Imaging

Please arrive 15 minutes early.
If you need to reschedule or cancel your appointment, please call the Western Wisconsin Health Imaging Department at 715-684-1395.

We will call you the day before your scheduled procedure to confirm your appointment. If your procedure is on a Monday, we will call you the Friday before.

Enter through the Western Wisconsin Health main entrance and report to the Imaging Department 15 minutes prior to your scheduled appointment. After registering, you will be asked to wait in the waiting room until all of your paperwork is done. A technologist will then take you to the imaging area.

Important:
If there is a chance that you are pregnant, please inform your physician and x-ray technologist.

WHAT IS ARTERIAL SEGMENTAL PRESSURE ULTRASOUND?

It is a test that uses Doppler ultrasound to measure the blood pressures in the legs to make sure there is normal blood flow. The test is usually done when there is intermittent claudication (leg pain on exercise).

Normally the blood pressures in the legs are similar to those in the arms. Lower pressures in the legs usually mean there are plaques (cholesterol deposits) in the leg arteries compromising the circulation.
Blood pressure measurements are made at different locations on the legs to see if there is narrowing of the arteries and where the blocks are occurring in the legs. The test is often done in people with diabetes because diabetes tends to cause small vessel disease.

PREPARATION

• Your feet should be bare during the test. You may want to wear shorts for this exam. If you are not wearing shorts, you may have to change into a hospital gown.
  
• Take any medicines prescribed by your provider, as directed.
• You may spend up to 1.5 hours in the imaging department.
  

DURING THE EXAM

• You lie on an exam table and a technician wraps blood pressure cuffs around your legs in four locations including the thigh, calf, and ankle. He or she then squirts some ultrasound gel onto your skin to help the Doppler sensor (which resembles a wand or pen) slide around easily and to help conduct sound waves through your skin.
• Each cuff is inflated to exert more pressure on your leg. This temporarily cuts off circulation in the leg.
• Many patients briefly experience some cramping pain in the calf or thigh (similar to the sensation you experience when a blood pressure cuff is inflated around your arm). As the cuff is deflated, the technologist places a Doppler sensor against your foot to detect the moment when blood flow starts up again. When it does, you will hear a noise that sounds like your heartbeat. Checking the air pressure of the deflating cuff at this time shows the leg blood pressure.
• After all the cuffs on one side have been tested, the other leg is checked in the same way. For comparison, you also have your blood pressure checked in each arm using the Doppler Technique.
• Patients have their leg pressures checked both before and after exercise. You are asked to walk on a treadmill for up to 5 minutes and then have the test again afterward.
• Depending on these results, you may be asked to go to another room for more imaging with the ultrasound room.
• If asked to go to ultrasound room to obtain a Doppler ultrasound. Doppler sonography is a special is a special technique that allows the physician to see and evaluate blood flow through arteries.
  

AFTER THE EXAM

• The technologist cannot give you any test results. But, he or she can answer any general questions you may have.
  
• You will be able to go home and return to normal activities.
  
• The scan will be read by a radiologist. You can expect follow-up from your provider regarding the results of your test.

BILLING

You will receive two bills for your examination. Western Wisconsin Health will bill for the examination. There will be a separate bill for the interpretation.

We thank you for allowing us to serve you and welcome any questions or comments you may have.

PATIENTS RIGHTS

As a patient, you have the right to know about and discuss with your family, your doctor and your nurse exactly what type of treatment and care you will be receiving.

The healthcare team at Western Wisconsin Health accepts the responsibility to ensure that you are adequately informed about all procedures. We hope the enclosed information will help.

Please arrive 15 minutes early.
If you need to reschedule or cancel your appointment, please call the Western Wisconsin Health Imaging Department at 715-684-1395.

We will call you the day before your scheduled procedure to confirm your appointment. If your procedure is on a Monday, we will call you the Friday before.

Enter through the Western Wisconsin Health main entrance and report to the Imaging Department 15 minutes prior to your scheduled appointment. After registering, you will be asked to wait in the waiting room until all of your paperwork is done. A technologist will then take you to the imaging area.

BEFORE THE EXAM

Wear a comfortable two-piece outfit. You must not wear any metal buttons, buckles, or zippers, as these materials may interfere with your results.

Let the technologist know!
For the success of the exam and for your safety tell the technologist if you:

• Are pregnant or think you may be.
  
• Have any metal in the part of your body being imaged, such as spinal fusion rods or a hip replacement.
  
• Have had a recent nuclear medicine scan or barium enema.
  
• Have a severely curved spine, have had spinal surgery, or can’t lie on your back.
  

DURING THE EXAM

When you are ready for the exam you will lie on your back and side on the exam table. An overhead “arm” will travel about your body and take readings of your bone density. It is very important that you lie still while the images are being taken so that the pictures are clear.

BONE DENSITOMETRY (DEXA)

Bone Densitometry has become the gold standard for measuring the density of your bones. Sometimes referred to as a DEXA scan (dual energy x-ray absorptiometry), bone densitometry is the test for evaluation of osteoporosis. The results of your exam are compared to others whose age, sex, and ethnic background are similar to yours. The measurement of bone minerals is very closely related to bone strength and your potential for bone fractures. As women age, along with many other health issues, their risk factors for osteoporosis increase.

The following is a list of the most common risk factors:

• Postmenopausal (no longer having periods)
  
• Early menopause (before age 45)
  
• Surgical menopause (removal of uterus and / or ovaries)
  
• Age
  
• Previous fracture
  
• Family history of osteoporosis
  
• Certain medications (including steroids and thyroid hormones)
  
• Caucasian / Asian descent
  
• Thin or small build
  
• Eating disorders
  
• Smoking
  
• Alcohol abuse
  
• Inactive lifestyle
  
• Inadequate calcium intake
  

Before discussing the actual Bone Densitometry procedure, you should know some facts regarding bone health. Osteoporosis is the most common type of bone disease. Osteoporosis occurs when the body fails to form enough new bone, or when too much existing bone is reabsorbed by the body. It is a condition
characterized by progressive loss of bone density and strength resulting in an increased vulnerability to fractures.

