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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 Ellena Thomas, 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. At Blue Ridge we may use an Anesthesiologist for sedation – you could incur an additional cost/bill for the Anesthesiologist. If you choose not to have an Anesthesiologist for sedation please contact our office. If you do not have insurance, please call our office at (540) 667-1244 ext. 236 (Christine) 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 48 hours may result in a charge of $75.00 to you. Arrive wearing comfortable clothes, to Blue Ridge Endoscopy at Winchester Medical Center, Medical Office Building #2, Suite 150, Mall Level at __________ on _____________, for your procedure that is scheduled to begin at _______________. 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 Blue Ridge Endoscopy 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. (IF YOU RECEIVED A PRESCRIPTION FOR PREP YOU ARE TO FOLLOW THE 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 below): Miralax® -- 8.3 ounces (238 grams) sized bottle Four Dulcolax® Laxative tablets or Biscodyl tablets (5mg) 64 ounces of Gatorade® or Crystal Light® (Diabetics: Crystal Light®) - chilled if desired ALL PATIENTS ARE TO DO THE FOLLOWING: 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. 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 instructions. 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 at ext __________.
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