Post Total Colectomy Preparation Instructions - For ALL Patients

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Post Total Colectomy Preparation Instructions - For ALL Patients 112509 These instructions are for patients who have had all of their colon removed and are preparing for a sigmoidoscopy or colonoscopy procedure. Your procedure is scheduled on at AM / PM. Please arrive 1 hour early to allow our front office to register you properly and to give the assessment nurses time to review your paper work, to give the necessary enemas, and to start an IV access when needed for successful sedation. PLEASE READ ALL INSTRUCTIONS ON THE DAY YOU RECEIVE THEM About Sigmoidscopy/Colonoscopy Some bowel preparation (cleansing) is needed to perform your procedure effectively. Any stool remaining in the colon can hide lesions and result in the need to repeat the procedure. You should plan to be at the hospital at least 2-4 hours. It is critical that you follow the instructions as directed. The physician will discuss your procedure with you when you are in the recovery room. If you had any biopsies taken, you will receive a letter with those results, usually 2-3 weeks after the procedure. If there are serious findings on the biopsy, your physician will contact you. Every effort will be made to keep your appointment at the scheduled time, but in medicine, unexpected delays and emergencies may occur and your waiting time may be prolonged. We give each patient the attention needed for his or her procedure. If you have questions or must cancel, please call 317-963-4040 or 1-877-962-4040 as soon as possible. What to Bring: 1. The completed enclosed forms. 2. The first and last name and address of all doctors you want to receive a copy of your procedure report. 3. Someone to drive you home. Sedation is usually given during your procedure. If you have not arranged for someone to drive you home your procedure may be cancelled. The person who signs you out must be with you on the unit before you can be released. You will not be able to drive, operate machinery, make important decisions or return to work for the rest of the day. You may resume normal activities the next day unless the doctor states otherwise. 4. A copy of relevant medical records from your referring physician. 5. Your insurance cards. Many insurance carriers (not Medicare) and managed care organizations require preauthorization or precertification. To obtain coverage for these procedures, we recommend you contact your insurance company. As a courtesy we will make every attempt to obtain the authorization for these procedures, please make sure we have your correct insurance information. If your insurance information has changed or is inaccurate, please contact our authorization coordinators at 317-278-5074 or 317-278-8660. 6. If you need an interpreter provided please contact the Gastroenterology Department at 963-4040 or toll free 1-877-962-4040.

Patient Checklist If you are affected by any of the conditions listed below, please follow these instructions. Diabetes Hip or knee replacement in the past six months, vascular graft in past year, coronary stent in past 6 weeks Aspirin Check with your physician regarding your dose of insulin and other diabetic medications needed the day before and the day of your procedure. Inform your doctor that you will be on clear liquids the day prior to your procedure. Typically, we recommend that you do not take your oral hypoglycemic or insulin before your procedure. Bring it with you to take after your procedure. Check your blood sugar frequently while taking the prep solution and the morning of your procedure. You may need antibiotics before your procedure. Please arrive two hours before your scheduled procedure time. Do not schedule your procedure before 8:00am. Please inform the nurse and your physician. If you are taking aspirin, please check with your referring or primary physician as to if or when you should stop taking the aspirin. If you are taking aspirin due to a doctor's order to prevent stroke or heart attack, we generally recommend you continue to take it. Coumadin, Plavix, Ask the physician who prescribed your medicine how to take it before and after your procedure. If you cannot contact your Heparin, Lovenox, physician, call us several days before your exam. If you take Coumadin, you may need a blood test two hours before your exam. or other Please do not assume that you can safely follow the same medication adjustments anticoagulants that have been made for your previous procedures. ***If you require an interpreter please contact the department 2 days before your procedure. What To Wear Wear comfortable, loose fitting clothing that is easy to step into. Wear flat shoes or tennis shoes. Do not wear jewelry or bring valuables. Directions and Parking The endoscopy unit is located on the fourth floor of the Indiana University Hospital Outpatient Center, connected to Indiana University Hospital at 550 N. University Boulevard, Indianapolis, IN. Take the gold elevator from the main lobby in the outpatient center (under the glass canopy) to the fourth floor. Turn left as you exit the elevator to the GI registration desk and waiting area. Parking is available in the attached self-pay garage located on the north side of the entrance to the out patient center. Clarian does not pay for patient parking. Garages and parking lots are owned by IUPUI. We apologize for any inconvenience this may cause. Valet parking is available at the entrance of the Outpatient Center for $5.00 (no tipping). Page 2 of 4