Osteoporosis is most commonly associated with menopause because lower estrogen levels increase the rate of bone reabsorption. When the balance is affected by decreased estrogen levels, the body
begins to increase bone removal. Though menopause is often considered the most common cause of osteoporosis, there are also other caused listed in the previous bullets.

Calcium and phosphate are two minerals that are essential for normal bone formation. Throughout youth, you body uses these minerals to produce bones. If calcium intake is not sufficient, or if the body does not absorb enough calcium from your diet, bone production suffers and the bone thins.

As people age, calcium and phosphate may be reabsorbed back into the body from the bones, which makes the bones weaker. Inadequate calcium and phosphate intake and reabsorption can cause fragile, brittle bones that are subject to fractures. The loss of bone density usually occurs gradually over a period of three years. Often, a person will actually suffer a fracture before they are aware that they have osteoporosis. By the time this occurs, the disease is in more advanced stages.

The National Osteoporosis Foundation recommends that you have a bone density test if:

• You are a woman age 65 or older
  
• You are a man age 70 or older
  
• You break a bone after age 50
  
• You are a woman of menopausal age with risk factors
  
• You are a postmenopausal woman under age 65 with risk factors
  
• You are a man age 50-69 with risk factors
  

A bone density test may also be necessary if you have any of the following:

• An x-ray of your spine showing a break or bone loss in your spine
  
• Back pain with possible break in your spine
  
• Height loss of 1/2 inch or more within one year
  
• Total height loss of 1-1/2 inches from your original height

WHAT IS A BONE DENSITOMETRY EXAM?

Bone Densitometry is a low-dose x-ray that checks for signs of mineral loss and bone thinning. The area x-rayed is usually the hip and spine. A bone density exam delivers approximately one-quarter to one-tenth the radiation that occurs during an ordinary chest x-ray. It is a simple, painless, and non-invasive procedure which takes approximately 15 minutes.

WHAT YOU CAN DO TO HELP PREVENT OSTEOPOROSIS?

The treatment of osteoporosis focuses on slowing down or stopping bone loss. It was once believed that when bone loss occurred, new bone could not be generated. However, there are a few new medications to treat osteoporosis that actually work to strengthen and rebuild bone tissue. Medications are often used
after a diagnosis of osteoporosis is made. However, there are lifestyle changes that you can make to minimize your risk.

• Diet – A diet that includes an adequate amount of calcium, Vitamin D, and protein should be maintained.
• High calcium foods – Include low-fat milk, yogurt, ice cream, cheese, tofu, salmon and sardines (with the bones) and green leafy vegetables (spinach or collard greens).
• Exercise – Regular weight-bearing exercise can reduce the likelihood of bone fractures associated with osteoporosis.
• Stop unhealthy habits – If you smoke, quit. Also limit alcohol intake. Limit beverages containing caffeine.
• Prevent falls – it is critical to prevent falls. Make sure your vision is good. Avoid areas that may increase your risk of falling. Use handrails in the bathtub if necessary. Remove throw rugs that may cause you to trip.
• Medications – There are a number of medications that are now used to prevent osteoporosis.

AFTER THE EXAM

• The technologist cannot give you any test results. But, he or she can answer any general questions you may have.
• You will be able to go home and return to normal activities.
• The scan will be read by a radiologist. You can expect follow up from your provider regarding the results of your test.

BILLING

You will receive two bills for your radiology examination. Western Wisconsin Health will bill for the examination. There will be a separate bill for the interpretation.

We thank you for allowing us to serve you and welcome any questions or comments you may have.

PATIENTS RIGHTS

As a patient you have the right to know about and discuss with your family, your doctor and your nurse exactly what type of treatment and care you will be receiving.

The healthcare team of Western Wisconsin Health accepts the responsibility to ensure that you are adequately informed about all procedures. We hope the enclosed information will help.

Please arrive 15 minutes early.
If you need to reschedule or cancel your appointment, please call the Western Wisconsin Health Imaging Department at 715-684-1395.

We will call you the day before your scheduled procedure to confirm your appointment. If your procedure is on a Monday, we will call you the Friday before.

Enter through the Western Wisconsin Health main entrance and report to the Imaging Department 15 minutes prior to your scheduled appointment. After registering, you will be asked to wait in the waiting room until all of your paperwork is done. A technologist will then take you to the imaging area.

WHAT IS A BREAST NEEDLE LOCALIZATION PROCEDURE?

Because the breast is a complex structure of glands, ducts, fibrous tissue and fat, abnormal tissue may be difficult to locate during surgery. Breast needle localization is a diagnostic procedure in which a special needle and x-rays are used to identify the precise location of abnormal breast tissue for the purpose of
performing a breast biopsy.

A biopsy is a highly detailed microscopic study of selected tissue to determine if specific cell changes have taken place, such as in cancer. The procedure more effectively utilizes the surgeon’s time, while minimizing the removal of healthy breast tissue.

WHAT WILL THE PROCEDURE BE LIKE?

The breast needle localization x-ray procedure will be performed by a radiologist (a radiologist is a physician who specializes in medical diagnosis by imaged tests such as ultrasound, x-rays,
etc.) and a radiologic technologist or a registered sonographer specializing in breast needle localization or ultrasound mammography. The technologist has completed a rigorous course in education and training and works under close supervision of the radiologist to assure the most accurate results from your examination.

The radiologist will review your most recent mammogram or ultrasound and additional views may be necessary. For this procedure, you will change from your clothing into a hospital gown. The radiologist will numb the area of interest and insert a localization needle. An x-ray or ultrasound will be taken to confirm the precise location of the needle. The purpose of this part of the procedure is to pinpoint the area of concern for your surgeon. If the x-ray shows that the needle is incorrectly positioned, the radiologist will reposition the needle and assure placement by x-ray.

With the abnormality precisely located, a small guidewire will be inserted through the needle to mark the position of the abnormality for the surgeon, and the needle withdrawn. Two additional x-rays will be taken to identify the exact location of the wire. The wire will then be taped to your skin.

HOW DO I PREPARE FOR THE PROCEDURE?

Your doctor will explain to you how to prepare for your breast needle localization procedure.

HOW LONG WILL THE PROCEDURE TAKE?

The breast needle localization procedure usually takes 30 to 60 minutes. Your doctor will advise you of the amount of time needed for your particular situation.

