Candice - My Neice

Sparks Of Insanity By Vinny "Bond" Marini Friday, August 11, 2006

Welcome To THE COUCH...Sit on Down and Get Comfy...

My sister's has twins... Candice & Joseph...

They were both born premature but have developed into incredibly wonderful children who love life so much...

Candice has been having troubles with eating and having pains in her stomach. My sister, Lynn and her husband Kevin have been taking her to specialists and having tests done and anything they can think of.

Two weeks ago, they flew to Minnesota to the Mayo Clinic to meet with more specialists.
Candice was subjected to many tests...Poked and prodded and x-rayed and such.

The last day (which was 3-4 days past their intended stay to begin with), as they are sitting in the airport in Minneapolis, the doctor called and asked them to come back. They had seen something on the last set of tests and x-rays.

There finally seemed to be a diagnosis... and that was Superior Mesenteric Artery Syndrome.

Never heard of it... you are not alone.
I quote from an article taken from

SMA syndrome was first described in 1861 by Von Rokitansky, who proposed that its cause was obstruction of the third part of the duodenum as a result of arteriomesenteric compression.

Despite the fact that about 400 cases are described in the English language literature, many have doubted the existence of
SMA syndrome as a real entity; indeed, some investigators have suggested that SMA syndrome is overdiagnosed because it is confused with other causes of megaduodenum. Nonetheless, the entity (also called cast syndrome) is a well-known complication of scoliosis surgery and often poses a diagnostic dilemma; its diagnosis frequently is one of exclusion.

Pathophysiology: The
SMA usually forms an angle of approximately 45° (range, 38-56°) with the abdominal aorta, and the third part of the duodenum crosses caudal to the origin of the SMA, coursing between the SMA and aorta. Any factor that sharply narrows the aortomesenteric angle to approximately 6-25° can cause entrapment and compression of the third part of the duodenum as it passes between the SMA and aorta, resulting in SMA syndrome.

In addition, the aortomesenteric distance in
SMA syndrome is decreased to 2-8 mm (normal is 10-20 mm). Alternatively, other causes implicated in SMA syndrome include high insertion of the duodenum at the ligament of Treitz, a low origin of the SMA, and compression of the duodenum due to peritoneal adhesions.

Frequency: In the US: The precise incidence of this entity is unknown. In a review of the literature, approximately 0.013-0.3% of the findings from upper GI tract barium studies support a diagnosis of
SMA syndrome.

Mortality/Morbidity: Delay in the diagnosis of
SMA syndrome can result in malnutrition, dehydration, electrolyte abnormalities, and even death.

Race: No racial differences have been identified.

Sex: More females are affected by
SMA syndrome. In one large series of 75 patients with SMA syndrome, two thirds of the cases involved women, with an average age of 41 years; one third of cases involved men, with an average age of 38 years.

ge: The SMA syndrome usually occurs in older children and adolescents. In one report by Geer, 75% of the cases occurred in patients aged 10-30 years.

You read that right 400 cases since 1861!

Candice and Lynn are still in Minnesota today, getting the names of doctors at Columbia Presbyterian, here in New York, so they can work on a protocal and, hopefully avoid surgery.

It is scary to find out your niece has something so rare, but also a total relief that...FINALLY we know what is causing this tremendous young woman to suffer so much.

Candice has not been able to do so many things the last year. She missed so much school, she has not been able to swim competitively...and she is a great swimmer...she has missed her friends and parties.

Seven weeks ago, we got to go to their 16th birthday...well Joe's 16th birthday and
Candice's Sweet 16!

Watching her that night you would never have known how badly she was feeling.

She is a real trooper, and was the life of her p

When you lay down to sleep tonight, please do me this favor...add
Candice to your prayers...that soon she is once again in the water swimming her heart out...laughing and smiling and enjoying the life a teenage deserves to live.

For that, I thank you.

Candice & her paternal grandmother, Teresa, cutting the rug!Candice & the author

Thanks for sitting on THE COUCH, hope you enjoyed your stay.

Remember .. Nets For Malaria - - find the big SI's Nothing But Net logo ... Or call 202.887.9040. Every cent goes to buying nets to place over the beds of children in Africa to stomp out Malaria. PLEASE HELP.

Keep that spark of insanity kids...It helps keep you an individual.

14 Of Your Sparks

  1. Anonymous Says:
  2. Your neice is beautiful Vince and I sincerely hope that she can get treatment and be well.

  3. Anonymous Says:
  4. Strangely enough, I have a student about your niece's age who was diagnosed with SMA a little over a year ago. She is currently undergoing treatment, and the improvement in her health has been remarkable. I pray that Candice's treatment will have excellent results and she will feel well again very soon. Best wishes to her and her family.


  5. Hun,

    I will be praying for your neice. I am happy that it was caught before there were any serious problems. Sometimes our bodies are our best indication of what is going on, small pains which we may attribute to normal daily living can sometimes turn to be serious problems like this. But I am happy that she is going to get treatment.
    Columbia Pres. is one of the best cardiac hospitals, alone with John Hopkins.

    Lots of love and hugs,

  6. Fred Says:
  7. Wow - that picture is great! She looks so much like her mom, and you look so much like your dad.

    I'm glad they identified what's wrong. And, living so close to NYC, that should be a great relief knowing there's world-class care right around the corner. Wish her well for me.

  8. Anonymous Says:
  9. Hey Uncle Vinny,
    Just read your blog. Thanks for all the great things you said about me. Say hi to the family. Love you all.

  10. twinnsmom Says:
  11. Wow! Thanks for including Candice in your blog. The more prayers the better! I love the photo of you and Candice.
    We are now home! We were at the Mayo Clinic for 14 days. Mayo Clinic is an unbelievable facility and we are glad that we went. We finally know why Candice has been suffering for so long. We now need to decide how we are going to treat this problem. It has been a long battle but we are going to win! We are so proud of Candice and how she has been dealing with this. We are hoping to speak with the doctor tomorrow since we have so many questions.
    Coco--do you know what type of treatment your student is getting? We would love to know or perhaps even speak to the family.
    Thanks to all of you for the prayers and support. Everyone has been wonderful!
    Lynn (Candice's Mom)

  12. Angell Says:
  13. She's gorgeous Vince! I'm so glad that they were able to diagnose what's wrong, and hopefully they've caught it in time.

    I'll keep praying and sending positive thoughts her way. :D

  14. Anonymous Says:
  15. Bond,

    I highly recommend Vanderbilt Children's Hospital in Nashville. That's where Chandler went with his open-heart surgery when he was 4 months. Best pediatric cardiologists in the country. The #1 guy was doing a double organ transplant the night Chan needed surgery, so we got the #2 surgeon: Dr. Christian.

    They saved his life. I will pray for your niece. :)

  16. Anonymous Says:
  17. P.S. Dr. Frank Fish was the #1 guy. Karla Christian was Chandler's godsend.

  18. Vince, just read your Friday blog this morning and I will definately add her to my prayer list. Prayer is very powerful and it DOES WORK!

  19. Thanks to you all for your warm thoughts and kind words...

    She is a beautiful young woman... that she is....

    Candice.. you have even more prayers from all of these strangers (to you) - so you know you will get healthy again...

  20. Anonymous Says:
  21. done

  22. Anonymous Says:
  23. p.s. nice yellow tux :)

  24. Anonymous Says:
  25. Awww, Bond, I hope your niece gets well soon! Children and teenagers should never be sick! God bless you both.


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