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Procedure Prep Instructions

What is a Colonoscopy?

A colonoscopy is a medical procedure used to examine the inner lining of the large intestine (colon) and rectum. This procedure helps in diagnosing, monitoring, and preventing various conditions, including colorectal cancer, polyps, and inflammatory bowel disease. During a colonoscopy, a flexible tube with a camera, called a colonoscope, is inserted through the rectum to visualize the colon’s interior.

Why is a Colonoscopy Performed?

Colonoscopy procedures are typically performed for the following reasons:

  • Screening for Colorectal Cancer: Recommended for individuals over 45 years of age or those with a family history of colorectal cancer.

  • Investigating Symptoms: To evaluate symptoms such as persistent abdominal pain, bleeding, or changes in bowel habits.

  • Monitoring Inflammatory Bowel Diseases: To assess the condition of patients with Crohn’s disease or ulcerative colitis.

  • Polyp Detection and Removal: To identify and remove precancerous polyps before they can develop into cancer.

After the Colonoscopy

Post-procedure, you might experience mild discomfort, bloating, or cramping, which should resolve within a few hours. Your doctor will discuss the findings with you and provide any necessary follow-up instructions. If any polyps or abnormal tissue were detected, further testing or treatment may be required.

Risks and Considerations

While colonoscopy is generally safe, there are some risks to be aware of:

  • Bleeding: Especially if a biopsy or polyp removal was performed.

  • Perforation: A rare but serious complication where a tear occurs in the colon wall.

  • Infection: Although uncommon, infections can occur.

Follow-Up and Results

Your doctor will provide detailed results and discuss any next steps based on the findings. If a follow-up colonoscopy is needed, your doctor will guide you on the appropriate timing and preparation.

Schedule Your Colonoscopy

Regular colonoscopies are vital for maintaining colon health and preventing serious conditions. If you’re due for a colonoscopy or have concerns about your digestive health, contact us today to schedule an appointment.

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Clenpiq Bowel Prep Instructions

Download Instructions

Medications:

  • Contact your prescribing provider for instructions regarding your blood thinning medications, such as: Aggrenox, Brilinta, Coumadin, Eliquis, Plavix, Pradaxa, and Xarelto, Warfarin etc.

  • Diabetic Patients: Contact your prescribing provider for directions regarding your diabetes medications.
    **DO NOT stop taking these mediations until directed by your prescribing provider**

One Week Prior:

  • Continue taking Aspirin products (including baby aspirin - 81 mg) unless directed otherwise by your provider or nursing staff.

  • Stop taking anti-inflammatory products such as: Aleve, Excedrin, Ibuprofen, Alk-Seltzer, etc. **Tylenol (Acetaminophen) is allowed if needed**

  • Stop taking ALL over the counter supplements and vitamins.

  • Stop taking GLP-1 medications (daily, weekly, oral, injectables) EXCEPT those mixed with insulin a minimum of 7 days prior to procedure (not including date of procedure).

    Phentermine

    Weqovy

    Ozempic

    Trulicity

    Mounjaro

    Saxenda

    Victoza

    Byetta

    Bydureon

    Others as directed by medical staff

  • Avoid eating: seeds, nuts, granola, corn, quinoa, and popcorn.

3-4 Days Prior:

  • Stop taking SLGT2 as listed below:

    • Jardiance

    • lnvokana

    • Farxiga

    • Synjardy

    • Steglatro (hold 4 days prior)

You are responsible for contacting your prescribing provider for holding instructions for all other prescription medications. 

One Day Before Procedure:

  • CLEAR LIQUIDS ONLY - no solid food

    • Allowed

      • Clear fat-free broth (any flavor)

      • Tea or coffee (no creamer or dairy) - sugar/honey are ok

      • Clear juices - apple, white grape

      • Carbonated beverages - Coke, Pepsi, Ginger-Ale, 7up, Sprite, Ice (flavored water)

      • Gatorade or other sports drinks

      • Flavored gelatin (Jello)

      • Popsicles (without milk or fruit pieces)

      • Electrolyte water (Propel, Smartwater, Fuji Water)

      • Clear Ensure - NOT chocolate, strawberry or vanilla

        NOTHING THAT IS RED, BLUE OR PURPLE

    • NOT Allowed

      • No dairy products (including oat and soy milk)

      • No alcohol

      • No juices with pulp (orange, pineapple, grapefruit, including lemonade)

It is important that you drink fluids and stay well hydrated prior to your procedure. 

