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.

Once you get to a hospital, assuming blood clots are an issue, then you'll get on the really good stuff like IV heparin, to continue what the aspirin started. But you can't keep that in a bathroom cabinet at home, and if a clot is trying to kill you, the sooner you get some anticoagulation going, the more chance you have of a good outcome. You do not want to have to wait until arrival at the ER, or even until paramedics reach you. As soon as possible. Give yourself the option.

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.

A lot of emergency preparedness stuff requires a bunch of work or money. "grab a bottle of aspirin at the shops" is incredibly cheap and easy, and while I hope you will never need to use it, if that particular grim reaper comes knocking someday, it may literally be what keeps you with us. It's extremely cheap insurance, please take it.
@danderson
Thanks for the advice and congratulations. I especially liked the part about not taking it for regular pain relief. It is far too easy to accidentally run out when you get older and live with daily pain.
@danderson I am glad you’re okay but please be careful with this. Certain medications increase the risk of bleeding and so do certain medical conditions that you might not even know you have. I am on such a medication (with contraindications) and I have had such a condition. I also have had to have surgery multiple times for bleeding totally unrelated. I can’t take anything that thins blood. Okay there might have to be at some point but I have to be careful is all I mean.

@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 I was reading between the lines and beginning to assume as much. Glad you got quick attention and hope you heal well. 💜
@danderson Well, that sucks; good luck for the recovery.
@danderson shit, glad you got out of it (mostly) ok, hope you recover fully soon!
@delroth Preposterously, after rolling a critical fail to start this adventure, over a couple days I went from "I need you to not sit up, or stand up, or exert yourself in any way. I'm admitting you to the ICU, they're on their way to get you" to "you should make a full recovery with no lasting damage". Modern medicine is pretty amazing.
@danderson oh wow. I've had PE, it's tough. Get better soon!!!
@danderson oooof, bleh, yikes, and all that sort of things. I wish you a fast and full recovery!

@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 Damn, that's coincidence. I had a mild one about a month ago. Thankfully a short visit to the ER got all of the tests and diagnosis done quickly. Anticoagulants for me as well. You know how you can tell if a drug will be expensive? If you recognize it from TV ads.
Glad you (and I) are on the mend.
Lots of caution ahead for us
@danderson Thank you for sharing, and I’m so glad you survived and are in recovery. Best wishes!

@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

@danderson

so thank you for reminding people not to freelance it

not all CVEs should be treated with blood thinners until a CAT scan

@deilann 100%. The goal is purely that if the emergency operator asks if you have aspirin, you can answer "yes" and have more options. The dispatcher has training and workflows to decide if it's the correct thing to do, follow their instructions. Just, do the easy thing to maximize available options.

@danderson

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 very glad to hear you made it through <3
@danderson glad to know you're okay 🙏 thanks for sharing the thread too