asprin usage

F. Frank LeFever flefever at ix.netcom.com
Tue Jul 13 21:42:12 EST 1999


Richard's point should be taken a bit further: "professional health
care specialists" who ARE physicians should not give "medical advice"
on the web.  "Medical EDUCATION" is another matter.  I usually try to
be circumspect about this and not advise individuals on what they
should or should not do, but will freely say what I know or believe I
know which might be relevant to a given question.

In the example below, please note that I qualify my statements by (1)
disclaiming expertise ("a little out of my area"), and (2) describing
my reasoning, citing the basis for my inferences, and trying to make
explicit the distinctions between what I believe is common knowledge
and what is my "guess".

I find the substantive contribution that Richard makes very
interesting, and will see if I can find any studies addressing the
issue of LDL/HDL ratios and bleeding due to aspirin.  My internist
usually discusses his reasoning for choice of treatment options,
including presctiption decisions, but he did not raise this issue when
he suggested I take baby aspirins; perhaps this finding is not
generally known, or perhaps my LDL/HDL ratio, although favorable, is
not so extreme as to pose this risk.

Another "educated guess": given her history of stroke, she may NOT be a
memberr of tthat group with naturally low LDL, high HDL...

F. Frank LeFever, Ph.D.
New York Neuropsychology Group




In <v04210100b3b0dccd0884@[132.236.112.58]> rhall at uvi.edu (Richard
Hall) writes: 
>
>--============_-1280253773==_ma============
>Content-Type: text/plain; charset="us-ascii" ; format="flowed"
>
>Aside from allergic reactions, is aspirin for everyone?
>
>Somewhere, possibly Science Weekly,  I read that individuals with low 
>blood cholesterols may be adversely affected by aspirin.  Apparently, 
>the HDL, LDL, VLDL system contributes important factors to 
>coagulation reactions.  Individuals with elevated LDL and presumably 
>VLDL s may benefit from aspirin, but that small population of 
>individuals with naturally low ratios of LDL/HDL may be more 
>susceptible to strokes or bleeding disorders when taking aspirin.  If 
>this is true, general advice to take even modest amounts of aspirin 
>may be ill advised.
>
>Regardless, should professional health care specialists who are not 
>physicians be giving medical advice to individuals over the web?
>
>rlh
>
>
>
>>A little out of my area, but I have worked with stroke patients, so
>>I'll offer this:
>>
>>(1) For prophylaxis for "normal" people, I believe one "baby" aspirin
>>every other day is fairly usual.  I don't know how many mgs this is,
>>but you can easily check it out.  Looking at an old aspirin bottle, I
>>see that (at least for the time release pills) 2 tablets, each 650
mg,
>>is a normal starting dose for a HEADACHE, followed by 1 or 2 more
every
>>6 hours, if needed.
>>
>>(2) For long term (daily or every other day) use, one has to be alert
>>to the possibility of gastric bleeding, but I would guess that the
dose
>>you describe, less than 1/4 of the usual initial headache dose, is
less
>>likely to cause this.  Just to keep it in perspective: I had very
>>serious gastric bleeding after a long period of heavy doses of
>>ibuprofen, with a course of methlyprednisone for a few days (due to
>>severe sciatica), but my internist/gastroenterologist thinks a baby
>>aspirin every other day would be good for me.
>>
>>(3) Given that she has a history of stroke, i.e. is demonstrably at
>>HIGH RISK for stroke, it seems reasonable to me that somewhat higher
>>than usual prophylactic dose would be prescribed (i.e. about a half
of
>>an aspirin tablet per day?  I believe I've heard that recommended for
>>normal prophylaxis also.
>>
>>(4) Some people ARE allergic to aspirin, and I can imagine the
>>possibility of finger swelling being an allergic reaction, but it
seems
>>to me more likely that the aspirin might work to REDUCE inflammation
>>and swelling due to the bone crack.
>>
>>(5) Which wrist?  Is it on the oopposite side of the body from the
site
>>of the stroke?  Prolonged  circulatory disturbance, autonomic
>>distrurbance, swelling, etc., are not uyncommon in limbs affected by
>>stroke.  (cf. "shoulder-hand syndrome"))
>>
>>F. Frank LeFever, Ph.D.
>>New York Neuropsychology Group
>>
>>
>>In <7mbt6b$e7p$1 at nobel2.pacific.net.sg> "pacific"