You MUST remain on a clear liquid diet until after your procedure.

  • Medications

    • You must stop erectile dysfunction medications 24 hours prior - including Viagra and Cialis

Bowel Prep:

  • Follow these instructions - DO NOT FOLLOW INSTRUCTIONS ON THE BOX

CLENPIQ PREP INSTRUCTIONS

For your procedure, you will take one half of the prep the evening before the test, and the other half the day of the test.

ONE DAY BEFORE PROCEDURE

Dose one (Bottle #1): At 5 p.m., drink the entire Clenpiq Bottle #1. Follow by drinking five or more 8 oz. glasses (cup provided) of clear liquids (minimum 40 ounces) within 4-5 hours. Please continue to drink additional clear liquids before bedtime.

DAY OF PROCEDURE

Dose two (Bottle #2): 6 hours before your ARRIVAL TIME, drink the entire Clenpiq Bottle #2. Follow by drinking four 8 oz glasses (cup provided) of clear liquids (minimum 32 ounces). Please drink additional clear liquids (water, black coffee (without milk or cream), apple juice, soda pop or club soda) until 4 hours prior to your ARRIVAL time.

Day of procedure

  • Stop all nicotine products (including ZYN pouches), stop all vaping, do not chew gum, or have hard candies/mints

  • ONLY CLEAR LIQUIDS - no solid food

    • Water

    • Black coffee (no creamer or dairy products) - sugar/honey are ok

    • Apple juice

    • Clear soda (7up, Sprite, club soda)

NOTHING BY MOUTH 4 HOURS PRIOR TO ARRIVAL OR YOUR CASE WILL BE CANCELLED

You should expect to spend up to 2.5-3 hours in our procedures unit, longer if you are scheduled to have an additional test done on the same day.

Transportation:

  • Driving is not allowed after a procedure with sedation/anesthesia.

  • It is required that you identify a driver for transporting you home. If you are unable to identify a driver, please let us know as soon as possible as your procedure may need to be cancelled/rescheduled.

Care at home:

  • For your safety, it is recommended that you have a responsible adult with your for 8-24 hours after a procedure to support you in the case of a complication or medication side effect.

It is the responsibility of the patient to understand if your procedure is covered - including difference between screening and diagnostic. Please contact your insurance carrier for further benefit coverage information.

If you have questions or must reschedule/cancel your procedure, please call GI - 541-706-4220. We request a minimum 72-hour notice for all cancellations and reschedules.

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Community cooking class

Our St. Charles Heart Failure Nurse Navigators had a great time teaching at a community cooking demonstration with High Desert Food & Farm Alliance at the Cascade Culinary Institute.

The class taught individuals how healthy foods and whole ingredients can enhance your heart health, and participants learned simple, delicious recipes using locally sourced ingredients. 

The recipe for the Blueberry Spinach Salad pictured above was created by Aysegul Sanford. You can make it yourself by visiting the Fool Proof Living website.

 

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Vaccinations during pregnancy

More videos about vaccinations during pregnancy can be found on the ACOG website.

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Community members are invited to take part in the 25th annual Heaven Can Wait 5K fundraiser to support breast cancer in Central Oregon. Registration is open now for the event set Sunday, Oct. 6 at 10 a.m. at Redmond High School. Over the years, this family-friendly walk/run has raised hundreds of thousands for Sara’s Project, which helps provide vital support services to people in Central Oregon with breast cancer.

