X-rays and Pregnancy
For women of child bearing age(12-50), all x-ray and CT exams of the abdomen, pelvis and proximal femurs, and all Nuclear Medicine exams are to be scheduled between day one and day fourteen following the start of the menstrual cycle, unless the chance of pregnancy can be excluded, i.e., hysterectomy, tubal ligation, use of birthcontrol pills, or other birth control devices.

Comparison Studies
Please make arrangements to bring all related imaging studies, i.e., prior x-rays, CT�s, MRI�s, Sonograms, Mammograms, etc., so that our radiologist can make comparisons and provide the best interpretation of your new studies.

Insurance Billing
Please bring your insurance information: We will be happy to assist you with the details of insurance filing or designing a payment plan if necessary.

Film Sign-Out Policy
To prevent delays and inconvenience, please notify us 24 hours in advance if you need to sign-out your films. We need this time to retrieve your films from our storage facility.

Referral Order for Exam
Written referral order and co-payment are needed and due at time of service. The written referral is similar to a prescription for medication, we must have it to perform your imaging exam.

An Upper G.I. Series is a fluoroscopic examination that uses a special substance, barium sulfate contrast media, to highlight the esophagus, stomach and duodenum. This exam lasts approximately 45 minutes.

On the day before the examination:

• Do not eat anything after 10:00 p.m. You may have liquids until midnight and then nothing until after the examination.

On the day of the examination:

• Do not eat or drink anything, chew gum or smoke until your examination has been completed.
• However, if your appointment is scheduled after 12:00 noon, you may drink up to one cup of clear liquid, coffee, or tea in the morning, but not later than 8:00 a.m.
• Generally you are not allowed anything by mouth until your exam is completed. Consult your physician or our office before taking any medication. Feel free to bring any medication with you to take immediately after the exam.
• After the exam, to prevent constipation, we recommend that you drink large quantities of fluids and take a mild laxative (Milk of Magnesia, castor oil, or Dulcolax), unless contraindicated by your doctor.

The Small Bowel Series is an x-ray examination that uses a barium sulfate contrast media to visualize the small intestines. This exam can follow an Upper G.I. Series and usually lasts 1 �-3 hours. This exam can last longer depending on how quickly the contrast moves through the intestine.

On the day before the examination:

• At 8:00 p.m. take three Dulcolax tablets or 2 tablespoons of Milk of Magnesia.
• Do not eat anything after 8:00 p.m. You may have liquids until midnight and then nothing until after the examination.

On the day of the examination:

• Do not eat or drink anything, chew gum or smoke until your examination has been completed. However, if your appointment is scheduled after 12:00 noon, you may drink up to one cup of clear liquid, coffee, or tea in the morning, but not later than 8:00 a.m.
• After the exam, to prevent constipation, we recommend that you drink large quantities of fluids and take a mild laxative (Milk of Magnesia, castor oil or Dulcolax) unless contraindicated by your doctor.

The Barium Enema is an x-ray examination using a barium contrast enema to visualize the large intestine. The exam lasts approximately 1 hour.

As preparation for this examination you will need to obtain a Fleet Prep Kit No. 2  from your local pharmacist. Because you will need to begin a special bowel cleansing preparation and follow a specific diet which is tailored to your age prior to the barium enema, the Fleet Kit must be obtained 3 days before your scheduled appointment if you are 65 years of age or older (2 days before your appointment if younger than 65).

Specific instructions are enclosed with the kit.

• If 65 or older, follow the 48-hour prep instructions.
• If younger than 65, follow the 24-hour prep instructions.
• Regardless of age, if you have a history of constipation follow the 48-hour prep instructions.

Most local pharmacies stock this kit or the pharmacist can order the kit, usually overnight, if not stocked.

I.V.P. examines the urinary system (kidneys, ureters and bladder) following the intravenous injection of a liquid iodine based contrast media. The exam takes approximately 1 hour.

On the day before the examination:

• Drink plenty of fluids, at least six glasses.
• Eat a light evening meal. Light meal includes clear soups (fat-free), small portions of fowl or fish, plain gelatin, white bread (no butter), plus any non-carbonated liquids.
• After dinner, take a mild laxative. Options include any of the following:
• 4 TBSP. Milk of Magnesia, or
• 4 Tablets Dulcolax, or
• 4 TBSP. castor oil.

