Tuesday 23 January 2018

Health Case Study: A Stroke of Genius

Dr. Barry Harrington who prescribes Warfarin for himself.
Dr. Barry Harrington who prescribes Warfarin for himself.

Joy Orpen

Dentist Barry Harrington, who survived a stroke in 1994, tells Joy Orpen about an at-home blood-testing kit 'for use by eejits', which would have massive benefits for patients

More frequent blood testing would have far-reaching benefits for patients who are taking warfarin. That is the view of one highly experienced medical professional who has been checking his blood from the comfort of his own home for more than a decade.

Barry Harrington, a dentist who has lived in the vicinity of Mount Merrion in south Dublin for most of his 74 years, suffered a stroke in 1994.

"I was writing a reference for one of my students at the [Irish] Dental Hospital when I suddenly went totally numb all the way down one side of my body," he says. "I walked to my office and lit up a cheroot. But I immediately said 'feck it' and put the cigar out. I called my secretary and told her I was having a stroke. She jokingly replied, 'I'm having a stroke too – because I'm working for you!' But then she asked if I really was having a stroke, and, when I said I was, she suggested calling an ambulance. I said no – I would drive myself home."

Barry now realises that this decision was totally ill-advised. In the end, he contacted a cousin who was a specialist attached to the veins unit at St James's Hospital. She told him to come to that hospital straight away and Barry's wife, Laura, drove him there.

"Everyone was in a flap at A&E," recalls Barry. "They did a CAT scan, X-rays, ECGs and various echo sound tests."

Eventually, it was discovered that the carotid artery in his neck was blocked. This artery supplies blood to the front of the brain which, among other things, deals with sensory perception, motor function and speech. Barry was put on warfarin, an anticoagulant which would help to prevent the formation of clots and blockages. Warfarin is highly effective, but its efficiency can be affected by imbibing other medications and certain foods, so its use has to be closely monitored.

Four hours after the onset, Barry's numbness began to lessen, and five days later he was allowed home.

Shortly after, he was the guest speaker at a dinner organised by the Irish Dental Association (IDA), which was attended by Dr James Reilly, who is now the Minister for Health. Barry began his speech by revealing: "Ten days ago I had a stroke." To which Dr Reilly is reputed to have joked: "I thought I was supposed to be off-duty tonight."

Barry was advised by his doctors to give up smoking immediately, which he did. Nevertheless, the question has to be asked – why hadn't he, an experienced medical practitioner, given up smoking long before his stroke occurred?

"There was no real connection between smoking and various diseases until fairly recently," he says. "Anyway, I always knew I would need a kick up the ass."

Barry was also advised to change his eating habits, reduce his cholesterol levels and get more exercise.

"The exercise I got was practically zero," he admits. "When I was in private practice I would start work at 8am and finish at 5pm. Then I worked for the IDA until 10pm. So there wasn't much time for much else."

However, he had managed to find a happy home in the stables.

"Of all the things I tried, including hurling, golf, rugby and sailing, horse riding was the best," he says. "I loved taking the dog, getting a horse and ambling along Coillte roads where I'd see the mountains and the wild flowers."

However, following his stroke, Barry discovered sudden jerky movements would make him feel very dizzy, so, sadly, his riding days came to an end. Instead, he enrolled at the local gym.

However, horse riding was not his only passion. There have been many aspects of his busy career that have brought him great satisfaction.

As the son of a dentist, he followed in his father's footsteps. But dentistry wasn't altogether his first choice. He might well have specialised in surgery if it hadn't been for the fact that he struggled academically. At college he was a slogger – he was at his books until 11pm, five nights a week. Barry was forced to battle hard at times, but in the end he graduated in dentistry in 1964.

It was only many years later that Barry discovered he had been suffering from undiagnosed dyslexia all along.

Nonetheless, he never allowed his difficulties to stand in his way. Apart from his private practice, he has held a number of prestigious medical posts.

He has also been instrumental in developing dental services at six Dublin prisons. He says there was pioneering work to be done back then, as HIV had become a serious issue inside.

Barry was also appointed chairman of the advisory body which made recommendations to the Government on ways of treating people who were living with bleeding disorders.

He has a distinguished history with the IDA and served as its president in 1998.

Today, Barry is taking life a little easier, but he remains determined to have his voice heard when it comes to the issue of home testing for patients on warfarin.

He first began to test his own blood in 1999 when he was invited to participate in a trial.

Until then, he used to spend hours at the hospital every few weeks having his blood tested; waiting for results and consultations with the specialists. Once the time spent waiting, the money spent travelling and the loss of earnings were all added together the costs became quite high.

The collateral damage becomes even higher for patients who are dependent on others to get them to the hospital.

Home testing not only does away with many of those drawbacks, it allows the patient to check their blood on a much more regular basis and so ensure that if any problems arise they are dealt with much more speedily, thus reducing the risk of further complications.

Barry is confident that the testing kit he uses was "made by geniuses to be used by eejits".

Illustrating the point, he pricks his finger and smears the resulting drop of blood on a testing strip which is then fed into a small machine for analysis.

Barry then texts the results to the hospital, and within two hours he receives feedback on the test's findings.

"I would say that the cost benefits of home testing are huge for both the patient and the health service," says Barry.

"The diabetes model has already proved this is so. Home testing for patients on warfarin is not available on the medical card, but it should be."

With that, he zips up his testing kit and heads off for lunch with Laura.

Irish Independent

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