Below information based on personal experience. Not a recommendation or advice.
I am putting up this post as the latest lessons learned as a stroke survivor.
Post stroke as with some other stroke survivors we were prescribed Asprin as a blood thinner as preventative medication to reduce risk of further stroke(s). Maybe it worked or maybe it was never going to happen (a second stroke) but we continued using asprin and did not have a second stroke (that we are aware of). However, its long term use (six years in our case) has resulted in damage to the stomach which now has to be repaired with more medication
We are now on Omeprazole 20 mg for 6 weeks to be reduced to 10 mg thereafter for the duration …
Based on the asprin lesson, we will seen to review the usage of Omeprazole once this repair treatment course ends.
In our experience, once on the medication, healthcare professionals have never proactively reviewed the medication to determine if continued use is necessary and as a result we have used most medications longer than necessary and have only come off them as a consequence of some unfortunate incident that has resulted in a visit to the hospital.
We have just had one such visit and we have now been taken off Asprin permanently with immediate effect.
Mother nature has come to our rescue once again
Whilst on asprin, blood will take longer to clot if you get cut and so you should be aware of this. Also, long term use of asprin, or if taken in high doses, may lead to stomach ulcers for some users.
You might bruise easily - we were picking up bruises all the time and there was always some part of the body that was bruised.
The decision on if to take asprin and for how long is up to you. The doctors will recommend it but depending on your personal circumstances, you should decide what course of action to take.
It is not straightforward and depends on lifestyle etc.
Namaste|
Editorial note:
The “We” refers to a nonagenarian (female) stroke survivor.
I am surprised you weren’t prescribed something for the stomach along with the aspirin. It is very common for it to cause tummy issues. Thats why we all get Lansoprazole alongside clopidogrel. You apparently can’t take omeprazole with clopidogrel but with aspirin you can. Hopefully once the omeprazole has done its job you can stop taking it especially if you’re no longer takibg aspirin.
During the six year period Mum must have been seen by consultants many times and only on one occasion did a consultant express surprise that Mum was not on PPI inhibitors (Omeprazole or Lansoprazole) but even then they did not think to correct the oversight. If you are expressing surprise, surely you should then follow up and find out why the PPI was not prescribed as clearly it is not a good thing to be doing, taking Asprin for the long term without countering the known side effect. But such is life.
Only time will tell, but it may be the case that all these gastric issues Mum has suffered from for the last six months or more specifically the bloating may have somehow been linked to the use of Asprin. And there we were thinking how nice it is to be only on the single medication post stroke, the “innocent” Asprin!!!
Guess what?
Even though you have logically and rightly in my view suggested that the Omeprazole can stop and especially as we are no longer taking asprin, the discharge summary includes under the "Plan for the Trust & Requested GP Actions:
Continue on 20mg BD omeprazole, in 6 weeks this is to be further stepped down to 20mg OD
Asprin stopped immediately
I shall not be surprised if the GP completely misses this and even more surprised if they actually suggest or do what you and I both know should be done which is to stop the PPI once it has done the repair job.
The onus is always on us the patients.
So far our nongenarian stroke survivor seems to be happy to back in her own bed and getting pampered which she clearly missed when you was in hospital. Not a very pleasant time for someone in her condition:
Bed - foam mattress when she needs an airbed
No food - didn’t have anything that can be given via PEG (luckily we had the foresight and took this from home)
Desperate attempts to get her discharged asap as she was being a “nuisance” when the nuisance was just her asking for things that all other patients in the hospital/ward were able to get.
Good to hear your m is back home & much happier. Hospitals are never great places to be. I would have thought a hospital would have had an air mattress but I guess they are in limited amounts so could have all been in use. With regards to food, I am not sure what to say really. It is a good job she has a well prepared family.
It is very strange that no action was taken with regards to the PPI inhibitors. There is a possibility that this is why she has been having so many tummy issues. I hope that now she has those meds that that all eases for her, which in turn will make things easier for you too.
