Daily Adult Aspirin for 75-Year Old / Paroxysmal Afib Stroke Prevention? August 24, 2020 01:02AM |
Registered: 12 years ago Posts: 8 |
Re: Daily Adult Aspirin for 75-Year Old / Paroxysmal Afib Stroke Prevention? August 24, 2020 02:22AM |
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JackC
...recommended that I take an adult-sized (325mg) Aspirin daily for AF induced stroke prevention.
Re: Daily Adult Aspirin for 75-Year Old / Paroxysmal Afib Stroke Prevention? August 24, 2020 04:21AM |
Admin Registered: 7 years ago Posts: 5,634 |
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JackC
My vastly experienced, but now older, EP recommended that I take an adult-sized (325mg) Aspirin daily for AF induced stroke prevention.
Re: Daily Adult Aspirin for 75-Year Old / Paroxysmal Afib Stroke Prevention? August 24, 2020 05:24AM |
Registered: 12 years ago Posts: 8 |
Re: Daily Adult Aspirin for 75-Year Old / Paroxysmal Afib Stroke Prevention? August 24, 2020 02:17PM |
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Re: Daily Adult Aspirin for 75-Year Old / Paroxysmal Afib Stroke Prevention? August 24, 2020 03:04PM |
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Re: Daily Adult Aspirin for 75-Year Old / Paroxysmal Afib Stroke Prevention? August 24, 2020 06:49PM |
Admin Registered: 7 years ago Posts: 5,634 |
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susan.d
Isn’t the sole purpose of a watchman implant after a LAA ablation is to stop NOAC altogether?
Re: Daily Adult Aspirin for 75-Year Old / Paroxysmal Afib Stroke Prevention? August 24, 2020 07:19PM |
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Re: Daily Adult Aspirin for 75-Year Old / Paroxysmal Afib Stroke Prevention? August 24, 2020 07:50PM |
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Re: Daily Adult Aspirin for 75-Year Old / Paroxysmal Afib Stroke Prevention? August 24, 2020 09:05PM |
Registered: 12 years ago Posts: 8 |
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Carey
Being a CHADS 1 means taking any sort of anticoagulant is a judgement call. Could be your EP is going with a sort of old school thinking of treating aspirin as a light weight anticoagulant for someone who doesn't have a strong need for one. Trouble is, aspirin comes with a pretty significant risk of GI bleeding.
I'm in sort of a similar situation. I have a Watchman device, which means the FDA thinks I should be taking aspirin, but the guy who implanted it (Natale) doesn't agree. He thinks a "mild" anticoagulant is still a good idea, so he prescribed half-dose Eliquis. It's a good compromise. It's still effective at that dose but has a much lower bleed risk than both aspirin and full-dose Eliquis. Maybe that's a conversation you should have with your EP.
Re: Daily Adult Aspirin for 75-Year Old / Paroxysmal Afib Stroke Prevention? August 24, 2020 10:45PM |
Admin Registered: 7 years ago Posts: 5,634 |
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susan.d
Last question: if you need surgery or a procedure such as a colonoscopy or ablation or dental surgery or name a scenario —would you need to bridge still since your LAA is closed off with your watchman and you are taking a low dose NOAC for other than af precautions?
Re: Daily Adult Aspirin for 75-Year Old / Paroxysmal Afib Stroke Prevention? August 24, 2020 10:48PM |
Admin Registered: 7 years ago Posts: 5,634 |
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JackC
When you say "half-dose Eliquis", what is your actual amount per dose/day?
One other question if I may: Considering I've been taking 100 mg Flecainide daily for over three years, do you know of any long-term potential issues regarding this drug? Is it protocol you would recommend knowing my background? This drug Flecainide) almost seems too good to be true considering the positive results, especially considering it was prescribed by the same EP who insisted I take an adult dose aspirin daily.
Re: Daily Adult Aspirin for 75-Year Old / Paroxysmal Afib Stroke Prevention? August 25, 2020 12:54PM |
Registered: 11 years ago Posts: 4,371 |
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JackC
After experimentation, I concluded that 100 mg of flecainide taken in the early evening was enough to keep me free from AF ever since.
Re: Daily Adult Aspirin for 75-Year Old / Paroxysmal Afib Stroke Prevention? August 25, 2020 09:36PM |
Registered: 12 years ago Posts: 8 |
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GeorgeN
Wondered if you'd tried an even lower dose, 50 or 75 mg? Reason I ask is the theory that an even lower dose would be less likely to lose its efficacy and would also give you more "headroom" to use on demand to convert any episodes that do come along.