Post Total Colectomy Preparation Instructions These instructions are for patients who have had all of their colon removed and are preparing for a sigmoidoscopy or colonoscopy procedure. 5 days before 2 days before The day before The day of your procedure your procedure your procedure your procedure Contact prescribing physician Complete forms sent from NO SOLID FOOD NO SOLID FOOD for instructions on dosage of the endoscopy department. NO ALCOHOL NO ALCOHOL blood thinners if you take any. List all current medications, Clear liquids ALL DAY find insurance cards, get (See page 4) until midnight You may take your morning names and addresses of the then have nothing more per mouth. medications as late as 3 hours physicians you want to before your scheduled procedure receive a copy of your procedure report. time. Remember to follow the special instructions for diabetic meds or blood thinners-see page 2. Stop herbals, vitamins, and oral iron supplements. Arrange a driver for after your procedure. Call the endoscopy unit for a No actual prep is given today. When registering at our front desk, language interpreter if needed Upon your arrival to the GI unit please inform the staff that you need at 317-274-0980. tomorrow enemas will be given enemas to complete your prep so to cleanse your lower GI tract. they can inform the assessment nurses. Stop any anti-inflammatory medications (Motrin, Advil, Ibuprofen, for example). Celebrex and Tylenol are OK to use Confirm that you have a driver to take you home following your procedure. Page 3 of 4

Clear Liquid Diet As a rule, if you can see through it, you can drink it. Gatorade is the preferred clear liquid (no red or purple) Clear fruit juices, white grape juice and apple juice Water Kool-Aide, PowerAde (no red or purple) Clear soup, broth or bouillon Popsicles (no red or purple) Tea or coffee without cream Hard candies (no red or purple) Soda pop, 7-Up, Sprite, regular or diet Pepsi and Coke, ginger ale, orange soda (no red or purple) Jell-O (no red or purple) Research Studies: Some patients who come to the endoscopy unit are asked to participate in a research study. If you are asked to participate, the study purpose and procedures will be explained to you. You have the right to decline participation. Declining participation will not affect the interest the doctors have in your case. The doctors at the endoscopy center are typically involved in research studies on how to improve endoscopy. Page 4 of 4

PATIENT NAME APPOINTMENT DATE ARRIVAL TIME After Jan. 15 phone numbers will be changing. Phone numbers beginning with 274 will change to 944. Phone numbers that begin with 278 will become 948. For example, 274-0981 will become 944-0981 REGISTER 4TH FLOOR GI/BRONCH SUITE 4100 YOU WILL RECEIVE A CALL FROM AN AUTOMATED SYSTEM AT LEAST 3 DAYS BEFORE YOUR PROCEDURE TO CONFIRM YOUR APPOINTMENT. PLEASE LISTEN TO THE MESSAGE AND RESPOND ACCORDINGLY. PLEASE READ THE ATTACHED INSTRUCTIONS UPON RECEIPT. FAILURE TO FOLLOW THE INSTRUCTIONS MAY RESULT IN AN INCOMPLETE TEST OR THE NEED TO RESCHEDULE YOUR PROCEDURE. **Important** If you have an implanted electronic device such as a pacemaker, defibrillator or nerve stimulator, it is required that you provide us with the manufacturer, customer service phone number, and diagnosis related to device. Patients with an implanted defibrillator should contact nurses station (317-274-0981) two days prior to appointment and provide this information. INDIANA UNIVERSITY HOSPITAL 550 N. UNIVERSITY BLVD. UH 4100 INDIANAPOLIS, IN 46202 (317) 274-4782 SCHEDULING (317) 274-0981 NURSES STATION THANK YOU FOR YOUR COOPERATION. PROCEDURE CHECKLIST MEDICATION LIST AND HEALTH HISTORY FORMS COMPLETED PREP COMPLETED (IF NEEDED) DRIVER NAMES, ADDRESSES, PHONE AND FAX OF ALL DOCTORS YOU WANT TO RECEIVE A COPY OF REPORT COPY OF RELEVANT MEDICAL RECORDS FROM REFERRING PHYSICIAN OR OTHER FACILITIES INSURANCE CARDS AND DRIVERS LICENSE/ID INFORMATION CARDS FOR IMPLANTED DEVICES SUCH AS PACEMAKER/ICD