DATE OF PROCEDURE: ________________________________________________ Please arrive 30 minutes before your scheduled time
Preparation for a procedure is very important. Proper preparation will reduce the risks of the procedure and will assist in obtaining proper results. PLEASE NOTE: YOU MAY REQUIRE SEDATION DURING YOUR PROCEDURE. IF SO, YOU SHOULD NOT DRIVE FOR TWENTY FOUR (24) HOURS OR OPERATE ANY MOTORIZED EQUIPMENT (IE–LAWN MOWER) AFTERWARDS AND YOU MUST ARRANGE FOR SOMEONE TO ACCOMPANY YOU FROM THE CLINIC TO YOUR HOME.
INSTRUCTIONS/INFORMATION FOR Esophagogastroduodenoscopy (EGD) GENERAL PREPARATION INSTRUCTIONS
You will be having a test called EGD, which simply means looking into the esophagus
(swallowing tube), stomach and duodenum.
Please check with your family doctor before stopping any of these medications. ALL OTHER MEDICATIONS YOU MAY TAKE.
Containing medications should be stopped 7 days prior to the procedure (including ASA 81 mg and Entrophen)
Should be stopped 5 days prior to the procedure
Should be stopped 1 week prior to the procedure.
Ticlopidine (Ticlid), Clopidogrel (Plavix)
Should be stopped 3 days prior to the procedure.
IMPORTANT: IF YOU ARE INSULIN DEPENDANT, CONSULT YOUR FAMILY DOCTOR. STOP ALL MEDICATIONS THAT CONTAIN ASPRIN OR ASA 7 DAYS BEFORE THE TEST. MORNING PREPARATIONS
You should have NOTHING to EAT after 7:00 pm the day before your procedure and NOTHING TO DRINK AFTER MIDNIGHT, NOT EVEN SIPS OF WATER, until after your procedure. REFRAIN FROM GUM AND CANDIES, if your mouth is dry you can swish water in your mouth and then spit it out.
You may have a light breakfast such as toast (refrain from eggs, bacon, and sausage) BEFORE 6:00 am and CLEAR liquids (no milk products) up to 6 hours prior to the time of your procedure, then NOTHING TO EAT OR DRINK, NOT EVEN SIPS OF WATER, until after your procedure. REFRAIN FROM GUM AND CANDIES, if your mouth is dry you can swish water in your mouth and then spit it out. PLEASE REFRAIN FROM USING PERFUMES, COLOGNES OR SCENTED SOAPS BEFORE YOUR TEST, AS SOME PATIENTS AND STAFF MEMBERS MAY SUFFER FROM ALLERGIES. THE PROCEDURE Description of the Test
Your throat will be sprayed with a local anaesthetic spray. If the spray is not sufficient, then sedation will be used intravenously. The tube will be passed into the back of your mouth and it will be guided into the back of the throat. You will be asked to swallow the tube as it will be passed down. At this point a plastic guard will be placed between your teeth to protect the delicate tube. The test will take no more than five minutes or so. If a narrow spot is found in the esophagus, it will be necessary to pass a rubber tube to stretch out the narrow spot. This is called dilatation. If a growth or unusual area is seen, biopsies may be required, but this is completely painless. After the test
You will be given the results and instructions regarding treatment before you leave the Clinic. If you have a sedative, a responsible adult must accompany you from the Clinic to your home after an initial rest at our Clinic for up to an hour. You must not drive after sedation. Directions to our clinic We are located at 267 O’Connor Street, between MacLaren Street to the north and Gilmour Street to the south. If you take the Queensway from the west, exit at Kent Street and proceed north to Somerset Street. Turn right onto Somerset and go two traffic lights to O’Connor. Turn right onto O’Connor and proceed one block to the Doctors Building on your left. Coming from the east, exit the Queensway at Metcalfe Street and proceed north on Metcalfe to MacLaren Street. Turn left on MacLaren and go to O’Connor Street. At O’Connor Street the building is on your left. There is a parking lot immediately adjacent to the building. PLEASE NOTE AGAIN: YOU MAY REQUIRE SEDATION DURING YOUR PROCEDURE. IF SO, YOU SHOULD NOT DRIVE FOR TWENTY FOUR (24) HOURS OR OPERATE ANY MOTORIZED EQUIPMENT (IE–LAWN MOWER) AFTERWARDS AND YOU MUST ARRANGE FOR SOMEONE TO ACCOMPANY YOU HOME FROM THE CLINIC.
