Stroke: Sunbury man's survival a matter of timing

By Amanda O’Rourke
The Daily Item

June 30, 2009 08:31 am

— SUNBURY — For Bruno Cafiso, life today is filled with trains, golf, reading and cooking — all with his 3-year-old grandson, Ryan.
“He’s very active,” Bruno said. “I’m glad I am with him and do things I probably I would never do.”
Three years ago, when Ryan was only a few months old, Bruno suffered a stroke that nearly killed him.
It was June 2006 when Bruno, after an afternoon of swimming, slipped and fell in his bathroom. But his wife, Bonna, knew it was more than just a fall.
“I was cleaning the kitchen floor and I heard a noise, and then I heard a moan,” Bonna remembered of that summer day in 2006.
She went to the bathroom to find her husband on the floor between the toilet and the wall. He couldn’t get up.
“He said, ‘Pull me. Pull my hand,’” Bonna said. “So I pulled and I said, ‘Push with your left foot and your left hand,’ and he said, ‘I am.’ ”
But he wasn’t. In fact, the left side of Bruno’s body was limp. He was in the midst of a stroke.
Bonna, a retired French teacher with no medical background, said she recognized immediately what has happening and, for the first time in her life, called 911.
It was likely her quick action that saved her husband from the stroke’s debilitating effects.
Into surgery
Within minutes, Bruno, still conscious and cracking jokes with paramedics, was in an ambulance on his way to the Geisinger Medical Center. Several hours after his arrival, he was in the operating room, about to become Geisinger’s first stroke patient to be treated with the MERCI retriever under the care of neuroradiologist Dr. David Carrington.
The MERCI retriever, in use only since 2002, can be used on patients who are in the midst of a large stroke, Carrington said, patients for which intravenous treatment is not an option.
In Bruno’s case, evaluation by Geisinger’s neurology service diagnosed him with an occlusion of the carotid artery.
“The main artery feeding the right side of his brain was blocked at the top,” Carrington said. “The whole hemisphere was at risk for having a stroke he would not have survived.”
Though the use of a catheter, Carrington inserted the MERCI retriever into Bruno’s groin and threaded it up to his brain, where it plucked from his brain the clot causing Bruno’s stroke. According to Carrington, six hours is the accepted window of opportunity when treating a patient with the MERCI retriever; the time frame is even smaller when using intravenous drugs.
It was 3:30 in the afternoon when Bruno fell in his bathroom, and about 8 p.m. when he was taken for surgery. Had Bonna wasted any time calling 911, or been away from the house at her yoga class, as she would have been had Bruno fallen even 10 minutes later, it’s likely her husband would not have survived.
But by the time Bonna saw him after surgery at 11 p.m. that night, he was able to move his left leg with ease.
“It was amazing to see the movement come back,” Bonna said.
Perhaps amazing to no one more than Bruno, who after awaking from surgery had no idea why he was in the hospital.
Bruno remembers falling the afternoon after swimming, he said, but nothing else.
“It was so quick, it’s unbelievable,” Bruno, a Frenchman and retired electrician, said. “No pain whatsoever.”
To this day, Bonna isn’t sure how she knew Bruno was having a stroke. She just knew.
Just like she knew 40 years ago as a student in France that she would marry Bruno Cafiso after she met him at a pizzeria. The day was Jan. 26, 1969. They were married nine months later and will celebrate their 40th wedding anniversary this year.
Now three years after Bruno’s stroke, the couple spends much of their time with Ryan and their new granddaughter, Alyssa, 2 months.
Bruno, or Papi as Ryan calls him, said chasing the active 3-year-old is better therapy than the weight training he does at the YMCA.
“Even though he makes me tired when he’s here, but when he’s not here I miss him so much,” Bruno said.
And aside from favoring his left side and losing a few strokes on his golf game, Bruno said, and Carrington agreed, that he has had no lasting effects from the stroke he almost didn’t survive.
“When we can get a patient in the right time window and are successful in getting them treat appropriately,” Carrington said, “it is very satisfying.”

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