BILLING

You will receive two bills for your radiology examination. Western Wisconsin Health will bill for the examination. There will be a separate bill for the interpretation.

We thank you for allowing us to serve you and welcome any questions or comments you may have.

PATIENTS RIGHTS

As a patient you have the right to know about and discuss with your family, your doctor and your nurse exactly what type of treatment and care you will be receiving.

The healthcare team of Western Wisconsin Health accepts the responsibility to ensure that you are adequately informed about all procedures. We hope the enclosed information will help.

Please arrive 15 minutes early.
If you need to reschedule or cancel your appointment, please call the Western Wisconsin Health Imaging Department at 715-684-1395.

We will call you the day before your scheduled procedure to confirm your appointment. If your procedure is on a Monday, we will call you the Friday before.

Enter through the Western Wisconsin Health main entrance and report to the Imaging Department 15 minutes prior to your scheduled appointment. After registering, you will be asked to wait in the waiting room until all of your paperwork is done. A technologist will then take you to the imaging area.

WHAT IS A CORONARY CTA?

Your medical provider wants you to have a Coronary CT angiogram. This scan uses X-rays and a computer to create images of your heart arteries. The images can show if plaque (fatty deposits) are causing your heart arteries to narrow or become blocked. Plaque limits the amount of blood that can flow in your arteries.

You will receive a contrast (X-Ray) dye through an intravenous (IV) line, which is placed in your arm. The dye will help your arteries show up in a scan.

The Coronary CT Angiogram procedure takes 1 – 2 1/2 hours. Cardiac Nursing staff will first take your health history, monitor your heart rate and administer beta blockers if necessary. Once your heartbeat is below 60 beats per minute, the nurse will bring you to the CT room. You will spend 15-20 minutes in the CT Room. The actual scan will take 13 to 30 seconds.

Tell your provider if you:

• Have an allergy to contrast dye
  
• Have kidney problems (you may need special preparation)
  
• Have diabetes
  
• You are pregnant
  
• Irregular heartbeat
  

BEFORE THE EXAM

• Do not drink anything with caffeine eight hours before the scan, including: decaffeinated coffee, tea, soda and chocolate.
  
• Do not eat anything four hours before the scan.
  
• Do not smoke the day of your test.
  
• You may drink liquids that are caffeine-free until the time of your scan.
  
• Take your regular medications unless your doctor tells you otherwise.
  
• Please bring a current medication list.
  
• No erectile dysfunction medications 24 hours before the test.
  
• Depending on your health history, you may need a blood test done prior to this test.
  
• A nurse will take a brief medical history.
  
• You may be given a medication which slows your heart rate. This will help the CT machine get clearer images.
  
• An intravenous line (IV) will be started in your arm.
  
• The nurse or technologist will answer any questions that you may have.
  

DURING THE EXAM

• You will be asked to lie on your back on a narrow, movable table. The table will be circled by a large doughnut-shaped machine.
  
• You will be asked to hold your breath for a brief time. Lying still during the scan is important.
  
• You may be given a nitroglycerin sublingual tablet right before the images are taken. The nurse or technologist will explain this to you.
  
• The contrast dye will be injected through the IV. You may feel a warmth or flushing right after the contrast is injected.
  

AFTER THE EXAM

• •The technologist cannot give you any test results. But, he or she can answer any general questions you may have.
  
• You will be able to go home and return to normal activities.
  
• The scan will be read by a radiologist. You can expect follow-up from your provider regarding the results of your test.

BILLING

You will receive two bills for your radiology examination. Western Wisconsin Health will bill for the examination. There will be a separate bill for the interpretation.

We thank you for allowing us to serve you and welcome any questions or comments you may have.

PATIENTS RIGHTS

As a patient you have the right to know about and discuss with your family, your doctor and your nurse exactly what type of treatment and care you will be receiving.

The healthcare team of Western Wisconsin Health accepts the responsibility to ensure that you are adequately informed about all procedures. We hope the enclosed information will help.

Please arrive 15 minutes early.
If you need to reschedule or cancel your appointment, please call the Western Wisconsin Health Imaging Department at 715-684-1395.

We will call you the day before your scheduled procedure to confirm your appointment. If your procedure is on a Monday, we will call you the Friday before.

Enter through the Western Wisconsin Health main entrance and report to the Imaging Department 15 minutes prior to your scheduled appointment. After registering, you will be asked to wait in the waiting room until all of your paperwork is done. A technologist will then take you to the imaging area.

Important:

If there is a chance that you are pregnant, please inform your physician and x-ray technologist.

WHAT IS COOLIEF PROCEDURE?

COOLIEF is a minimally invasive treatment option targeting nerves that are causing pain.

COOLIEF cooled radiofrequency can bring nonsurgical relief to those suffering from OA pain, without the use of opioids. Radiofrequency ablation is becoming more popular in treating OA pain because this minimally invasive, non-narcotic procedure directly targets the nerves responsible for sending pain signals to the brain.

HOW COOLIEF WORKS

This RF energy creates a treatment area that safely deactivates the pain-causing sensory nerves, while leaving motor nerves intact to preserve function.

The COOLIEF radiofrequency generator transmits a small current of thermal energy through a water cooled electrode placed within the tissue.

PREPARATION

• Before the procedure, tell your doctor if you have any allergies or are taking any blood thinners.
  
• Nothing to eat or drink 8 hours prior
  
• Ride home needed
  

AFTER THE EXAM

• You will be observed for about 30 minutes in the recovery area.
  
• You will need to bring a driver with you.
  

WHAT SHOULD I DO WHEN I GET HOME?

• Rest for a few hours as needed.
  
• Walk with help as long as numbness, weakness or drowsiness is present.
  
• Resume activities as tolerated; do not over do it.
  
• Resume your regular diet.
  
• Follow your doctor’s instructions about going back to work.
  
• Take your medicines as usual. If you stopped taking your blood-thinning medicine, check with your doctor about taking this again.
  
• You may apply ice for 15 minutes on and 60 minutes off.
  
• • The injection may cause increased pain for 1 to 2 days. Use your pain medicines as usual.
  
• You may remove the bandage after several hours. You may bathe or shower the next day. A small bruise and tenderness at the injection site is normal for 1 to 2 days. Avoid hot tubs or whirlpool tubs with jet sprays for 72 hours.
  
