Microsoft word - colonoscopy prep 2014 _2_.doc

DR. YAFFE’S COLONOSCOPY PREP 2014
Read this at least 7 days before the procedure. Go to our Website,
www.yafferuden.com, hit the “ENDOSCOPY” button and you will be guided
through the “CONSENT” and a short form that needs to be filled out. This
information is also on the Website.
I will attempt to look inside your entire five feet of colon. The procedure takes 15
to 20 minutes. You will be sleeping comfortably under the influence of IV
Propofol and Versed administered by a Board Certified anesthesiologist,
usually Dr. Graziano Carlon, who ran the Sloan Kettering ICU for many years.
IMORTANT INSURANCE INFO:
Dr. Carlon, our chief anesthesiologist, is in-network for approximately 70%
of patients. However, many other insurances are covered entirely, even if
he is not in-network. Please check with your insurance program and,
realize that even if a procedure is covered, you may have an in-network
deductible that hasn’t yet been met. In that case you would be responsible
for all or part of the charge for BOTH-procedure AND anesthesia. Under
those circumstances, we must get a credit card authorization, upon your
arrival, to cover the potential unpaid portion. If you have any questions about
anesthesia billing, Dr. Carlon is happy to take your call: 646-361-4800 or 646-
244-0950. Mary Monong, our Billing Manager at Yaffe/Ruden can be reached
at 212-879-4700 ext #6234.
MEDICAL CLEARANCE:
If you are over 65, or if you have any significant medical issue, you must be
seen by an M.D or P.A. to get pre-anesthesia clearance within 90 days of
the procedure. You may obtain medical clearance in our office by coming in up
to 7 days before the procedure to be evaluated. Patients under 65 with no
medical issues must have been seen within 12 months by an M.D. in order to
be cleared for anesthesia.
THE PROCEDURE:
-You will not feel a thing! It is a very relaxing sleep from which you usually
awaken quickly! (George Bush had this anesthesia and Cheney was President
for 5 minutes!) You will be able to leave within 30 minutes after the procedure,
and you will be able to eat and go to work within an hour. NYS Law mandates
that you need to be discharged to your mode of transportation accompanied by a
responsible adult. We can provide that person if it is inconvenient for someone to
accompany you. You will be allowed to drive 4 hours after the procedure.
-Make a good effort to be well cleaned!! The prep is the hard part. I can’t
see through a clouded lens!

PLEASE READ BEFORE STARTING PREP:
1) If you tend to be constipated, take milk of magnesia for a few nights
before the prep starts.
2) Try to minimize corn, quinoa, sesame and seeds for 3 days before the
procedure.
3) Eat a VERY LIGHT LUNCH the day BEFORE the procedure-no later than
1:30PM.
4) After lunch, drink only clear fluids-anything where you can read through to
the other side of the glass. Water, seltzer, black coffee, tea, vodka and Gatorade
are all OK. -In order to prevent hunger, some patients can drink liquid Sustacal
or Ensure (Vanilla or Strawberry, NOT Chocolate) nutritional supplements
available over-the-counter in pharmacies. You can drink up to 4 cans up until
midnight. (Non-Chocolate Sustacal and Ensure are not clear, but are
completely absorbed in the small bowel, and are OK.)
5) Please take all your normal meds up to the night before the procedure.
(Bring your morning meds with you to the office when you come in for the
procedure).
6) DO NOT take aspirin for 3 days before the procedure as it might increase
the risk of bleeding if a polyp is removed.
7) If you take an anticoagulant or, if you have taken a few aspirin, in most
cases it will not make a difference unless a large polyp is removed. Tylenol,
Aleve and Advil are OK.
8) If you have an artificial valve, or a very serious, significant heart murmur, or
are on Plavix, please call. We often let you stay on anticoagulants unless we
know we have to remove a polyp. 9) If you may be pregnant or are
breastfeeding, please call.
10) NO FLUIDS AFTER 12AM INCLUDING WATER. NOTHING!!!!!

