Hi. Quick break from the posting for a serious PSA.
Please have a bottle of aspirin in your home. Make sure the tablets can be chewed as well as just swallowed. Make sure you remove any fiddly foil seal and such. Don't use this aspirin for regular pain relief, just keep it around and know where it is.
Hopefully, you'll never need it and will just feel silly for having it. But if a bad time comes for you someday, being able to chew aspirin when emergency services tells you may save your life.
Aspirin is an anticoagulant, meaning it reduces your blood's ability to clot. Normally this is an undesirable side effect, because if you're bleeding you want your blood to clot and stop the bleeding.
But heart attacks and other cardiovascular events can be caused by blood clots obstructing blood vessels. Your body's not supposed to let that happen, but for various reasons sometimes it does. When it does, minutes count and you _need_ to tip the odds in your favor.
Fastest way to do that without a hospital is to chew some aspirin. Chewing it breaks through the outer coating that's meant to delay release of the active compound, and dumps anticoagulant into your bloodstream as quickly as possible.
It won't magically solve clots that are already there, but it's putting your finger on the scale. Your body is constantly in a tug of war between biological pathways that want to form clots, and pathways that prevent and dissolve them.
Chewing aspirin is like sending reinforcements to the "pls no clots" faction of your body, as quickly as possible. It stops new clots forming, and existing ones growing. It gives your body some extra margin that it can use to start dissolving the one(s) causing your cardiac event.
It's not a cure, not even close. It's an emergency mitigation that _may_ buy you extra time while paramedics reach you and get you further help.
But trust me, you want to have that option.
Note, this is something you want to have available, but you should not freelance it. If you think you're having a heart attack, embolism or other cardiac event, call 911/999/112/whatever your local version is, tell them where you are and what's happening, that you have aspirin and aren't allergic, and follow their instructions.
In some countries you can buy "low dose" aspirin, which come with slightly different instructions. That's ok too.
This PSA brought to you by: hi! I just had a serious pulmonary embolism, and spent a couple days in intensive care. I'm okay, the immediate danger has passed, though full recovery will take a while longer.
Having aspirin on hand allowed me to begin anticoagulation treatment within seconds of the bad time starting, and 10-60min sooner than waiting for first responders or ER treatment. There's a high chance that was the difference between "scary but you'll be fine" and an obit.
@danderson I know it’s well intended and it might be good for many people but it’s not something that can be done blindly necessarily.
I do see you say that later and I am glad you did but still worth pointing out.
Glad you’re safe! Best wishes for a full recovery (and hope for no further problems).
@danderson What were your symptoms?
I'm at risk so it would help.
@roknrol None of the obvious ones :/
Some shortness of breath all day, gradually increasing - like I'd just gone up a couple flights of stairs but I was just standing around. Went away while sat down.
Then in evening, in a ~10min span, suddenly worse shortness of breath, extreme upper body sweating (like, fully coated in a layer of sweat, felt like I was being cooked), feeling faint, and eventually lost consciousness for ~10s. That's when 911 and aspirin happened.
@danderson Thank you very much. I have experienced those symptoms (although not altogether like that) at other times, so your explanation lets me know what to look for.
My heart attack was not typical either, so I just like to know what the "possibles" are.
@roknrol Yeah, annoyingly all these symptoms are also things that happen for other less drastic reasons, so even if you're looking for them it can be hard to tell if it means anything.
Really the big lesson for me is never ignore shortness of breath you can't explain, however slight. Might be nothing, or it might be slight just because it hasn't gotten worse yet :/
@roknrol The early buildup was barely noticeable in the moment, I just put the windedness down to "I must be tired", not "oh this is very obviously wrong".
But, no chest pains at all, no racing or irregular heartbeat until the climax. Just a little winded and tired, and then everything all at once. First responders after the event did note persistent tachycardia (110-130bpm resting heart rate), but I don't know if that was present before.
@danderson Wow, that sounds really scary. I'm glad you pulled through ok.
My heart attack presented as a muscle cramp in my back...that was it; no other symptoms other than not being able to sleep (which I chalked up to anxiety and back pain). Eventually it wore me down and I went to the ER.