• If you are diabetic, your blood glucose may increase for several days. Call your primary doctor if the blood sugar levels concern you.
  

CALL US IF YOU HAVE:

• Excessive or abnormal bleeding, persistent chills, or fever over 100°F.
  
• A major change in the pattern or level of your pain.
  

For questions or concerns, please contact your provider by calling 715-684-1111.

BILLING

You will receive two bills for your examination. Western Wisconsin Health will bill for the examination. The radiologist will bill separately for his interpretation, consultation with the physician and report.

We thank you for allowing us to serve you and welcome any questions or comments you may have.

PATIENTS RIGHTS

As a patient you have the right to know about and discuss with your family, your doctor and your nurse exactly what type of treatment and care you will be receiving.

The healthcare team of Western Wisconsin Health accepts the responsibility to ensure that you are adequately informed about all procedures. We hope the enclosed information will help.

Please arrive 15 minutes early.
If you need to reschedule or cancel your appointment, please call the Western Wisconsin Health Imaging Department at 715-684-1395.

We will call you the day before your scheduled procedure to confirm your appointment. If your procedure is on a Monday, we will call you the Friday before.

Enter through the Western Wisconsin Health main entrance and report to the Imaging Department 15 minutes prior to your scheduled appointment. After registering, you will be asked to wait in the waiting room until all of your paperwork is done. A technologist will then take you to the imaging area.

Important:

If there is a chance that you are pregnant, please inform your physician and x-ray technologist.

CONTRAST MEDIA

Some exams require contrast media, or dyes, to help enhance the visualization of certain tissues. If dye is needed, it is administered by injection into a vein. You may feel a slight sensation during this injection. Although contrast is not harmful, it’s iodine-based, which can trigger an allergic reaction in some patients.

Inform your physician and x-ray technologist if you:

• Have a known allergy to the contrast dye.
  
• Have diabetes.
  
• Have a history of kidney problems.
  

PREP BEFORE THE EXAM

CT of the Head/Neck/Chest/Hematuria Protocol
You should drink clear fluids and be hydrated prior to your exam. You may take your medications with clear liquid prior to your exam. Depending on your health history, you may need a blood test done before this test.

CT of the Renal Stone Protocol, Sinuses, Extremities and Spine
You may eat and drink up to the time of the exam. Lumbar spine and Renal Stone Protocol patients must be barium free.

CT of Abdomen/Pelvis
You should drink clear fluids and be hydrated prior to your exam. You may take your medications with clear liquid prior to your exam. For most indications oral contrast is not required but for some indications, (post op, eval abscess) you will be asked to drink an oral contrast media. You will be asked to arrive 1 hour prior to your exam time, Depending
on your health history, you may need a blood test done prior to this test.

THE EXAM

For most exams you will be asked to wear a gown. You will be asked to lie very still on the table. The table will be surrounded by a large, donut-like structure. The table will move you in and out of the opening to
the proper positioning for your particular exam. Several pictures will be taken which will take approximately 30 minutes.

• Head – visualization of the intracranial anatomy
  
• Chest – visualization of the thoracic anatomy
  
• Abdomen/Pelvis – visualization of the abdominal and pelvic anatomy
  
• Spine – visualization of intervertebral disc, spinal canal and vertebral bodies
  
• Extremity – visualization of the extremities anatomy
  

AFTER THE EXAM

• The technologist cannot give you any test results. But, he or she can answer any general questions you may have.
  
• You will be able to go home and return to normal activities.
  
• The scan will be read by a radiologist.
  
• You can expect follow-up from your provider regarding the results of your test.
  

BILLING

You will receive two bills for your radiology examination. Western Wisconsin Health will bill for the examination. There will be a separate bill for the interpretation.

We thank you for allowing us to serve you and welcome any questions or comments you may have.

PATIENTS RIGHTS

As a patient you have the right to know about and discuss with your family, your doctor and your nurse exactly what type of treatment and care you will be receiving.

The healthcare team of Western Wisconsin Health accepts the responsibility to ensure that you are adequately informed about all procedures. We hope the enclosed information will help.

Please arrive 15 minutes early.
If you need to reschedule or cancel your appointment, please call the Western Wisconsin Health Imaging Department at 715-684-1395.

We will call you the day before your scheduled test to confirm your appointment. If your test is on a Monday, we will call you the Friday before.

Enter through the Western Wisconsin Health main entrance and report to the Rehabilitation Services Desk 15 minutes prior to your scheduled appointment.

ABOUT THE TEST

Your doctor wants you to have an echocardiogram (also called cardiac ultrasound, echo or echogram). This is a study of the function of your heart valves and blood flow.

You will not feel the ultrasound. It is painless and safe. There is no known danger to anyone – even pregnant women or their unborn babies.

WHAT IS AN ECHOCARDIOGRAM?

A transducer makes and sends the sound waves. As it is moved over your chest, pictures of your heart walls and valves reflect part of the sound waves back to the transducer. This makes the images of your heart.

The images appear on a screen and are recorded on videotape. A cardiologist (heart doctor) will read your
echocardiogram.

A Doppler echo is often done at the same time to see how the blood flows in your heart. The “swishing” sound you will hear during the test is your blood flowing through valves and chambers.

This test takes about 60 minutes. Please plan your day accordingly.

PREPARATION

• You may eat and resume your normal activities unless your doctor gives you other directions.
  
• Take any prescribed medicines by your doctor as directed.
  

DURING THE TEST

• You will be given a gown to wear, but you must not have any clothes on from the waist up.
  
• The sonographer will put small adhesive patches (electrodes) on your chest to record our electrocardiogram (ECG).
  
• You will be asked to lie on your left side.
  
• The sonographer will put an odorless, water-soluble gel on your skin where the transducer (wand) will go. This may feel cool and a bit moist. The gel helps the transducer get the best pictures possible.
  
• The room lights will be dimmed so the monitor won’t reflect any glare.
  
• You may feel a slight pressure from the transducer as it is being moved across your skin. Tell the sonographer if you are uncomfortable.
  
• The sonographer may ask you to hold your breath, change your position or lie quietly.
  
• An imaging contrast may be needed to enhance the quality of the echo. This requires an IV to be placed in your hand or arm.
  