Re: Daily Adult Aspirin for 75-Year Old / Paroxysmal Afib Stroke Prevention? August 25, 2020 09:45PM |
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Re: Daily Adult Aspirin for 75-Year Old / Paroxysmal Afib Stroke Prevention? August 25, 2020 10:23PM |
Registered: 12 years ago Posts: 562 |
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JackC
Hi Carey, thanks for the welcome.
I've been a reader of this forum for maybe 20 years. Is that possible?
Over those many years, the information gleaned from this website has pretty much kept my AF under control. THANK YOU!
George correctly guessed my CHADS score at 1 and I don't have any contributing medical issues requiring Aspirin.
Re: Daily Adult Aspirin for 75-Year Old / Paroxysmal Afib Stroke Prevention? August 25, 2020 10:47PM |
Registered: 12 years ago Posts: 8 |
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Carey
Since you're only taking the flecainide once daily, is it safe to assume it's extended release? If so then you probably can't split the pills.
The smallest dose it comes in is 50 mg, so you could ask your EP to let you try that for a while. There's no advantage to going to twice daily dosing except that those would be immediate release and could be split.
Re: Daily Adult Aspirin for 75-Year Old / Paroxysmal Afib Stroke Prevention? August 25, 2020 11:19PM |
Registered: 12 years ago Posts: 8 |
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colindo
Hi Carey, thanks for the welcome.
I've been a reader of this forum for maybe 20 years. Is that possible?
Over those many years, the information gleaned from this website has pretty much kept my AF under control. THANK YOU!
George correctly guessed my CHADS score at 1 and I don't have any contributing medical issues requiring Aspirin.
If you have a CHADS score of 1 you may consider nattokinase. I am 76, have CHADS score the same as you and take Nattovena, one in the morning and one last thing at night.
My sister took Aspirin for about 12 months and had a brain bleed and stroke.
Re: Daily Adult Aspirin for 75-Year Old / Paroxysmal Afib Stroke Prevention? August 26, 2020 12:09AM |
Admin Registered: 7 years ago Posts: 5,634 |
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JackC
I'm taking a white elliptical/oval tablet with imprint ANI on one side and 381/100 on the other. They look to be easily "splitable" with a provided center-line indentation. Not being a capsule, I would assume I have the quick-release type...
Re: Daily Adult Aspirin for 75-Year Old / Paroxysmal Afib Stroke Prevention? August 26, 2020 01:55AM |
Registered: 11 years ago Posts: 4,371 |
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JackC
I have not tried a lower dose than 100 mg once daily at 8:30pm.
If I were to try a lower dose, would you recommend a split regimen or once a day? BTW, are there tablets available of less than 50 mg?
Re: Daily Adult Aspirin for 75-Year Old / Paroxysmal Afib Stroke Prevention? August 26, 2020 02:00AM |
Registered: 12 years ago Posts: 8 |
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Carey
I'm taking a white elliptical/oval tablet with imprint ANI on one side and 381/100 on the other. They look to be easily "splitable" with a provided center-line indentation. Not being a capsule, I would assume I have the quick-release type...
Extended release drugs are often pills rather than capsules, but since the tablet is scored that definitely means it can be split. So if you want to try lowering your dose to 50 mg, you can do that easily. But 100 mg once daily was already a low dose and taking it once daily isn't the normal dosing. Immediate release flecainide is given twice daily. Does your prescription actually say once daily or did you just reduce it on your own?
Re: Daily Adult Aspirin for 75-Year Old / Paroxysmal Afib Stroke Prevention? August 26, 2020 02:21AM |
Registered: 12 years ago Posts: 8 |
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GeorgeN
I have not tried a lower dose than 100 mg once daily at 8:30pm.
If I were to try a lower dose, would you recommend a split regimen or once a day? BTW, are there tablets available of less than 50 mg?
Hi Jack,
Like you, I took my entire dose at night, reasoning that all my episodes came in the wee hours, so that is when I needed protection. I actually started the first night with 300 mg, my PIP dose, went the next night to 200 and then titrated down from there to 0 over about 6 weeks or so. As I've posted before, I started taking ginger spice at night also. I ultimately substituted the ginger by itself for the flec. It wasn't quite as good, but nearly so. I continued that for another 6 or so months till I figured out the calcium and stopped the brie. The standard dosing theory with flec is you are trying to get to and keep a relatively constant serum level for every 24 hours. My approach was to keep the serum level the highest when my risk was highest. I assume this is your reasoning, too.
