<s>[INST] Yesterday I fell off our porch and have a golfball size hematoma in the middle of my shin. Of course it is painful but today it has turned red and below towards ankle is red and hot.  I have factor V Leiden and have a long history of blood clots.  I am resistant to coumdin and take 150 mg lovenox injections bid. The fact it is getting hot is bothering me more than anything and like I said is very painful and sensitive.  Should I go to the ER?  Thank you.  My email is  YYYY@YYYY / [/INST] Hello,thanks for writing thanks asking at HCM,I have read your question,your body is showing certain reactions to the haematoma , the pain and read this causing is generally the symptoms of it.All the drugs you using seem to be all right. Since you said that it is hurting I suggest you to consult a ER or a general physician nearby.Taking antihistamines and and painkillers as prescribed by the physician  may reduce the pain within within an hour or so.Wishing you a good health,Dr K Sanga Reddy </s>