The aspirin argument.

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Clippy99

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My valve replacement was pretty traditional. My arteries etc are clean. I do have a small aneurysm but if that kills me not sure aspirin could save me from a dissection. What is the current thinking. I get more annoying things from aspirin than beta blocker. Thoughts?
 

Keithl

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Really depends on your doctor. I have been on baby aspirin for over 20 years and after my surgery surgeon has me on baby aspirin. I get it as aspirin helps prevent the platelets from sticking. My guess that and blood thinners help cover all bases. I am fine with it as there some studies that show baby and full aspirin can help prevent cancers of colon and others.
 

pellicle

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Hi

My valve replacement was pretty traditional. My arteries etc are clean. I do have a small aneurysm but if that kills me not sure aspirin could save me from a dissection.
I'm a bit lost here ... how would aspirin assist you in any way from a dissection?

To my mind there is not enough hard evidence to support aspirin doing something critical, however there is sufficient that I'm now retaking it (300mg tablets from supermarket, split into 150mg size taken every second day). My tipping point was a mate who's a pharmacist (and my age) saying he takes it because there's enough evidence to make him inclined to do so. So call me a lemming ...
 

carolinemc

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Hi



I'm a bit lost here ... how would aspirin assist you in any way from a dissection?

To my mind there is not enough hard evidence to support aspirin doing something critical, however there is sufficient that I'm now retaking it (300mg tablets from supermarket, split into 150mg size taken every second day). My tipping point was a mate who's a pharmacist (and my age) saying he takes it because there's enough evidence to make him inclined to do so. So call me a lemming ...
there is enough evidence of the asprin could thin the blood too much. I will be seeing a new cadio and will be discussing the asprin regiment with her/him. I was taking it after bypass in 01 and cardio at KU stopped it in 04. Then I get started up again in 2018. So hopefully I can stop the aspirin regiment soon. I will keep up you all posted in that. Taking childrens' chewable 81 mg.
 

carolinemc

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My valve replacement was pretty traditional. My arteries etc are clean. I do have a small aneurysm but if that kills me not sure aspirin could save me from a dissection. What is the current thinking. I get more annoying things from aspirin than beta blocker. Thoughts?
Aspirin does not prevent a dissection of the heart. Your cardio needs to go back to med school if he/she thinks that. Good luck dodging the bullet.
 

Clippy99

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Lost in translation...bit of joke DR. didn't say that it would help with dissection...me saying that dissection is the only thing I am really at risk for. Not a heart attack. So why do I need it?

My most annoying side affect is the lots of arm Purpra?.....whatever it's called and some bruising. Also if I take it 7-10 days straight it kills my stomach. Right now I have taken it on myself to take it just 4 days a week.
 

Protimenow

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I take one 81 mg enteric coated aspirin once a day. The coating keeps it from dissolving in the stomach. I get them at Costco - 730 (two regular years) for, if I recall, less than $4. This dose hasn't bothered my stomach, and probably won't bother anyone else's.
Some of you may be taking too much aspirin. (If doctors say 'baby aspirin', it probably really means the enteric coated 81 mg aspirin).

carolinemc - just a friendly note - the word is regimen. A regiment is a military unit. (My wife says 'regiment', and it's awfully difficult to try and correct her - it's better just to let it pass.) Please, group, don't slam me for this (I've ignored 'endocarditas', 'aspirin', 'congested' heart failure, and other things, so please cut me some slack). After my TIA, I'm even more anal about words and spelling than I was pre-TIA.
 

Clippy99

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Oh yeah 100% baby aspirin..really just the coated kind. For whatever reason I have never tolerated it well.
 

pellicle

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carolinemc - just a friendly note - the word is regimen. A regiment is a military unit. (My wife says 'regiment', and it's awfully difficult to try and correct her - it's better just to let it pass.)
well probably you should have used that same methodology here. But now that its out in the open I'll add content to this. My favorite is prostrate cancer.

887142


which should of course be prostate.

I don't get worked up about it though and it makes me grin. Being wicked (and more than just a bit naughty) I occasionally make some mild fun in hospitals (when I hear nurses say "prostrate cancer") by saying something like "yes, too much lying around causes this"

In terms of "letting it pass" its always wise as one gets older to ensure that its only gas that's passing.


:)
 

gerrychuck

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Grammar Police; To Serve and Correct! I'm with you, Protimenow; seriously!

Back on topic, I was on baby aspirin for quite a while after my mitral valve replacement, primarily because I forgot to stop taking it. Instructions to stop after the first couple of months somehow got missed. Anyway, when I did finally stop, I noticed a huge difference in bruising; I still get some impressive bruises at times, but no where near as much as I did when I was on both warfarin and aspirin. I have clean arteries as well, so I was happy to be done with the asa.
 

Protimenow

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I've been taking 81 mg aspirin for so long, that I can't compare the experience of bruising when I take both than to bruising before I added aspirin.

