Below are answers to the most frequently asked questions that we receive
from our patients . You are always welcome to ask us directly if
you have other questions or concerns.
What happens on my arrival to the facility ?
During your first visit, you will be asked to register at our reception
desk and to fill out a set of forms. The receptionist will also verify
that we have correct demographic data such as your current address
and contact information. She will also need to review your current
insurance information - so be sure to bring your insurance cards
with you. If you have HMO insurance that requires prior referral,
she will also need to check that we received authorization for your
visit.
You will then be taken by the nurse to an admission room where your
vitals signs will be recorded. A comprehensive health history will
be taken. This may take about 15 minutes, but is time well spent.
You will be asked to recall details of your past medical history
that puts things in perspective for the doctor. You will be asked
to disrobe and put on a hospital gown. The nurse will be verifying
that you have prepared properly for the procedure .An IV catheter
will be inserted in your arm by the admitting nurse, in order for
the physician to administer the IV sedation medications.
The doctor will then interview you and perform a focused physical
examination. Just prior to your procedure , then the procedure will
be performed as planned by your physician.
How do I prepare for my upper endoscopy procedure
?
You need three things to prepare for a Gastroscopy examination (EGD):
- An appointment for the examination.
- An empty stomach. You must be fasting for 6 hours prior. No food
or drink.
- A driver to take you home since you will not be able to drive
until the following morning. We ask that your driver come with
you and plan to stay the entire time you are here which averages
about 1 1/2 hours. This is about 2 hours less than the average
length of stay at the hospital outpatient surgery department.
How do I prepare for my Colonoscopy?
The standard preparation for colonoscopy begins the morning of the
prior day. After having a light breakfast, the rest of the day should
consist only of a clear liquid diet. No solid food or milk products.
Just tea or coffee (no cream) , Jell-O, clear broth, soft-drinks
, Popsicles and water. Most patients will be asked to use the standard
lavage solution (GoLytely, Colytely, Nulytely, PEG solution) which
you drink the evening prior to your test. Don't make any plans for
that evening. You will be at home in your bathroom most of the time
Should I take my normal medications before my test?
Yes. In general, it is best that you take all of your normal medications
before and after your scope test. The exceptions would be those patients
on diabetic medications (insulin or pills) and those who take medications
to prevent clotting such as Coumadin, Plavix, and Ticlid. If you
are diabetic or on these "blood thinners," our doctor needs
to review your medications and decide what should be done.
What happens if I start vomiting while I am taking
the preparation solution?
If you are taking your laxative solution and develop symptoms of
nausea or vomiting, stop the preparation process for an hour or so.
Then, if you feel better, try to pick up where you left off. It works
better if you slow down the drinking by taking smaller sips rather
than drinking fast. A warmed towel or blanket on the abdomen helps.
If you cannot complete the preparation, let your doctor’s office
know. Your test may need to be rescheduled or an alternative preparation
tried. If you develop severe abdominal pain during your preparation,
stop and call the doctor’s . There is always a physician on
call through the answering service.
I am drinking the preparation solution , and my bowels
have not moved?
Be patient. This laxative solution rarely fails. Most patients have
a bowel movement within an hour or two of starting the solution.
Sometimes, there may be a delay. If you have drunk at least half
of the solution (8 glasses) and your bowels have not moved, just
stop for a while. If nothing happens in an hour, try taking a small
disposable 4-oz Fleets enema. They are available at your drugstore.
Please pick up the enemas at the store before you start your preparation.
If you still have no results after all that , please contact your
physician for an alternate preparation.
The instructions on the bottle of solution is different
than the ones you gave me?
The doctor’s office provides most patients with printed instructions
for their preparation. If you have those, follow them. If you didn't
receive any written instructions, simply follow the instructions
on the bottle.
I lost my instructions on how to prepare for my scope
test
Please contact us or the doctor’s office , we will provide
you with a new copy . or simply follow the instructions on the bottle.
Can I put flavoring into my preparation solution?
Yes. If you were given the unflavored solution and wish to add some
flavoring, it is OK. Ignore the warning on the label about not adding
any flavoring and add one packet of Crystal Light Lemonade or Iced
Tea Mix or Koolaid . These two flavors do not interfere with the
preparation or testing. Do not add any brightly colored flavoring,
such as red, green, or blue as these may interfere with the examination
Wouldn’t my rectum be sore after having so many
bowel movements during preparation?
It might be. The very nature of the cleanout process means that
you will have many liquid bowel movements over several hours. This
might cause some soreness around the anal area. You can minimize
this by using soft toilet tissue , followed by a baby wipe after
each bowel movement. Some patients report less problems if they apply
an ointment such as 1% Hydrocortisone cream , zinc-oxide ointment
, or a similar Vaseline base ointment to the anal area after each
bowel movement. You might consider purchasing these items when you
go to pick up your laxative solution.
Do I have to drink all 4quarts of laxative preparation
solution?
