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PATIENT
INFORMATION AND PROCEDURES
Pre-Procedure
Instructions / Post Procedure
Instructions / The Basics After
Angioplasty
PRE-PROCEDURE
INSTRUCTIONS
(FOR ALL DIAGNOSTIC & INTERVENTIONAL PROCEDURES)
General
Information: Your procedure will be scheduled
at Washington Adventist Hospital, 7600 Caroll
Avenue, Takoma Park, Maryland. The telephone number
is (301) 891-7600
Arriving to the Hospital: You will need to
arrive at the hospital at least 3-4 hours prior to
your procedure and report to TRANSCARE, Lower Level
1 (enter through the Emergency Room door, next to
the parking deck.) Please be advised that we will
do everything to have your procedure at the scheduled
time. However, emergencies may cause unavoidable delays
and we appreciate your patience.
Lab Work: Your pre-admission testing will
be done at the hospital upon your arrival. Patients
with HMO insurance must go to their corresponding
lab.
Procedure
Instructions & Medications
(IMPORTANT - PLEASE REVIEW ALL INFORMATION)
- Do
not eat or drink anything after midnight the night
before the procedure.
- You
can take all of your medications the morning of
the procedures with a small sip of water.
- If
you are DIABETIC, withhold all of your diabetic
medications in the morning of the procedure. If
you take GLUCOPHAGE, discontinue TWO DAYS PRIOR
to your procedure.
- If
you take COUMADIN, discontinue FOUR DAYS PRIOR to
your procedure.
- Please
inform us of any allergies to drugs. If you have
a dye allergy (or allergy to shellfish or iodine),
you will need to be pre-medicated THREE DAYS PRIOR
to your procedure.
- Bring
all of your nedications in their original containers
with you to the hospital.
FOR
CAROTID STENT PATIENTS: DO NOT TAKE ANY MEDICATIONS
THE MORNING OF YOUR PROCEDURE
If
you need further clarification, or if any of the pre
procedural information above is unclear, contact us
before the scheduled procedure is to take place.
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POST-ANGIOPLASTY
PATIENT INSTRUCTION SHEET
(IMPORTANT - PLEASE REVIEW ALL INFORMATION)
Now
that you have had a successful angioplasty, you and
your physicians need to monitor your heart to make
certain that the results continue. Listed below are
some instructions and general information.
ACTIVITY:
- Light
activity for the first 3-5 days after the angioplasty.
No heavy lifting. Do not push yourself to the point
of fatigue, shortness of breath, or chest pain.
Leisure walking is a good activity.
- Moderate
activity after 5 days up to 4 weeks after the angioplasty.
- Full
activity level after 4 weeks. You should not engage
in strenuous activity or manual labor until a stress
test has been performed and you have then been given
clearance.
- You
may shower after an angioplasty when you go home.
You can easily remove any bandage/Band-Aid at the
groin puncture site in the shower. Do not soak in
the bathtub until 5 days after the procedure.
TESTING:
- A
nuclear stress test may be performed 6 to 12 weeks
after the angioplasty. The results of this test
are generally favorable and help to guide your physician
in prescribing an activity level for you.
- Another
follow-up stress test may be performed in 4 to 6
months to assess any restenosis (re-blockage) which
can occur up to 2-50% of cases [even with drug eluting
stents].
MEDICINES:
- Aspirin.
You should take one tablet (325 mg) daily. If you
have problems with upset stomach or bleeding, a
coated aspirin such as Ecotrin should be used. A
children's/baby aspirin is sometimes recommended.
Aspirin mildly anticoagulants ("thins") the blood
and prevents clotting at the site of the angioplasty.
Aspirin should be continued indefinitely. Stent
patients should take adult strength (325 mg) aspirin
unless advised by your doctor.
- Plavix.
This medication prevents blood clotting from
the platelets. Plavix is similar to aspirin, but
is also used with aspirin in patients with stents.
It is very important to take this medication EVERY
DAY for at least one year or longer if recommended
by you doctor.
