LUNG CANCER EVALUATION CENTER - PATIENT INFORMATION

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Patient Information

	Preparing for Bronchoscopy
	Preparing for CT Needle-Guided Biopsy
	Preparing for Cardiac Stress Test
	Preparing for Cardio-Pulmonary Stress Test
	Preparing for Heimlich Valve Homecare
	Preparing for PET Scan
	Preparing for PET Scan for Diabetic Patients

Preparing for Bronchoscopy

You have been scheduled to have a bronchoscopy on _______________ at ________ AM/PM. Please check with your insurance company to see if prior authorization is needed and notify us if it is required.

1. You MUST arrange to have someone (not a taxi) drive you home after the bronchoscopy. This requirement is for your safety. Although you will be observed for several hours after the procedure, you will still be affected by medications you will receive. If you do not have a responsible driver, the procedure will be cancelled.
2. DO NOT EAT OR DRINK ANYTHING AFTER MIDNIGHT the night before the bronchoscopy. If you take over-the-counter medication or any blood thinners including aspirin, please alert the physician. You may be asked to refrain from taking these medications before the procedure.
3. You should plan to arrive at University Medical Center 1 hour before the time of your procedure. Stop at Central Registration in the main lobby. Then report to the Endoscopy Suite on the 14th floor, north tower, of the hospital.
4. The nurse in the holding area will start an IV line (intra-venous; into a vein), give you the necessary medication, and perform a brief medical evaluation.
5. You should plan to be in the recovery area for about 2 hours after the procedure is over.

If you have any questions before the bronchoscopy, do not hesitate to call us at 444-2981 during the day, or speak with the pulmonary physician on call at night or during the weekend at 631-689-8333 (operator).

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Preparing for CT Needle-Guided Biopsy

1. You MUST have a driver with you on the day of your biopsy or THE BIOPSY WILL NOT BE DONE. You cannot take a taxi or bus.
2. Do not eat or drink anything after midnight the night before the biopsy.
3. Do not take aspirin, ibuprofen (Advil, Genpril, Haltran, IBU, Menadol, Midol, Motrin), or vitamin E for 3-7 days prior to the biopsy. If you are taking any anti-coagulant (anti-clotting medication, also called blood thinner)-clopidogrel (Plavix), warfarin (Coumadin), enoxaparin (Lovenox-heparin)-PLEASE bring this to our attention IMMEDIATELY as it may require being stopped for a longer period of time and approval from a physician.
4. If you see a hematologist for any blood-related medical condition, please let us know.
5. If you are diabetic, please let us know so we can instruct you on when to stop (temporarily) taking your diabetic medication.
6. Take the main elevator down to 4th floor. Report to CT SCAN-Special Procedures to check in. Expect to be there for a total of about 3-4 hours.
7. If your CT scan was done at another facility other than here at Stony Brook University Medical Center, we will have to scan your films onto our system.

Biopsy date: ________________________________________________________
Medication to stop taking: _____________________________________________
Special instructions: __________________________________________________

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Preparing for Cardiac Stress Test

Your doctor needs you to have a stress test to evaluate the condition of your heart. You may be asked to run on a treadmill (exercise stress test), or have medication given to you by means of an IV line (intra-venous; into a vein) (chemical stress test). Often special x-rays are then taken of your heart (nuclear imaging).

1. Do not eat or drink anything 6 hours before the test.
2. Do not have any caffeine or decaffeinated products 24 hours before the test.
3. Do not take the following medications: _____________________________________________
4. Wear comfortable clothing and sneakers or rubber-soled shoes.

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Preparing for Cardio-Pulmonary Stress Test

A cardio-pulmonary stress test, also called a pulmonary exercise stress test, tells how much air moves in and out of your lungs when you exercise.

1. Small pads (electrodes) will be placed on your upper body to monitor your heart. You will also wear nose clips and breathe through a mouthpiece. Before you start to exercise, your heart rate, breathing, and blood pressure will be monitored. You will exercise as long as you can. Before the test and at the end of the test, a blood sample may be taken. Plan to spend 1-2 hours from the time of arrival until the time you can go home.
2. Any inhaled medications that you take for breathing problems should be stopped 4 hours before the test. Unless instructed by your doctor, continue to take any other prescription medications that you normally take.
3. Bring a list with you of any medications that you are currently taking.
4. Wear walking shoes, such as sneakers, and wear comfortable clothing that does not restrict your breathing.
5. Report any recent upper respiratory infection, cold, sinusitis, bronchitis, or pneumonia.
6. Please arrive 15 minutes before your scheduled procedure time. You must register prior to the test.
7. Have a light breakfast/lunch 2 hours prior to the test.
8. Do not smoke 12 hours prior to the test.
9. The Pulmonary Function Lab is located in Suite 2 on Level 5 (main lobby level) in the hospital.

