What to Expect

(Printable Instructions)

(Printable Instructions)

(Printable Instructions)

(Printable Instructions) Barium Enema – Colon Exam

Please purchase the following items:

• GATORADE (two 64 oz. bottles, NOT red, pink, or purple)
• LIQUIDS for the day before your Barium Enema (see list below)
• DULCOLAX 5mg tablets (four tablets)
• 2 MIRALAX Bottle 238 grams. You will take one bottle the evening before the procedure and the second bottle the day of the procedure, four hours before your scheduled exam time.
• Medications listed above are laxatives, they are available for purchase over-the-counter.

2 DAYS PRIOR TO THE PROCEDURE

Follow a Low Residue Diet which includes:

• Well-cooked vegetables (potatoes and tomatoes without skins)
• Canned or cooked fruit
• White bread, crackers
• Eggs
• Boiled, baked, or broiled chicken, beef, fish, or pork
• Sherbet, cake, or pie without seeds, nuts, raisins, or coconut

Foods and fluids to avoid:

• Beans, fried foods, any raw vegetables, fresh fruit, seeds, nuts, raisins, coconut, anything labeled “high fiber”
• Wheat or seeded bread, wheat or seeded crackers
• Orange juice
• Tomato juice

1 DAY PRIOR TO THE PROCEDURE

Follow a Clear Liquid Diet which includes:

• Sodas: regular or diet (7-up, Sprite, Orange Soda, Cola)
• GATORADE or POWERADE
• Apple or grape juice
• Iced tea

ALSO 1 DAY PRIOR TO THE PROCEDURE

Follow these instructions:

• 2:00 PM: take 2 DULCOLAX tablets
• 5:00 PM: mix one entire bottle of MIRALAX into 64 ounces of GATORADE
• Shake the solution until fully dissolved: drink an 8 ounce glass every 10-15 minutes until the solution is gone.
• 7:00 PM: take the last 2 DULCOLAX tablets
• Nothing to eat or drink after midnight
• You may take your regular medications with sips of water

DAY OF PROCEDURE

• Clear liquids are allowed only to take essential medications; heart and blood pressure medications must be taken no later than 6:00 am on the day of the procedure
• Start drinking the second mixture of 238 grams MIRALAX + 64 ounces GATORADE; drink 8 ounces every 10-15 minutes until solution is gone
• If you take diabetic medications, you need to take a half dosage the day before your procedure and none the day of your procedure
• Nothing by mouth two hours prior to your procedure
• Your bowel movements must run light yellow with no particles. If it is not, please call us prior to your procedure

TIPS

• If you are having difficulty keeping the solution down, try drinking through a straw
• Even if stool is clear after drinking the first solution the day before, you must still take the second solution the day of the procedure due to stool that forms in the bowel overnight
• Wear loose fitting clothing as you may feel bloated post procedure
• Bowel movements should begin about one hour after drinking the solution. It is not uncommon to feel bloating, abdominal fullness and nausea after the first few glasses of solution; these symptoms are a sign the preparation is working and will subside once the bowel movements begin. If you experience severe discomfort or distention, stop drinking temporarily or separate the portions at longer intervals (from 10-15 minutes apart to 20-30 minutes apart) until these symptoms subside.

(Printable Instructions) CT Scan

CT Scan – Abdomen and/or Pelvis

Obtain 2 bottles of Readi-Cat from either your referring physician (at the time of scheduling) or the closest RMI office. Do not eat or drink anything 2 hours prior to your appointment time (with the exception of water).

If A.M. appointment:

• Drink ½ of the first bottle just before bedtime, finish the rest of the first bottle 2 hours before your arrival time.
• Drink ½ of the second bottle 30 minutes before your arrival time. Finish the second bottle upon arrival.

If P.M. appointment (12 pm or later):

• Drink ½ of the first bottle 6 hours before your arrival time. Finish the rest of the first bottle 2 hours before your arrival time.
• Drink ½ of the second bottle 30 minutes before your scan time. Finish the second bottle upon arrival.

CT Scan – Head or Chest

• Nothing to eat 2 hours prior to exam (Including no gum or hard candies), but you can drink water up to the time of your appointment.
• You may take all current medications.

