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SHANDS Patient Name: Med. Rec.# PROCEDURE DATE: ARRIVAL TIME: Endoscopy LOCATION: □Shands Endoscopy Center 2001 SW 13th Street Gainesville, FL 32608 □ Shands at UF 1515 SW Archer Road Gainesville, FL 32610 _ ___ 2-Day Colonoscopy Prep You have been scheduled for a Colonoscopy to examine your large bowel(colon). It will be necessary for you to prepare your bowel prior to the procedure. For this preparation, you have been given a prescription called NuLytely, GoLytely, CoLyte or TriLyte. This prep is not absorbed by your body but rinses solid matter from your colon. You should expect to empty your bowel frequently. THE DAY OF YOUR PROCEDURE: Bring with you: Adult driver that MUST remain with you until you are discharged home (please plan to be here approximately 2-4 hours) Driver’s License or Picture ID with full name and date of birth and insurance cards Written List of Current Medications Advanced Directive / Living Will if available If you have Sleep Apnea, please bring your CPAP machine with you Wear loose, comfortable clothing Remove ALL jewelry Leave ALL valuables at home See medication instructions below MEDICATION INSTRUCTIONS: Take your heart, blood pressure, pain meds, seizure and Parkinson’s medication with sip of water 2 hours before arrival time day of procedure If Diabetic: Do NOT take diabetic pills evening prior or morning of procedure. Cut insulin dose in half the night prior to procedure and HOLD any morning insulin dose the day of procedure Do not take any iron supplements for 7 days prior to procedure If you are on blood thinners (Aspirin, Plavix, Coumadin or Pradaxa), and we have not given you instructions, please contact the physician that prescribed the medication for further instructions PREP INSTRUCTIONS: Clear Liquid diet for two days prior to procedure: NO SOLID FOODS AT ALL Drink clear fluids each hour to stay hydrated up until Midnight (or bedtime) night prior to procedure, nothing after Midnight At 6pm on Day 1: Drink 1 bottle of Mag Citrate At 8pm on Day 1: Drink 2nd bottle of Mag Citrate At 3pm on Day 2:Start ½(64oz.) of GoLytely: 8oz. glass every 10-15min until done At 9pm on Day 2:Start second ½ of GoLytely: 8oz. glass every 10-15min until done. MUST complete prior to Midnight. NOTHING AFTER MIDNIGHT the night prior to procedure(No food, no liquids, no water) EXAMPLES OF CLEAR LIQUID DIET: Clear or strained fruit juices: NO Red, Orange or Purple in color Clear broth, bouillon or consomme’ Clear gelatin, popsicles, or fruit-flavored ices: NO Red, Orange or Purple in color Coffee, tea, carbonated drinks, Kool-Aid or Gatorade: No Red, Orange or Purple in color CONTACT US: For scheduling questions or pre-procedure questions, please call (352)265-ENDO (3636) NOTE: If your procedure is being done at Shands at UF, you will receive a phone call from the Presurgical Clinic (265-0076) to make appointment prior to procedure. If you do not attend this preop appointment, your procedure could be delayed or cancelled. Colonoscopy instructions 2013 Colonoscopy instructions 2013