TAYLOR STATION Surgical Center
(614) 751-4466 Jeffrey S. Sams, M.D. Preparation for Colonoscopy Miralax / Sports Drink Unsplit Your examination has been scheduled at: TAYLOR STATION SURGICAL CENTER 275 Taylor Station Road, Columbus, OH 43213 Located on the corner of Taylor Station and Morrison Roads. Please call to pre-register (614) 751-4466. Arrive 90 minutes before scheduled procedure time.
PLEASE READ THESE INSTRUCTIONS CAREFULLY AS SOON AS YOU RECEIVE
THEM, AND CALL TSSC WITH ANY QUESTIONS AT (614) 751-4466.
IF YOU ARE ON COUMADIN, PLAVIX, OR INSULIN, PLEASE CALL TSSC FOR
If you take iron (ferrous sulfate), Metamucil, Citrucel, Perdiem or other bulk agents, stop them at
least five days before the procedure. Also, eat no nuts, seeds, corn or popcorn within five days of your procedure.
Pick up the following items at least a day or two before the procedure:
○ Miralax, one 238 gram (8.3 oz) bottle or two 4.1 oz bottles of Dulcolax Balance.
○ Gatorade, Crystal Light or similar sport drink, two 32 oz bottles, or clear beverage of your choice. (not red or purple) ○ Fleet enema, one (green box) ‘just in case’ – see below ○ Hemorrhoidal ointment or diaper cream, small tube, if desired
THE DAY BEFORE YOUR PROCEDURE YOU MUST BE ON CLEAR LIQUIDS (NO SOLID FOOD!) the entire day before the procedure. You may have clear liquids up to (4) hours before the exam. Clear liquids include juices without pulp (apple, white grape, lemonade, etc.), sports drinks, water, tea, coffee, (no cream), gelatin (e.g. Jello)
without fruit, soft drinks, clear broth or bouillon, ice pops (e.g. Popsicles). Avoid red or purple colors (which may look like blood in the colon). Keep your self well-hydrated by drinking 4-8 oz. of such fluids every hour you are awake. In the afternoon the day before your procedure, take (2) Dulcolax tablets with water. (Do not chew or crush. Do not take the Dulcolax tablets within 1 hour of taking an antacid.) Divide the Miralax or Dulcolax Balance powder between the two bottles of sports drink. Cap the bottles and shake well to completely dissolve the powder. You may refrigerate the solution if desired. By late afternoon or early evening, start drinking both of the bottles of prepared sports drink. Drink one (8 oz) glass every 15-30 minutes until the bottle is empty. The solution may taste better if you take it chilled, or through a straw. If you have nausea, discomfort or bloating, stop drinking the solution for an hour or so until the discomfort goes away, and then resume the prep, waiting longer between drinking each glass. If your perianal area becomes irritated from the diarrhea, we recommend you apply a petroleum based hemorrhoid ointment or diaper cream locally to protect your skin and use Tucks pads or diaper wipes to gently clean your skin. THE MORNING OF YOUR PROCEDURE You may take clear liquids as desired up until four hours before the exam. You should take your medications the morning of the exam, except as previously instructed (e.g. insulin, Plavix, and Coumadin/ warfarin). Aspirin is allowed. If you feel your bowel prep result is not fully clear, use the Fleet brand enema (green box), which you may administer to yourself early in the morning of the exam. You may follow this with tap water enemas by refilling the Fleet enema bottle, until your results are clear. Remember to arrive 1 ½ hours before your scheduled exam time. You MUST have a driver who can bring you home after the procedure, as sedatives are usually given for these exams. (We will not sedate a patient who has no driver!)
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C l i n i c a l C a r e / E d u c a t i o n / N u t r i t i o n / P s y c h o s o c i a l R e s e a r c h O R I G I N A L Secondary Failure of Metformin Monotherapy in Clinical Practice ONATHAN B. BROWN, PHD, MPP 8% to define initial success and secondary HRISTOPHER CONNER, PHARMD, PHD REGORY A. NICHOLS, PHD studies have examined the potential ben-efits of immediate versus del