CT Scan – Cardiac

Printable CT Scan Instructions

CT Scan – Spine or Extremities

• No prep necessary.

(Printable Instructions) IVP – Intravenous Pyelogram

• Eat a light lunch. Only clear liquids for dinner.
• Drink a large glass of water at 2, 4, 8, and 11pm the day prior to the examination.
• Drink one chilled 10 oz. bottle of Magnesium Citrate (found at your local pharmacy) at 7pm.
• Nothing to eat or drink after midnight. Including no water, gum, or hard candies.
• Take all medications except diabetic meds containing metformin or glucophage.

(Printable Instructions) MRI/MRA

All MRI Scans

Metallic surgical implants and accidentally implanted metallic objects can interfere with magnetic resonance
imaging (MRI). Some can actually be hazardous to your safety during the examination. If you have any of the
following items or conditions, please contact RMI before scheduling:

• Defibrillator / Pacemaker
• Dentures (need to remove prior to exam)
• Electrodes
• Hearing Aids (need to remove prior to exam)
• Renal Transplant / Renal Failure
• Carotid Clips
• Brain Aneurysm Clips or Coils
• Artificial heart
• Prosthesis (need to remove prior to exam)
• Insulin Pump (need to remove prior to exam)
• Aortic Clip
• Neurostimulator
• Shunts
• Loop Recorder / Cardiac Monitor
• Cochlear Implant / Stapes ImplantAre or suspect you may be pregnant
• Have any history of metal in your eyes or have had brain, eye, ear, or open-heart surgery.

Dress comfortably. Sweat suits are recommended, as are sports bras for women. You should arrive for your
examination with as little metal on you as possible. Any implants or prostheses should be approved prior to the
exam. Please leave jewelry and other valuables at home. Body piercings should be removed prior to the examination.

MRE (Magnetic Resonance Enterography)

• Nothing to eat or drink 8 hours prior to your exam time.
• If diabetic, please take your diabetic medications in the morning of the exam with a small sip of water. Check your blood
  sugar levels prior to arriving for your exam. If your blood sugar level is above 200, please call our office to reschedule
  the exam to another day due to the use of Glucagon(sugar) during exam. Please bring your diabetic medications with
  you to your appointment.
• Arrive to your appointment 90 minutes prior to table time.

MRI Abdomen

• Nothing to eat or drink 4 hours prior to your exam time.

MRCP

• Nothing to eat or drink 6 hours prior to your exam time.

(Printable Instructions) Nuclear Medicine

Bone Scan

• No special preparation is necessary.
• This exam requires two visits. The first will be approximately 30 minutes for the injection. Then you will return 3-4 hours
  later for delayed images that take about 30 minutes.

Renal Scan

• No special preparation is necessary unless your doctor ordered this exam to exam to evaluate renal artery stenosis as a
  cause for hypertension.
• If your doctor ordered this exam to evaluate renal artery stenosis as a cause for hypertension, you will be required to be
  off any ACE inhibitor medication 48 hours prior to the exam. It may also require an additional day of testing.
• The exam takes 60 minutes to complete.

Gastric Emptying Scan

• Do not eat or drink after midnight, the night before your exam.
• If you have an allergy to eggs, please contact our office.
• The exam takes 4 hours to complete.

Hepatobiliary Scan (HIDA)

• Do not eat or drink for at least 4 hours before the test and do not take any pain medications.
• The exam takes approximately 2 to 4 hours to complete.

Radioiodine Treatment of Thyroid Disease

• No special preparation is necessary.
• This treatment requires a consultation office visit with a radiologist before treatment will be given, which lasts
  approximately 30 minutes.
• You will return on another day for a very short visit for the actual treatment.

Thyroid Uptake and Scan

• This is a two day test. On day one you will come in to take a radioactive pill. You will return the following day (20-26
  hours later) for the scan. Each appointment takes about 30 minutes.
• If you take thyroid medications such as Levothyroxine, Synthroid, Armour, Levothroid or Levoxyl, you must be off them
  for six weeks before your scan.
• If you are taking PTU (propylthiouracil) or methimazole (Tapazol), you must be off these medications for one week
  before the scan.