On the day of the examination:

• Do not eat solid foods until after the exam.
• Non-carbonated liquids are allowed up to three hours before the exam.
• After the test is completed, drink several glasses of liquid throughout the day.

For patients using Glucophage or Glucovance:
You must contact the Center for special instructions before you begin this preparation.

Myelography is the x-ray of the spinal cord after the injection of a contrast media into the subarachnoid space of the cord. It is principally used to evaluate the condition of nerve roots and the effect of adjacent structures on the nerves.

On the day before the examination:

• Drink plenty of fluids.
• Eat regular meals.

On the day of the examination:

• Have only liquids for breakfast.
• Please try to arrive on time and bring all related films, such as spine x-rays, M.R.I.�S, CT Scans, for our Radiologist to review.
• The exam is usually completed quickly, but you are required to be at the Center for up to 4 hours. It is recommended, but not required that someone stay with you.
• You may choose to bring something to read and something to eat after the exam. We will provide spring water since you will need to drink plenty of fluids after the exam. If you prefer other drinks you may bring them.
• Someone must drive you home! We cannot release patients who are driving themselves.
• You will receive prescriptions to be filled following the myelogram.

• Abdomen / Pelvis

Do not eat solid foods 4 hours prior to exam. Clear liquids and medications are allowed up to 2 hours before exam. Patients need to drink a barium contrast (a liquid that shows the intestines) at least one hour prior to the appointment. We prefer that you obtain the contrast from the Center one day in advance so that you may begin to drink it at home prior to the appointment. Patients must arrive two hours prior to the appointment if they cannot obtain the contrast in advance.

Please bring all related films for our radiologist to review.

For Diabetic Patients using Glucophage or Glucovance:
You must contact the Center for special instructions before you begin this preparation.

• Sinus
• Spine
• Extremeties
• Chest, Brain, Neck, etc.

Do not eat solid foods 4 hours prior to exam. Clear liquids and medications are allowed up to 2 hours before exam. Arrive at scheduled time.

Please bring all related films for our radiologist to review.

For Diabetic Patients Using Glucophage or Glucovance:
You must contact the Center for special instructions before you begin this preparation.

To image the prostate gland, a small ultrasound probe is placed in the rectum. The exam lasts approximately � hour. Tissue samples can also be obtained through this probe if a biopsy is needed. Unless otherwise indicated, please follow the instructions below. This will prepare you for both the prostate ultrasound and also the biopsy in the event that the radiologist performing the study determines that biopsy is necessary.

In advance of the procedure you will need to purchase a Fleet enema and you will need a prescription from your physician for an antibiotic (6 Cipro tablets, 500 mg.). This is to prevent infection in the event that a biopsy is performed.

On the day before the examination:

• Take one Cipro tablet at 8:00 a.m. and one at 8:00 p.m.

On the day of the examination:

• Take one Cipro tablet at 8:00 a.m. and if biopsy was performed, also at 8:00 p.m. Administer Fleet enema according to the instructions, two hours before the exam.
• Since a biopsy may be performed and is considered to be a minor surgical procedure, you will need to bring someone with you to drive you home. We cannot release patients who are driving themselves.

If biopsy was performed:

• Follow all other instructions given to you after the biopsy.
• Take one Cipro tablet at 8:00 p.m. the evening of the biopsy. Take another Cipro tablet at 8:00 a.m. and one at 8:00 p.m. on the day following the biopsy.

IMPORTANT NOTE: If you are on blood thinning medications, aspirin therapy, or have any bleeding disorders, please notify us at the time of scheduling. Special arrangements will need to be made.

Sonography is the use of �sound waves� to record images to the abdomen. This examination lasts approximately 30 minutes.

On the day before the examination:

• Maintain a fat free and non-dairy products diet.
• Take only clear liquids after dinner. (The liquids you drink may be plain water, clear citrus fruit juices, and other juices such as apple, cranberry or grape, tea or coffee without milk or cream.)
• Do not eat or drink anything, chew gum or smoke after midnight.

On the day of the examination:

• Generally you are not allowed anything by mouth until your exam is completed.  Consult your physician or our office before taking any medication.  Feel free to bring any medication with you to take immediately after the exam.
• Do not eat or drink anything, chew gum or smoke until after your examination is completed.

