colonoscopy by B8V9r47


									                                 WINCHESTER GASTROENTEROLOGY ASSOCIATES

James E. Gardiner, M.D.                                                    Llewellyn I. Kitchin, M.D.
Nicholas D. Snow, M.D.                                                     Richard John Sears, M.D.
Richard L. Nemec, M.D.                                                     Grace L. Shih, M.D.
John E. Habeck, C.F.N.P.                                                   Lisa Kerr, PA-C
                              190 Campus Blvd, Suite 300, Winchester, Virginia 22601
                                Telephone: (540) 667-1244 Fax: (540) 662-1187

                              COLONOSCOPY PREP INSTRUCTIONS

       INSURANCE ISSUES: If your colonoscopy has been scheduled for screening (meaning that you have no
        symptoms), but then the doctor finds and removes a polyp (which happens over ½ the time), then your
        colonoscopy is no longer considered a screening procedure. It has now become a “surgical” procedure. Your
        insurance benefits may be different depending on whether or not your colonoscopy becomes a “surgical”
        procedure. You might want to check with your insurance company first, before beginning the colon
        preparation. Also, if a pre-certification is required, you must call your insurance company immediately.
        Authorization may take a period of time. If additional information is required from your insurance company,
        advise them to contact our office. If you do not have insurance, please call our office at (540) 667-1244 ext.
        232 (Rachel) to make payment arrangements.

       If you cannot make your appointment time, please immediately notify us at 667-1244. This number is available
        afterhours for messages. Failure to notify us of your cancellation within 24 hours may result in a charge of
        $75.00 to you.

       Arrive wearing comfortable clothes, to The Endoscopy Center at Winchester Medical Center, Medical Office
        Building #2, Mall Level for your procedure that is scheduled although we try our best to start at your scheduled
        time, sometimes there are delays. We ask for your patience.

       Expect to spend 2.5 to 3 hours at the Endoscopy Center after your arrival. This time includes preparation as well
        as the procedure itself, and then time to adequately recover from the sedation. Keep in mind this time may vary
        due to unexpected delays.

       Since you will be sedated, you will need to arrange for someone to drive you home after the procedure. If you
        do not have a driver your procedure will be cancelled. You cannot go home by cab unless you have a
        responsible party with you. Your driver should wait for you in your room to listen to the doctor’s comments.

To prepare for your test:
INSTRUCTIONS ON YOUR PREP) No Prescription than do the following:
       You will need these items from a pharmacy/store: (you will need to purchase all the following items listed
         Miralax® -- 8.3 ounces (238 grams) sized bottle
         Four Dulcolax® Laxative tablets or Biscodyl tablets (5mg)
         64 ounces of Gatorade® or Crystal Lite® (Diabetics: Crystal Lite®) - chilled if desired

       Fill out your History and Physical form completely (front only).

       Do not stop your aspirin unless you are specifically told to do so by your physician. You may take Tylenol, but
        avoid NSAIDS such as Advil, Aleve, or Ibuprofen at least 5 days prior to your Colonoscopy.

       Try to stop using Plavix 7 days prior to your procedure. Please confirm with your cardiologists or internist that it
        would be safe to stop this medication for 7 days. If it is not safe, do not stop the medication.

       Coumadin is typically stopped 5 days prior to the procedure. Please confirm with your cardiologist or internist
        that it would be safe to stop this medication for 5 days. If it is not safe, please call our clinic for further

       If you had total joint surgery within the past 3 months, please call our clinic
        (540) 667-1244 to reschedule procedure.

       If you are diabetic, you should typically take one-half of your typical nightly dose the night prior. You should
        hold your morning insulin and/or diabetes pill(s) on the morning of the procedure. They can be resumed once
        you start eating again.

       If you are on your menstrual period, use a tampon, if possible.

On the day before your test:
     Drink only clear liquids. No solid food or milk products. Avoid all red or purple colored liquids. Examples are:
                   o Water
                   o Clear broth or bouillon (such as chicken or beef broth)
                   o Strained fruit juices (no pulp)
                   o Popsicles, Italian Ice
                   o Soft drinks, Kool Aid, Coffee or tea (no milk or cream), Gatorade
                   o Jell-O

This only pertains to those patients who are not following a prep prescription instructions :
       Mix the ENTIRE bottle of Miralax® with the 64 ounces of Gatorade®/Crystal Lite® and refrigerate until needed.
       Take four (4) Ducolax® or Bisacodyl tablets between 4-6pm (TAKE ALL 4 PILLS AT ONE TIME).
       Two hours after taking the Dulcolax® (Bisacodyl) tablets begin drinking the Miralax® solution. Finish 6 cups (8
        ounces every 10-15 minutes) before you go to bed. You will have about 2 cups of solution leftover for the
        morning prep. Most people have a BM an hour after starting; some people may take several hours longer.
        Even if you are having diarrhea prior to starting the prep, you need to complete the full prep.

The day of your Colonoscopy:
    4 hours before your scheduled procedure ALL PATIENTS are to drink all remaining prep solution. You should
       have no additional clear liquids at this time. Brushing your teeth/dentures is permitted.

       If you are to take your morning medications, take with small sips of water only. If your test is scheduled before
        10 AM, hold your morning medications until after your procedure is completed. If your test is scheduled for 10
        AM or after 10AM, you may take your morning medications.

       If bowel movements are not clear (transparent yellow water) about 1 hour after your morning dose, call the
        Endoscopy Center (540) 536-8746 for further instructions after 6:30am.

If you still have questions call: (540)667-1244 and ask for scheduling

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