John a

Doctor’s phone number: 650-498-6690 Waverley Phone: 650-324-0600 Waverley Fax: 650-289-1620
PROCEDURE: Colonoscopy
FACILITY: Waverley Surgery Center
PATIENT: ______________________________
DATE OF EXAM: ________________________
ARRIVAL TIME: ________________________
PLEASE READ THESE INSTRUCTIONS AT LEAST ONE WEEK PRIOR TO
YOUR COLONOSCOPY. Following this schedule will prepare you for a safe and
convenient experience. The cleaner your colon is, the better the quality of the exam.
Five days before colonoscopy:
ƒ Please stop taking any form of aspirin and Plavix. Tylenol (acetaminophen) may be
ƒ If you have diabetes, please check with your primary care doctor for instructions on how to manage your diabetes medicines on the day before and the day of your colonoscopy. ƒ If you have an internal defibrillator, we need to do your exam at Stanford Medical Center. Call Dr. Selling/Chan’s office to reschedule. Pacemakers are fine. ƒ Take the prescription for HalfLytely to your pharmacy and purchase it. If you have lost your prescription, please call our office and we can call your pharmacy. You may also buy Vitamin A and D ointment or petroleum jelly to apply to your perianal area during the prep if desired. ƒ Arrange for a ride home for the day of your exam. This person should be known to you and by law, has to be at least 18 years of age. If you are disabled or anticipate difficulty with mobility in a semi-sedated state, it would be advantageous to have this person stay with you for a few hours after arriving home. Taxis and trains are acceptable only if you are accompanied by an adult companion. If needed, an acceptable transportation service is Older Adults Care Management (650)329-1411
Three days before colonoscopy:
ƒ Stop taking Coumadin (warfarin). If you have an artificial heart valve, you should
discuss an alternative anticoagulant with your cardiologist or primary care doctor. Cutting your usual dose of Coumadin in half for 3 days is an alternative in this case if acceptable to your cardiologist. ƒ Avoid eating nuts, seeds, popcorn, grapes, peas, onions, beans, and tomatoes. Two days before colonoscopy:
ƒ Please stop all anti-inflammatory medications (Ibuprophen, Advil, Motrin, Mobic,
Indomethacin, Aleve, Datril, Naproxen, Naprosyn, Nuprin).
One day before colonoscopy:
ƒ THESE INSTRUCTIONS ARE IMPORTANT. YOUR COLON MUST BE
CLEAN. NOTE THAT THE HALFLYTELY PREP MAY TAKE 8 HOURS. ƒ Start drinking clear liquids in the morning and continue throughout the day. Do not
ingest solid foods, milk or milk products. Clear liquids include all of the following that are not red or purple; fruit juices (apple, white grape, lemonade), water, clear broth or boullion, black coffee or tea, Gatorade, carbonated and non-carbonated soft drinks, Jello and popsicles. Other than as mentioned above, you may take your usual medications today. ƒ Included in the HalfLytely kit are two bisacodyl tablets. Swallow both tablets with water. Do not chew or crush the tablets. This should be done in the late afternoon. ƒ Mix HalfLytely by adding water to the 2 liter mark on the container. Add a flavor pack if desired. Shake the jug to dissolve the powder. Most people find the solution easier to drink when it is chilled, but you may drink it at room temperature. After having a bowel movement induced by the bisacodyl, or waiting a maximum of 6 hours after the bisacodyl, drink the first glass of the solution. Drink about 8 oz. every 10 to 15 minutes until you have finished the solution. To mask the taste, you may suck on a lemon or lime wedge after each glass. Bowel movements may begin within 1 hour of starting the prep or may not occur for 2-3 hours after finishing. They may continue 2 to 4 hours after the last glass. Remain close to the bathroom, as multiple bowel movements will occur. Bloating, nausea and/or chilling may occur, but will improve when bowel movements begin. If nausea is significant, stop for 30 minutes, then resume drinking. Consider using petroleum jelly around the anus before starting and during the prep. Adequate cleansing will take 6 to 8 hours.
Day of colonoscopy:
ƒ Take your usual medications (not mentioned above) at least 2 hours before arrival. Do
not take morning blood pressure medications unless your arrival time is after noon. Don’t bring any antibiotics (for heart valve prophylaxis) with you. If you think you need antibiotics, tell the nurse when you arrive. ƒ You may have only clear liquids until two hours before your arrival time at the
surgical center, nothing thereafter.
ƒ Please arrive on time. Parking is underneath the building. Take the elevator to the first floor and go to the Reception desk. You will be at the surgical center for 2 hours. ƒ Wear loose, comfortable clothing. ƒ Bring your photo ID and your insurance card. ƒ A nurse will check you in and insert an IV catheter into a vein. ƒ During the exam your cardiovascular status will be monitored. Supplemental oxygen will be given via a nasal cannula. An IV medication will be given which will make you sleepy and relaxed. You will be comfortable lying on your left side during the exam. The colonoscope will be passed through your entire large intestine. If necessary, small biopsies may be taken and, if present, polyps (small growths) may be removed. You will feel no discomfort if this is done.
After the colonoscopy:
ƒ You will be observed until you adequately recover from the effects of the medication. If you desire, the doctor may discuss your findings with your ride if he/she is available. Discharge instructions will be given to you and your ride in the recovery area. You cannot drive until the following morning. You may eat a regular diet and take your usual medications when you arrive home unless otherwise directed at discharge. Are there any complications from colonoscopy and polypectomy?
ƒ Colonoscopy and polypectomy are associated with very low risk when performed by doctors with special training and experience in these endoscopic procedures. One possible complication is perforation, a tear through the wall of the bowel. Another complication is bleeding which may occur from the site of biopsy or polyp removal. It is usually minor and stops on its own or by cauterization (application of electrical current) during the exam. Rarely, surgery is necessary. A third complication is a localized irritation of the vein in your arm that may occur at the site of medication injection. A tender lump could develop and may remain for several weeks to months. Elevation of the arm and local application of heat speeds recovery. A fourth possible complication may occur if the doctor is unable to visualize an abnormality due to poor colon preparation. It is important that the colon be clean to get the best visualization.
Causes for concern warranting a call to your doctor:
ƒ Rectal bleeding greater than one quarter cupful, or a lesser amount lasting more than
ƒ Increasing abdominal pain.
ƒ Nausea or vomiting.
ƒ Fever or chills.
Please note:
ƒ If you have any questions about your exam, please feel free to discuss them with Dr.
Selling/Chan or the nurse at 650-498-6690. ƒ You will be responsible for both a facility fee from Waverley Surgery Center and the physician’s professional fee. If a biopsy is done, there will be a separate charge from Stanford Pathology. If you need to cancel your appointment for any reason, please call the nurse at least 48 hours in advance. There is a $50.00 no-show charge per Menlo Medical Clinic management. Thank you for trusting us with your care.

Source: http://menloclinic.com/content/dam/menloclinic/coloprepwithHalfLytely.pdf