Carolina Digestive Health Associates

Transcription

1 Carlina Digestive Health Assciates Prcedure Infrmatin Yu are scheduled fr a Clnscpy. Please read all f the attached infrmatin as sn as pssible s yu are prepared fr yur upcming prcedure. PHYSICIAN PERFORMING PROCEDURE: DATE: PROCEDURE TIME: LOCATION: CHECK-IN TIME: Please clsely fllw the instructins belw in prepping fr yur prcedure. It is very imprtant that yu fllw them carefully, r we will be unable t perfrm the prcedure and it will be cancelled. This packet includes: 1. Instructins fr 7 days, 5 days, 3 days and 2 days prir t yur prcedure 2. Instructins fr diabetic patients 3. Instructins fr the day prir t yur prcedure 4. Shpping list fr the preparatin 5. Clnscpy infrmatin This infrmatin shuld answer mst f the questins yu may have abut yur prcedure. If yu still need additinal assistance, please cntact ur ffice nearest yu. As a reminder, if yu cancel yur prcedure less than 3 business days befre yur scheduled appintment, yu may be charged a $100 n shw fee. Yu must have an adult driver with yu at all times when yu are at the endscpy center/hspital. Yu shuld expect t be at the endscpy center/hspital between 2 ½ and 3 hurs. Yur driver must stay at the endscpy center/hspital during yur prcedure. Exceptin: If yu are scheduled fr a flexible sigmidscpy and yu are NOT receiving sedatin, then yu may drive yurself hme after yur prcedure. Carlina Digestive Health Assciates Phne Numbers Billingsley: Matthews: Belmnt: Mnre: Cncrd: Pineville: Davidsn: University:

2 Medicatin Instructins 7 DAYS BEFORE PROCEDURE: Discntinue taking Phentermine and Hydrxycut. 5 DAYS BEFORE PROCEDURE: Discntinue taking medicines that may thin yur bld, such as: COUMADIN, PLAVIX, TICLID, Heparin, Aspirin, Excedrin, Effient, Alka Seltzer, Empirin, Ectrin, Bufferin, Ascriptin, Ibuprfen, Mtrin, Advil, Medipren, Nuprin, Naprxen (Naprsyn), Aleve, Sulindac, Clinril, Pirxicam, Feldene, Indmethacin, Indcin, Diclfenac and Vltaren unless therwise directed by yur physician. If any f these are a medical necessity fr yu, please infrm us as sn as pssible by calling ur ffice. Please stp all irn prducts, multi-vitamins, and fish il. IF YOUR DOCTOR HAS PRESCRIBED ASPIRIN: Please decrease yur aspirin t 81 mg a day. After yur prcedure, yu will be infrmed when yu may resume taking yur regular medicatins. Tylenl is safe t use prir t this prcedure. *** If yu d nt see yur medicatin r supplement listed here, verify with yur lcal pharmacy yur medicatin desn t include Aspirin. *** *** Cntact us if any majr health prblems ccur between nw and yur prcedure. 2 DAYS BEFORE THE PROCEDURE: Discntinue taking Xarelt, Eliquis, and Pradaxa. If either f these are a medical necessity fr yu, please infrm us NOW. DAY OF THE PROCEDURE If yu take Bld Pressure Medicatins, Heart Medicatins, r Seizure Medicatins take yur medicines, at the times yu nrmally wuld, with a sip f water. GENERAL INSTRUCTIONS FOR DIABETIC PATIENTS Check yur bld glucse during the preparatin perid, especially if yu suspect it is t lw. Yur bld glucse levels may run higher than usual during this perid due t adjustments in yur diabetes medicatin. If bld glucse becmes extremely high (greater than 350), call ur ffice, yur PCP r yur diabetes dctr. Fr lw bld glucse levels, yu may drink sweetened clear liquids (such as apple juice). Infrm the endscpy nurse upn arrival if this was necessary. Resume yur usual diabetic diet and medicatins immediately after yur prcedure(s) unless yu are instructed t d therwise. If yur diet remains restricted fllwing the prcedure, ask fr instructins regarding diabetic medicatin adjustment.

