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SHANDS Endoscopy 1515 SW Archer Road Gainesville, FL 32608 Small Bowel Enteroscopy Spirus -Retrograde Patient Name: Med. Rec.# PROCEDURE DATE: ARRIVAL TIME: You have been scheduled for a Small bowel Enteroscopy 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: 1. Bring with you: a. Adult driver that MUST remain with you until you are discharged home (please plan to be here approximately 2-4 hours) b. Picture ID with full name and insurance cards c. Written List of Current Medications d. Advanced Directive / Living Will if available e. If you have Sleep Apnea, please bring your CPAP machine with you 2. Wear loose, comfortable clothing 3. Remove ALL jewelry 4. Leave ALL valuables at home 5. See medication instructions below MEDICATION INSTRUCTIONS: 1. Take your heart, blood pressure, seizure and Parkinson’s medication with sip of water(2 hours prior to arrival time) 2. 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 3. Do not take any iron supplements for 7 days prior to procedure 4. If you are on blood thinners (Aspirin, Coumadin or Pradaxa), and we have not given you instructions, please contact your Primary Care Physician for further instructions PREP INSTRUCTIONS: Clear Liquid diet for the entire day the day prior to procedure: NO SOLID FOOD AT ALL Drink clear fluids each hour to stay hydrated up until Midnight(or bedtime) At 6pm, start ½ (64oz.) of GoLytely: 8oz. glass every 10-15min until done with first half May continue clear liquid diet until Midnight: NOTHING AFTER MIDNIGHT(except prep below) SIX HOURS BEFORE ARRIVAL TIME: Start second ½ of GoLytely: 8oz. glass every 10-15min until done. MUST complete within 1 ½ hours. 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 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 2012 Colonoscopy instructions 2012