<mvpl at pacific.net.sg>
>>writes:
>> >
>> >I hope someone could help.
>> >
>> >My mum is a stroke patient and has been on Asprin. When she was
>>discharge
>> >from the hospital , she was given 100mg asprin. When she return for
>>follow
>> >up , the doc give her 300mg. Is this normal ?
>> >
>> >1. I thought it should be the mg should be lower as time goes by...
>> >
>> >2. My mum also has a bone crack on her wrist and there is swelling
on
>>her
>> >hand up to finger point,
>> >It's been 2 months already, and the swelling still there, is the
>>swelling
>> >due to her stroke and aspirin ?
>> >
>> >Anyone has any info, please advise. Thank you.
>> >
>> >Derek
>> >
>> >
>> >
>> >
>> >
>
>--============_-1280253773==_ma============
>Content-Type: text/enriched; charset="us-ascii"
>
>Aside from allergic reactions, is aspirin for everyone?
>
>
>Somewhere, possibly Science Weekly,  I read that individuals with low
>blood cholesterols may be adversely affected by aspirin.  Apparently,
>the HDL, LDL, VLDL system contributes important factors to coagulation
>reactions.  Individuals with elevated LDL and presumably VLDL s may
>benefit from aspirin, but that small population of individuals with
>naturally low<underline> ratios</underline> of LDL/HDL may be more
>susceptible to strokes or bleeding disorders when taking aspirin. 
><underline>If</underline> this is true, general advice to take even
>modest amounts of aspirin may be ill advised.
>
>
>Regardless, should professional health care specialists who are not
>physicians be giving medical advice to individuals over the web?
>
>
>rlh
>
>
>
>
><excerpt>A little out of my area, but I have worked with stroke
>patients, so
>
>I'll offer this:
>
>
>(1) For prophylaxis for "normal" people, I believe one "baby" aspirin
>
>every other day is fairly usual.  I don't know how many mgs this is,
>
>but you can easily check it out.  Looking at an old aspirin bottle, I
>
>see that (at least for the time release pills) 2 tablets, each 650 mg,
>
>is a normal starting dose for a HEADACHE, followed by 1 or 2 more
>every
>
>6 hours, if needed.
>
>
>(2) For long term (daily or every other day) use, one has to be alert
>
>to the possibility of gastric bleeding, but I would guess that the
>dose
>
>you describe, less than 1/4 of the usual initial headache dose, is
>less
>
>likely to cause this.  Just to keep it in perspective: I had very
>
>serious gastric bleeding after a long period of heavy doses of
>
>ibuprofen, with a course of methlyprednisone for a few days (due to
>
>severe sciatica), but my internist/gastroenterologist thinks a baby
>
>aspirin every other day would be good for me.
>
>
>(3) Given that she has a history of stroke, i.e. is demonstrably at
>
>HIGH RISK for stroke, it seems reasonable to me that somewhat higher
>
>than usual prophylactic dose would be prescribed (i.e. about a half of
>
>an aspirin tablet per day?  I believe I've heard that recommended for
>
>normal prophylaxis also.
>
>
>(4) Some people ARE allergic to aspirin, and I can imagine the
>
>possibility of finger swelling being an allergic reaction, but it
>seems
>
>to me more likely that the aspirin might work to REDUCE inflammation
>
>and swelling due to the bone crack.
>
>
>(5) Which wrist?  Is it on the oopposite side of the body from the
>site
>
>of the stroke?  Prolonged  circulatory disturbance, autonomic
>
>distrurbance, swelling, etc., are not uyncommon in limbs affected by
>
>stroke.  (cf. "shoulder-hand syndrome"))
>
>
>F. Frank LeFever, Ph.D.
>
>New York Neuropsychology Group
>
>
>
>In <<7mbt6b$e7p$1 at nobel2.pacific.net.sg> "pacific"
><<mvpl at pacific.net.sg>
>
>writes: 
>
>>
>
>>I hope someone could help.
>
>>
>
>>My mum is a stroke patient and has been on Asprin. When she was
>
>discharge
>
>>from the hospital , she was given 100mg asprin. When she return for
>
>follow
>
>>up , the doc give her 300mg. Is this normal ?
>
>>
>
>>1. I thought it should be the mg should be lower as time goes by...
>
>>
>
>>2. My mum also has a bone crack on her wrist and there is swelling on
>
>her
>
>>hand up to finger point,
>
>>It's been 2 months already, and the swelling still there, is the
>
>swelling
>
>>due to her stroke and aspirin ?
>
>>
>
>>Anyone has any info, please advise. Thank you.
>
>>
>
>>Derek
>
>>
>
>>
>
>>
>
>>
>
>>
>
></excerpt>
>
>--============_-1280253773==_ma============--




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