Colon Prep Instructions
You will need to drink a laxative solution (called Miralax) to clean your colon. You must complete the entire prep to ensure the most effective cleansing. Purchase one bottle of Miralax 238 grams from your pharmacy.
You will need transportation home as you will not be allowed to drive after the procedure.
Three days before your colonoscopy 1.Soft diet/low fiber. No nuts, seeds, popcorn, hard fruit or vegetables. 2.Obtain a bottle of Miralax 238 grams. If you tend to be constipated, or sometimes need a laxative, take 2 tablespoons of Milk of Magnesia at 8 PM for the next two days. 3.Arrange for your ride home after the procedure. One day before your colonoscopy 1.No solid food - Clear liquids only for breakfast, lunch & dinner. Clear liquids are any liquid you can see through (water, soft drinks, tea, cranberry or apple juice, Gatorade, clear broths) plus coffee and Jello. Do not drink or eat anything with red food coloring like red Jello. Cranberry juice is okay. 2.4-7 pm: Take all three Dulcolax tablets provided for you. Be close to a bathroom after taking the Dulcolax as diarrhea can be urgent. Prepare your Miralax solution by mixing the entire 238 gram bottle with 64 ounces (2 quarts) of Gatorade or other flavored clear drink of your choosing (not red or purple). Shake until the Miralax is dissolved. One hour after taking the Dulcolax, begin drinking the Miralax at a rate of about one 8 oz glass every 15 minutes until you have finished one quart. 3.You should continue to drink clear liquids until bedtime. This will help keep you hydrated.
Morning of Procedure:
1.Five to eight hours prior to procedure begin to drink the second quart. Drink 8 oz every 15 minutes until gone. Drink another pint of clear fluid of your choice. 2.You may continue to drink clear liquids up until three hours prior to the procedure, then nothing by mouth.
SPECIAL MEDICATION INSTRUCTIONS
We recommend you make the following medication changes prior to your procedure:
•Blood-thinning medications (such as Coumadin, Ticlid, Plavix, Persantine, Aggrenox and Lovenox) may need to be discontinued prior to your procedure. Please contact your prescribing physician for instructions well in advance; you may need to be off these drugs up to 7 days prior to your procedure. •Unless prescribed by your physician, please avoid the following medicines if possible: aspirin, aspirin-containing products or non-steroidal anti-inflammatory drugs (e.g. Ibuprofen, Nuprin, Advil, Aleve, Motrin, etc.) for 5 days prior to your appointment. •Do not take iron pills for 7 days prior to your procedure. •Continue taking your other prescribed medications (e.g. blood pressure pills) as usual; if you have any questions about your medications, call your prescribing physician. •Diabetic patients
If you take an oral hypoglycemic (“sugar pill”), do not take it the day of your procedure. If you are taking insulin, you should only take half (1/2) of your usual scheduled insulin dose before your procedure.
LOW or SOFT FIBER DIET: 3 days prior to colonoscopy
No vegetables, hard fruit or nuts
SOUPS:Broth or cream soups MEATS:Tender Veal, beef, lamb, ham, chicken, turkey, liver, pork, fish or shellfish FRUITS: Fruit juices, peeled or baked apples, ripe banana, canned peaches, canned pears, plums, apricots and cherries CEREALS & BREADS:Refined cereals such as corn flakes, puffed rice, corn pops, frosted flakes, rice krispies, well cooked oatmeal, rice, noodles, macaroni, spaghetti, farina, grits, cornmeal, cream of wheat, white bread, plain crackers, plain rolls, biscuits, cornbread, plain waffles, and pancakes DESSERTS: Pudding, custard, ice-cream, sherbet, cookies, gelatin desserts
BEVERAGES: Coffee, tea, juices, carbonated beverages, and milk
FATS: Butter, margarine, cream, sour cream, oil, crisp bacon, smooth peanut butter, mayonnaise MISC:Eggs, Seasonings, jelly, honey, syrup, lemon juice, vinegar, cocoa, catsup, mustard, gravy, sauces, hard and chocolate candy made without nuts, coconut and dried fruits
CLEAR LIQUID DIET: 1 Day prior to colonoscopy
SOUPS: Clear bouillon, clear broth, of consommé
BEVERAGES: Tea, black coffee (decaf/regular), carbonated beverages (soda pop), Kool-aid,
Gatorade, water JUICES: Cranberry, grape, apple (NO orange juice or tomato juice) DESSERTS: Jell-O, Iced popsicles, water ices (NOT red or purple colors) MISC: Sugar, salt, hard candy (Lifesavers, etc.)
Patient Rights and Responsibities
J. Scott Gibson M.D., P.C.
Yamhill Valley Endoscopy
Information disclosure. You have the right to accurate and easily-understood information about your procedure, health care professionals, and health care facility. If you speak another language, have a physical or mental disability, or just don't understand something, help should be given so you can make informed health care decisions.
Participation in treatment decisions. You have the right to know your treatment options and take part in decisions about your care. Parents, guardians, family members, or others that you select can represent you if you cannot make your own decisions.
Advanced Directive. In accordance with facility policy, you may receive, upon request, an Advanced Directive allowing you to specify your medical care choices and assign a health care representative in the event that you are unable to make decisions for yourself. If you want information on Oregon’s Advance Directive law, you may find it at http://www.oregon.gov/DCBS/SHIBA/advanced_directives.shtml If you make your wishes about resuscitative care known to the staff at Yamhill Valley Endoscopy, we will honor your request to the best of our abilities.
Respect and non-discrimination. You have a right to considerate, respectful care from your doctors, health plan representatives, and other health care providers that does not discriminate against you. You have the right to be free from all forms of abuse or harassment.
Confidentiality of health information. You have the right to talk privately with health care providers and to have your health care information protected. You also have the right to read and copy your own medical record. You have the right to ask that your doctor change your record if it is not correct, relevant, or complete.
Billing. All patients have the right to examine and receive an explanation of their bill, regardless of the source of payment.
Complaints and appeals. You have the right to a fair, fast, and objective review of any complaint you have against your doctor, health care facility or other health care personnel. This includes complaints about waiting times, operating hours, the actions of health care personnel, and the adequacy of health care facilities. If you have a complaint or grievance, you may submit it verbally or in writing to any staff member and the matter will be taken to the Quality Assurance Committee within two weeks. You will be informed of the outcome of the evaluation of your complaint and, if appropriate, any remedial action taken.
Privacy and care. You have the right to personal privacy and to receive care in a safe setting.
To register complaints you may contact the Office of the Medicare Ombudsman at http://www.medicare.gov/Ombudsman/activities.asp
You may also contact the Oregon Department of Human Services, Health Services, P.O. Box 14450,Portland, Or 97293-0450, 971-673-0540.
Physician Financial Interest Disclosure
Your procedure is scheduled to be performed at Yamhill Valley Endoscopy, located at 2375 NE Cumulus Ave., McMinnville, Oregon. This facility is owned exclusively by Dr. Scott Gibson. You have the right to obtain healthcare services at any hospital or endoscopy center and from any provider of your choice.
Below you will find instructions for a colonoscopy prep, Patient Rights and Responsibilities and Physician Financial Interest Disclosure, and a link to learn about and obtain an Oregon Advance Directive. Simply click on the links below to be taken to the information you need.
Except in very unusual cases, all patients undergoing procedures will have sedation. For that reason, all patients must have a driver to take them home. For most procedures, the patient will be able to leave 1 1/2 to 2 hours after arrival. Friends and family members are not allowed in the procedure room, but may be with the patient immediately before and after the procedure.