Cardiologist says, I have "a plaque."

I guess that's better than mulitple plaques.  He wants me to try to take the enteric coated 81mg aspirin for six months and then will do a blood test to see if it's working.

Anybody know the odds on this?  (I've shown him graphics of my rearrangement...he would still rather I try the coasted aspirin and check in six months.)

How did he diagnose the plaque?  I'm just curious how he'll follow-up on that with a blood test as opposed to an imaging test.  

Did he check a PLAC (or PLAC-2) level?  That blood test checks for arterial inflammation and, if elevated, increases the risk of cardiovascular events.  It is treated with things such as aspirin (like he mentioned), niacin, omega 3's, and statins.  It is easily followed with bloodwork only. 

Just curious.  Sometimes docs get in a hurry and don't explain themselves well and PLAC and plaque sound exactly the same.  If he did mean plaque, I sure want to know what blood test he's talking about.  I love learning new things!

Just curious...what's the diff between a plaque and a PLAC?

Here's a link to the PLAC test with explanation.  It basically measures a specific lipoprotein that is a marker for cardiovascular inflammation.  

http://www.plactest.com/

Next time, you're going with me!  It will be in April...please make note of it now.

He was discussing the results of my carotid ultrasound.  He drew me a picture of my artery and said, "Right here, you have a plaque."  (But he didn't spell it, so he MAY have said, "you have a PLAC."  Do I have a PLAC?  Or a plaque?)

He said he would follow up with a blood test...to see if I'm actually absorbing the aspirin.  But I don't remember if the young woman scheduling it said "sensitivity" or "resistance."  But the follow up is to see if I'm "getting" the aspirin, using the enteric form.  If not, he'll change me to "uncoated" aspirin.

Did I say it better or screw it up more?

Aha!  Crystal clear!  That would be a plaque (hopefully teeny-tiny)!  

Now I got it!

Sorry to muddy the waters.  (I won't ask what your PLAC is)

Oh, and April sounds good!  I'm ALWAYS up for a road trip!

So, do you think we absorb enteric aspirin?  Or will it flow on through unmolested?

These--and other questions--will be answered in April.

But if anyone here TAKES coated aspirin and it works for them, that would be nice to know. 

That's a great question.  I'm curious to see what the test shows on you. 

Enteric coatings are acid-resistant, so most dissolve around pH's of 5 or greater.  The question for us is where exactly in our digestive system does that occur?  You can even continue absorbing the aspirin throughout the colon.  

It would seem to make sense that if we take enteric-coated tablets it might benefit us to be on a proton pump inhibitor to help reach that pH faster and maximize absorption.  Just a thought as I ramble. . . 

Hmm, the whole purpose of enteric coating is to PREVENT the release of the contents of the tablet in the stomach, for one of two purposes: (1) to prevent an acid-labile drug from being destroyed in the stomach or (2) to prevent a stomach-mucosal-damaging drug from coming into contact with the stomach.

It was my understanding that the reason for enteric aspirin was the latter, so taking it AND a PPI would make it more dangerous to our stomachs.

But I could be wrong.  It's happened before, I think ...

Most PPI's get the stomach's pH greater than 4, but I don't know how much greater (and probably varies among different brands).  I don't know if they get the pH high enough to dissolve the enteric coating or not.  With a VSG, it would seem likely that they would increase the stomach's pH even more than in a normie's stomach.  If that's the case, then it would completely negate the enteric coating's protection and make the risk the same as taking regular aspirin.  

I don't know. . .  Research time!