Blood thinners are a leading cause of drug-related harm. Can the risk be lowered?

To the best of my ability I write about my experience of the Universe Past, Present and Future
note: For example I was told to stop taking my blood thinner for 3 days in the hospital in case they had to give me an emergency operation then. Luckily, I didn't have to have one (at least at that time.
For example, I was in the hospital for something like diverticulitis caused by a Naval Hernia on January 4th. They thought about giving me an emergency operation but couldn't because I was taking Eliquis which is likely now the most prescribed blood thinner that I know of. However, luckily I survived without emergency surgery which is good because it allowed me to recover enough for a robotic Surgery with the best robotic Surgeon on the West Coast that I could find.
However, just be aware if you get cut or injured in any way so that you are bleeding often you cannot easily stop the bleeding. However, blood thinners do prevent strokes and heart attacks caused often by blood clots. So, if you need blood thinners to stay alive then maybe they are worth the risk of bleeding out one day?
Also, I take Eliquis specifically for Atrial Fibrillation which I almost died from in 2022. However, at that time they put me on amiodarone which allowed my heart to strengthen a lot now. So, in some ways my heart is stronger even than it was at my age 37 and I'm now 77 years old. Often I guess if you have an irregular heartbeat like runs in my father's family you might need amiodarone to prevent death from atrial fibrillation. also, in 2022 I had what is called a cardio-verion which is basically a Taser to the heart to stop Atrial fibrillation. However, sometimes this kills older people but they have to stop the Atrial Fibrillation in some way so this is one method.
Note: Also I don't do exactly what Doctors want regarding my Blood thinner because they wanted me to take one every 12 hours but this made me too dizzy to walk or drive a car. So, I decided to take one right at bedtime instead because I'm going to sleep then and this doesn't affect my walking or driving.
So, this was my solution to prevent blog clots at night which is when often a person might be the most vulnerable to this. However, I told someone my method but he wouldn't do this but he was in his 80s and has passed away now as of last January 2024. However, for him what happened is before he started taking blood thinners he got a clot in his right arm and he was right handed. So, he had to be life flighted by helicopter from the remote place he lived to a Sacramento Hospital about 4 hours by car from Mt. Shasta where he lived remotely. He was so freaked out by almost losing the use of his right arm and the incredible pain while flying to the hospital in Sacramento by Helicopter that he took two a day and didn't listen to me because he was just too freaked out by what had happened and almost losing the use of his right arm. However, I wasn't here in Mt. Shasta when he passed away and wasn't able to find out what actually took his life. Likely it was just old age and natural causes because he was in his 80s.
begin quote from NBC NEWS:

Larry Bordeaux, 65, has been on blood thinners since 2010, after he started developing deadly clots following an operation.
He credits the drugs with saving his life. If he stops taking them for several days — which he must sometimes do before certain medical procedures — clots develop quickly.
Still, Bordeaux, of Havelock, North Carolina, knows that being on blood thinners is a double-edged sword: They put him at a heightened risk of serious, uncontrolled bleeding. Since he started taking them, Bordeaux has experienced complications ranging from a serious hematoma — in which a pool of blood forms outside of blood vessels — to gastrointestinal bleeding.
“Even with something like a simple fall, if the blood thinner [dose] is not correct, I could bleed out,” said Bordeaux, who has since become involved with the National Blood Clot Alliance, a nonprofit organization that aims to reduce deaths and complications from blood clots, as well as prevent adverse events linked to blood thinners.

Bordeaux is just one of more than 8 million people in the U.S. who take blood thinners, also called anticoagulants. Many, like him, are prescribed the drugs after they develop clots following surgery. Others take blood thinners because of an age-related heart rhythm disorder called atrial fibrillation, which makes clots likelier to form.
Blood clotting, of course, is an essential process in the body to stop bleeds. But when blood clots form too readily, it can block blood flow, leading to embolisms, heart attacks and stroke. Blood thinners work by interfering with the body’s normal blood clotting process. At the same time, the drugs are also responsible for a staggering number of unintended bleeding events, sending hundreds of thousands of older people to the hospital every year. A study in the American Journal of Medicine estimates that that costs the health care system more than $2.5 billion every year.
“While they prevent stroke and embolism, they do cause bleeding,” said Dr. Samin Sharma, director of the Cardiovascular Clinical Institute at Mount Sinai Fuster Heart Hospital in New York City. “Studies have shown that they decrease the [risk of an] ischemic stroke, but the [risk of a] hemorrhage stroke goes slightly up.” (Ischemic strokes are caused by blockages, while hemorrhagic strokes are caused by bleeds.)
