Preparing for Surgery
Dr Jenny Cook | Sydney Gynaecologist & Advanced Laparoscopic Surgeon
Admission Papers
Dr Jenny Cook operates out of East Sydney Private Hospital, St Luke’s Private Hospital, and Prince of Wales Private Hospital. You will be directed to a website to complete the e-admission form.
Bowel Preparation Details
Prior to Laparoscopic Surgery
First – Purchase Picolax from your Pharmacist
Before you Take Picolax
Do Not Take Picolax If You Have:
- an obstruction in your intestine (gut)
- severe kidney problems
- a perforated gut wall
- gastric retention
- severe inflammatory bowel disease, like ulcerative colitis, Crohn’s disease, or toxic megacolon
- an allergy to any of the ingredients in the product
If you are pregnant or breast-feeding, talk to your doctor before you take Picolax.
If you are taking other oral medicines, speak to your doctor. Most other oral medicines should be taken at least one hour before or one hour after taking picolax because they may be flushed through your digestive system and not work so well.
However some medicines such as sustained release preparations or medicines with a narrow therapeutic window, such as the contraceptive mini-pill, may need to be taken more than one hour before or after picolax contraceptive cover from the oral contraceptive pill is likely to be incomplete if it is taken at any time during the process of bowel cleansing with picolax (an hour before the first dose of picolax until after the investigation).
Therefore an alternative method of contraception should be used for the length of the cycle when picolax is taken.
Patients with diabetes should consult their doctor prior to use of Picolax.
When to Take Picolax
Follow all directions given to you by your doctor carefully. They may differ from the information contained in this page.
Important: Do not take any solid food from when you start to take Picolax until after the examination.
Two Days Before Your Procedure
Avoid eating brown bread, red meat, cereals, yellow cheese, vegetables, fruit or anything with nuts or seeds in it.
One Day Before Your Procedure
Only Drink Approved Clear Liquids
When taking Picolax it is important to maintain hydration and electrolyte balance. Clear liquids include:
- water,
- clear soup, chicken or beef broth
- tea or coffee (without milk or non-dairy creamer),
- all liquids (which are not coloured red or purple) including
- fruit juices without pulp,
- carbonated or non carbonated soft drinks,
- fruit flavoured cordials
- sports drinks, Gastrolyte, Barley sugar is allowed
- jelly (yellow or orange),
Do Not Drink Water Alone
Drinking only water to replace the fluid losses may lead to electrolyte imbalance, particularly to hyponatraemia and possibly seizures.
A combination of these approved clear liquids will give a variety of fluid intake.
How to prepare picolax
Slowly add the contents of one sachet to a large glass of cold water (approx 250ml).
Stir gently until effervescence ceases
How to drink picolax
Drink the solution slowly but completely, followed by a full glass of water. Continue drinking a variety of approved clear fluids* (approximately 250ml every hour) to ensure adequate hydration.
What to expect when taking picolax
Picolax usually induces frequent, loose bowel movements within two to three hours of taking the first dose
You should:
- Remain within easy reach of toilet facilities at all time while using Picolax
- Not plan any other activities until after your procedure or examination
- Consider using a plastic cover sheet as a mattress protector for the bed
- Arrange for someone to take you to and from the procedure or medical examination
- Replenish your system by drinking liquids after returning home from your procedure
How to reduce discomfort
During the period of taking picolax you should consider the following:
- Loose-fitting clothing is recommended
- Alcohol-free and fragrance-free wet wipes and soft toilet tissue may minimise the expected irritation from wiping
- Frequent application of a protective cream, lanolin, petroleum jelly (vaseline) or zinc cream will reduce discomfort
Side effects of picolax
Like All Medicines, Picolax Can Have Side Effects.
Blood Sodium Levels Could Also Decrease, Particularly If You Take Medicines That Affect Your Kidneys, Such As Ace Inhibitors And Diuretics Used For The Treatment Of Heart Disease. Very Low Blood Sodium Levels Can Cause Convulsions (fits)
If Your Blood Sodium Levels Change, You May Feel Breathless, Very Thirsty With A Severe Headache Or Get Puffy Ankles.
How To Store Picolax
Keep Picolax Sachets At Room Temperature (below 30ºc), Stored In Their Original Packaging, And Do Not Use After The Expiry Date On The Label.
Keep All Medicines Away From Children
Picolax Product description
Each picolax sachet contains the following ingredients:
- Sodium picosulfate 10mg
- Magnesium carbonate 7.9G (equivalent to 3.36G magnesium oxide (mgo))
- Citric acid-anhydrous 11.8G
- Lemon flavour
- Acesulfame potassium
- Povidone
- Silicon dioxide
Diet
It will be necessary to fast from 8 hours prior to your procedure.
If you are having a laparoscopy, we recommend a special diet on the day prior to the procedure. This includes clear fluids (clear soup, jelly, black tea, fruit juices). It is recommended that you do not consume solids or milk products on this day.
You will be advised to take a light bowel prep – one sachet of picolax at 4pm on the day prior to surgery. You will have loose bowel motions after about 5 hours. You will need to drink adequate water during this time to avoid dehydration.
Medications
Take your medications as usual on the morning of the surgery with a sip of water.
You will need to stop all aspirin and anti-inflammatory medications (eg nurofen, ponstan) at least 7 days prior to the surgery. These medications can cause bleeding.
If you take warfarin, Dr Cook will organise a review by a haematologist to organise discontinuing this medication and commencing an alternate medication around the time of the operation.
If you take regular steroid medication, Dr Cook will organise a review with the anaesthetist to increase the dose around the time of the operation. This will be in conjunction with your usual prescribing doctor.
Time of Admission
You will be contacted on the day prior to the surgery by our Practice Manager to notify you of the time to arrive at the hospital. This is usually about 2 hours prior to your operation. Some women will require an earlier admission.
Diabetics will be earlier on the list.If you require an earlier admission, please notify us and we will do our best to accommodate your request.
Day Stay Procedures
This means that you will have your surgery and go home on the same day. You will see Dr Cook and the anaesthetist prior to your surgery. You will be admitted through the hospital’s Day Procedure Unit. The enquiries desk will be on the Ground Floor. You will be discharged with specific instructions regarding your type of surgery. Dr Cook will ensure that you have any necessary medications to take home. Dr Cook will contact you on the following day to talk briefly about the surgery and ensure that you are progressing well. A follow up appointment will have been arranged prior to the surgery by Monash IVF.
Longer Stay in Hospital
This will be required for longer procedures including Hysterectomy, Pelvic Floor Repair, complex Endometriosis surgery and Myomectomy. You will either be admitted through the hospital’s Day Procedure Unit or through the Gynaecology Ward. The enquiries desk will be on the Ground Floor.
When your operation is complete, you will go to Recovery. From there you will be taken up to the Gynaecology Ward. Dr Cook will review you the following day in the hospital.
The nursing staff at the hospital will make your stay as comfortable as possible. They will attend to any special dietary requirements or other requests.
You will be discharged with instructions regarding your type of surgery. Dr Cook will ensure that you have any necessary medications to take home. A follow up appointment will have been arranged prior to the surgery by Monash IVF.