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PREPARING FOR YOUR PROCEDURE


Important factors for a successful procedure is gaining an understanding of the entire process. It is encouraged that you ask your doctors and nurses questions about: the procedure; your diet prior to your appointment; the process of being admitted to the hospital (if applicable); the type of anesthesia you may need; your medical history; your home medication regimen; insurance coverage; and legal arrangements.

These are some tips to help make your medical procedure as smooth as possible:


  • Contact your insurance carrier to find out what your coverage is that they provide for the medical procedure.
  • Ask your insurance carrier if they provide any wellness benefits that may entitle you to discounted nutritional care and other rehabilitation services after discharge.
  • Advise your surgeon of any medical conditions you have, and any medications you take at home on a regular basis. Some medications may need to be temporarily stopped in advance. Be sure to mention all herbal supplements as well as over-the-counter medications, they may impact your medical procedure as well.
  • Talk with your surgeon about any anesthesia you might be given.
  • If your surgeon determines it necessary, you will need to be medically assessed for the procedure by your primary care physician. This may include the completion of several types of tests - blood tests, an ECG, a chest x-ray, and/or pulmonary function tests depending on your physician’s orders.
  • Eat foods rich in iron to help boost your circulatory system and blood counts prior to surgery (green leafy vegetables, lean red meats, etc.) up until 12 hours before your procedure.

Colonoscopy/EGD Instructions


The following instructions are very important and must be carefully followed to assure your well-being during and after the procedure.

If you are taking blood thinners (ex: Coumadin, Plavix, Xeralto), please let us know.

FOUR DAYS BEFORE THE PROCEDURE:
  1. STOP taking phentermine or any other weight loss equivalents

FIVE DAYS BEFORE THE PROCEDURE:
  1. STOP taking Aspirin and NSAIDS (ex: Ibuprofen, Motrin, Advil, Naproxen, Aleve, Excedrin, Meloxicam, Diclofenac, and Mobic)
  2. STOP taking fish oil, herbal supplements, iron and multivitamins

THE DAY BEFORE THE PROCEDURE:
  1. Do NOT eat, drink, or smoke anything after midnight. No candy, mints, gum or tobacco products. Your procedure will be delayed or cancelled for your safety.

THE DAY OF THE PROCEDURE:
  1. Dress Comfortably. Please leave valuables and jewelry at home.
  2. Bring ID, insurance cards and a list of medications and allergies.
  3. Arrange for a ride home. You CANNOT drive yourself after the procedure. Sedation given requires you to arrange for a responsible adult to accompany you from the procedure to your home and remain with you for a reasonable period of time. If you do not have a driver, your procedure will be cancelled.
  4. Make arrangements to be off work the entire day of your procedure.
  5. If you must wear contacts, bring a container to place them in.
  6. You make take blood pressure, heart, seizure or thyroid medications with a small sip of water the morning of your procedure.



Your insurance company will be contacted for surgery approval. Every effort will be used to confirm insurance verification, but it is in your best interest to check with your insurance company that the PHYSICIAN, SURGERY FACILITY AND ANESTHESIA GROUP are contracted (This will ensure your highest level of benefits). You will be billed separately for physician, facility, anesthesia and possible pathology/lab.

If you have any insurance questions or if there is a change in insurance, please contact the business office at 620-845-6492.

Colonoscopy Prep Instructions


In preparation for your procedure, you will need to purchase the following items:

  1. 4 - Dulcolax/Bisacodyl 5mg Tablets
  2. 1 - 8.3oz/238 gram bottle of Miralax
  3. 64oz of Gatorade or any other clear liquid of your choice including water

TWO DAYS BEFORE THE PROCEDURE:
  1. DO NOT eat vegetables or nuts

ONE DAY BEFORE THE PROCEDURE:
  1. Clear liquids only. No solid food, milk or alcohol. (*see below)
  2. At 5:00 pm take 4 Dulcolax tablets with at least 8oz of clear liquid
  3. At 6:00 pm mix the 255 gram bottle of Miralax in 64 oz of Gatorade (not red or purple), water, tea or clear juice. Shake the solution until the Miralax is dissolved. Drink an 8oz glass every 10-15 minutes until the solution is gone. If you become nauseated and vomit, stop drinking the mixture until the nausea subsides, then resume drinking it at a slower pace until the solution is gone.
  4. Continue drinking clear fluids until bedtime.

