You are scheduled for a colonoscopy in our endoscopy center on . The facility is located at 347 East 37th Street. Plan to arrive 10 minutes prior to the scheduled time of the procedure. Shortly after checking in at the front desk, the staff of the endoscopy center will direct you from the waiting room to a changing area. We provide locked storage for the security of your personal possessions. You will then meet the gastroenterologist who will be performing the procedure and the anesthesiologist who will be providing the sedation. Your medical history will be reviewed and questions that you might have will be answered by the physicians. At that time, please remember to inform us of any medication allergies that you may have. The duration of the procedure and the recovery time afterwards are each approximately 30 minutes in duration. You should expect to be at the facility for 1 to 1 1/2 hours. We strongly recommend that you have an escort accompany you home from the office after your procedure. If you are 65 years of age or older, an escort is mandatory and failure to have an escort will result in cancellation of your procedure and a $250 fee. We also require that no patients drive for12 hours following the procedure. If you are a female and may potentially be pregnant, please schedule the procedure at a time when you are sure that you are not pregnant. You should stop taking nonsteroidal anti-inflammatory medications (NSAIDS) including aspirin, vitamin E, and blood thinners 5 days prior to the procedure. More specifically these medications include: Aspirin Aspirin-dypyridomole (Aggrenox) Clopidogrel (Plavix - check with your Cardiologist) Coumadin (3-5 days, please check w/your prescribing doctor - see below) Dipyridomole (Persantine) Heparin and Lovenox Ibuprofen (Advil, Motrin, Nuprin) Meloxicam (Mobic) Naproxen (Aleve, Naprosyn) Ticlopidine (Ticlid) If you have a cardiac stent, do not stop taking aspirin or Plavix without first consulting your cardiologist. If you take coumadin for a cardiac condition, stroke prevention, or vascular disease, you should consult your cardiologist, neurologist or internist prior to stopping the medication. If you have diabetes and take either insulin or oral medications, dosing may need to be adjusted for the day prior and the day of the procedure. Please consult your internist or endocrinologist regarding this issue. You should be aware that there is an approximate 0.2% to 1% risk for complications associated with colonoscopy. These risks include but are not limited to: 1) adverse reactions to medications, 2) gastrointestinal bleeding, 3) colonic perforation which may require operative repair. You should also be aware that colonoscopy is not 100% accurate and that there is a small possibility of a missed diagnosis of cancer or polyps despite having a competently performed colonoscopy. Please call our endoscopy coordinator (212-726-7407) 3 to 5 days prior to the procedure to confirm your appointment. Cancellations less than 3 business days in advance or failure to show for the scheduled procedure may result in a $250 charge. If any questions arise prior to the procedure, please contact us at 212-726-7407. It would be helpful to avoid nuts and seeds in your diet for a couple of days before your procedure. In addition, our physicians, including the gastroenterologist and anesthesiologists, are available for any questions that may arise. To assure
your comfort and safety, an Anesthesiologist will provide sedation for your procedure. Anesthesia services may involve extra charges. Please check with your insurance carrier. Our gastroenterologists recommend the SUPREP preparation which may be purchased from a local pharmacy with a prescription provided with the information materials. We also suggest purchasing 2 additional bisacodyl tablets in case extra preparation is needed. You may also want to buy 'baby wipes' for your comfort during the preparation. During the day before the procedure, you should restrict your diet to clear liquids (nothing red or purple) which include the following: Strained fruit juices without pulp. Water. Clear broth or bouillon. Coffee or Tea. Gatorade, Kool-Aid, carbonated and non-carbonated soft drinks. Jell-O and ice popsicles. Vanilla ice cream, milk, plain yogurt (breakfast only). Step 1: On at pour One of the 6-ounce bottles of SUPREP liquid into the mixing container. Add cool drinking water to the 16-ounce line on the container and mix. Drink ALL the liquid in the container. You MUST drink TWO more 16-ounce containers of WATER over the next 1 hour (Fill the cup up 2 more times with plain water and drink it). Step 2: On at pour the remaining 6-ounce bottle of SUPREP liquid into the mixing container. Add cool drinking water to the 16-ounce line on the countainer and mix. Drink ALL the liquid in the container. You MUST drink TWO more 16-ounce containers of WATER over the next 1 hour (Fill the cup up 2 more times with plain water and drink it). We encourage you to drink as much water and other clear liquids as possible before you start the SUPREP and between the two doses of SUPREP to optimize the quality of the preparation. If your stool does not turn to a watery liquid consistency 1 hour after completing the preparation you may need to take more laxative such as 2 bisacodyl tablets. Please call your doctor if there are questions regarding this issue. During the day of the procedure, you can not have anything to eat or drink 5 hours before the scheduled time of the procedure. You may take your regular medications with a sip of water 3 hours before the procedure unelss otherwise instructed by your Doctor. As stated, please plan to arrive at our practice 10 minutes prior to the scheduled time of the procedure. You may want to bring socks or slippers as well as a loose short sleeve T-shirt to wear during the procedure. We recommend that you do not wear any jewelry to the office. If you are a managed care patient, please remember to obtain insurance company referral authorization from your primary physician prior to the procedure. Please bring the referral with the authorization number with you. We hope that this process goes as smoothly as possible for you. If there are any questions during any point of the process feel free to contact us for assistance. If you call on an evening or a weekend, please make sure the service gets you in contact with the covering physician. Remember: Please do not DRINK or EAT for the 5 hours prior to the scheduled time of your procedure! This includes no sucking candy or chewing gum. If you would like to review information regarding a colonoscopy including the consent form, you may do so at our website - www.mhmg.net
Helpful Tips for Managing the Cost of Your Medications 1. Of the thousands of medications available in the United States, some are available under both a brand name (for example, Motrin) and under a generic name (ibuprofen); 2. Medications generally become available as a generic after their patent has 3. Generics are usually much less expensive than the brand name medication; but 4. Most g
ISCHEMIC STROKE ORDERS WITHOUT ALTEPLASE (TPA) 1. Admit inpatient to : Telemetry Meridian 6 (satellite telemetry) OR if critically ill to ICU to CCU 2. Attending Physician: 3. Condition: 4. Code Status: 5. Allergies/Intolerances: 6. Diet : NPO Initiate nursing bedside swallow screen if po medications ordered. Ok to give po meds with sips