“Heaven Can Wait is a time to show love and support for the breast cancer community in Central Oregon, including patients, survivors, family members and caregivers,” said Jenny O’Bryan, Executive Director for St. Charles Foundation. “This year will be particularly special, as we celebrate the 25th anniversary of Heaven Can Wait.”

O’Bryan says organizers have a lot of fun extras in store and want to raise the bar for support.

“In honor of our 25th year, we hope to raise an additional $25K for patient support programs that help provide free wigs, post-surgical bras, transportation, education of early detection and massage therapies for those in need,” said O’Bryan.  

This year’s event will kick off at Redmond High School’s football stadium and will wind through Dry Canyon. Dogs are not permitted at the event.

Individuals can sign up online at HeavenCanWait.org. Individuals can also sign up to volunteer to support the event.

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For Keith McCray, an attendant with St. Charles Bend’s Environmental Services team, the fulfillment he finds in his job comes not from his day-to-day tasks, but from the people he meets along the way.

“This is the best place I’ve ever worked, because I get to go into patient rooms and clean their rooms and talk with them,” he said.

“And they’re having a bad day, man. They’re in the hospital,” McCray continued. “So to bring them a little joy and a little conversation is fantastic to me. I wish I’d known about this job when I was 21 years old, because I would’ve been doing it all along.”

McCray brings to those patient rooms a sense of perspective and empathy that not everyone can provide. A few years ago, he was working at a national home improvement retailer when he fell off a truck and suffered a traumatic brain injury.

“I was in the hospital for a week and off work for two months, trying to relearn how to talk correctly and walk correctly,” he said. “So for me, especially when I’m working on the third floor (home to Bend’s Ortho/Neuro unit) and I’m meeting patients with head injuries, I feel like I know what they’re going through.”

Among other duties, McCray’s job is to empty the trash cans, change soiled linens and mop floors. But like many of St. Charles' EVS workers, he also gives patients a chance to talk with a non-clinical caregiver – someone who isn’t in the room to discuss test results or deliver potentially worrisome news.

“We were looking for something for Keith that would fit with his personality, and he always wanted to be able to connect with people,” said his wife of 26 years, Kelly. “He’s a chatty, outgoing guy, and he felt like he didn’t matter at his previous job. He feels like he matters here.”

A chance encounter brought McCray to St. Charles. In late 2021, when Kelly’s mother was in the hospital for surgery, she started talking to the guy who cleaned the room. Recognizing that working in the hospital would give her husband the kind of people- and service-driven work he needed, she encouraged him to apply for a job.

He was hired shortly after his interview.

“Moving 425-pound refrigerators starts to wear on your body after seven years,” McCray said. “So I gave my two-week notice and came to the hospital. It’s the best place I’ve ever worked.”

Before he worked at the home improvement retailer, McCray was a mechanic for more than 30 years.

“I was the kind of guy that I could pull your transmission out, take it apart and fix it, put it back together, and you're good for another 200,000 miles, but I couldn’t do that now to save my life,” he said with a laugh.

“But now, I wake up every morning and I’m excited to go to work,” McCray said. “I get to help people when they need it most. I get to work with a wonderful team of nurses and everyone else. I get to work in a positive environment where I have the support I need. And I like being a part of that.”

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As you may have read, St. Charles has entered into a letter of intent with The Center to explore expanding our relationship with the goal of preserving and strengthening access to orthopedic, neurosurgical and physical medicine in the region. I want to review our announcement with you here because this effort is so important to our region and to the health system.

St. Charles has longstanding ties with The Center, which has 27 surgeons and 27 advanced practice providers offering orthopedic, neurosurgery and physical medicine care in Central Oregon. We currently own The Center’s clinic building on our Bend campus and we co-own Cascade SurgiCenter — also located in that building — with The Center physicians. 

Our announcement means we are exploring the possibility of employing a substantial number of The Center physicians, providers and employees. If the transaction ultimately moves forward, The Center’s providers will become part of the St. Charles umbrella of services.   