AFTER THE TEST

• The technologist cannot give you any test results. But, he or she can answer any general questions you may have.
  
• You will be able to go home and return to normal activities.
  
• The scan will be read by a cardiologist. Follow-up with your provider regarding the results of your test.
  

BILLING

You will receive two bills for your examination. Western Wisconsin Health will bill for the examination. There will be a separate bill for the interpretation.

We thank you for allowing us to serve you and welcome any questions or comments you may have.

PATIENTS RIGHTS

As a patient you have the right to know about and discuss with your family, your doctor and your nurse exactly what type of treatment and care you will be receiving.

The healthcare team of Western Wisconsin Health accepts the responsibility to ensure that you are adequately informed about all procedures. We hope the enclosed information will help.

Please arrive 15 minutes early.
If you need to reschedule or cancel your appointment, please call the Western Wisconsin Health Imaging Department at 715-684-1395.

We will call you the day before your scheduled procedure to confirm your appointment. If your procedure is on a Monday, we will call you the Friday before.

Enter through the Western Wisconsin Health main entrance and report to the Imaging Department 15 minutes prior to your scheduled appointment. After registering, you will be asked to wait in the waiting room until all of your paperwork is done. A technologist will then take you to the imaging area.

Important:

If there is a chance that you are pregnant, please inform your physician and x-ray technologist.

WHAT IS AN EPIDURAL STEROID INJECTION?

This is a procedure done to help control pain or numbness from nerve irritation.

WHAT CAUSES NERVE IRRITATION?

There can be many causes, for example:

• As we age, several parts of the back can break down, causing bulging or bone spurs. These can push into either the spinal cord (spinal stenosis) or into the opening where nerves leave the spine. This irritates the nerves, causing pain, numbness, weakness, or tingling.
  
• The disc between the bones in the back may be “bulging” into the nerve area, due to injury or breaking down with age. Bone spurs due to arthritis can push into these areas.
  
• Scar tissue and changes after neck or back surgery may irritate the nerves as well.
  

WHERE IS THE EPIDURAL SPACE?

It is located along the entire length of the spinal canal. The nerves pass through this space as they exit the
spine. Injecting steroid (cortisone) medicine into this space may help relieve irritation, soreness and swelling of the nerves at and near this level.

WHERE IS THE INJECTION GIVEN?

An MRI, CT scan or your symptoms (where it hurts) will direct the doctor to the area causing pain. There are 3 places the injection may be given to you:

• Along the middle of your spine
  
• On either side of your spine
  
• Up through your tailbone
  

PREPARATION

• It can be done as an outpatient procedure or in the hospital.
  
• Before the procedure, tell your doctor if you have any allergies or are taking any blood thinners.
  

DURING THE EXAM

• You will lie on your abdomen on an X-ray table.
  
• The area to be injected will be cleansed with an antiseptic solution, which will feel cold. Then the area will be numbed with local anesthetic (you’ll feel a “pin prick” and slight burning).
• Using X-ray guidance, the doctor will inject the steroid along with saline or local anesthetic, into the
  epidural space. You may feel some pressure, but there should not be pain.
  

AFTER THE EXAM

• You will be observed for about 30 minutes in the recovery area. The affected arm or leg may feel temporary numbness, tingling or warmth.
  
• You will need to bring a driver with you.
  
• The steroid will take 24 to 48 hours to begin to work, with peak effect in 3 to 5 days. You and your doctor will decide if a second injection should be done, depending on how you feel. You may receive a total of 3 epidural injections over 6 to 12 months.
  

DISCHARGE INSTRUCTIONS

You were given a number of medicines during the procedure. These may include sedatives, local anesthetics, steroids and other medicines. Any of these drugs or the procedure itself can cause side effects, including drowsiness, temporary numbness, weakness and soreness.

You may feel temporary numbness, weakness or tingling:

• In the neck, arm, or fingertips (if your procedure was done in your neck)
  
• In the legs (if your procedure was done in your lower back)
  

WHAT SHOULD I DO WHEN I GET HOME?

• Rest for a few hours as needed.
  
• Walk with help as long as numbness, weakness or drowsiness is present.
  
• Resume activities as tolerated; do not overdo it.
  
• Resume your regular diet.
  
• Avoid driving until numbness and the weakness wears off.
  
• Follow your doctor’s instructions about going back to work. Often patients return to work the same or next day.
  

OTHER INSTRUCTIONS

• Take your medicines as usual. If you stopped taking your blood-thinning medicine, check with your doctor about taking this again.
  
• You may apply ice for 15 minutes on and 60 minutes off.
  
• The injection may cause increased pain for 1 to 2 days. Use your pain medicines as usual.
  
• The steroid medication may take 24 to 48 hours to start relieving pain. Peak pain relief occurs in 3 to 5 days.
  
• You may remove the bandage after several hours.
  
• You may bathe or shower the next day. A small bruise and tenderness at the injection site is normal for 1 to 2 days. Avoid hot tubs or whirlpool tubs with jet sprays for 72 hours.
  
• If you are diabetic, your blood glucose may increase for several days. Call your primary doctor if the blood sugar levels concern you.
  

CALL US IF YOU HAVE:

• Excessive or abnormal bleeding, persistent chills, or fever over 100º F.
  
• A major change in the pattern or level of your pain.
  
• A severe headache that does not go away with usual treatment methods.
  

For questions or concerns, please contact your provider by calling 715-684-1111.

BILLING

You will receive two bills for your examination. Western Wisconsin Health will bill for the examination. There will be a separate bill for the interpretation.

We thank you for allowing us to serve you and welcome any questions or comments you may have.

PATIENTS RIGHTS

As a patient you have the right to know about and discuss with your family, your doctor and your nurse exactly what type of treatment and care you will be receiving.

The healthcare team of Western Wisconsin Health accepts the responsibility to ensure that you are
adequately informed about all procedures. We hope the enclosed information will help.

Please arrive 15 minutes early.
If you need to reschedule or cancel your appointment, please call the Western Wisconsin Health Imaging Department at 715-684-1395. If you are calling after 4:00 pm or on a weekend to cancel your test, please call Shared Medical Technology (SMT) at 1-800-352-7254.

We will call you the day before your scheduled procedure to confirm your appointment. If your procedure is on a Monday, we will call you the Friday before.