Call the office between 8 AM and NOON if you have any Prep Questions. The
number is 212-879-4700 ext #6244 and Kathy or Alfa will be happy to answer
them.
PREP OPTIONS:
1) PREPOPIK PRESCRIPTION: 5 oz. of PREPOPIK followed by 40 oz. of
any clear fluid at 5PM, followed by 5 oz PREPOPIK at 8 PM and 24 oz
of clear fluids. (OK to start at 2PM and 5PM if that is more
convenient.) Mix the solution for 2-3 minutes-water, cranberry or
grape juice or ginger ale are all OK. You may be able to get savings
coupons at WWW.PREPOPIK.COM.
2) MOVIPREP PRESCRIPTION: Simply drink one quart of the
MOVIPREP fluid at around 5 PM and the next quart around 3 hours
later. If any questions, go to WWW.MOVIPREP.COM.
3) DULCOLAX-MIRALAX PREP is over-the-counter and requires you to
purchase 3 ingredients: a) 4 Dulcolax Laxative tablets-MUST BE THE
LAXATIVE PILLS! (over-the-counter) b) MIRALAX POWDER 238 gm.
bottle. (over-the–counter) c) 64-oz bottle of Gatorade or PowerAde.
DIABETICS may use diet soda.
-Mix the entire 238 gm. bottle of Miralax with 2 quarts of Gatorade in
a large pitcher. Stir, chill, add ice and let it breathe for at least a few
minutes in order to fully appreciate the flavor!
-Depending on your schedule, starting between 1-4 PM, the day
BEFORE the procedure, take ALL 4 Dulcolax tablets at once. It usually
takes between 4-6 hours before the action begins. If you are a
frequent laxative user, please start with DOUBLE your USUAL
effective, Dulcolax dose.
-2 hours AFTER the Dulcolax, start drinking your chilled Miralax
cocktail. (We entertain creative names for this cocktail, so please feel free
to jot down your thoughts during your private moments).
-You should pace yourself to drink about 8 8-oz glasses (64 oz all told)
over a 2-4 hour period. This is roughly 1 glass every 15-30 minutes
until finished.
4) COLONIC PREP: On occasion, we have had patients who REALLY
DON’T WANT TO TAKE ANY PREP. For them, we have had a good
experience with patients who have gone for a COLONIC, (90 minutes
BEFORE the COLONOSCOPY!) Schedule with Nancy Tran: 212-832-
6800 @ Provence Wellness, 150 E. 55th St. ($150) or schedule with
Marsha: 212-988-7816 @ LaBreque Spa, 171 E.65th St & 3rd Ave, 50
yards from the office ($200). If you tend to be constipated, take milk of
magnesia for a few days to loosen things up!
5) OSMOPREP is the prescription 32-pill plus 64 oz of water version of
Phosphosoda which can also cause occasional kidney damage.
6) HALF-LYTELY PREP is another prescription mixture consisting of 64
oz liquid.
7) FLEETS PHOSPHOSODA PREP: In the past we have used 1.5 oz of
Fleets Phosphosoda in 8 oz of water followed, 2 hours later by
another 1.5 oz in 8 oz of water. This also is occasionally associated
with kidney damage so we rarely use it.

WHAT TO EXPECT ONCE PREP BEGINS:
-Expect to use the facilities at least 10-15 times over about 5 hours, once
activity begins. Activity usually begins 2-5 hours AFTER STARTING THE
PREP. ULTIMATELY, the stool should be clear, lemonade-like, NOT sludgy
or brown. PLEASE CHECK THE BOWL! Expect some cramps. If you have
questions about success, call at 8 AM when the phones get turned on. We
can improvise in the morning if necessary.
DAY OF PROCEDURE:
-If you have a 7:15AM appointment, arrive at 6:50AM; if 7:45AM
appointment, come at 7:15AM. Otherwise, arrive at the scheduled time and
expect a 30-minute pre-procedure check-in and usually, a Fleet enema.
AFTER THE PROCEDURE:
-You can expect to leave approximately 60 minutes after we start the
procedure. Most patients will want to eat breakfast and you will be capable of
being at work within an hour of leaving the office. NO DRIVING A CAR OR
OPERATING HEAVY MACHINERY (AIRPLANES, BACKHOES, CHAINSAWS
ETC.) for 4 hours after anesthesia. It is a good idea to bring an EXTRA PAIR
of underwear.

AND FINALLY……
-Menstrual periods, viral syndromes or urinary infections do not interfere.
-PLEASE REMEMBER to bring INSURANCE and REFERRAL FORMS.
-Again, CALL the number above if you have questions!!
-AND REMEMBER, NO FLUID, INCLUDING WATER, AFTER 4 AM!!
NOTHING AT ALL, NADA AFTER 4AM!!

Source: http://www.yafferuden.com/wordpress/wp-content/uploads/2013/12/COLONOSCOPY-PREP-2014-_2_.pdf