Brief Ans-Antibiotic and infection induced Neutropenia / Under Evaluation Hi Dear !! Thanks for your query to HCM. I reviewed facts of your query in context to your health issues and feel concerned about them. My Primary Opinion- In My opinion, in the given situation you seem to suffer from-TOS(Thorasic Outlet Syndrome)-Venous with ?Cervical Extra rib with thrombophlebitis. The cause of this thrombotic complication in your wife s case is mostly from overuse UEDVT-Upper Extremity DVT- along with Axillary vein compression and bruising / friction during exhausting upper limb use. Do s Suggested- Get Chest/Neck X-ray with CT Neck /chest, to rule out TOS-Venous in your wife s case. Physiotherpay /change of posture initially with painmedicines need to be tried first. Rest to the upper limb -for 2 weeks. Tab NSAIds, Antibiotics/ blood thinners need to be tried. Percuataneous Catheter directed thrombolysis-with TPA(tissue plasminogen Activator)like Activase/anteplase-for avoiding PE(pulmonary embolism) may be thought of if complaints are not relieved with initial treatment of your wifes upper arm problem. if no relief-Decompressive surgery with relief of clavicle / scaleni anticus / or extra cervical rib compression on axillary veins would be needed. Other causes need to be ruled out,after getting more details from you. Reply to specific query of your s - Q-1-What they do by refering to hematologist? Ans-In view of the above discussion,you might be sent for getting INR test , as you are put on blood thinners.Other causes of blood origin for cause of this thrombophlebitis like Hughes Syndrome(APS-Anti-phospholipid antibody syndrome) need to be ruled with hematologist. Next Appointment- Asap-to resolve your emergency problem Dear, Please update more information and details, on the lines asked above,to give further suggestions in this confusing complaint query. If you update more information/ details upon these suggestions, I would give further suggestions on medicines to correct your health issues. If need be, update any health issue 24 x 7 by a direct question to ME, at following HCM link-http://doctor.healthcaremagic.com/Funnel?page=askDoctorDirectly&docId=70229 Dear, if you don t have any further query in this regard, Do close this query with YOUR pleasing and excellent feedback comments to rate this reply and service, to boost the morale of incoming Emergency patients like YOU, at HCM services. If you want to update more details and ask more update queries , You are most Welcome herewith !! Good Day!! Wishing Good Healthy Life in time to come!! Dr.Savaskar M.N. Senior Surgical Specialist M.S.Genl-CVTS