3 Diabetic Instructins If yu are diabetic and having a Clnscpy, r a Clnscpy and EGD, fllw these instructins: ORAL DIABETES MEDICATIONS - If yu take ral diabetic medicatins, stp these medicatins the day befre yur clnscpy. Yu will be n clear liquids nly fr mst r all f this day. Restart these medicatins after the prcedure when yu resume eating. INSULIN If yu take insulin f any type, fllw these guidelines: Lantus r Levmir - Take yur usual dse unless yur bld glucse is tightly cntrlled (glucse levels are usually in the nrmal range r are ccasinally lw). In that case, reduce the dsage by ne frth n the day befre yu begin yur laxative prep (tw days befre yur clnscpy) and n the day f the prep (the day befre yur clnscpy). Resume yur usual dse after the prcedure. (Example: If yu take 40 units, adjust t 30 units) 70/30 r 75/25 insulin - Take half f yur usual dse the day f the prep (the day befre yur clnscpy). On the mrning f the prcedure, take half f yur usual dse r, if yu have a prcedure befre 11:00am, bring yur insulin with yu t take befre yur next meal. Resume yur usual dse after the prcedure. Meal-related insulin If yu take a set dse f insulin befre each meal, stp this the day f the prep (the day befre yur clnscpy). Cntinue t take Sliding Scale Insulin as usual. Resume yur usual dse after the prcedure. Sliding Scale Insulin Cntinue this as usual. Insulin pump Reduce the dse f yur insulin by ne frth r cnsult yur endcrinlgist fr recmmendatins. Resume yur usual dse after the prcedure. (Example: If yu take 4 units/hur, adjust t 3 units/hur)

4 2 Day GLytely/NuLytely - Afternn Prcedure 3 DAYS BEFORE THE PROCEDURE Stp eating CORN, BEANS, CELERY, LETTUCE, TOMATOES, RAW FRUITS, SEEDS, and NUTS until after yur clnscpy. Pick up supplies frm yur pharmacy (see shpping list) 2 DAYS BEFORE YOUR PROCEDURE NO SOLID FOODS UNTIL AFTER THE PROCEDURE IF YOU EAT, YOUR PROCEDURE WILL BE CANCELLED 2 days befre yur prcedure, the nly thing yu can have is clear liquids. Yu will have nthing ther than clear liquids until after yur prcedure has been cmpleted. The clear liquid diet ends fur (4) hurs befre yur prcedure; at that pint yu must have nthing further. Yu may have water, clear fruit juices (white grape, apple), sda (Sprite, Ginger Ale, Pepsi, Cke, and diet clas), Jell-O, ice pps, brth, builln, cffee, tea, Gatrade Yu may NOT have anything red, purple, blue, r range Yu may NOT have milk r milk prducts (this includes nn-dairy creamers) TAKING YOUR PREP MEDICATIONS 2 Days befre prcedure 12:00 nn Add water t the tp line f ONLY ONE GLytely/NuLytely bttle (bttle cntains 4 liters f fluid). Yu may mix in 2 lemnade flavred Crystal Lite tubes int the bttle t add flavr if desired. Shake well and place the bttle in the refrigeratr t make the slutin cld. **NOTE: Slutin is nly gd fr 24 hurs after it is mixed. ** Take 2 (5mg.) bisacdyl (Dulclax) tablets with an 8z. glass f water. These tablets can be purchased ver the cunter. D nt crush, break, r chew them. D nt take the tablets within 1 hur f taking an antacid (e.g. Pepcid, etc). 4:00 pm Start drinking the slutin. Drink an 8z glass f the GLytely/NuLytely slutin every 15 t 20 minutes. Drink slwly. If yu drink t quickly, this can cause nausea, blating, r vmiting. If yu feel yurself start t get sick, yu may stp drinking fr abut 30 minutes and then restart. D nt take any ther medicines within 1 hur f starting t drink the slutin. Drink all f the GLytely/NuLytely slutin.