This is, simply put, the right thing to do. While not without risk, St. Charles is in a position to step in and help support a service line that is critical to our community. Due to ongoing reimbursement challenges and rising operating costs, Central Oregon has lost a dramatic number of orthopedic surgeons in the region in the past 18 months. I regularly hear from patients who are frustrated at long delays in orthopedic care. It currently takes patients in need of a joint replacement six months to receive an initial consultation appointment and another six months before surgery is scheduled.   

Working closely with The Center’s leadership, we understand the clinic is at risk of losing additional providers without immediate financial support, which also puts St. Charles Bend’s trauma program at risk. We rely on The Center’s team of orthopedic and neurosurgeons to help us care for more than 2,000 trauma patients every year.   

So, we are embarking on an exciting time where our teams will complete a due diligence process and put together a plan and timeline with a goal of completing the transition as soon as possible without disruption to patient care. As part of this process, we have applied to the Oregon Health Authority for an emergency exemption of its Health Care Market Oversight review to expedite the transaction and more quickly shore up services.   

Exploring a potential transaction with The Center is possible only because of our recent efforts to stabilize St. Charles. I’m incredibly proud that we are in a position to help support a critical health care service in our region. 

Sincerely,
Steve

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Grand Rounds - July 19, 2024  
"Long COVID: A Primer For Primary Care"

Speaker: Eric Herman, MD. Assistant Professor of Family Medicine, Oregon Health Sciences, University School of Medicine.

 

 

Objectives

  1. Define Long COVID.
  2. Identify common signs and symptoms of Long COVID.
  3. Discuss the proposed etiologies for Long COVID.
  4. Discuss evaluation and management of Long COVID.

Accreditation: St. Charles Health System is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. St. Charles Health System designates this live activity for a maximum of 1.0 AMA PRA Category 1 Credit(s)TM.

The period to claim credit for this activity expires one year after its original publication. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Claim Credit

Target Audience: Physicians, Nurses, Pharmacists, Allied Health Professionals

Accessibility/Program Questions: St. Charles Health System encourages persons with disabilities to participate in its programs and activities. If you anticipate needing any type of accommodation or have questions about the physical access provided, please contact Continuing Medical Education at [email protected].

Oher CME or Clerkship questions: also contact Continuing Medical Education at [email protected].

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St. Charles Health System announced today recipients of a variety of Community Benefit grants, awarding more than $106,000 to 16 local organizations in Central Oregon. The grants were awarded to provide basic needs, to support local diversity, equity and inclusion initiatives, to sponsor local events and as part of St. Charles’ Priority Grant to increase a sense of belonging and reduce loneliness and isolation.

Local nonprofit Friends of the Children Central Oregon will utilize the priority grant funding from St. Charles to start a brand-new cooking class series designed to teach youth and families essential culinary skills and health eating habits while strengthening community connections.

“We are incredibly grateful to St. Charles Health System for their generous grant funding. With this support, we can offer hands-on cooking lessons, guided by professional chefs, that not only teach practical skills but also inspire confidence and independence in our participants. Together, we are building a brighter future for Central Oregon's youth, one meal at a time,” said Chloe Manke, development director for Friends of the Children Central Oregon.

Organizations receiving funding to reduce isolation and increase belonging include:

  • BEAT Children’s Theatre received funding to offer theater programs for students with developmental disabilities.

  • Better Together Central Oregon will use funding to support the organization’s LatinX Family and Youth Family Councils.

  • City Club of Central Oregon will use funding to expand engagement opportunities.

  • Friends of the Children Central Oregon received funding to start a new cooking class series to encourage healthy eating and connection for youth from under-resourced families.

  • Namaspa Foundation received funding to support their program “Empowerment, One Breath at a Time.”

  • Newberry Regional Partnership will use funding to begin a large-scale community engagement effort in southern Deschutes County.  

  • The Peaceful Presence Project received funding to support a program that connects and supports family members serving as caregivers for seriously ill loved ones.

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The Center Orthopedic and Neurosurgical Care & Research and St. Charles Health System have signed a letter of intent to explore expanding their relationship to preserve and strengthen access to orthopedic, neurosurgical, physical medicine and rehabilitation medicine in the Central Oregon region.   