@roknrol Ah yeah, upper back pain was one that ICU docs mentioned is somewhat common - either because a muscle's being starved and cramping, or just referred pain from elsewhere in the chest because bodies are stupid.
It's really tough :/ I'm glad you were okay too.
@danderson @roknrol I'm curious if my daily biking + fitbit would make that more apparent, or not. If I'm winded, there's a reason (more reasons than there used to be when I was younger, but still, a reason). Seems like trying to run the motor up to its usual bike-to-work range would provoke some symptom, also. Last time I had the flu, the first symptom was "why am I so slow?"
I keep aspirin in my back pack. Back when I shared an office with Rick Hudson, we kept some taped to the door.
@danderson thank you for reminding people of this
also want to add that while most strokes are ischemic (a clot in the brain) do not give someone with stroke symptoms aspirin
about 10% of strokes are hemorrhagic, a bleed in the brain
giving them aspirin will kill them
call 911, make every second count, but do not give blood thinners
so thank you for reminding people not to freelance it
not all CVEs should be treated with blood thinners until a CAT scan
i survived an ischemic stroke and i hear so many people suggest to just do it at the sign of stroke symptoms that sometimes i think knowing 10% chance of death is a good figure to be aware of 
blood thinners saved my life, but only after a CAT scan because it's such a gamble
@danderson yup, that's what I have in my FAKs - 81mg chewable pills.
My primary use case is wilderness medicine, so diagnosing a heart attack in the field is next to impossible and "dial 911" part requires satellites in the best case and is impossible in the worst. So the protocol for suspected heart attack is chew two (160 mg) every four hours while you attempt evac/rescue. That's a small enough dose to have negligible potential side effects while still maybe providing some benefit.
@jacob Yup, the 81mg stuff is what I have too. It's a good choice for a first aid stash, if it's available. Can confirm they are very chewable in an emergency 😬
And yeah, wilderness medicine is much trickier. IME at least, when 911 is involved they'll make you take a full 320mg since more help is minutes away and so it's worth the slight extra risk to tip the balance further.
@danderson If you are on regular medication, please check if you can consume it without serious side affects!
Yes in a emergency situation life threatening things are always cared first (eg. Turnkeys). But please make sure if you’re preparing that you handle the least harmful stuff for you in your IFAK (Individual First Aid Kit).
I personally removed all my Aspirin from my personal Medical Bag, cause of other Medication im taking.
Please talk to your GP! I‘m just a random girl on fedi.
This reminded me that I need to get more aspirin once I scrounge up enough money for groceries.
I literally have a diagnosed heart condition.
@danielcornell @danderson
you have to be careful with stroke. Basically there are two types of stroke:
ischemic or blood clot in the brain, for which anti coagulants like TPA are used.
However the other cause of stroke is hemorrhagic - which means a burst blood vessel of some sort - in this case you don't want anticoagulants.
@MsMerope @danielcornell Yeah, it's complicated. To reemphasize what a later post in the thread said: when I say keep aspirin around, I don't mean decide on your own whether or not to use it.
In an emergency, call the emergency services, tell them what's happening, and they will tell you whether aspirin should be taken, and how much. The goal is purely to be able to say "yes" if the operator asks you if you have aspirin available. They have training and workflows, follow their instructions.
Oh, YIKES, I got a little way down the thread and realized "Something bad happened to Dave and that's why he's writing this!"
Am so very relieved to hear you're OK and on the mend.
I used to always have aspirin in the house, Bayer or Excedrin. Switched for no reason to ibuprofen. Will start stocking up on aspirin again.
@mwt That's something people need to know: aspirin does expire.
I keep my backpack 1st aid kit stocked up, but realized recently the aspirin was years out of date.
I take the Ibuprofen for muscle pain & didn't notice the aspirin was getting older, as it's only for fever and similar things.
@danderson Thanks for this PSA! I have a small bottle of chewable low dose aspirin on hand. But I hadn't thought to make it speedily available. When going to do that, I discovered it was expired! The shopping list has been updated.
I'll make my own PSA about it, but another thing to keep on hand in case emergency services asks for it is a lolipop for diabetic shock.
@danderson I didn't have this — but after reading your post, I now do. Thank you!
And I'm very glad to read you're going to be OK.
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