Sonography is the use of �sound waves� to record images of the kidneys and the urinary bladder.

On the day of the examination:

• No solid foods four hours before your examination.
• Drink two 8 ounce glasses of water one hour before your appointment time.
• Do not empty your bladder after drinking the water until the examination is completed.

Sonography is the use of �sound waves� to record images of the bladder, uterus, and ovaries. This examination of the pelvic anatomy lasts approximately 30 minutes.

On the day of the examination:

• Start drinking four 8 ounce glasses of water 1 �-2 hours before your appointment time. Finish drinking the 4 glasses one hour before your appointment to allow your bladder time to fill.
• Do not empty your bladder after drinking the water until the examination is completed, or you may need to reschedule.
• Your bladder must be full in order to do the examination. You will be able to empty your bladder when the examination is completed.

Sonography is the use of �sound waves� to record images of the bladder, uterus, and ovaries. This examination of the pelvic and fetal anatomy lasts approximately 30-60 minutes.

On the day of the examination for patients up to 21 weeks pregnant:

• For patients less than 12 weeks pregnant, start drinking 32 ounce glasses of water 1 �-2 hours before your appointment time. Finish drinking the 32 ounces of water one hour before your appointment to allow your bladder time to fill.
• Patients 12 - 21 weeks pregnant should finish drinking only 16 ounces of water one hour before your appointment.
• Do not empty your bladder after drinking the water until the examination is completed, or you may need to reschedule.
• Your bladder must be full in order to do the examination. You will be able to empty your bladder when the examination is completed.

On the day of the examination for patients 22 or more weeks pregnant:

• No preparation is required for patients 22 or more weeks pregnant.
• You do not need to have a full bladder at this stage of pregnancy.

The Biophysical Profile uses Sonography to evaluate fetal status and activity. A large meal before the test is necessary to enhance fetal activity. The exam may require 30-45 minutes.

On the day of the examination:

• Finish eating a large, high carbohydrate meal with dessert 30 minutes before the exam time.
  Example: Baked potato, french fries, soda, pie, cake, ice cream, hamburger, etc.
• Please bring comparison films if baby was scanned elsewhere previously.

If diabetic, please contact our office for instructions.

Radioisotope tracers injected into veins can be used to visualize various organ systems and pathologic processes in the body. The tracers travel through the body and a special �gamma camera� is used to detect the tracer and produce medical images. Nuclear medicine is an extraordinary medical tool. It�s reliable, painless, and low-risk.

Hepatobiliary Scan instructions:

• Do not eat or drink for 5 hours prior to the exam except for water.

Thyroid Uptake instructions:

• Do not eat seafood for 72 hours prior to the exam.
• Do not eat or drink anything 4 hours prior to the exam except for water.

For other Nuclear Radiology Exams:

• No preparation is required.

Important Note:

• A written referral order is absolutely required at the time of service. Please obtain this from your doctor and bring it with you.

• On the day of your exam do not apply underarm deodorant or powder from the waist to the neck. If you must use powder or deodorant, please let us know before the exam so that we may provide you with wipes to remove it.
• Please try to wear a two-piece outfit for your ease of changing and comfort.
• If you have had prior mammograms at another institution, you must bring them with you or have them mailed to us one week prior to your appointment. These will be utilized for comparison to your new exam.

Special mammography imaging and localization equipment allows needle biopsy of the breast as an outpatient.

• No preparation is required.
• If you take aspirin or blood thinners, please discontinue using these 3 days in advance of the procedure. Check with your physician. Regular medications should be taken as prescribed.
• A comfortable, two piece garment should be worn.
• Your most recent mammogram must be provided to us at least 24 hours in advance of the procedure.

Quick and comfortable test to detect fracture risk due to osteoporosis. Also used to monitor treatment.

• Do not take calcium supplements for 24 hours prior to the exam.
• You should not have certain radiologic studies within the 7 days before the exam, i.e., barium studies, studies involving IV or oral contrast, or Nuclear Medicine studies.
• Try to wear an outfit without buttons, snaps, zippers, or anything metal.
• Bring all of your medications and vitamins in their original bottles.
• Bring any recent x-rays of hips, pelvis, or lower back.
• You may want to check with your insurance company about coverage for this test.