It depends on the preparation prescribed. If Magnesium
Citrate is taken before the PEG solution, you may only need
to drink the first 2 quarts of the PEG solution if the output has
become clear. If the PEG solution is taken alone, all 4 quarts
must be consumed. Don't forget that you have 30 feet of digestive
tract that we are trying to clean out from the top down. Even though
it's hard to believe, it takes this whole gallon of laxative solution
to really do a good job. If you want an accurate examination, it
is important that your preparation for the test is complete. If
your colon is not well cleaned out, the test may have to be aborted
and rescheduled for another day.
Should I hold my Aspirin and anticoagulants prior
to my procedure?
Theoretically, aspirin and drugs like ibuprofen can inhibit blood
clotting and make the risk of bleeding higher , especially if you
are going to have a biopsy taken or polyp removed. If you are on
daily aspirin or ibuprofen you must stop it at least 1-3 days before
your test to get it out of your system. NOTE: If you are taking a
daily aspirin to prevent a stroke or heart attack, don't stop it
without consulting your physician first .
If you are on anticoagulants , such as Coumadin , Plavix and similar
medications , those need to be stopped 3-5 days before your procedure
. Only your physician can make such a determination . Some high risk
patients need to be placed on an alternate anti-coagulant regimen
while being off their usual anticoagulant .
Why do I need to bring a driver to my scope test?
Scope examinations such as gastroscopy, colonoscopy, and endoscopic
ultrasound require sedation to prevent pain and discomfort. These
medications make the test quite simple for the patient, but do not
wear off immediately. Because of this, you cannot drive your car
at least 12 hours or until the following morning. Therefore, it is
necessary for you to come with a friend or family member who can
safely drive you home after your test is over. We ask that your driver
come with you and stay the entire time you are at our center. This
makes them available for questions, and allows the doctor to meet
with them in the recovery room after your test to explain the results
Will my scope test be painful?
No. That is the nice part. With the
modern anesthetic sedatives, your examination should be
painless. In fact, after their exams most patients ask, "When
is the test going to start?" Of course, the price you pay for
a painless test is the fact that you will not be able to work or
drive the rest of the day. That is why you need a driver to take
you home.
What should I expect during my scope test?
After your pre-operative assessment, you will be taken by stretcher
to the Endoscopy Room. Don't be surprised if it looks like an operating
room. They look the same. The nurse will place you on equipment that
monitors your heartbeat and blood pressure and gives you nasal oxygen.
Don't be alarmed. This is routine for everybody. You will then be
asked to roll onto your left side on the padded stretcher. The doctor
will then administer the sedative into your intravenous line, and
that's about all you can expect. The rest of the test is done while
you are in a state called "conscious sedation." This is
not like general anesthesia such as heart surgery. But a pleasant
semiconscious state in which you should feel no pain and be unaware
of the actual test itself
If the doctor finds a polyp during my test , will
he remove it?
In most cases, yes. All of our doctors are trained in the latest
endoscopic techniques. Most polyps can be removed at the time of
colonoscopy. Rarely, a polyp is too big or too flat to remove and
surgery is necessary. If the physician sees a very large polyp or
a mass that cannot be safely removed through the scope , the patient
will be referred to a surgeon to have it removed. The polyps that
are removed will be sent to pathology for a closer examination .
Does a colonoscopy show that I have cancer?
Yes. In fact, colonoscopy is considered to be the most accurate
way to determine the health of your colon. This includes checking
for cancer, polyps, colitis, diverticulosis, and other less common
lower digestive problems. The good news is that it is very rare
for us to find colon cancer in an individual who is just coming in
for a screening exam as a routine checkup. We often find polyps which
are removed to PREVENT a colon cancer in the future
How will I feel after my test?
After your test, you will probably have a dry mouth and feel drowsy,
gassy, and hungry. The dry mouth and drowsiness are from the sedation.
They will gradually wear off. The gassiness is from the air that
is inflated into the digestive tract during the scope test. This
helps your doctor see inside your stomach or colon. We try to remove
most of the air after the procedure, but some of it just has to pass
naturally. Of course, since fasting is part of the preparation, you
will feel hungry. Our recovery room nurse will offer you some juice
after your procedure.
Once you go home, you can pass the rest of the gas and are able to
eat. Soon, you will be back to normal. Usually there is no real pain
after a scope test nor sore throat after gastroscopy. The sedation
given during your examination will likely prevent you from remembering
exactly what the doctor had to say. However, you are given a full
written report to take home and read once you are more alert.
How soon will I be able to eat after my test?
Immediately. As soon as you awaken in our recovery room, our nurse
will offer you some juice. Once you go home, you can have a normal
breakfast or lunch. Eat whatever you feel like. Just go slow at first.
Use some common sense. Don't try to make up for 3 missed meals all
at once . If your physician wants you to be on a special diet after
your procedure , it will be marked for you on your discharge instructions.
How long do I have to wait for the results of my test?
The results of a scope test are immediate. After you awaken from
your sedation, the doctor will discuss the results of the test with
you and your family. We also give you a written explanation of what
was found and what treatment, if any, is anticipated. You will also
have an opportunity to ask questions. Of course, any biopsies or
samples taken for lab analysis will not be available that day. In
that case, you will need to make a follow-up appointment with your
physician . Another reason that you need a companion to come with
you is that the medications make you groggy and you may forget what
the doctor tells you after the test. It is best to have another set
of ears with you. |