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Help! post surgery--possible SMA

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  • Help! post surgery--possible SMA

    My son had a fusion on 6/30 with Dr. Michael Vitale. Spencer was discharged from the hospital on 7/4 and, aside from being quite crabby, seemed to be doing pretty well. But this past Sunday, 7/11, he started vomiting up everything he eats. We went for a 2nd post op visit today and one of Dr. Vitale's associates said it could be SMA. The small amount of research I've done has me scared. Does anyone have experience with this issue?

  • #2
    SMA stands for superior mesenteric artery syndrome--a new, scary term for me.

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    • #3
      Okay I read up on that. It's amazing that they suggested that, it being so exquisitely rare. But it is good that they thought of it if indeed your son has that.

      How many cases have they seen? I bet not many.

      It sounds like there are fixes for it, both conservative and surgical.

      It's good you got it early if that is indeed what he has.

      Hang in there. Keep posting.

      Best regards,
      sharon
      Sharon, mother of identical twin girls with scoliosis

      No island of sanity.

      Question: What do you call alternative medicine that works?
      Answer: Medicine


      "We are all African."

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      • #4
        I spoke w Dr Vitale tonight; he said if it was SMA it would have happened immediately after surgery, but the various things I read online said it typically happens 6-12 days post op. Kevinsmom posted her son's experience w SMA on this forum about 5 years ago and the symptoms correspond almost exactly to Spencer's. Dr. V says maybe a stomach bug, take him to pediatrician. Meanwhile, Spencer ate 2 tablespoons of white rice this evening and couldn't keep it down. He hasn't consumed and digested any food since Sunday. I'm trying not to freak out. Pediatrician tomorrow.

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        • #5
          So sorry you/your son are going through this. Is he having normal bowel movements? Lots of people have posted about functional bowel obstruction post-surgery because of all the drugs. That can cause vomiting, too.

          Keep us posted--sending good thoughts your way.

          Evelyn
          age 48
          80* thoracolumbar; 40* thoracic
          Reduced to ~16* thoracolumbar; ~0* thoracic
          Surgery 3/14/12 with Dr. Lenke in St. Louis, T4 to S1 with pelvic fixation
          Broken rods 12/1/19; scheduled for revision fusion L1-L3-4 with Dr. Lenke 2/4/2020
          Not "confused" anymore, but don't know how to change my username.

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          • #6
            Originally posted by trav86 View Post
            I spoke w Dr Vitale tonight; he said if it was SMA it would have happened immediately after surgery, but the various things I read online said it typically happens 6-12 days post op. Kevinsmom posted her son's experience w SMA on this forum about 5 years ago and the symptoms correspond almost exactly to Spencer's. Dr. V says maybe a stomach bug, take him to pediatrician. Meanwhile, Spencer ate 2 tablespoons of white rice this evening and couldn't keep it down. He hasn't consumed and digested any food since Sunday. I'm trying not to freak out. Pediatrician tomorrow.
            The pediatrician might be a place to start but you might consider elevating this immediately to a specialist which I guess would be a gastroenterologist or someone who has a chance of having seen some of these cases.

            Good luck.
            Sharon, mother of identical twin girls with scoliosis

            No island of sanity.

            Question: What do you call alternative medicine that works?
            Answer: Medicine


            "We are all African."

            Comment


            • #7
              Originally posted by Confusedmom View Post
              So sorry you/your son are going through this. Is he having normal bowel movements? Lots of people have posted about functional bowel obstruction post-surgery because of all the drugs. That can cause vomiting, too.

              Keep us posted--sending good thoughts your way.

              Evelyn
              We can only hope and assume they don't send kids home without bowel sounds.
              Sharon, mother of identical twin girls with scoliosis

              No island of sanity.

              Question: What do you call alternative medicine that works?
              Answer: Medicine


              "We are all African."

              Comment


              • #8
                Our experience

                Wil all the surgeries we have been involved in, we have always had excellent care and observation of bowel sounds before discharge. Good luck and this wont last forever! Mary

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                • #9
                  Originally posted by twinsmom View Post
                  Wil all the surgeries we have been involved in, we have always had excellent care and observation of bowel sounds before discharge. Good luck and this wont last forever! Mary
                  Yes I don't think the situation with long-term narcotics usage causing bowel issues applies to kids as a rule as it might apply to adults as a rule. There seems to be a very wide gulf in recovery trajectories between kids and adults.

                  What kids do have to deal with are surgeons who do NOT restrict all food and drink prior to bowel sounds and they suffer needlessly and horribly because of it. The surgeons know better. I assume the OP's surgeon ruled out an ileus but you can never be sure what with the sheer number of patients and parents who come on here who clearly have been allowed (or just took it upon themselves to ignore advice) food and drink prior to bowel sounds.