Please make sure to bring a valid OHIP card with you. You will be asked to fill out a Medical History and Consent to Treatment form. If you have any questions about the information you are required to provide please ask our staff. If you are not comfortable speaking or reading English you should bring an interpreter with you to the appointment. Once you arrive and are registered at the Clinic you should expect to be here for an average of 60– 90 minutes. Because of the use of sedation during the procedure you will not be allowed to drive for 24 hours.
Fees: please read the following carefully Arriving late or the sudden cancellation of your appointment causes inconvenience for other patients and our staff. If you need to cancel or reschedule your appointment we require 4 business days’ notice before the scheduled time of your appointment, or you will be charged a cancellation fee of $150.00.
Consultations, colonoscopies, gastroscopies (EGD), and day surgery procedures are OHIP insured services. Please bring a valid OHIP card with you to your appointment. There is however an additional annual uninsured services fee of $80.00 (payable to the clinic by cash, cheque, debit card, VISA, or MasterCard) to cover the cost of any additional uninsured services that you may require. You will be given a receipt for the payment which you may submit to your private health insurer for reimbursement or to file with your income tax return. If this proves to be an issue with you or you have any questions about these services please speak to the staff at the time of booking or at your appointment. You will not be denied the procedure if you don’t pay the fee. AFTER THE PROCEDURE
As soon as the procedure is done you will be taken to the recovery area in the Clinic. Recovery time varies with each patient, but typically it ranges from 30 to 60 minutes. Once you are ready, you may leave with the person that accompanied you. You will be instructed not to drink or eat anything for at least 1 hour after your throat has been sprayed. If sedated, you should not go to work for the rest of the day. Do not drive or operate machinery or drink alcoholic beverages for 24 hours following the procedure. You may resume your regular medications. POSSIBLE COMPLICATIONS
If an esophageal dilatation is required because of food getting stuck at a tight spot on the way down, then perforation of the esophagus or putting a tear in the swallowing tube is a possible but rare complication. If it ever occurred, an operation would be required to repair it. A second less severe complication that can occur is a phlebitis or inflammation of the vein in the arm at the site of injection of the sedative. This is rare, but not as severe as phlebitis in the legs, and generally heals without treatment.
Although complications are rare gastroscopies are medical procedures that do carry with them possible risks and complications including but not limited to pain and bleeding. If the bleeding continues or increases after 24 hours contact your doctor or go to the nearest hospital emergency department.
Commento biblico – musicale dell'introito e traduzioni Il libro di Ester è una delle cinque Meghillôt (in ebr. “rotoli”) e viene letto durante la festa dei Purim. Narra l’avventura di una giovane ebrea che assurge al rango di regina e grazie a questa sua posizione riesce a scongiurare una persecuzione contro il suo popolo all’epoca del re persiano Assuero/Serse. Il testo dell�
MEDICATIONS AND TOURETTE’S DISORDER: COMBINED PHARMACOTHERAPY AND DRUG INTERACTIONS Barbara Coffey, M.D., Cheston Berlin, M.D., Alan Naarden, M.D. Introduction Tourette Syndrome (TS) or Tourette’s Disorder (DSM IV) is a complex neuropsychiatricdisorder characterized by a changing pattern of motor and vocal tics that begin in childhood. Many individuals with Tourette Syndrome have a