I DO get a lot of bruising - even with an INR hovering around 3.0. But I can't, for now, really tell if the aspirin contributes to it or not.

--

carolinemc -- yes, prostrate is a good example -- from a nurse, it's even worse. There are lots of words where more common wording is used instead of the correct term. One of my favorites -- a student who lived in a farming community believed that an award for journalistic excellence was the "Pullet Surprise.' I don't want to get too far off subject here, but these things show up quite often, if you're a careful reader (and know the correct spelling).
 

LondonAndy

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I don't get worked up about it though and it makes me grin. Being wicked (and more than just a bit naughty) I occasionally make some mild fun in hospitals (when I hear nurses say "prostrate cancer") by saying something like "yes, too much lying around causes this"
FWIW my favourite hospital joke is when asked "Any allergies" I reply "Pain". Always surprised at how few people appear to say this, as nurses always laugh ...
 

Keithl

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One thing I need to watch more than the aspirin is the fact that I take garlic and fish oil, both known to cause more bleeding, bit not in a way to impact INR. Before surgery and before they made me stop all my supplements I went for full blood labs including a INR. my INR was 1.0 as expected and now I have my latest full labs just before surgery to compare as I work my supplements back in. I may have mentioned this before, but currently thinking goes beyond basic cholesterol numbers. Cardiologists are finally coming around to ththe science around advanced lipid panels which break down the make up of the various cholesterols. I have been getting advanced lipid panel test for years, before my then cardiologist knew what to do with it. Now some routinely ask for it. LDL and HDL are only part of the story, the quantity and size of the particles seems to be a better indication of potential issues.
 

pellicle

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One thing I need to watch more than the aspirin is the fact that I take garlic and fish oil, both known to cause more bleeding,
my advice is to just focus on the INR, forget about the "knowns" (which are probably fluffy), eat how you normally eat, test weekly and target your target INR (which is probably 2.5) and just enjoy life.
 

Keithl

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Absolutely what I am doing, but I have always had full labs pulled every 6 months to validate my diet and exercise choices to a point. I eat my normal diet and will work the warfarin to get to my 2.5 target, which I ironically hit on yesterday’s test with my Coagusense. I really am liking that meter
 

pellicle

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Absolutely what I am doing, but I have always had full labs pulled every 6 months to validate my diet and exercise choices to a point.
myself I only get comparison lab draws to validate my meter readings. The meter gives me the weekly readings to steer my directions, I don't seek validation of my choices, because after 8 years I've concluded that there is no validations, only keeping on the road, between the lines ...
 

Thomas

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This conversation just brought to mind an issue we have here. I know it's a bit off topic.

... but currently thinking goes beyond basic cholesterol numbers. Cardiologists are finally coming around to the science around advanced lipid panels which break down the make up of the various cholesterols.
My wife and I go to a "functional medicine" doc (not my gp). His work in our experience is much more thorough than my gp's analysis of bloodwork. As keithl says above, he follows the science and disects tests like cholesterol to a far greater degree than the traditional general analysis my GP does. The approach to fixing a problem is on what's causing it. Diet and supplements are the basis for fixing most issues. My GP would just drug me up to make things seem better and disregard long term effects of the drugs like statins.

The problem we have is that our medical system (Ontario, Can.) will not back this approach to medicine. This doctor had to stop practising traditional medicine because of his natural approach, which was ok; but now is not even allowed to issue blood work requisitions. I have to get the req.s from my cardiologist who's totally on board. My GP will not do it. My assumption is that big pharma has its tentacles in a little deep.
 

pellicle

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My assumption is that big pharma has its tentacles in a little deep.
an alternative view is that the existing "Medical Systems" transcend humans and is itself a repository of knowledge and evidence going back hundreds of years (see Royal Society formed on 28 November 1660 which eventually led to more specific disciplines as knowledge grew) and is itself an entity which has as its basis the vetting and understanding of knowledge to bring to its decision base such principles as evidence and veracity.

Its not perfect, not least because it is filled with imperfect creatures like humans, but it is indeed an evolving thing. However it has indeed cleaned up the snake oil and shonks which probably underpinned medicine for most of human history (see witch doctors or even homeopathy).

Whether individuals do or do not get better outcomes from a specific approach is moot, but when this becomes statistically significant (the better outcomes) it will be evaluated and incorporated into the body of medicine (as indeed many things already have) (resistance is futile).

Short term "big pharma" may have an influence on "Medical Systems" but I would view that the noise of their mutually competing systems also cancels itself out (rather like Brownian Motion jiggles dust but you need wind to move it).

I also view these Organisations in a Manturanan way (see biology of cogntion) in that they are indeed living and adapting organisms (a rule set, which is indeed what biochemistry is and we humans the hardware that runs it).

sorry about the deep dive into philosophy... myself I personally lean towards an interconnected-ness of problems, a more holistic view rather than a reductionist view. However sometimes that can be problematic too.

*(normal programing will now resume)
 

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