Parathyroid Scan

• No special preparation is necessary.
• This is a two part test. The first appointment you will receive an injection of a radioactive tracer and then images will be
  taken. You will then return about 2 hours later for another set of images. The first appointment is 30 minutes. The
  second appointment is 60-90 minutes.

Thyroid Scan Only/MUGA Scan

• No special preparation is necessary.

(Printable Instructions) PET/CT Scan

Food and Drink

(Required diet to be followed day prior and day of the exam)

• An all meat, eggs, cheese diet ONLY.
• Only drink water. You must be well hydrated.
• Do not eat carbohydrates. This includes potatoes, pasta, rice, breads, chips and pretzels.
• Do not eat cookies, candy, fruit, drink soda pop, alcoholic beverages, coffee or any other beverages containing caffeine.
• Your blood sugar must be between 50-200 in order for us to complete your scan.
• Do not consume any food or drink 6 hours before your scan this includes candy, gum, mints, cough drops and all
  tobacco products.

Readi-Cat

(Contrast beverage; can be picked up at any of our locations)

• Drink one full bottle of Readi-Cat (barium sulfate) 2 hours prior to your arrival time.
• Absolutely no food or drink after drinking the Readi-Cat.
• We suggest chilling the Readi-Cat.

Medications

• Patients taking steroids (i.e. Prednisone, Dexamethasone, Decadron) must discontinue this medication 24 hours prior to
  your appointment.
• Insulin dependent patients must discontinue Insulin 4 hours prior to your appointment.
• Patients taking Metformin must discontinue this medication 24 hours prior to your appointment. Your blood sugar must
  be between 50-200 in order for us to complete your scan.
• All other medications can be taken as prescribed by your physician.

Restrictions

• Avoid all strenuous activities and exercise 24 hours prior to your exam.
• Patient cannot have chemo treatment 24 hours prior to appointment.

Clothing

• We suggest dressing comfortably and in layers to stay warm as the exam rooms are kept cool.
• Please avoid any clothing with large buttons, zippers or any other metal objects on them.
• Suggestions: sweatpants, sweatshirt, pajama pants.

What to Expect

After checking in, our staff will check your blood sugar level and you will be injected with a small amount of radioactive
sugar. Then, you will be required to sit or lie down for 45-60 minutes. An interview process will take place to obtain your
medical history. The actual scan will take about 30 minutes. Please plan on being at the office for approximately 2 hours.
Failure to follow the instructions listed above will result in cancellation of your appointment. You will be responsible for a
$175.00 cancellation fee. If you need to cancel or reschedule your appointment, please contact us at
810-244-7100 no later than 24 hours in advance.

(Printable Instructions) Ultrasound

MSK (Musculoskeletal) Ultrasound

• Wear comfortable, loose fitting clothes.

Ultrasound Pelvis or Fetal

• You will need to come in with full bladder.
• Please drink 36 oz. of water and have it finished 1 hour prior to exam time.
• Do not urinate once you have started drinking, until after your exam.

Ultrasound Abdomen: Liver, Gallbladder, Pancreas, Aorta

• Nothing to eat or drink after 10 pm the night before your exam (including no gum or hard candies)

Ultrasound Kidney

• Nothing to eat 4 hours prior to exam.
• You will need to come in with full bladder.
• Please drink 36 oz. of water and have it finished 1 hour prior to exam time.
• Do not urinate once you have started drinking, until after your exam.

Child’s Prep For Pelvis And/Or Kidney Ultrasound

• Nothing to eat 4 hours prior to exam.
• Double the age of the patient and have them drink that number of ounces of water 1 hour before their
  appointment and finish the water within 15 minutes.
• Do not urinate once you have started drinking, until after your exam.

Ultrasound Prostate

• Take Fleet Enema (found at your local pharmacy) 1 hour prior to exam.

(Printable Instructions) Upper GI/Small Bowel

• Nothing to eat or drink after 10pm the night before your exam. Including no water, gum, or hard candies.
• No breakfast on the day of the examination.