Even President Donald Trump has mentioned the risks linked to blood thinners, in particular aspirin, which he takes daily. “I take the larger one, but I’ve done it for years, and what it does do is it causes bruising,” he told The Wall Street Journal at the end of last year.
According to Dr. Pieter Cohen, an associate professor of medicine at Harvard University, who carried out a recent study on emergency room visits due to blood thinners, the most common issue is bleeding in the stomach or the wider GI tract.

“A bunch of those people need to be hospitalized to stabilize the situation, or they may need a transfusion,” Cohen said. “So that can be very serious. A very swift, massive GI bleed that cannot be stabilized can lead to disability or death.”
People taking anticoagulants can also experience serious bleeds from small cuts or grazes, uncontrolled nosebleeds, blood in the urine and, more rarely, brain hemorrhages or bleeding in the lungs.
“If you have a source of blood loss, anticoagulants increase the likelihood that you will lose more blood, that you will require a transfusion and that you’ll have a worse outcome,” said Arthur Allen, a clinical pharmacist and president-elect of the Anticoagulation Forum, which is working to establish better ways of reducing risk of serious bleeds.
Yet advocates feel that many patients and their families are not sufficiently informed of the risks related to blood thinners.
“Bleeding events aren’t rare edge cases; they happen every day,” said Leslie Lake, president of the National Blood Clot Alliance. “The staggering part is not just the numbers, but how quietly these events occur, often dismissed as complications rather than preventable harms.”
Many of those harms are preventable: Research suggests that almost half of all adverse events related to such drugs could be avoided.
So what can be done better?
Blood thinner harm was not supposed to still be a major issue. For nearly 60 years, the drug of choice was warfarin, which was originally developed as a rat poison. The major limitation of warfarin is that it does not work uniformly, and patients need regular blood tests to constantly monitor and adjust the dose.
“Warfarin was a very, very tricky drug,” Allen said. “There was a constant balancing act that required getting a blood test done anywhere from once a week to once a month.”
In 2010, a new class of blood thinners arrived, known as direct oral anticoagulants, or DOACs. Four of them are available in the U.S. — apixaban (sold under the brand name Eliquis), dabigatran (brand name Pradaxa), edoxaban (Savaysa) and rivaroxaban (Xarelto) — and clinical trials have shown them to be safer and more consistent than warfarin.
Yet in the real world, that has not translated to improved safety. More than a decade since the new class of blood thinners were introduced, about 300,000 people in the U.S. taking anticoagulants still end up in the emergency department every year with bleeds, and the proportion being hospitalized on the newer drugs remains similar to that of warfarin, according to a 2024 study.
Why? Part of the promise of the newer drugs was that they did not require the same degree of monitoring as warfarin. Because of that, Allen said he is concerned that the new generation of blood thinners is sometimes prescribed without sufficient oversight. In particular, the risk of bleeds can be aggravated when blood thinners are prescribed for too long or through overmedication, with one particularly pertinent example being when blood thinners are given alongside antiplatelet drugs — another class of anti-clotting medications that are commonly prescribed after people have experienced cardiac events.
“There’s a suggestion that a third of patients who are on anticoagulants are also on antiplatelet agents, and often inappropriately,” Allen said. “In reality, antiplatelets are rarely indicated in combination with anticoagulants, and when they are, it’s usually [supposed to be] time-limited.”
In a statement to NBC News, Daiichi Sankyo, which makes Savaysa, said that the drug is used to reduce the risk of stroke and clots but added that anticoagulants can increase the risk of serious bleeding. The statement also noted that patients’ kidney function should be checked before they start treatment.
Johnson & Johnson, which makes Xarelto, said in a statement that the drug reduces risk of clots and stroke for adults with certain medical conditions, but they encourage patients to speak with their health care providers to understand the benefits and risks of any medication. Bristol Myers Squibb and Boehringer Ingelheim, makers of Eliquis and Pradaxa, respectively, did not respond to requests for comment, but both websites mention the risk of bleeding from the drugs.
Another issue is patients taking blood thinners alongside common anti-inflammatories such as aspirin, which also acts as a blood thinner and is also known to increase bleeding risk. A study in Michigan found that 1 in every 3 patients taking blood thinners for atrial fibrillation or venous thromboembolism — a serious condition where clots form in deep veins — were also regularly taking aspirin.
