organs. Initially, this decrease in blood flow is what can cause a person to get a stomach ache after eating a meal.  Dr. Thompson said that he only sees one to two cases of MALS per year. A lot of vascular surgeons go through their career without ever seeing a single case of MALS, so that makes him a place of referral.
After a period of time, scar tissue builds up, and from the decrease in blood flow there is a result of nerve damage. This, unfortunately, is the case for me. The next step, it to treat it.

Fighting Back with Knowledge

November 14, 2010/ 4:30 PM
POSTED BY BRITTANY CURRAN
A SENIOR AT STEPHENS COLLEGE

Finding information on MALS, reminded me of finding research for a research paper. It took me hours to find one article on this syndrome. MALS is so rare, that there are not very many studies or cases that have been documented. Trying to research this condition was extremely frustrating. A friend of my mom’s read an article in the Springfield newspaper, Chronic Pain: MALS may provide an answer, which talked about a teenage girl with chronic stomach pain. She had been dealing with this pain for two years, she had gone to Mayo Clinic and when they could not find anything wrong with her, they told her and her parents that it was all in her head. This girl had missed 180 days of her sophomore year, and her entire junior year of high school. My symptoms all seemed to match the symptoms this girl had been having before she had the surgery. We then sent the article on to my primary doctor in Jefferson City, MO. My primary doctor is, Dr. Stanley Horner, so that he could look into this condition and start trying to get a hold of the doctor who is mentioned in the newspaper article. Dr. Horner said, “Sometimes doctors have to be open to learning from their patients, and not just rely on what they learned in medical school. Sometimes, the answers don’t come from the knowledge they learned from books, but they have to be open to ideas and suggestions that their patients bring to them.” This is the moment I felt someone actually believed that I was in pain.

Dr. Liu, is the pediatric surgeon from Chicago, who operated on the girl from the newspaper. Dr. Liu is the leading doctor in the nation who performs MALS surgeries. After speaking to his nurse, we were told to go get a 3D Image CT Scan, to confirm our suspicions. When I had been told to get yet another test done I became a little upset. Throughout the course of these past three years, I have had a multitude of tests done on me. I started with an Upper and Lower GI, ultrasounds, MRI, CT Scan (with and without dye), Doplar ultrasound, and the final definitive test was the 3D Image CT Scan. The radiologist who read the last CT Scan immediately called Dr. Horner because the image showed “something was not right.” We now knew what was wrong, but the next hurdle was getting an appointment with Dr. Liu who had been fielding phone calls from all over the country since that newspaper article had come out.

The symptoms that can come with MALS are severe stomach pain, especially after eating meals, and weight loss. There are some other symptoms that can come with this syndrome which include, nausea and diarrhea. I only suffered from the weight loss, and severe stomach pain, but my pain had been going on for so long that I am in a constant state of pain. Until a month ago, those were my only symptoms, but I recently began having the constant feeling of nausea all day long. Because I have been eating very little, to avoid the pain and nausea worsening, I have become dehydrated at times. I have also started having fainting episodes because my body has been trying to compensate with the pain that it is experiencing.

Luck was on my side when I got an appointment with Dr. Robert Thompson. Dr. Thompson is a vascular surgeon at Barnes Jewish Hospital in St. Louis, MO. He is the next stop on this blogger’s journey to becoming healthy once again.