Fellow of the American College of Gastroenterology Faculty Lecturer, Mount Sinai School of Medicine You are scheduled to have an endoscopy on ___________________ at ___________ AM/PM PLEASE MAKE SURE TO REVIEW THESE INSTRUCTIONS A WEEK BEFORE YOUR PROCEDURE! THE WEEK BEFORE YOUR ENDOSCOPY • Make sure to arrange for an escort for the day of the procedure. Discuss with Dr Gutman a
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Preparations before Hyperbaric Oxygen Therapy
Smoking, alcohol and chronic caffeine consumption decrease the amount of oxygen that can be transported by the circulatory system. It is strongly recommended that clients refrain from smoking during the course of treatments. If termination of smoking is not possible, a period of two hours prior and two hours after treatment must be tobacco free. Please eat at least a light meal 2 hours prior to treatment. Please discuss your medications with your family physician and/or our staff. Some medications are contra-indicated for HBOT, including, but not limited to: There is no need to interrupt your medication routine due to HBOT. It is helpful to bring a list of medications. If you have flu, cold, sinus or ear problems, the ability to clear ears and sinuses may be a chal enge. Please inform us if you do.
Risk and side effects of HBOT
Most common problem is trauma to the ears and sinuses due to pressure If you have difficulty with clearing of ears, please notify the chamber operator. The treatment will be stopped until the pressure is equalized in the ears. The temperature will increase slightly during the pressurization. Temperature will normalize during treatment and fall at a return to atmospheric pressure. It is important to breathe normally, without holding your breath. A few clients may notice improvement in vision; others may have worsening of their vision over the course of treatments. Save your glasses, because vision changes are temporary and vision will usually return to pre-treatment condition within 3-4 months. Confinement anxiety (claustrophobia) is managed by maintaining communication Clients with cataracts may experience accelerated maturation of the cataract, but HBOT does not cause cataract formation. Oxygen toxicity can affect the brain. Seizures occur rarely during HBOT and are self-limiting. Seizures due to oxygen toxicity will cease when the client is removed from breathing pure oxygen. If you notice any unusual behavior during treatment, notify the staff. Pulmonary toxicity may occur in patients who receive excess oxygen. This is very rarely seen with the protocols currently used. If you have any of the following conditions, you may not be eligible for HBOT. Asthma (Small airway hyperactivity may result in air trapping and damage to the
Congenital spherocytosis (this is a condition in which the person has fragile
blood cel s. HBOT may result in massive cell destruction.) Emphysema with CO2 retention (Caution must be exercised in giving high
pressures and high concentrations of oxygen to clients who may be existing on the hypoxic drive in order to continue breathing. Clients with emphysema may develop difficulty breathing in the chamber and require emergency care. In addition, gas trapping and subsequent lung rupture can occur. This is also true for any condition that is associated with bul ous formation in the lungs.) High fever (High fevers tend to lower the seizure threshold due to oxygen
toxicity and may result in the delay of relative routine therapy.) History of middle ear surgery or disorders (Please notify us of any current or
past ear problems. There is a risk of further injury with inability to clear ears.) History of seizures (HBOT may lower the seizure threshold. Initially, seizure
activity will usually increase, but after about 20 treatments, the seizures will start to decrease. Typically, they stop completely or decrease significantly.) Optic neuritis (There have been reports in patients with a history of optic
neuritis of failing sight and even blindness following HBOT. This complaint would seem to be extremely rare but of tragic consequence.) Pneumothorax (A pocket of trapped gas in the lungs will decrease in volume on
compression and re-expand on surfacing during a cycle of HBOT. These changes may result in further lung damage and or arterial gas embolization. If there is a communication between the lung and pneumothorax with a tension component, then a potentially dangerous situation exists as the pressure is lowered. For this reason, it is mandatory to have a chest tube in place to relieve a pneumothorax before contemplating HBOT. Please let us know if you have a history of chest trauma or surgery.) Pregnancy (The fears that either retrolental fibroplasias or closure of the ductus
arteriosus may result in fetus whose mother undergoes HBOT appear to be groundless from considerable Russian experience. However, we continue to exercise caution in treatment of pregnant women. HBOT will not be considered if you are pregnant.) Upper respiratory tract infection (These are relative contra-indications due to
the difficulty such clients may have in clearing ears and sinuses. Treatment may best be postponed until condition is resolved.) Please let us know if any of the following occur during the course of treatment: diarrhea, cold, flu, nausea, vomiting, ear or sinus infection, a change in medications, not eating prior to HBOT and/or diabetic who has not taken prescribed insulin.
Only 100% cotton clothing are allowed in the chamber. We will provide cotton scrubs for
you to change into. No shoes are allowed in the chamber.
Please do not wear / remove the following item before treatment:
Lipstick/make-up/Vaseline/oil based products Hair spray/oil/gel/topical hair products Skin oil/ointment/lotions/sprays/topical products Nail polish (24 hrs before treatment) Synthetic clothing/silk clothing/wool clothing Hearing aids/battery operated items/ electronic devices Cigarettes/lighters/warming objects/matches Patient will be consulted by the hyperbaric physician.
Allard, R., Marshall, M., Plante, M-C. (1992). Intensive follow-up does not decrease the risk of repeat suicide attempts. Suicide and Life threatening behaviour, 22(3), 303-314. Andersen, U.A, Andersen, M., Rosholm, J.U., & Gram, L.F. (2001). Psychopharmacological treatment and psychiatric morbidity in 390 cases of suicide with special focus on affective disorders. Acta Psychiatrica Scand