NIGHT BEFORE PROCEDURE:
  1. Do not eat or drink anything AFTER MIDNIGHT until your procedure has been completed.
  2. If you take medication, you may have it on the morning of the procedure with a small amount of water.

* CLEAR LIQUID DIET - ONLY THESE FOODS ARE ALLOWED:
  • Soups: Clear bouillon, broth or consomme
  • Beverages: Regular or decaffeinated teas and coffee (no milk or cream), Kool-Aid, carbonated beverages, Gatorade, G2, or Pedialyte.
  • Juices: Apple and White grape juice, strained lemonade, limeade, orange drink. ANY JUICE YOU CAN SEE THROUGH AND HAS NO PULP IS ACCEPTABLE.
  • Dessert: Popsicles, Jell-O.

Following all the instructions below will result in your stool being a clear liquid signaling you are ready for your procedure.


PLEASE ARRANGE FOR TRANSPORTATION HOME.


Sterile Epidural


IMPORTANT PRE-PROCEDURE INSTRUCTIONS:
You will need a companion with you after the procedure. You should not drive following the procedure.

Please notify the scheduler if you are allergic to Betadine (Iodine), Lidocaine, Contrast Dye or Latex.

PLEASE STOP THESE MEDICATIONS THAT MAY INCREASE BLEEDING RISKS:
  • All Aspirin products (including Bayer, Ecotrin, Alka Seltzer, Baby or Low-Dose Aspirin, etc.) seven days prior to procedure.
  • Non-steroidal anti-inflammatory (NSAIDs: Advil, Motrin, Nuprin, Ibuprofen, Aleve, Naproxen, Relafen, Voltaren, Lodine, Mobic, Etc) medications two days prior to the procedure.
  • Blood Thinners (Coumadin, Warfarin, Plavix, Ticlid) Please contact your provider for further instructions on how to manage this.
  • All herbal medication, supplements, fish oil and Vitamin E two days before procedure.
  • You will need to stop taking Metformin (Glucophage or Glucovance) for two days AFTER the procedure. Although Metformin does not increase bleeding risk, it may interact adversely with the contrast dye that we use.

Please note that it is recommended that you continue all other prescribed medications (blood pressure, insulin, water pill, etc as well as prescribed pain medications not known to have bleeding effects such as Ultram, Tramadol, Vicodin, Hydrocodone, and Tylenol Acetaminophen).

CHECK IN PROCEDURE
Patients will need to come in the Emergency Room entrance and check in at the nurses' station.

If you expect delays or need to cancel please call 620-845-6492.

RISKS AND COMPLICATIONS
All medical interventions have benefits and risks. Spinal injections have certain risks and complications that can include: spinal headache, increased pain, bleeding (rare), infection (rare) or nerve injury (rare).

PROCEDURE
The procedure is usually brief, but your position during the procedure is important to make the injection go smoothly, with the least discomfort to you.

Your skin will be cleaned with a sterilizing solution and a sterile drape will be placed over your skin.

Local anesthetic (Lidocaine) is usually given near the injection site to numb the skin. This typically feels like a pin prick and some burning like a bee sting.

Flueorscopy (Xray Imaging) is used for precise placement of the injection. Contrast dye will be injected to confirm the correct placement of the needle.

A small bandage will be placed at the injection site.

AFTER THE PROCEDURE
In most cases, you will be discharged within 30 minutes after the procedure.

AFTER DISCHARGE
You may apply an ice pack, 20 minutes at a time to the injection site if you experience soreness.

Avoid getting into baths, hot tubs, swimming pools, lakes, pond, etc for 48 hours after the injection. Keep the injection site clean and dry. You may remove the bandage one day following the procedure.

Rest is encouraged after the injection. Return to your normal daily activity 24 hours after the procedure.

You may resume your anti-inflammatory medications 24 hours after the procedure.


SIDE EFFECTS THAT MAY OCCUR, BUT WILL GO AWAY IN A FEW DAYS ARE:
  • Briefly increased pain
  • Trouble sleeping
  • Facial flushing
  • Mild flu like symptoms

WHEN TO CALL THE DOCTOR *620-845-6492
  • Severe pain
  • Severe headache that gets works when sitting up or standing, is better when you lie down.
  • Fever or chills
  • Loss of bladder or bowel control
  • Redness or swelling around the injection site.