“Aspirin is very readily available over the counter, and if the patient hasn’t been educated enough, that can lead to serious adverse outcomes,” said Dr. Sabine von Preyss-Friedman, a geriatric specialist and president of the Post-Acute and Long-Term Care Medical Association.
Experts say another common and often overlooked limitation of anticoagulants is that even with the newer generation of the drugs, doctors need to take care to prescribe the appropriate drug and dose for a patient. If the original dose is too high or it is not adjusted over time — to account for changes in kidney function, weight and patients’ increased risk of falling as they get older — the risk of serious or fatal bleeding events increases.
Cohen said that in prescribing apixaban, the most commonly used blood thinner in the U.S, the typical dose is 5 milligrams twice daily but that for people over 80, the dose should be half of that.
Can more bleeds be prevented? While hematologists and vascular medicine doctors have the most expertise managing blood thinners, the ubiquitous nature of the medications means they are prescribed by everyone from primary care physicians to cardiologists. Allen said dosing errors could be avoided by training more vascular medicine doctors.
Sharma said that when the bleeding risk is deemed too high, it is better not to prescribe such drugs at all.
“Sometimes you have to make a decision,” he said. “If you think there’s a high chance of bleeding and the stroke risk is low to intermediate, we can make a decision that giving anticoagulants will be more risky.”
These are not always easy choices to make, and anticoagulation experts like Allen are wary of creating a world where doctors are too scared to prescribe blood thinners, as that would be likely to lead to more strokes and even more preventable harm.
Instead, some hospitals are turning toward predictive models to help doctors weigh patients’ risk of bleeding versus their risk of stroke.
Toby Trujillo, a professor in the clinical pharmacy department at the University of Colorado Anschutz, said emerging AI tools could help doctors identify the correct dose for a patient, as well as prioritize which patients need to be seen by specialists.
“Some health systems across the country have worked with their electronic health record system to develop what is known as a ‘DOACX Dashboard,’” Trujillo said. “Once it is available, it will flag patients on DOAC therapy that are in need of a specialist. The dashboard may identify patients who may have started on a new medication that interacts with a DOAC, patients who have had a change in their kidney function or who have been prescribed an inappropriate dose. This can help focus the expertise of specialists to patients who need them.”
Newer treatment possibilities are also on the horizon. Experts are studying whether ablation — a surgical procedure that uses either heat or cold energy to create tiny scars in the heart to block the faulty electrical signals driving irregular heartbeats — can be a better long-term solution for atrial fibrillation, allowing patients to stop taking blood thinners.
Clinical trials are looking at a new generation of blood thinners known as Factor XIa inhibitors, which work by targeting a particular protein involved in the clotting process and may have a lower risk of bleeding than the current versions.
“Inhibiting this specific coagulation protein carries the potential for maintaining efficacy in preventing clots, but with a lower risk of bleeding,” Trujillo said. “If they do show a reduced risk of bleeding compared to the DOACs, that will be another advance in making anticoagulation safer.”
Whether it’s newer medications or simply better management, Allen said, finding ways to address patient harm linked to blood thinners could go a long way to prevent adverse events that affect hundreds of thousands of people and their families every year.
Von Preyss-Friedman agreed.
“I think we can really prevent a lot of GI bleeds, traumatic brain injuries and all kinds of emergency department visits if we get this under better control,” she said.
David Cox is a freelance journalist focusing on all aspects of health, from fitness and nutrition to infectious diseases and future medicines. Prior to becoming a full-time journalist, he was a neuroscientist attempting to understand how and why the brain goes wrong.
As I have gotten older my sleep schedule has changed which happens to many people over 40 or 50 by the way. Why is this? Not sure really.
However, this is what is happening to me for several years now so I'm very lucky to be mostly retired so I can usually deal with this ongoing in my life now.
Basically it's like this.
If I go to sleep at about 10:30 pm at night with my wife then I can usually sleep to about midnight. However, if I wake up at midnight to use the bathroom then often I'm awake until 1 or 2 or 3 or 4 am.
On one level because I'm mostly retired it gives me time to think my own thoughts and to be alone (which for me is often a good thing). However, on the other hand sometimes it can be a bit much to be alone every night or most nights like this.
So, if you see that I'm blogging between midnight and 4 am especially just know that then (depending upon how much sleep I got already that night I have to make up for it somehow.
So, for example, last night I slept from about 9 pm to 3am and then I was awake until 6 am or so. Then I slept from 6 am to around 10 AM. So, that gave me a total of 8 or 9 hours sleep. So, I was mostly okay today.
