Pre-Exam Preparation Instructions

Esophagus - Barium Swallow

• Do not eat or drink anything after 10 pm the night before the exam.
• You are allowed to take regular medications.

Upper Gastrointestinal - UGI, Small Bowel (SBFT)

• Do not eat or drink anything after 10 pm the night before the exam.
• Do not take oral medications until after the exam.

Gallbladder - Oral Cholecyctogram (OCG)
This is a 2-day exam:

• 1st day - A preliminary X-ray is done and the patient is given the oral contrast.
• 2nd day - X-rays of the gallbladder are performed.

Barium Enema (BE, BE Air Contrast, or Double Contrast BE)

• A preparation kit will be given to you on the day before the exam. If you don't have a kit, you should pick one up at the Ponahawai Clinic. Instructions are included in the kit.
• You are allowed to take regular medications.

Intravenuous Pyleogram - IVP

• A preparation kit will be given to you on the day before the exam. If you don't have a kit, you should pick one up at the Ponahawai Clinic. Instructions are included in the kit.
• You are allowed to take regular medications.

Important note regarding IV Contrast with Glucophage © or Glucovance © (metformin HCl)

If you are on either of the above medications, please discontinue the drug on the morning of the exam. Instructions and a lab slip for Bun and Creatinine will be given to you. You should refrain from taking the drugs for 48 hours, and only resume taking the drugs after the doctor has checked the lab results for normal renal function. The reason for this directive is:

Pre-medication for IV Contrast
Clinical Indication:

• For patients with known allergy to IV Contrast
• For patients with very high risk of IV Contrast Reaction

• 40 mg Prednesone the night before the exam
• 40 mg Prednesone the morning of the exam
• 50 mg Benedryl the morning of the exam

CT Exams
CT exams can involve two types of contrast agents:

• IV Contrast (X-Ray Dye)
  This makes the blood vessels and organs show up on the images. You should not eat or drink anything for 4 hours prior to the exam. This is to prevent the patient from aspirating vomitus, should the unlikely event occur.
  If you are taking Glucophage © or Glucovance ©, please see the note above.


• Oral Contrast
  This makes the bowels show up on the images.
  You should pick up the contrast at the Ponahawai Office.

Head, IAC, Temporal Bones, Orbits

• Do not eat or drink anything for 4 hours prior to the exam unless the exam is ordered specifically stating "without contrast".
• You may take regular medications.

Sinuses, Facial Bones
No special instructions.

Neck

• Do not eat or drink anything for 4 hours prior to the exam.
• You may take regular medications.

Chest

• Do not eat or drink anything for 4 hours prior to the exam.
• You may take regular medications.

Abdomen, Liver, Pancreas, Spleen

• Do not eat or drink anything for 4 hours prior to the exam.
• You need to pick up oral contrast at the Ponahawai clinic on the day before the exam.
• If the exam is on the same day, you need to arrive 2 hours early to drink the oral preparation.
• You may take regular medications.

Pelvis

• Do not eat or drink anything for 4 hours prior to the exam.
• You need to pick up oral contrast at the Ponahawai clinic on the day before the exam.
• If the exam is on the same day, you need to arrive 2 hours early to drink the oral preparation.
• You may take regular medications.

Abdomen & Pelvis or Chest, Abdomen & Pelvis

• Do not eat or drink anything for 4 hours prior to the exam.
• You need to pick up oral contrast at the Ponahawai clinic on the day before the exam.
• If the exam is on the same day, you need to arrive 2 hours early to drink the oral preparation.
• You may take regular medications.

Spiral KUB
No special instructions.

Extremeties

• For bone detail (fractures) - No special instructions.
• For mass, tumor: Do not eat or drink anything for 4 hours prior to the exam.
• You may take regular medications.

Ultrasound
Some ultrasound exams require the patient to refrain from eating of drinking for at least 6 hours prior to the exam. This is to prevent the gallbladder from contracting.
Diabetic patients on medication will be scheduled appropriately so they will not become hypoglycemic due to fasting.

Carotids, Doppler
No special instructions.

Thyroid
No special instructions.

Abdomen, Gallbladder, Liver, Spleen

• Do not eat or drink after 10pm the night before the exam, or at least for 6 hours prior.
• You may take your regular medications with very little water.

Renal (Kidneys), Aorta
No special instructions.

Pelvis, OB, Amniocentesis

• Finish drinking 32-48 fl. oz. of liquids by 1 hour prior to the appointment. Liquids may be anything except dairy products.
• You must have a very full bladder for the exam. Please try not to urinate until after the exam.
• You may eat normal meals.
• You may take regular medications.

Testicular
No special instructions.

Extremities
No special instructions.

Breast Biopsies

• Either you or a guardian, if needed, must be able to give an informed consent for the procedure.
• You should have a ride available after the procedure
• Please contact the WIC scheduler if any of the following is the case:
• You are taking aspirin or any other blood-thinning medication
• You are allergic to Lidocaine
• You need antibiotic therapy before any dental or surgical procedures.


• For a Stereotactic Biopsy:
• You must be able to lie on your stomach for at least one hour, and weigh less than 250 pounds.

Needle Localization

• No perfumes, powders, or deodorant
• Eat a light meal. Do not intake any caffienated foods (coffee, soda, etc.)
• Do not take aspirin for at least three days prior to your appointment.
• Wear comfortable, 2-piece clothing and a comfortable bra.
• Do not wear earrings or jewelry.
• Arrive at the office at least 10 minutes before your appointment.
• Have a ride available after the procedure.

DEXA (Bone Density Exam)

• The weight limit of the exam table is 240 pounds.
• You should not have any of the following for at least three days prior to the exam: radiopaque contrast (barium) or radioactive injections (nuclear medicine exam).
• Do not take calcium supplements or vitamins on the day of the exam.

Breast Ultrasound
Please provide the location of breast lump, mass, or nodule (Example: left breast, 1 o'clock) when scheduling an appointment.

Mammogram
No perfumes, powders, or deodorant.

Ductogram
Please provide the following information when scheduling an appointment:

• Location and site of nipple discharge.

Treatment of Varicose Veins
No special instructions.

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