DR. DAVE HEPBURN  |  FEBRUARY 27, 2013

Dr Dave ASA

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DR DAVE

“Come to grandpa little guy, c’mon, c’mon weegeebeewockawockabeebebbe”
THWAAAAACK!! 

“OK, Asa, that poker really hurt grandpa, see the layers of peeled skin.”

My other grandkids love me, I know this by the way they curl up in my lap and whisper in my ear “Got any spare change old fella?” But grandson number three, Asa, is skittish of me, perhaps something to do with the time I dropped him off the back of the Harley. (It wasn’t that far a fall, only a couple of feet, though I think his mom was upset about the 90mph thing)  Regardless, I am now Asa resistant. 

You too may be ASA resistant and that would also be a bad thing. 

Apparently several billion of us take a daily ASA (aspirin) because we seem to remember Dr. Phil or Dick Butkus report that people who take an 81 mg aspirin each day have less strokes, less heart attacks, pay less taxes and can throw large footballs through small tires. And they are, in fact, correct. But hold on. 

It turns out that many of you who take a daily ASA are wasting your time, money and possibly your health. Some 15-40 percent of the population may be ASA resistant meaning that aspirin doesn’t offer you the protection of blood thinning it is meant to. For some, taking aspirin may be as useless as a bikini boutique in Baghdad. It may even be harmful.  

In some really recent relevant research ASA has been shown to be completely ineffective in a significant proportion of the population. It doesn’t deactivate those notorious clot formers known as platelets. But this population continues taking the aspirin thinking they are protecting themselves from the disasters that are strokes and heart attacks. 

“Blood thinning” is so essential that all patients who have had heart attacks or strokes, or those who plan to, are placed on aspirin and/or Plavix. 

Stu was a classic suburban guy who drove a classic Suburban, often to the video store around the corner preceded by a stop at McWendy’s, habits that tend to create the 45-year-old heart-attack-in-waiting North American male, the crown prince of angioplasties. At the behest of his wife, Stu took a baby ASA every day, which of course protected him from, well … it turns out nothing. One morning (most heart attacks occur at 8 a.m. which is why I advise always setting your alarm for 8:30) he noticed a pressure sensation in his chest. He was sweating more than he normally did during his morning exercises of opening the sports section and tying up his shoes. An hour later he was sporting a revealing lovely spring fashion hospital gown while lying on the cold table in the cath lab, awaiting his angioplasty. 

“Bill, we’ve got a big Mac plaque attack in cath lab 3.”

“On any meds?”

”Just 81mg ASA.”

“Ouch, that puts him at higher risk if he’s on ASA and still had an MI. Must be a bad one.”

“Maybe, or maybe he’s just resistant to the ASA.” 

As it turned out Stu was in fact resistant to ASA and the only thing it was doing for him was giving him a false sense of security, which he used to continue to abuse his coronary arteries. He was woefully mistaken and now faces life as a “cardiac cripple.”    

I would urge those who take aspirin to continue to do so if your doctor has suggested it. But you might want to find out if it is doing any good or if, in fact, you are resistant to it. If so, your options include switching to a different anti-platelet agent such as Plavix. This little drug is so effective at preventing killer clots that if you’ve not had a heart attack or stroke I suggest it is worth getting one just so you can see how well it works. Though a tad more expensive than aspirin, it is a tad cheaper than angioplasty and stroke rehab. After all, you want to be around to strap your grandkids into the sidecar.

Dr. Dave's book The Doctor is In(sane) is now available for those with a sense of humor and half a sense of health.