In any case, my pills are 100 mg and I would cut them to get whatever dose I wanted. I think they make smaller doses, but I've always used 100 mg pills.
If yours are cutable, I'd continue with nightly dosing, since that is working. I would slowly titrate down to see what the minimum effective dose is and then stay there. First, I'd go to 75 mg and then 50 (which IS a very low dose). Who knows? I think I recall somebody using 25 mg/day way back in the day, here. I assume you are comfortable taking the risk that you may provoke an episode if you go too low.
George
Re: Daily Adult Aspirin for 75-Year Old / Paroxysmal Afib Stroke Prevention? August 26, 2020 02:57AM |
Registered: 11 years ago Posts: 4,371 |
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JackC
George, with your success controlling your AF, are you still concerned with the thickness of your blood?
Re: Daily Adult Aspirin for 75-Year Old / Paroxysmal Afib Stroke Prevention? August 26, 2020 04:02AM |
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Re: Daily Adult Aspirin for 75-Year Old / Paroxysmal Afib Stroke Prevention? August 26, 2020 05:41AM |
Admin Registered: 7 years ago Posts: 5,634 |
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JackC
Don't kill me, but just kinda did it on my on. My prescription initially called for 100 mg twice a day. I did that for only a couple of weeks, as I was feeling very tired/week... so I decided to try a 50 mg dose in the morning and continue with the 100 mg dose at night. Anyway, I still didn't feel the way I wanted or expected, so I eliminated the morning dose altogether. That allowed me to seemingly regain most of the energy.
Except for drinking ice-water, ALL of my AF bouts have occurred between 2:00 and 3:30 am.
Considering my background, what time would you recommend I take a 100 mg controlled-release flecainide?
Re: Daily Adult Aspirin for 75-Year Old / Paroxysmal Afib Stroke Prevention? August 26, 2020 10:41AM |
Registered: 11 years ago Posts: 4,371 |
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susan.d
George-doesn’t af count as a point?
Re: Daily Adult Aspirin for 75-Year Old / Paroxysmal Afib Stroke Prevention? August 26, 2020 01:59PM |
Registered: 11 years ago Posts: 4,371 |
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JackC
George, with your success controlling your AF, are you still concerned with the thickness of your blood?
Re: Daily Adult Aspirin for 75-Year Old / Paroxysmal Afib Stroke Prevention? August 26, 2020 02:34PM |
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Re: Daily Adult Aspirin for 75-Year Old / Paroxysmal Afib Stroke Prevention? August 26, 2020 03:02PM |
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Re: Daily Adult Aspirin for 75-Year Old / Paroxysmal Afib Stroke Prevention? August 26, 2020 04:30PM |
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Well then I don’t know if the first ER doctor with only an audible Doppler diagnosis of dvt without a screen is accurate or not. From Wednesday to Sunday I was admitted on heparin shots and also another frequent NOAC drug. I was not examined from Wednesday to Sunday morning (holiday -extremely short staffed) but instead I was stuck in a hospital bed and told not to get up or risk the clot to reach my lungs. Sunday a bunch of residents entered along with an attending who wheeled in a monitor based Doppler. The attending flatly said I was misdiagnosed and never had dvt because he couldn’t see it. They left and an hour later during discharge, the original doctor entered and stressed to me to ignore that doctor and he was 100%sure it was a dvt.Quote
Carey
History of a thromboembolism counts for 2 points and a DVT is a thromboembolism.
Re: Daily Adult Aspirin for 75-Year Old / Paroxysmal Afib Stroke Prevention? August 26, 2020 05:38PM |
Admin Registered: 7 years ago Posts: 5,634 |
Re: Daily Adult Aspirin for 75-Year Old / Paroxysmal Afib Stroke Prevention? August 26, 2020 08:14PM |
Registered: 12 years ago Posts: 562 |
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JackC
colindo, thanks for jumping in...
For starters, I'm very sorry to hear about your sister. I sincerely hope she has recovered and is doing well...
I was just about to ask if there were any proven natural alternatives v.s. pharmaceuticals for thinning your blood.
Are there tests to monitor the effectiveness of your blood-thinning protocol?