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Like Bill, we ask that our pts avoid gassy foods and carbonated drinks the
day before their exam.  Additionally, we ask that they take a dose of Gas-X
the night before and the morning of their exam.
Can't tell you the last time we couldn't achieve a complete renal exam.
Agree with the lateral decubitus position.  If you angle up under the ribs,
you can see the entire renal artery in most patients.
MaryAnne Waters
UVM

-----Original Message-----
From: Bill Schroedter [mailto:[log in to unmask]]
Sent: Thursday, November 21, 2002 12:44 PM
To: [log in to unmask]
Subject: Re: renal artery prep


Elaine,  I know that Miles Cramer had what I thought to be the ultimate prep
(you out there Miles???) However, it seemed to us that the more detailed we
made the procedure, the less compliance we had. Now, we simply tell the
patient to avoid gassy foods and especially carbonated beverages, hold
breakfast but drink lots of water and let them take their meds. The large
belly can be overcome by utilizing a lateral decubitus position, as can the
gas. (More than one way to skin a cat or see the renal artery). If the
patient is normal, it is almost never a problem. If the person is abnormal
or borderline and are very difficult due to gas, we will simply have them
come back a different day. Then you can do a face to face about the prep and
they seem willing to comply.
You should be able to visualize just about everyone with experience, a good
instrument, and most importantly patience! Good luck
Bill Schroedter
Venice,Fl
----- Original Message -----
From: "Elaine Erickson" <[log in to unmask]>
To: <[log in to unmask]>
Sent: Thursday, November 21, 2002 6:01 AM
Subject: renal artery prep


> In spite of the standard prep for renal artery duplex exams, our patients
> have been extremely gassy.  We work in an out patient facility, and depend
> on the patients to follow through with the prep.  We ask them to eat only
> lean meat, boiled or broiled the night prior to the study; we ask the
> eliminate the consumption of fruit, vegetables (especially
onions,broccoli,
> cauliflower, cabbage) and dairy products; we suggest boiled noodles or
> potatoes without butter, sour cream, or heavy sauces to accompany their
> meat.  They are instructed to take several dosages of over-the-counter
anti-
> gas product with lots of water. In spite of these instructions, they are
> still producing amounts of intestinal gas that sometimes inhibits complete
> interrogation of the abdominal vasculature.  Actually, sometimes I think
> their large intestine is in need of evaculation, especially when imaging
is
> undoable in the upper abdomen, where the transverse colon lies, and no
> peristalsis is seen in that region. Many of them have a large abdominal
> girth, and that might be part of the problem.  Has anyone out there
> tinkered with their prep to perfection, and willing to share your
findings.
> Thank you,
> Elaine
>
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