Dr. Kathie A.S. Koziol - JOHN D by gjjur4356

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									Kathie A.S. Koziol MD, FRCP(C)                                  TELEPHONE (250) 652-7912
Practice of Gastroenterology                                          FAX (250) 652-7913


   Please initial after reading and bring back to Dr. Koziol the day of your procedure. Please
  confirm your appointment with South Island Surgical Centre 2 weeks prior to your procedure
                                         date at 658-9311.

                           PREPARATION FOR COLONOSCOPY

                    SOUTH ISLAND SURGICAL – 203 – 4450 Chatterton Way

ONE DAY PREPARATION SHEET FOR:

APPOINTMENT DATE:                               CHECK IN TIME:
ONE DAY BEFORE PROCEDURE:
• Clear fluids for breakfast, lunch and dinner. (No solids). Clear fluids: apple juice, cranberry
  juice, black tea or coffee, Coke, Ginger Ale, Sprite, chicken or beef broth, Jell-O, Gatorade,
  water. No solid food, dairy products or orange juice.
• 9 AM        Mix and drink one package of Pico Salax with 150 ml of water. Please make
  sure you drink one cup of clear fluids each hour. Continue on clear fluids only for the
  rest of the day.
• 4 pm:       Mix and drink the second package of Pico Salax with 150 mg of water. Please
  make sure you drink one cup of clear fluids each hour. Continue on clear fluids only for
  the rest of the day.
• Have nothing to eat or drink after midnight on the night before or on the morning of your
  examination. EXCEPTION: You can take your regular medications with a sip of water the
  morning of your examination.
• It is important to take the complete prep, as a proper examination is optimal only with a clear
  bowel.
• No alcohol for 48 hours before and 24 hours after the test

THE DAY OF THE PROCEDURE
• Report to South Island Surgical promptly at the time indicated.
• You will be asked to sign a consent form for the procedure indicating that you have been
   informed of the risks of it. Let us know if you have allergies to Demerol, Fentanyl, Valium or
   Versed. Do you have glaucoma?
• A responsible adult MUST drive you home after the test, as you will be sedated.
• You may be sleepy after the procedure for up to 12 hours. You should be able to return to
   normal activities the next day.

ARE YOU ON BLOODTHINNERS

NOTE: As Dr. Koziol may remove polyps from the colon if she sees them, you must
discontinue all ASA and NSAIDs one week prior to your appointment. Examples of ASA and
NSAIDs are: Entrophen, Clinoril, Voltaren, Motrin, Advil, Ibuprofen, Feldene, Toradol,
Celebrex, Vioxx etc.) Discontinue Coumadin/Warfarin 3 days prior to the procedure. As
well, discontinue all iron preparation for one week prior to procedure.

COMPLICATIONS: (AS DISCUSSED WITH DR. KOZIOL)
• Getting stomach contents into lungs (aspiration)
• Bleeding                                                          Please refrain from wearing
• Infection                                                         scented products during your
• Reaction to medication                                                visit. Thank you.
• Making a tear through the wall of the large bowel (perforation)


             3 – 7865 PATTERSON ROAD • SAANICHTON, BC • V8M 2C7

								
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