                  Maybe there is hope this is an ileus and not SMA. That question needs asking.
                  Last edited by Pooka1; 07-14-2010, 07:24 AM.
                  Sharon, mother of identical twin girls with scoliosis

                  No island of sanity.

                  Question: What do you call alternative medicine that works?
                  Answer: Medicine


                  "We are all African."

                  Comment


                  • #10
                    Does anyone know if Dr. Vitale restricts all food and drink prior to bowel sounds?

                    Maybe we can solve this right now though probably not.
                    Sharon, mother of identical twin girls with scoliosis

                    No island of sanity.

                    Question: What do you call alternative medicine that works?
                    Answer: Medicine


                    "We are all African."

                    Comment


                    • #11
                      I don't know if bowel sounds were a criterion for Spencer being allowed to eat and drink post op. We were not told that food or drink were restricted, but he didn't eat or drink anything for about 24 hours because he didn't want to. At some point, they reduced the amount of fluid he was receiving IV because they wanted him to drink. About day 3, he was put on restricted liquids because his sodium was low. He was also given laxatives orally every day while in the hospital and had a bowel movement before he went home.
                      Do you know if his symptoms are consistent with an ileus? They sure don't seem consistent with a virus.

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                      • #12
                        Originally posted by trav86 View Post
                        I don't know if bowel sounds were a criterion for Spencer being allowed to eat and drink post op. We were not told that food or drink were restricted, but he didn't eat or drink anything for about 24 hours because he didn't want to.
                        Our surgeon was extremely strict about this. Neiher kid had food or water until Day 3 when bowel sounds were heard. This was heartbreaking because they were very thirsty starting on the day of surgery for most of that time though they were not very hungry at all at any point while in the hospital. But it was the lesser evil... the surgeon is strict about this for a very good reason and you can read all about that reason in the various testimonials on this site which sound horrifying.

                        At some point, they reduced the amount of fluid he was receiving IV because they wanted him to drink. About day 3, he was put on restricted liquids because his sodium was low. He was also given laxatives orally every day while in the hospital and had a bowel movement before he went home.
                        Do you know if his symptoms are consistent with an ileus? They sure don't seem consistent with a virus.
                        I am no expert but if he had a bowel movement then I think that rules out an ileus but by the same token, why doesn't that rule out SMA also? What I don't know is if an ileus or SMA can develop later after the bowel is clearly working. Perhaps this may be due to an adhesion or something? Anybody know?

                        The low sodium might be a clue. See if you can link that to SMA or ileus or something.

                        You will solve this. Press ahead and press the surgeons to discuss details of differential diagnoses.
                        Sharon, mother of identical twin girls with scoliosis

                        No island of sanity.

                        Question: What do you call alternative medicine that works?
                        Answer: Medicine


                        "We are all African."

                        Comment


                        • #13
                          Trav86, I hope this is just a minor setback and he gets over it quickly.
                          Pooka what do you mean restrict food/water until bowel sounds heard? My son has had 3 previous surgeries(notfor Scolio) and they have always started on the drinking right away, food maybe day later, then of course miralax or something to get it going... Is this not how some do it?? Im not trying to argue with you or anything just curious...
                          Kelly
                          mom of Cameren 12 yrs. old
                          Chiari,retroflex odontoid,syringomyelia,scoliosis
                          Chiari decompressions 6/2005,5/2006
                          Syringopleural shunt 6/2009
                          Boston Braced off & on 6.5yrs
                          scoliosis surgery- 9/15/10 T4-L4 Dr. Bridwell
                          Fell & broke finger,surgery 3/2011

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                          • #14
                            From what I've read online, it seems that being able to move one's bowels does not rule out either ileus or SMA. Spencer had some ginger ale this morning and thus far has kept it down. We're trying jello now. I read a study that said lying on the left side can help alleviate SMA, so I'm having him do that. I'm thinking I'll buy something like ensure, but will consult with pediatrician before feeding it to him. We have an appointment at 1:30.

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                            • #15
                              Since my daughter hasn't had her surgery yet, I can't really offer an informed opinion other than to suggest the possibility that your son might be having a reaction to his pain meds?

                              My husband had a terrible work accident where he lost his thumb. He was prescribed pain meds and they weren't working. So, to supplement the pain meds he also started taking Tylenol. He immediately started vomiting and couldn't keep anything down. After speaking a pharmacist, he should have been taking Motrin instead of Tylenol as Tylenol was already present in the pain med he had been prescribed. In other words, he was overdosing by accident.

                              I don't know if this could be what's happening in your case. Just throwing it out there as a possibility.
                              Mother to 14 yo Cheyenne. Surgery 8/23/10 Shriners, SLC.

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