Central Oregon is experiencing a rapid reduction in access to care across many different types of medicine. As costs to provide care are increasing while reimbursements for services remain flat to declining, many independent providers have left the market and smaller specialty groups have closed their doors. The number of orthopedic surgeons in Central Oregon has decreased dramatically in the past 18 months making access to necessary care a significant burden for patients and their families.

Although it has tried to fill current care gaps on its own, The Center is facing similar operating headwinds as other independent specialty practices that are making it difficult to retain and recruit providers and staff. A transaction of this nature will be subject to review by the Oregon Health Authority under its Health Care Market Oversight program. However, given the urgency of the current situation and the threat to patients, The Center and St. Charles intend to seek an emergency exemption from the Health Care Market Oversight review process in the hopes of expediting the integration plans and the parties’ ability to more immediately stabilize care in the community. 

“The physicians, advanced practice providers and staff of The Center are committed to providing exemplary and efficient care to our beloved Central Oregon community,” said Dr. Christopher Healy, an orthopedic surgeon and president of The Center’s board. “With the ever-mounting challenges facing independent physician practices, a partnership with St. Charles will allow us to better meet the needs of our growing community. St. Charles also shares a mission of providing exceptional care to our region, so aligning with their organization is a natural path forward to delivering orthopedic, neurosurgical and physical medicine care.”

The Center operates three clinic locations in Bend and one in Redmond, with outreach clinics in Sisters, Prineville, Madras, La Pine, Burns, and John Day, enabling patients to receive expert care close to home. The Center employs 27 physicians, 27 advanced practice providers, and approximately 200 support staff.

“St. Charles and The Center are both local organizations that are committed to providing the best possible care for Central Oregonians,” said Dr. Steve Gordon, president and CEO of St. Charles. “St. Charles has the ability to step in and help shore up these services for our patients and community, which is not only the right thing to do it’s critical to ensuring continued access to a wide variety of services throughout the region.”

Without immediate financial support, Healy said The Center leadership team is concerned more providers will leave the region worsening the long delays patients are experiencing for care. It can take up to six months to schedule an initial orthopedic evaluation with a total joint replacement surgeon and another six months to schedule surgery.

“Physicians from The Center have been active members of the St. Charles medical staff for decades,” Healy said. “St. Charles is the right partner as they are the leader in health care in our area and will help provide stability to musculoskeletal care in the region.” 

In addition, St. Charles Bend’s designation as a Level II Trauma Center is dependent on having a robust group of orthopedic and neurosurgeons available to provide on-call coverage for trauma surgeries when needed, Gordon said. More than 2,000 patients are treated annually for acute and often life-threatening trauma at St. Charles, especially in the summer months when regional recreational activities increase.

“Six of the orthopedists at The Center regularly share daily trauma service shifts, three more provide occasional shifts and all of The Center physicians provide night and weekend assistance,” Gordon said. “The loss of these physicians could result in an ‘orthopedic desert’ in Central Oregon and the loss of Level II trauma services for tens of thousands of square miles east of the I-5 corridor. We can’t let that happen.”

The Center and St. Charles will put together a transition plan and have a shared goal of completing the transaction as swiftly as possible without any disruptions to patient care. The Center currently provides care to all residents of Central and Eastern Oregon, including rural counties and individuals who may face barriers to care. In the past year, The Center has provided:

  • At least 1,000 visits by patients from each of seven Oregon rural counties (Deschutes, Crook, Klamath, Jefferson, Grant, Lake and Harney) and more than 100 visits from patients from Wheeler and Wasco counties

  • More than 45,000 visits by seniors, including more than 8,000 by patients over age 80

  • More than 6,000 pediatric visits (age <18)

  • More than 19,000 visits provided in Redmond, thus preventing patients from having to drive 20 miles further south to Bend for care

  • More than 450 visits provided to residents of Warm Springs

  • More than 12,500 visits to Oregon Health Plan (Medicaid) members

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