Enter through the Western Wisconsin Health main entrance and report to the Imaging Department 15 minutes prior to your scheduled appointment.

STRESS TESTS ARE ORDERED FOR MANY REASONS:

• Diagnose Coronary Artery Disease
  
• Evaluate symptoms such as chest pain, shortness of breath, or fatigue
  
• Evaluate an abnormal EKG
  
• Prior to a surgical procedure
  
• Determine exercise tolerance
  

Your doctor would like you to have an Exercise Nuclear Stress Test. This test allows your physician to see how well blood is flowing to your heart muscle during rest and with activity.

Specially trained staff will be with you throughout the procedure.

The test is completed in the Imaging Department. It takes about 3-4 hours. Please plan your day accordingly.

THINGS TO KEEP IN MIND BEFORE YOUR TEST:

• Do not eat or drink anything that has caffeine (such as regular or decaffeinated coffee, tea, pop, energy drinks, Crystal Light, or chocolate) for 12 hours before your test.
  
• No alcohol for 24 hours before the test.
  
• Take your medications as directed unless otherwise instructed.
  
• Do not smoke for 4 hours before arriving for your test.
  
• You may eat a light breakfast before your arrival.
  
• Bring or wear comfortable clothing and shoes to exercise in.
  
• You should not have had any other nuclear medicine exams within 24 hours preceding your cardiac stress test.
  
• If you need to cancel your test, 24 hours notification is required.
  

DURING YOUR TEST

• When you arrive for your test, a brief medical history will be completed and an intravenous (IV) line will be inserted for the injection of a small dose of nuclear tracer.
  
• A series of pictures lasting about 15 minutes will be taken at rest and again after the stress portion of the test.
  
• During the stress portion of the test, you will be walking on a treadmill. Electrodes will be placed on your chest; your heart rate, rhythm and blood pressure will be continuously monitored throughout the test as the speed and elevation of the treadmill increases to make your heart work harder.
  
• The average time spent walking on the treadmill is 6-10 minutes.
  
• Once your maximum exercise level is achieved, a second dose of nuclear tracer will be given through your IV site. You will need to walk 1 minute after this injection.
  
• The reading physician will be able to compare the “rest” and the “stress” pictures and be able to see if there are any areas where blood flow to the heart muscle is decreased.
  
• This test is done in conjunction with Shared Medical Technology (SMT).
  

AFTER YOUR TEST

• You may leave after your test is completed. There are no restrictions on driving associated with this test.
  
• The technologist cannot give you any test results. But, he or she can answer any general questions you may have.
  
• The scan will be read and interpreted by a specialist in nuclear radiology.
  
• Make a follow-up appointment with your provider one week after your test to discuss your results.
  
• Do not exercise or exert yourself until you have received your test results.

BILLING

You will receive two bills for your radiology examination. Western Wisconsin Health will bill for the examination. There will be a separate bill for the interpretation.

We thank you for allowing us to serve you and welcome any questions or comments you may have.

PATIENTS RIGHTS

As a patient you have the right to know about and discuss with your family, your doctor and your nurse exactly what type of treatment and care you will be receiving.

The healthcare team of Western Wisconsin Health accepts the responsibility to ensure that you are adequately informed about all procedures. We hope the enclosed information will help.

Please arrive 15 minutes early.
If you need to reschedule or cancel your appointment, please call the Western Wisconsin Health Cardiac Rehab Department at 715-684-1485. If you are calling after 4:00 pm or on a weekend to cancel your test, please call CMI at 1-800-236-0084.

We will call you the day before your scheduled procedure to confirm your appointment. If your procedure is on a Monday, we will call you the Friday before.

Enter through the Western Wisconsin Health main entrance and report to the Imaging Department 15 minutes prior to your scheduled appointment. After registering, you will be asked to wait in the waiting room until your paperwork is done. A technologist or nurse will then take you to the imaging area.

STRESS TESTS ARE ORDERED FOR MANY REASONS:

• To diagnose Coronary Artery Disorder
  
• To evaluate symptoms such as chest pain, shortness of breath, or abnormal fatigue
  
• If you’ve had an abnormal EKG
  
• Prior to a surgical procedure
  
• To determine exercise tolerance
  

Your doctor would like you to have an Exercise Nuclear Stress Test to see how blood is flowing to your heart muscle during rest and activity.

The test requires two appointments and is completed in the Imaging Department.

The rest scan appointment will take approximately one hour. The stress appointment will take approximately two hours. Please plan accordingly.

Specially trained staff will be with you throughout the procedure.

THINGS TO KEEP IN MIND BEFORE YOUR TEST:

• Do not eat or drink anything that has caffeine (such as regular or decaffeinated coffee, tea, pop, energy
  drinks, Crystal Light, or chocolate) for 12 hours before your stress test.
  
• No alcohol for 24 hours before the test.
  
• Take your medications as directed unless otherwise instructed.
  
• Do not eat, drink or smoke for 4 hours before arriving for your test.
  
• Bring or wear comfortable clothing and shoes to exercise in.
  
• You should not have had any other nuclear medicine exams within 24 hours preceding your cardiac stress test.
  

DURING YOUR TEST

• When you arrive for your rest scan, you will received an injection of a small dose of nuclear tracer, which will need to absorb for a short period of time. During this time, you will be able to read or watch TV. Once the tracer is absorbed, a series of pictures lasting about 30 minutes will be taken.
  
• When you arrive for your stress scan, a brief medical history will be completed and an intravenous (IV) line will be started for the injection of a small does of nuclear tracer. Electrodes will be placed on your chest; your heart rate and rhythm will be continuously monitored throughout the test as you walk on a special treadmill. The speed and elevation will increase to make you heart work harder. The average time spent walking on the treadmill is 6-10 minutes. Once a Target Heart Rate is achieved, a small dose of nuclear tracer will be given through your IV site and you will need to walk for one minute following the injection. Your last set of pictures will be taken after you have stopped walking and have rested for a few minutes.
  
• The reading physician will be able to compare the “rest” and the “stress” pictures and be able to see if there are any areas where blood flow to the heart muscle is decreased.
  

AFTER YOUR TEST

• You may leave after your test is completed. There are no restrictions on driving associated with this test.
  