I know you will but keep on at the GP to make sure they do as instructed by the hospital. I am lucky in that respect as my GP is very good. I have had many a random phone call to discuss hospital letters and meds.
I do hope that this post is not going to worry certain people but when I was in hospital with my stroke this year, I was initially prescribed clopidegrel which has been the anticoagulant drug of choice for many years. However, my hospital is a training hospital and loves a research trial and is one of 4 in the country that is the pilot for rolling out of genome testing. It seems that some people are resistant to clopidegrel and are therefore prescribed aspirin instead.
Namaste amanjiB,
Very interesting — I am on aspirin but due to change ro clopidogral in 4 days (2 weeks after leaving hospital. I also have a supply of lansoprazle. Is Lansoorazle and omiprazole basically the same? Im thinking of interrogating my GP regarding comparability of the 2 together.
Thanks any info…..
Hello Baldrick - there are differences between Omeprazole and Lansoprazole and you should speak with medical professionals e.g. pharmacist or GP to understand which might be better for you.
They are both PPIs and one acts faster than the other but I suspect that would only be relevant if you are treating something like acid reflux e.g. short term relief from stomach burns. As we are talking longer term preventative treatment, perhaps that is why Omeprazole has been prescribed for Mum.
Both come with side effects that are “not serious” and Omeprazole seem to have fewer but again these things will be different for different people.
I don’t know anything about Clopidogrel but it seems it should not be used with Omeprazole.
If you are using Lansoprazole then that may explain why you are being switched to Clopidogrel as they are normally paired together.
But I think your idea to interrogate the GP is the way forward.
[quote=“ManjiB, post:7, topic:44264”]
Hi All - i suffered a major stroke 4y ago. I was initially prescribed Asprin when in hospital but then the docs at Addenbrookes hospital changed this to Clopedogrel and Lansoprazole to counter the effects of Clopidogrel. I had serious side effects with Lansoprazole and had to stop it. I suppose that may not be the case for others. Different folks experience this differently. Good luck my friends in your recovery.
When i went into hospital the medications I was put on initially (following a ct scan to rule out a bleed/haemorrhagic stroke) were Colpidogrel, Aspirin, Lansoprazol and Statin. Once fully diagnosed down to Colpidogrel and statin.
Until the source of my stroke was diagnosed I was on the aspirin as it was felt beneficial until diagnosis was given.
Would have dropped the statin but although LDL and HDL levels are ok individually, the ratio between is out so statins help to manage that.
Consultant explained carefully the effect of aspirin long term (hence Lansoprazol) and that when possible i would come of it. It was a couple of months later that was done.
Hi Phil - Nothing has ever been explained to us carefully and no one has taken interest in the long term effects and periodic reviews. So we ended up taking Asprin for six years (without the PPI inhibitors to offset the “negative” effect of the Asprin).
Not sure if you were lucky with your consultant who reviewed your condition and then when it was possible took you off the meds. That to me was a result and good for you.
As the saying goes, “All’s well that ends well”.
Sadly it’s all a bit of a lottery with post stroke care. Being an engineer by trade I was very inquisitive as to what was happening/how it happened etc and asked lots of questions.
Fortunately i was able to ask as I know all too well speech is a big issue for many and just not possible. In many ways these people are the ones who need things explained carefully.
The more i think about it the more it does seem most things fell in line for my journey and I appreciate that is not the case for everyone
You are 100% correct in all you say. It is very much a lottery and not everyone has the ability to speak, discuss and comprehend the consequences of all that is happening and being done to them/for them.
If anything, I would suggest you amongst the minority of post stroke care survivors who have received anywhere near what might be considered as “text book” post-stroke care.
Despite advocating for my Mum and perhaps because I was advocating for her, she simply has not received anywhere near the level of care and support she should have had.
Perhaps things did fall in line for you and for that we should be thankful