But, then, if I have an early morning appointment this is difficult for me so I try to schedule doctors appointments all between about 2 pm and 4 pm when I have to see specialists of various kinds. But, if I have to be at some appointment or other in the morning then often I have to make up sleep by taking a nap in the afternoon.
However, one of the biggest ways to prevent senile dementia is actually taking naps over 60 or 70 years of age. Somehow the brain of an older person needs more rest and regrouping time and if that rest and regrouping time isn't received then often people get some kind of dementia after 60 or 70 years of age.
So, if you are over 40 or 50 naps are your friend if you want your brain to keep working ongoing.
By God's Grace

It's basically a way for the Galactic Government to prevent human extinction on earth.
It's because of the perilous time we are living through this century regarding Global Climate changes, Autonomous military robots on land, sea, air, and Space, Isolationism which tends to create things like World war II like last time etc.
I think if nuclear war hadn't happened in Hiroshima and Nagasaki that that precedent not happening would have changed a lot what happened since World War II of the United Nations etc and the world pulling together more than ever before (at least until Trump arrived on the Scene). Though I am also putting the whole Chapter here likely your best read would be to just click on the link below for the clearest copy to read so it doesn't bleed into the Links on the main page of my Website.
begin quote from:
To the best of my ability I write about my experience of the Universe Past, Present and Future
Here is a link to Chapter 2
Galactic Time Guard Headquarters on the Invisible planet near the Galactic Core:
The Invisible planet is a perfect location for the Galactic Time Guard Headquarters. It is invisible so the only thing people there worry about is someone running into the planet in some space ship that doesn't know it's there.
However, technology has been developed that will create an anomaly in the space ships instruments momentarily which will automatically transport them to the other side beyond the planet (no matter what direction they are going through the planet so it is as if the planet is not there (their experiences of this). And this anomaly though it might show up on the spacecraft's sensors will usually be considered just a blip or malfunction in the system and nothing else. If people pursue their question far enough a mind wipe of those people regarding this one issue is done.
So, the Invisible Planet that the Galactic Time guard works from is relatively impervious from harm from any direction because of this. It also is close enough to the Black hole which holds all the stars and planets together in the galaxy and yet far enough away that there isn't much traffic this close to the Black Hole simply because it is harder to navigate a space ship and more costly because of fuel to go very close to the black hole without being sucked into the Anti-matter galaxy the other side of the black hole. Plus matter beings like humans usually don't survive the transitions from the Milky Way matter galaxy through the Black Hole to the Anti-matter Milky way Galaxy on the other side of the black hole in the opposite dimension of the Matter Galaxy Milky way Galaxy that you and I live in.
The Section of the Galactic Time Guard that deals with earth is speaking now in a meeting about Earth and it's ecology.
Section leader Alpha: "I got a message from the Galactic Ranger Core in charge of Galactic Park Earth today."
One meeting member: "What about it?"
Section leader Alpha: "Well. It seems that sanctioned time travelers, Captain Forward and Lieutenant Back from 1992 went forward in time and realized humans went extinct in 2095 all over the earth. So, it seems that they are trying to change time so not all humans die like this."
2nd meeting member: "That makes sense. The idea is not to extinct earth born humans but to reduce their impact on the earth. There's only two ways presently understood to do this. Either you thin them out by some fair method OR you have everyone tear down all their cities and homes on earth and have them all move underground or onto ships on the ocean, one of the two."
Section Leader Alpha: "So, you have studied about Earth then?"
2nd meeting member: "Yes. By the way I'm known as Arcane and I basically live on earth with my family but I'm also a Galactic Time Guard Member."
Section Leader Alpha: "So, you know almost everything necessary about Earth to help us then?"
Arcane: (Also, 2nd meeting member): "Yes. I believe so."
Section Leader Alpha: " It appears that the naturally occurring virus there is starting to be mutated by various people on earth and beyond."
Arcane: "Yes. From my point of view this is very problematic on many different levels."
Section Leader Alpha: "Why?"
Arcane: "The point is I think to try to thin out mankind in as fair a way as possible so the best and brightest and most intuitive and most intelligent and physically healthy survive."
Section Leader Alpha: "You sound like you are thinking of people sort of like deer or bears on Earth."
Arcane: "It's a mind game I play with myself in order to think rationally about all of this. First, everyone cannot survive and have earth's ecology to survive too."
Section Leader Alpha: "Yes. I'm trying to adjust to this kind of thinking too even though I find it abhorrent in nature."
Arcane: "Yes. There is something on earth called Lifeboat Theory where you have to deal with issues like this."