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Preparing for Heimlich Valve Homecare

A Heimlich valve is a one-way valve that allows air to flow out of your chest through a chest tube when you breathe out (exhale), but prevents air from entering your chest when you breathe in. You and your family must follow these instructions for the proper care of the chest tube and the Heimlich valve:

1. Never clamp the chest tube unless told to do so by your doctor.
2. Never obstruct the end of the valve; air needs to flow out. If there is drainage, a gauze pad can be placed at the end to catch the drainage but allow air to escape.
3. Keep the connection between the chest tube and Heimlich valve securely taped.
4. If the valve becomes detached from the chest tube, reattach it and call us at 631-444-2981 immediately
5. If the chest tube accidentally falls out, cover the drain site in your chest with a sterile gauze pad and call us at 631-444-2981 immediately, or go to the nearest emergency room.
6. If the suture that holds the chest tube breaks, secure the tube with tape to the skin, and call us.
7. Patients may shower while the chest tube and valve are in place. Coordinate with your visiting nurse. The dressing around the chest tube should be changed daily.
8. Fluttering of the valve leaflet and/or honking like a duck-like noise is normal.
9. If you experience any of the following, call 631-444-2981:
   • Shortness of breath or chest pain
   • Fever over 101 degrees
   • Swelling of the neck or arm
   • Any foul-smelling or cloudy drainage
10. You will be asked to return to clinic weekly to be evaluated by your surgeon or nurse practitionerto see when the chest tube is ready to be removed.

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Preparing for PET Scan

1. You have been scheduled for a PET scan. The weight limit for the machine is 375lbs.
2. If you have problems keeping this appointment, please call 631-638-2121 to cancel or reschedule the appointment.
3. Please have your doctor's office fax your prescription immediately to us at 631-638-2323. If you have a copy of your prescription please bring it with you. Note that your insurance company may require preauthorization for this test. Check with your doctor's office to make sure they have obtained you authorization.
4. You need to fast for 6 hours prior to the study. The test is very sensitive. If you eat candy, gum, nutrasweet, sugar, ice cream or any other food, you may need to repeat the test. You may only drink plain water during the 6 hours of fasting prior to the test.
5. Your last meal should be at least 6 hours prior to the exam. If possible, eat a high protein meal, such as chicken, meat, fish, bacon, eggs, ham. You should avoid carbohydrates, such as bread, rice, pasta, potatoes, chips or any sweet foods. If you are a vegetarian you may eat vegetables up to 6 hours before your exam
6. It is recommended that you drink at least ½ quart of plain water prior to the study. You should begin drinking water at least an hour before your exam. You may drink water at any time prior to this (please do not drink flavored water). If you have kidney or heart problems, do not drink water if your doctor has advised you not to drink additional fluids.
7. Please take all regularly prescribed medications. There are no restrictions on medications, as they will not interfere with the test. There is a special preparation for diabetic patients. If you aretaking insulin or oral diabetic medication, please consult the information sheet for Diabetic Patients (see below).
8. We start the test by placing an IV in your arm. The medication is injected through the IV. After the injection, you must wait 60 minutes to allow the medicine to circulate prior to the imaging. You may be asked to drink oral contrast. The total procedure time is approximately 3 hours.
9. If you are anxious, tense, or claustrophobic, please ask your doctor to prescribe a sedative for you to take prior to coming for you PET scan. Only your regular physician is allowed to give you this type of medication. If you will take a sedative, you must arrange to have a responsible adult drive you home form the exam.
10. Please bring copies of your latest CT and MRI films, as well as the reports.
11. Exam location: Cancer Center, Ambulatory Care Pavilion.
12. After the procedure, please stay away (at least 3 feet) from any children or pregnant women for 6 hours.

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Preparing for PET Scan for Diabetic Patients

For the purpose of this exam, you are considered diabetic ONLY if you are currently taking insulin or oral medication for your diabetes.

1. See above (PET Scan)
2. See above (PET Scan)
3. See above (PET Scan)
4. Diabetic patients will be scheduled for a PET scan after 11am. Please follow your normal morning routine of taking your diabetes medication with food 6 hours prior to the exam. Prescription medications do not interfere with the exam, so please take all regularly scheduled medications prescribed by your doctor.
5. If possible, your morning meal should consist of protein, such as bacon, eggs, ham, fish, chicken or meat. Please avoid carbohydrates, such as bread, rice, pasta, potatoes and sugars. The test is very sensitive. Even gum, candy, ice cream, nutrasweet or flavored water may affect the test and cause a repeat exam.
6. See above (PET Scan)
7. Please make sure that your blood sugar is less than 160 on the day of the PET scan. Please make sure to inform us when you schedule the exam, and again when you arrive, that you are diabetic.
8. See above (PET Scan)
9. See above (PET Scan)
10. See above (PET Scan)
11. See above (PET Scan)
12. See above (PET Scan)

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