• The technologist cannot give you any test results. But, he or she can answer any general questions you may have.
  
• The scan will be read and interpreted by a specialist in nuclear radiology.
  
• Make a follow-up appointment with your provider one week after your test to discuss your results.
  
• Do not exercise or exert yourself until you have received your test results.

BILLING

You will receive two bills for your radiology examination. Western Wisconsin Health will bill for the examination. There will be a separate bill for the interpretation.

We thank you for allowing us to serve you and welcome any questions or comments you may have.

PATIENTS RIGHTS

As a patient you have the right to know about and discuss with your family, your doctor and your nurse exactly what type of treatment and care you will be receiving.

The healthcare team of Western Wisconsin Health accepts the responsibility to ensure that you are adequately informed about all procedures. We hope the enclosed information will help.

Please arrive 15 minutes early.
If you need to reschedule or cancel your appointment, please call the Western Wisconsin Health Imaging Department at 715-684-1395.

We will call you the day before your scheduled procedure to confirm your appointment. If your procedure is on a Monday, we will call you the Friday before.

Enter through the Western Wisconsin Health main entrance and report to the Imaging Department 15 minutes prior to your scheduled appointment. After registering, you will be asked to wait in the waiting room until all of your paperwork is done. A technologist will then take you to the imaging area.

WHAT IS A MAMMOGRAM?

A mammogram is an x-ray image of the breast. It is the best screening tool used today to find breast cancer early. A mammogram can find cancer before a lump can be felt.

Have a mammogram every year starting at the age 40. If you are younger than 40 with a family history of breast cancer or other concerns, talk with your health care provider about what screening tests are right for you. Have a clinical breast exam at least every 3 years starting at age 20, and every year starting at age 40.

PREPARATION

• Avoid using deodorants, antiperspirants, powders or lotions on the breasts and underarm areas on the day of the exam. Ingredients of these products can show up on a mammogram and make it harder to interpret.
  
• You may eat and resume your normal activities unless your doctor gives you other directions.
  
• Take any prescribed medicines by your doctor as directed.
  
• Before your mammogram, you will undress from the waist up, so it is a good idea to wear a shirt you can remove easily.
  

DURING THE EXAM

Getting a screening mammogram takes about 20 minutes. During the procedure, each breast is pressed between two plates and an x-ray image is made. Two views of each breast are taken, one with the x-ray
beam aimed from top to bottom and the other from side to side. Sometimes the pressure can be uncomfortable, but only lasts a few seconds.

BREAST IMPLANTS AND MAMMOGRAPHY

Mammography is a safe and effective screening tool for women who have breast implants. However, the implants can make it harder to interpret the mammogram. So, if you have implants, it is important to tell your physician before scheduling your mammogram. The mammography machine must be specially adjusted to get the best image of the natural breast tissue. Special positioning of the breast may also be required. Four views of each breast will be taken (instead of the standard two).

BREAST CANCER FACTS

• One in eight women will be diagnosed with breast cancer in her lifetime.
  
• Breast cancer is the most commonly diagnosed cancer in women.
  
• Breast cancer is the second leading cause of cancer death among women.
  
• Each year it is estimated that over 230,000 women in the United States will be diagnosed with breast cancer and more than 40,000 will die.
  
• Although breast cancer in men is rare, an estimated 2,350 men will be diagnosed with breast cancer and approximately 440 will die each year.
  
• Over 2.9 million breast cancer survivors are alive in the United States.
  

RISK FACTORS INCLUDE:

• Being a woman
  
• Getting older
  
• A personal history of breast cancer
  
• A family history of breast or ovarian cancer
  
• Never having children or having a first child after age 35
  
• Beginning your menstrual period at an early age (before 12)
  
• Alcohol use
  
• Current or recent use (for more than 5 years) of menopausal hormone therapy (postmenopausal hormone use) containing estrogen plus progestin
  

DIGITAL BREAST TOMOSYNTHESIS (3D MAMMOGRAPHY)

What are the advantages of having a digital tomosynthesis exam if I am visiting for a routine screening mammogram?

• Tomosynthesis helps to distinguish normal overlapping tissue from an underlying mass, and it can lead to a more accurate diagnosis.
  
• Tomosynthesis reduces the chances of screening patients having to come back for additional imaging tests.
  

What are the advantages of having a digital tomosynthesis exam if I am visiting for a diagnostic mammogram?

• Tomosynthesis improves the accuracy of the mammogram in some diagnostic patients. The radiologist may use tomosynthesis in your evaluation if he or she feels that it will be helpful.
  

How much additional radiation will I receive?

• The radiation dose is equivalent between tomosynthesis and the traditional mammogram for each view.
  

What happens if I choose not to undergo a tomosynthesis exam?

• A state-of-the-art standard digital mammogram will still be performed.

AFTER THE EXAM

• The technologist cannot give you any test results. But, he or she can answer any general questions you may have.
  
• You will be able to go home and return to normal activities.
  
• The scan will be read by a radiologist. You can expect follow-up from your provider regarding the results of your test.
  

BILLING

You will receive two bills for your radiology examination. Western Wisconsin Health will bill for the examination. There will be a separate bill for the interpretation.

We thank you for allowing us to serve you and welcome any questions or comments you may have.

PATIENTS RIGHTS

As a patient you have the right to know about and discuss with your family, your doctor and your nurse exactly what type of treatment and care you will be receiving.

The healthcare team of Western Wisconsin Health accepts the responsibility to ensure that you are adequately informed about all procedures. We hope the enclosed information will help.

Please arrive 15 minutes early.
If you need to reschedule or cancel your appointment, please call the Western Wisconsin Health Imaging Department at 715-684-1395.

We will call you the day before your scheduled procedure to confirm your appointment. If your procedure is on a Monday, we will call you the Friday before.

Enter through the Western Wisconsin Health main entrance and report to the Imaging Department 15 minutes prior to your scheduled appointment. After registering, you will be asked to wait in the waiting room until all of your paperwork is done. A technologist will then take you to the imaging area.

WHAT IS AN MRI?