Section Leader Alpha: "How does it work?"
Arcane: "The mental exercise is that you are on the ocean in a single lifeboat and there are too many people to fit in that lifeboat. What do you do so some of the people survive this?"
Section leader Alpha: "Though this is an abhorrent exercise in survival I can see how this could be useful to the survival of Earth and it's ecosystem presently."
Arcane: "If you study Earth's human populations like I have you see that humans didn't reach their first billion people until the early 1800s. However, then they reached their 2nd billion by around 1927 Ad earth time. But, then between 1927 and 2021 they went to almost 8 billion people."
Section Leader Alpha: "Wow! I had no idea there were so many people there now. The ecosystem must be collapsing about now."
Arcane: "Yes. It is. There are climate change fires in places like California, and flooding in China where people are drowning in underground trains and flooding caused by what we call Hurricanes in Louisiana and China and other places around the world and the short term and long term death toll just from climate change is extreme even for earth and ongoing."
Section Leader Alpha: "So, what you are saying is that something has to be done and relatively fast to keep any ecology alive on earth at all!"
Arcane: "Yes."
Section Leader Alpha: "What do you recommend, Arcane?"
Arcane: "Well. I don't like to recommend bad things for earth but it's more about fine tuning how some people can still be alive by 2100 AD earth time at the moment. How do we do this?"
Section Leader Alpha: "Yes. How do we do this?"
Arcane: "What is presently happening is that people on earth are tinkering with variants in various countries mostly separate from Governments but sometimes governments are involved especially among educated people who see that everyone will die if something isn't done soon. But, most people are not technologically aware of just how bad things really are already."
"So, What I'm recommending I really wish I didn't have to. What I'm recommending to fine tune everything is not enforcing laws against Space marauders who are sort of like people in space ships that have been kicked off of planets because they don't obey the laws. They sort of remind me of people who travel their countries in Vans or motor homes and stay short periods of times various places sort of as modern day gypsies."
Section Leader Alpha: "I'm not familiar with the term Gypsies."
Arcane: "Originally I think it referred to people from Egypt who traveled to other lands. You notice that Gyp in the word is a section of Egyptians. So, this is where I believe this really started hundreds and maybe thousands of years ago."
Section Leader Alpha: "I'll take your word for it. So, how does this relate to now?"
Arcane: "Well. If we relaxed the Space Marauder laws then people wouldn't be stopped from scavanging earth. I cannot believe I'm recommending this but I did some research and realized it could help prevent human extinction on earth."
Section Leader Alpha: "What?"
Arcane: "What I did was ask the robotic sentients the ideal course of action on earth which would allow humans to survive this century with good genetics and sanity intact. This is the best course of action they had for me."
Section Leader Alpha: "It sounds insane."
Arcane: "Yes. It did to me until I looked at their projections from allowing this to happen."
Section Leader Alpha: "Crazy."
Arcane: "When the Robotic sentients explained to me that we can apply or step back from Space Marauder laws in regard to Earth at each and every point I began to understand how this all could work."
Section Leader Alpha: "So, basically what you are saying is Space marauders will be looting earth and allowed to up to a certain point."
Arcane: "No. Only specific things will be allowed to happen. It will appear to governments that a foreign alien power is attacking earth sort of like Islamic Terrorists have the last 50 years or more. But, what will really be happening is something entirely different which will move earth to a more survivable state."
Section leader Alpha: "So, it's sort of like putting hunters out on a game refuge somewhere to thin out the general population?"
Arcane: "Unfortunately, it's applying Lifeboat theory to the survival of humans on earth. It's better some survive than none survive."
Section Leader Alpha: "I think everyone is completely horrified by this plan but we will soon vote on this and other plans. I think we all need to withdraw now and think about this plan because if the Robotic Sentients came up with it it means they have spent thousands to millions of Robotic man hours researching this already."
Arcane said: "I agree."
So, all those present at the meeting withdrew to think about and to research the computer models that the robotic sentients had come up with.
What are Space marauders?
They are people kicked off of every planet because they refuse to follow the laws specifically on any normal law abiding planet. They remind me of everything from motorcycle gangs to campers and motor home dwellers who travel around to the nicest places to be in the U.S. or Canada right now or ongoing.
Space marauders are also in "Guardians of the Galaxy the Movie." They can be seen as good in some situations and bad in others but basically not law abiding groups of space travelers. So, you would most likely find them in places like Florida, Hawaii, or ski resorts or beautiful places around the world where people like to be with no smoke or much bad weather that time of year.
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