Chelsea Bagnall has been suffering from excruciating pain for years, almost as long as she can remember. From childhood, she was plagued by intermittent urinary tract infections, vomiting, and bowel problems, all of which caused her immense distress.
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03-30, 2025Four years ago, when Chelsea was 15, her health took a sharp turn for the worse. Vomiting became commonplace, and she began to experience fainting spells. Her weight plummeted to 40 kilograms, giving her a body mass index (BMI) of just 13. Regrettably, instead of receiving a proper diagnosis, she was misdiagnosed with an eating disorder and forcibly admitted to an inpatient treatment program, where she was force-fed for a year.
Now, after years of suffering, 19-year-old Chelsea has finally received the correct diagnosis: median arcuate ligament syndrome (MALS) and superior mesenteric artery syndrome (SMAS). These two rare conditions compress major arteries, causing excruciating pain when eating. In 2021, doctors were so concerned about her weight that Chelsea was sent to a hospital in New South Wales.
At the hospital, she was immediately fitted with a nasogastric tube in an attempt to stabilize her weight. "I was there for a few days, and a psychiatrist came to talk to me, but I quickly realized I wasn't in a normal ward. I was put in a room with three other girls, all with tubes in their faces. I didn't fully understand at the time, but I had been pre-emptively categorized into a group I didn't understand at all," Chelsea recalled.
Chelsea said that when she saw a psychologist, the doctor asked her leading questions about her eating habits. "She asked me, 'What do you think of your body? Have you ever made yourself vomit? Have you ever starved yourself?'" Chelsea said. "I answered very clearly, 'No, I have never starved myself, I have never made myself vomit. I have never thought about being thin.' I told her very clearly, 'I want to gain weight. I want to be healthy.'"
Despite Chelsea's insistence that she did not have an eating disorder, doctors diagnosed her with avoidant/restrictive food intake disorder (ARFID) and sent her to an eating disorder treatment program, where she spent several months. Her mother, Emma Bagnall, told 9news.com.au that she also felt pressured to believe the diagnosis. "They pulled me aside and talked to me separately. They told me, 'She will do everything she can to get out of it. She will make excuses. She will resist staying here,'" Emma said. "She was crying, begging me to take her home, and I had to calm her down."
As part of the treatment program, Chelsea was weighed every morning and then placed in a room to eat her meals on a strict schedule under the watchful eye of hospital staff. "If we didn't finish on time, the food would be thrown away. I was there, and I realized these girls didn't have the same problems with eating as I did; they weren't experiencing excruciating pain. They were reluctant and refused at first, but eventually, they gave in because they realized they had no choice. I tried to eat, but I couldn't keep up. Before I knew it, the alarm would go off, and my food would be taken away," Chelsea said.
Chelsea said that when she didn't finish her food on time, she would be given a liquid supplement, but she would often vomit it up immediately. While other patients in the eating disorder treatment program recovered and went home, Chelsea remained in the hospital for a long time, attending school there. Emma said the treatment her daughter received was "inhumane," but more concerning was the lack of other tests to determine what was making her sick. "They should have sent her to a rheumatologist, an endocrinologist, and a gastroenterologist. But they didn't," Emma said. "No doctor did any tests, and no one consulted her about anything else. There was no further investigation."
It wasn't until the family moved to Canberra that things began to change. Doctors in Canberra were puzzled, confirming that Chelsea showed no signs of an eating disorder and began running gastrointestinal tests. However, the real breakthrough came last Christmas when Chelsea saw a general practitioner who was filling in for Chelsea's regular doctor while she was away. Emma said the GP took out a stethoscope, listened to Chelsea's stomach, and commented that he couldn't hear anything. He ordered a CT angiogram, and while the mother and daughter were initially skeptical, it proved to be the key to unlocking the mystery.
The scan showed that Chelsea's left renal vein was being compressed, leading to a diagnosis of superior mesenteric artery syndrome (SMAS). A subsequent ultrasound revealed that Chelsea's celiac artery was also being compressed, indicating that she had median arcuate ligament syndrome (MALS). Further tests showed that there were three areas requiring surgery, and Chelsea will finally get the help she needs in an operation in May.
Canberra vascular surgeon Gert Frahm-Jensen said that vascular compression syndromes, such as MALS and SMAS, are a controversial topic. Frahm-Jensen, an associate professor at the Australian National University's College of Medicine and Psychology, said, "They are considered to be very rare, but in reality, they may be more common than we think. What's more tricky is that sometimes patients' scans show vascular compression, but they have no symptoms, and sometimes they have only relatively mild compression, but their symptoms are severe."
Frahm-Jensen said that while about one-fifth of the population has some degree of celiac artery compression, consistent with MALS, most of these people are not affected by chronic abdominal pain or difficulty eating. The difficulty in diagnosing MALS is also due to the fact that there are many causes of stomach pain, which are more common, including gallbladder or pancreatic problems or inflammatory bowel disease. "In many cases, it becomes a diagnosis of exclusion, meaning you've ruled out everything else," Frahm-Jensen said.
Although some doctors are skeptical about whether MALS and SMAS are real diseases, about 70% of people who undergo surgery for MALS and SMAS experience an improvement in their symptoms after the operation, he said. Chelsea said she hopes the surgery will give her the chance to live a normal life, but the experience of being abandoned by the medical profession and enduring years of pain has left her traumatized.
For those who are struggling with undiagnosed health issues, Chelsea wants to say, "You know your body. You know if there's a problem. Don't stop advocating for yourself, no matter how difficult it gets, no matter how much you're dismissed, no matter how many times you're gaslighted into believing you're okay. If you know there's a problem, fight for it, because you won't get anywhere unless you do."
