One man’s journey, several doctors’ expertise

Patient Mario Garisto and his wife Ghadeer Malek. In 2018, it was discovered that Mario’s broken back was the result of an epileptic seizure. A partnership of specialists at the Krembil Brain Institute, University Health Network (UHN), changed his life.

Sometimes, questions are easy. Other times, they have you taking a step you never expected. The step becomes a walk, and the walk, a journey – a journey on which help is essential.

For Mario Garisto, a question brought him on a journey at UHN, and the help he got was life-changing.

Four years ago, Mario’s day-to-day revolved around owning and managing a restaurant in Toronto’s Junction neighbourhood. A pronounced ache in his back was first blamed on hockey, but as the pain persisted – and with the enthusiastic encouragement of his wife Ghadeer Malek – Mario was referred to esteemed interventional radiologist, Dr. Kieran Murphy at the Krembil Brain Institute, UHN.

Blaming muscle strain was tossed aside when an X-ray revealed five broken vertebrae in Mario’s spine. With this startling discovery came another revelation: epileptic seizures were the cause. Mario’s back injury was not the first case of unexplained back pain he’d endured over his life, but the diagnosis left his head spinning.

“When I was told it was epilepsy I had no idea what epilepsy was or what a seizure did,” remembers Mario. “I didn’t know how to explain it, or even what to explain.”

Radiating kindness

Enter esteemed neurologist, Dr. Esther Bui at UHN’s Epilepsy Clinic. Radiating kindness, patience and optimism, Dr. Bui spoke with Mario about his most recent injury, as well as incidents stretching back to childhood. Honing in on a plan of action, the impact of Dr. Bui’s help was “massive.”

“It turned out I’d been having seizures for so long, yet had no idea I’d been having them until then,” explains Mario. “For the first time in 35 years, I’d gone from not knowing what the hell the matter with me was one day, to the next day knowing I’m going to be part of a solution because Dr. Bui said we were going to grab this by the horns.”

Following his first phase of prescribed medication, Mario’s next steps were visits to the Epilepsy Monitoring Unity (EMU) at UHN, the largest adult epilepsy monitoring unit in Canada. Undergoing a battery of tests involving video and electroencephalogram (EEG) recordings, it was discovered that Mario was having up to five seizures in a row. By mapping these seizures, tests pinpointed exactly where they were emanating from.

Now was the time to meet Dr. Taufik Valiante, Director of the Surgical Epilepsy Program at UHN. Overseeing tests and discussing options, Dr. Valiante’s pre-surgery requirements included Mario undergoing functional magnetic resonance imaging (fMRI), a process that measures brain activity by detecting changes associated with blood flow.

“Just like the rest of the epilepsy team, Dr. Valiante was very compassionate,” remembers Mario. “He explained the surgery and talked to me at great length. It is still amazing to me how he and the rest of team care so much about the small details of their patient’s lives.”

With the positive potential of surgery confirmed, a month later Mario got the call. Dr. Valiante subsequently performed a temporal lobectomy, a procedure in which portions of the brain identified as responsible for seizures are removed.

After the four hour procedure was complete, a slower than expected recovery time led to a return to the EMU, and further discussions with Dr. Bui involving best possible medications moving forward.

Part of the team

More than four years after Mario’s first visit to Dr. Murphy and Dr. Bui, and two-and-a-half years since brain surgery under Dr. Valiante, Mario may not be cured, but his epilepsy is no longer as problematic as it used to be. Mario now has regular meetings with Dr. Bui, and his continuum of care at UHN includes sessions with neuropsychiatrist, Dr. Karl Farcnik at the Centre for Mental Health, meetings which have been invaluable to his post-surgery recovery.

“Dr. Bui has said a million times since the surgery ‘I won’t give up on this,’ says Mario. “Whenever I see her I never feel rushed or hurried, and she always makes me feel welcome.”

Today, Mario wakes up every morning grateful to be alive, moving forward with the support of Ghadeer, and the knowledge and awareness he credits to the team at UHN.

“Most people don’t understand epilepsy, but people at the hospital get it, and I came away thinking of the people there banding together not just as my caregivers, but my friends,” says Mario. “Now, I not only have self-awareness, but confidence in myself because they didn’t make me feel like I had a disease – they made me feel like I was part of the team.”

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