Major Operations/Changes in your Health
If you had any major operations or changes in your health such as uncontrolled blood pressure or blood sugar, heart attack, stroke, chest pain, trouble breathing, surgery, or hospital admission in the last 30 days, please inform us immediately. Our clinical team will need to evaluate your unique circumstances and decide how to proceed.
Food & Liquids
Food: Begin fasting 8 hours before your arrival time. This means no food, gum, candy, or mints during this time.
Liquids: You may have only water or apple juice up until 3 hours before your arrival time. After that, do not consume any liquids.
Medications: You may take blood pressure or heart medications with a small sip of water.
For Diabetics: Follow the separate diabetic instructions provided.
Pre-Fasting Meal: Before starting your fast, eat a high-protein meal.
Diabetic Instructions
If you are diabetic, the following instructions apply to you.
| Procedure Arrival Time | Instructions |
|---|---|
| Before Noon | If you use injectable medication, use half of the scheduled dose the night before. If you use an oral medication, take a full dose of your medication the night before. Do not take any diabetic medication on the day of the surgery. Please bring your diabetic medication with you. |
| After Noon | If you use injectable medication, use half of the scheduled dose the night before, and half of the scheduled dose with your breakfast. If you use an oral medication, take a full dose of your medication the night before (if you take it at night). Do not take any oral diabetic medication on the day of the surgery. Do not use the sliding scale on this day. Please bring your diabetic medication with you. |
Medication Instructions
GLP-1s
GLP-1s apply to ALL sedation procedures.
| Medication | Stop (before) | Restart (after) |
|---|---|---|
| Semaglutide Injection (Ozempic) Dulaglutide (Trulicity) Exenatide (Byetta) Exenatide extended release (Bydureon) Tirzepatide (Mounjaro/Zepbound) | Stop 7 Days before your procedure | Start again after procedure |
| Liraglutide (Victoza) Lixisenatide (Adlyxin) Semaglutide Tablets (Rybelsus) | Stop 24 hours before your procedure | Start again after procedure |
Anticoagulants / Blood Thinners
ATTENTION: The following medication instructions only apply to the following procedures! If your procedure is NOT listed here, then you DO NOT need to alter your medications.
Stimulator Trial / Implant / Revision, Vertebral Augmentation, Vertebroplasty, Kyphoplasty, Epidural Steroid Injection, Selective Nerve Block, Discogram, Sympathetic Nerve Block, Stellate Ganglion Block, Celiac Plexus Block, Trigeminal Block, Sphenopalatine Block
| Medication | Stop (before) | Restart (after) |
|---|---|---|
| Full Strength Aspirin Ticlopidine Clopidogrel Prasugrel Ticagrelor Cangrelor Ticlopid Plavix Effient Brillinta Kengreal | Stop 7 Days before your procedure | Start again, 24 hours after your procedure |
| Coumadin Warfarin | Stop 5 days before your procedure | Start again 24 hours after your procedure |
| Low Dose sq Heparin 5000 units BID | Stop 24 hours before your procedure | Start again 8 hours after your procedure |
| Enoxaparin Lovenox Delteparin Fragmin | Stop 24 hours before your procedure | Start again 12 hours after your procedure |
| Diabigatran Rivaroxanban Apixaban Edoxaban Pradaxa Xarelto Eliquis Savayasa | Stop 4 days before your procedure | Start again 24 hours after your procedure |
| Garlic Dong Quai Danshen Ginko Biloba Panax Ginsent Vitamin E | Stop 7 days before your procedure | Start again 24 hours after your procedure. |