I will look inside your entire five feet of colon . The procedure takes fifteen to twenty minutes. You will be comfortably sleeping, under the influence of IV Propofol and Versed, administered by a board-certified anesthesiologist.

(Insurance usually covers the anesthesiologist, and he will be very reasonable if for some reason there is a problem. Please call any morning in the office, if questions, ext. 244, and ask for Dr. Graziano Carlon. Dr. Carlon may call the night before the procedure to get additional information.)

You will not feel a thing! It is a very relaxing sleep, from which you will awaken very quickly. (Bush had this anesthesia and Cheney was president for 5 minutes). You will be able to leave within thirty minutes after the procedure, and you will be able to eat, and go to work within an hour! NYS law mandates that you need to be discharged to your mode of transportation accompanied by a responsible adult, and we can provide that person if it is inconvenient for someone to accompany you. You will be allowed to drive four hours after the procedure.

Make a good effort to be well cleaned!! The prep is the hard part. I can't see through a clouded lens! This 'tasty', 'pleasant', nearly enjoyable prep requires you to purchase 3 ingredients:

1. Four DULCOLAX LAXATIVE tablets from the pharmacy-- MUST BE THE LAXATIVE PILLS! (Over-the-counter). 2. MIRALAX POWDER 238gm bottle (over-the-counter). 3. 64 oz. of Gatorade or Powerade. Diabetics may use diet soda, any flavor.

Preparation In detail: Please take all your normal medication. Do not take aspirin for three days before the procedure, as it might increase the risk of bleeding if a polyp is removed. If you take an anticoagulant, or if you have inadvertently taken a few aspirin, call. In most cases, an aspirin will not make a difference unless a large polyp is removed. Tylenol, Aleve and Advil are okay. If you have an artificial valve or a very serious significant heart murmur, please call. If you are pregnant or breastfeeding, please call.

You may have a LIGHT LUNCH the day before the procedure. After lunch, drink only fluids - anything you can read through. (Water, seltzer, black coffee, tea, vodka, Gatorade are okay.)

IT SHOULD BE EMPHASIZED THAT ALL FLUID INTAKE, INCLUDING WATER, SHOULD END EIGHT (8!) HOURS BEFORE THE PROCEDURE.

In order to prevent hunger, some patients drink liquid Sustacal or Ensure, nutritional supplements available over-the-counter in pharmacies. You can drink up to 4 cans up until midnight. (Sustacal and Ensure are not clear, but are completely absorbed in the small bowel, and are okay

SPECIFIC DIRECTIONS FOR DULCOLAX/MIRALAX/GATORADE PREP:

Mix the entire 238 gram bottle of Miralax with 2 quarts of Gatorade in a large pitcher. Stir, chill, add ice, and let it breathe for at least a few minutes in order to fully appreciate the flavor.

Depending on your schedule, STARTING BETWEEN 1-7PM the DAY before the procedure, take all four Dulcolax Laxative tablets. It usually takes between 4-7 hours before the action begins. If you are a frequent laxative user, please start with double your USUAL effective Dulcolax dose. If constipated, start with daily Milk of Magnesia for a few days prior to the prep to help 'loosen' things up. Call the office between 8am and noon , 212-879-4700, ext 244, if colonoscopy prep questions.

Two hours after the Dulcolax, start drinking your chilled Miralax cocktail. (We are entertaining creative names for this cocktail, so please feel free to jot down your thoughts during your private moments.) You should pace yourself to drink about eight 8 ounce glasses (64oz.) over a 2-4 hour period, roughly one glass every 15-30 minutes, until finished.

Expect to use the facilities at least 10-15 times, over about 5 hours once activity begins. The stool should be clear, lemonade-like, not sludgy or brown. Expect some cramps. If you have questions about success, call at 8 am, when the phones get turned on. We can improvise in the morning if necessary.

You can expect to leave approximately 45 minutes after we start the procedure. Most patients will want to eat breakfast and are capable of being at work within an hour of leaving the office. No driving a car or operating heavy machinery (airplanes, backhoes, chainsaws, etc.) for 4 hours after anesthesia.

It is a good idea to bring an extra pair of underwear.

Menstrual periods, viral syndromes, or urinary infections do not interfere with the colonoscopy! Call if you have any questions!!! 212-879-4700. Bring any Insurance or Referral Forms.

fyi: There are other prep options which we generally do not use:

• In the past, we used 1.5 ounces of Fleets Phosphosoda in 8oz of water followed by another 1.5 oz in 8 oz of water 2 hours later. This is occasionally associated with kidney damage, so we rarely use it. Visicol is the prescription 28 pill version of Phosphosoda which can also cause occasional kidney damage.
• MoviPrep is a pleasant tasting prescription prep which requires a 24 oz drink at 6PM, then another 24 oz drink at 9pm.
• Half-lytely is another prescription mixture, requiring a 64 oz intake of liquid.