5 1 Day Befre Prcedure 12:00 nn Add water t the tp line f the remaining GLytely/NuLytely bttle (bttle cntains 4 liters f fluid). Yu may mix in 2 lemnade flavred Crystal Lite tubs int the bttle t add flavr if desired. Shake well and place the slutin in the refrigeratr t make it cld. **NOTE: Slutin is nly gd fr 24 hurs after it is mixed. ** 4:00 pm At this time, yu will need t drink 2 liters (half) f the GLytely/NuLytley slutin. This shuld be cmpleted within 4 hurs f starting. This can be tlerated best by drinking an 8z glass f the GLytely/NuLytely slutin every 10 t 15 minutes. Drink slwly. If yu drink t quickly, this can cause nausea, blating, r vmiting. If yu feel yurself start t get sick, yu may stp drinking fr abut 30 minutes and then restart. D nt take any ther medicines within 1 hur f starting t drink the slutin. At 8:00pm - Please pick ne clumn f instructins t fllw: IF YOUR STOOL IS CLEAR Clear: yellw in clr r clear with NO particles Fllw the instructins belw 8:00pm Yu may stp drinking the slutin 10:00pm Drink half f the slutin left in the GLytely/NuLytely cntainer (1 liter). Drink all f this slutin within ne hur.at this pint yu shuld have 1 liter left IF YOUR STOOL IS NOT CLEAR Nt Clear: If yu see particles fllw instructins belw 8:00pm Yur cln is nt clear enugh yet t have yur Clnscpy Drink half f the GLytely/NuLytely left in the cntainer (1 liter). Drink all f this slutin within ne hur. At this pint yu shuld have 1 liter left 10:00pm Drink all f the remaining slutin in yur GLytely/NuLytely cntainer (1 liter). Drink all f this slutin with ne hur. This will leave yur cntainer empty. *After finishing this dse f GLytely/NuLytely, yu may have clear liquids up until 4 hurs befre yur prcedure time. During the 4 hurs befre yur prcedure, yu may nt have anything t eat r drink, including: water and all ther clear liquids, gum, candy, chewing tbacc, snuff r fd items. * YOUR STOOLS SHOULD BE LIGHT YELLOW OR CLEAR WITH NO PARTICLES. IF THIS IS NOT THE CASE, PLEASE CONTACT YOUR PHYSICIAN.

6 Yur Shpping List Items t purchase frm yur pharmacy: 2 GLytely/NuLytely bttles (cntains 4 liters f fluid) Prescriptin required 2 (5mg.) bisacdyl (dulclax) tablets These are ver the cunter. Items t purchase frm any stre fr yur prep: Tw lemnade flavred Crystal Lite tubes can be added t the bttle f GLytely/NuLytely fr flavr, if desired. 2 Bttles - Prescriptin required OTC nly 2 tablets needed Lemnade nly Examples f clear liquids yu may purchase frm any stre: Water Yellw, Green r Clear clred Gatrade Clear fruit juice white grape r apple Sda - Sprite, Ginger Ale, Pepsi, Cke, and diet clas Cffee (n creamer) ICE pps (yellw & green)n fruit bars Brth Builln Jell-O (yellw & green) Tea DO NOT HAVE ANYTHING RED, PURPLE, BLUE OR ORANGE DO NOT HAVE MILK OR MILK PRODUCTS (THIS INCLUDES NON-DAIRY CREAMERS)

7 Clnscpy Infrmatin Clnscpy lets the physician lk inside yur entire large intestine, frm the lwest part, the rectum, all the way thrugh the cln t the lwer end f the small intestine. The prcedure is used t diagnse the causes f unexplained changes in bwel habits, signs f cancer in the cln and rectum, inflamed tissue, abnrmal grwths, ulcers, bleeding, and muscle spasms. Fr the prcedure, yu will lie n yur left side n the examining table. Yu will be given medicatin t keep yu cmfrtable and t sedate yu during the exam. This medicatin has a slight amnesic effect s yu may nt remember the prcedure. The physician will insert a lng, flexible tube int yur rectum and slwly guide it thrugh yur cln. The scpe als blws air int yur cln, which inflates the cln and helps the physician see well. Mst f the air is remved as the examinatin is finished. Yur physician may bipsy tissue and/r remve plyps by using tiny instruments passed thrugh the scpe. All (bipsy) tissue is sent t the lab fr testing. If there is bleeding in the cln, the physician can use instruments thrugh the scpe t stp the bleeding. Yur cln must be cmpletely empty fr the clnscpy t be thrugh and safe. T prepare fr the prcedure, yu must fllw a clear liquid diet and use a laxative slutin the day befre the prcedure. DRINKING LIQUIDS AFTER THE RECOMMENDED TIME FRAME MAY CAUSE ASPIRATION, MEANING THE FLUID COULD GET INTO THE LUNGS AND CAUSE LIFE THREATENING COMPLICATIONS. Please see the attached sheets fr cmplete preparatin details. Clnscpy takes minutes, hwever, yu will need t plan t be at the endscpy center / hspital fr 2 ½ t 3 hurs. The medicine given fr sedatin shuld keep yu frm feeling discmfrt during the exam.