What causes clots in the elbow, arm and neck?
Patient: Developed pulmonary embolism following shoulder surgery. They found clots in my surgery elbow, arm, neck, and both lungs. I ve been on Coumadin and Lovenox injections for 9 days now. INR levels still not in therapeutic range (1.3). Doc doubled the Coumadin/Warfarin to 10mg for the past few days. Yesterday I noticed an itching on the inside of my wrist. Sometimes I see 5 or 6 small red dots, but mostly it s invisible. The area is always damp and noticeably different in temp from rest of my arm. I m concerned reading about Warfarin Rash/Necrosis . I also know that my PCP is going to wave this away as nothing because you can t SEE it. He has not yet demonstrated a knowledgeable grasp of Embolisms and Coumadin protocol so i dont trust him to address this properly. Is this serious enough to pay another visit to the ER tonight? Doctor: Hi, dearI have gone through your question. I can understand your concern. You have pulmonary embolism.  Ypu have high chance of blood clotting. So you need blood thinner like warferrin as prophylactic treatment.Dosage is very important in warferrin treatment. You should take warferrin to maintain your INR between 2 to 3.  If it goes above that then there is chance of bleeding.  If it goes below then there is chance of clotting. So keep this thing in mind. Consult your doctor and set the dosage accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.