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Ask Dr. Arun Phophalia Your Own Question
Dr. Arun Phophalia
Dr. Arun Phophalia, Doctor (MD)
Category: Health
Satisfied Customers: 35771
Experience:  MBBS, MS (General Surgery), Fellowship in Sports Medicine
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I've been on coumadin since December of 2012 due to

Customer Question

I've been on coumadin since December of 2012 due to apulmonary embolism. The hospital could not find a reason for it and the hematology expert had no idea either. I am now on blood thinners forever. I went off them once when my INR was a 1.1 with Dr approval. Within a month was back in Dr with same problem. Why can't they find a reason for it? This is very stressful and frightening to me.
Submitted: 2 years ago.
Category: Health
Expert:  Dr. Arun Phophalia replied 2 years ago.


I am Dr. Arun and will be helping you today.

I am sorry that your question was unanswered for long.

Did you have DVT (blood clot / deep vein thrombosis) any time previously? Or have a family history?

What were the investigations done?

Expert:  Dr. Arun Phophalia replied 2 years ago.

It seems that you are offline; so I am writing you an initial answer. We can discuss this further.

One of the common causes are hereditary factors as following for pulmonary embolism:

There are many other causes too like increased coagulability of blood, veins and arteries have internal irregular surfaces predisposing for the clot formation etc. Many of these may not be detected despite the medical advancements and modern medical imaging. Usually the causes for pulmonary embolism are multifactorial and are not readily apparent in many cases. Your doctor may have investigated all the above causes. Occasionally an initial investigations panel may not reveal the cause but if the same panel is repeated after sometime;; may reveal some abnormality.

  • Antithrombin III deficiency

  • Protein C deficiency

  • Protein S deficiency

  • Fibrinogen abnormality

  • Resistance to activated protein C

  • Factor V Leiden (most common genetic risk factor for thrombophilia)

  • Plasminogen abnormality

  • Plasminogen activator abnormality.

It is privilege assisting you.

Please let me know if you have further queries or unanswered questions.

Please consider a positive rating if this interaction has been satisfactory, as this is the only way we experts are credited and compensated for the time and work. You are not charged again for giving a rating.

Thank you.

Wishing you all the very best in life.

Expert:  Dr. Arun Phophalia replied 2 years ago.

Thank you for the opportunity to answer completely your Question. Please make sure to rate me because that is how I am credited for my work.

Now, I will provide an Additional Service offer so that you have this option available on your question list to get a hold of me directly in the future.

This additional service offer can be used for

- if you would like to schedule a new, private email session or to ask me directly a new question. It's up to you.

Thank you.