- Cholesterol/Lipid-lowering
medications. Zocor, Lipitor, Mevacor, Pravachol,
Lescol; Niacin; Cholestyramine/Questran; Colestipol;
Lopid. These medications help lower the blood cholesterol
and triglyceride levels and can slow the progression
of heart disease. They do not prevent recurrence
of blockage after angioplasty or stenting.
- Nitroglycerin
tablets. Put 1 tablet under the tongue for chest
pain if the discomfort persists for at least 5 minutes.
Sit or lie down when you take this medication. You
may take another nitroglycerin in 5-10 minutes up
to a total of 3 tablets. If the discomfort is still
present after 2-3 tablets, call your doctor or go
immediately to the closest emergency room.
- Beta-blocker.
(Atenolol/Tenormin; Corgard/Nadolol; Toprol {Lopressor/Metorolol};
Inderal/Propranolol). These medications slow the
pulse and control the blood pressure. They are used
to prevent angina/chest pains and to treat high
blood pressure.
- Nitrates
(Nitroglycerin patch; Ismo/Imdur/Monoket/Dilatrate/Isordil).
Nitrates prevent spasm of the artery that was treated
with angioplasty. Nitrates also prevent episodes
of angina or chest pain. Nitrates can cause headache
that usually can be relieved with Tylenol.
- Calcium
channel blocker. (Procardia/Adalat/Norvasc/Calan/Isoptin/Verapamil;
Cardizem/Diltiazem; Cardene) may be prescribed for
several months after the angioplasty. This medicine
prevents spasm of the artery that was treated by
angioplasty. It is frequently used for patients
who have undergone the Rotoblator procedure.
- Acid
blocking medications. (ulcer-type medications
- Prilosec, Axid, Zantac, Tagamet/ Cimetidine, Pepcid).
These medications prevent stomach bleeding in patients
on powerful anticoagulants like the combination
of aspirin and Coumadin.
- Coumadin.
Some patients are placed on this medicine, which
is a strong "blood thinner". Your blood will need
to be tested every 1 to 2 weeks in the beginning
to regulate the medicine. Call your physician immediately
if you notice excess bruising or bleeding, black
tarry stool, blood in the urine, or vomiting of
bloody or coffee-ground appearing material.
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THE
BASICS AFTER ANGIOPLASTY
WHAT
IS NORMAL AFTER AN ANGIOPLASTY:
- Bruising
or discoloration in the groin area where the catheter
was inserted. This may extend along the inner thigh
and up towards the abdomen. It may take 3 to 4 weeks
to disappear.
- A
small lump where the catheter was inserted. The
lump should not increase in size.
- Soreness
over catheter insertion site when pressed upon.
- Slight
oozing of clear or pink-tinged liquid from the catheter
hole for the first few days after the angioplasty.
- Tiredness
and fatigue in the first few days after the procedure.
- Fleeting
chest discomfort that lasts a few seconds is probably
not important.
WHAT
IS ABNORMAL AND SHOULD BE REPORTED TO YOUR DOCTOR:
- Chest
pain or discomfort similar to what you felt before
the angioplasty or similar to the discomfort you
may have felt when the balloon was inflated in your
artery during the procedure.
- A
lump in the groin that increases in size and/or
is painful without touching the area.
WHAT
YOU CAN DO TO HELP:
- If
you smoke, stop immediately. Smoking causes cholesterol
deposits to build in the blood vessels.
- Eat
a low-cholesterol, low-fat diet. A dietician or
your physician can instruct you further on this.
- If
you are diabetic, stick to your diet and keep your
blood sugar well controlled. If you have high blood
pressure, keep your blood pressure controlled with
prescribed medicines. Low salt diet is recommended
for patients with high blood pressure or heart failure.
- If
you are overweight, lose weight.
- Exercise
ONLY as prescribed by your doctor. Aerobic exercises
(walking, swimming, running, bicycling, etc) help
condition the heart and blood vessels.
- Alcohol
may be consumed in moderation only.
If
you need further clarification, or if any of the post
procedural information above is unclear, contact us
with any questions.
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