An MRI is a non-invasive and painless procedure in which radio waves and powerful magnets linked to a computer are used to create remarkably clear and detailed pictures from side-to-side, top-to-bottom, and front-to-back. The pictures show the difference between normal and abnormal tissue and enable doctors to determine what the inside of a particular structure looks like. This makes it very useful in diagnosing abnormalities in all parts of the body. A MRI takes a body part and slices it and produces an images of each slice. Much like taking a loaf of bread and looking at one slice at a time.

PREPARATION

MRI can be performed through clothing. However, metals in the area being scanned can cause errors in the images called artifacts. Therefore, you will be asked to remove your jewelry, watch, hairpins, bobby
pins, hearing aids, removable dental work, bra, and glasses. Your hair should be free of hairspray or gel and you should avoid wearing makeup.

The MR technologist will ask you questions before you have your procedure. It is very important that he or she know if you have:

• had any surgeries
  
• a pacemaker
  
• aneurysm clips
  
• a history of working with metal
  
• an implanted drug infusion device
  
• a history of injury by bullet or shrapnel
  
• metallic plates, pins, screws, or other implants
  
• an IUD
  
• tattoos or permanent makeup
• a transdermal patch, nicotine or hormone patch
  

Check with the technologist if you have any questions of concerns about any implanted object or health condition that could impact your MRI. Be sure to notify the technologist if you think you may be pregnant.

If you are having a scan of the abdomen, (MRCP, Liver, Pancreas, Kidneys), do not eat or drink anything 4 hours prior to your scan.

While our machine is state of the art and has been designed to be as comfortable as possible, due to the nature of MRI and the necessity to remain still during the duration of the test some patients do feel claustrophobic. If you are concerned about claustrophobia, please talk with your provider about further options prior to arriving for your appointment.

HAVING AN MRI

Your technologist has been specially trained to perform your MRI. He or she will answer all your questions regarding the test and will make sure you are comfortable during the MRI. After changing into a gown, your technologist will help you get positioned on the MRI table, a special coil may be placed over the area being imaged to improve the quality of the images. You will be under constant observation and will be able
to communicate with the technologist. Headphones will be provided so that you can listen to music during your exam.

The length of your exam will depend on the imaging you are having done and can vary between 30 – 90 minutes. For some MRI studies, a contrast agent may be used to enhance the visibility of certain tissues or blood vessels.

RISKS

Every year approximately 10 million patients undergo MRI procedures. MRI has been shown to be extremely safe as long as proper safety precautions are taken with regard to metal objects. In general, the MRI procedure produces no pain and causes no short or long-term damage of any kind. There is also no radiation exposure and therefore is a preferred option when possible.

If you have any questions or concerns prior to your MRI please call us at 715-684-1395 and we will be happy to help you.

BILLING

You will receive two bills for your examination. Western Wisconsin Health will bill for the examination. There will be a separate bill for the interpretation.

We thank you for allowing us to serve you and welcome any questions or comments you may have.

PATIENTS RIGHTS

As a patient you have the right to know about and discuss with your family, your doctor and your nurse exactly what type of treatment and care you will be receiving.

The healthcare team of Western Wisconsin Health accepts the responsibility to ensure that you are adequately informed about all procedures. We hope the enclosed information will help.

Please arrive 15 minutes early.
If you need to reschedule or cancel your appointment, please call the Western Wisconsin Health Imaging Department at 715-684-1395.

We will call you the day before your scheduled procedure to confirm your appointment. If your procedure is on a Monday, we will call you the Friday before.

Enter through the Western Wisconsin Health main entrance and report to the Imaging Department 15 minutes prior to your scheduled appointment. After registering, you will be asked to wait in the waiting room until all of your paperwork is done. A technologist will then take you to the imaging area.

Important:

If you are a woman of childbearing age (13 – 50) and there is a chance that you are pregnant, please inform your physician.

PATIENT INFORMATION

Nuclear medicine scans use very small, safe amounts of radioactive material to obtain images of specific organs. The radioisotope used depends on the organ to be examined, since each organ picks up its own specific material. Thus, iodine is picked up by the thyroid gland, calcium by the bone, and so on. By using the appropriate material, almost every organ in the body can be scanned.

PURPOSE

Nuclear medicine scanning helps your doctor to see a picture of how your organs function. Organs routinely scanned by this examination include the liver, heart, brain, lungs, and thyroid gland, but many others can be scanned as well.

HOW THE EXAM WORKS

Once the radioisotope reaches the target organ, it is taken up by the cells of the organ, and there, the radioactivity given off can be picked up by a special camera and stored in a computer. Images can also
be photographed and studied. Valuable information on the condition of your various organs and organ systems can be obtained.

DURING THE EXAM

A technologist will help you get properly positioned under the camera, and the radioisotope will be given to you, either in the vein or by mouth. You should realize that you will receive only a tiny amount of radioactive material which will be eliminated from your body in one or two days. Most scans require a variety of images, so you may have to assume different positions.

YOUR PREPARATION

Several hours may be required to perform your scan. Some of the nuclear scan procedures require special preparation.

• Hepatobiliary Scan with CCK (HIDA)
  – Nothing to eat or drink eight hours prior to exam.
  – Should not have had any barium studies five days prior.
  – No pain medications eight hours prior to exam time.
  – Scanning time usually takes 2 hours.
  
• Gastric Emptying Imaging
  – Nothing to eat or drink after midnight if test in am.
  – Nothing to eat or drink eight hours prior if in pm.
  – Two days prior, no pain meds, sedatives or tranquilizers.
  – No caffeine/nicotine 24 hours prior to exam time.
  – Scanning time usually takes 4 hours.
  
• Renal Imaging (with Captopril)
  – Patient should be well hydrated and on clear liquids the morning of the test.
  – Must be off of diuretics for 48 hours. Patient must arrive early for Captopril dose. If patient is on
  Captopril or other ACE Inhibitor, they must bring this medication with. Radiology department will give
  instructions for this.
  
• Thyroid Uptake and Imaging
  – Must not be pregnant or breastfeeding. If breastfeeding, discontinue for four days post scan.
  – If you are on any thyroid medications please contact the radiology department for withholding times.
  – No iodine contrast agents for at least 4 weeks.
  

AFTER THE EXAM

• The technologist cannot give you any test results. But, he or she can answer any general questions you may have.
  
• You will be able to go home and return to normal activities.
  
• The scan will be read by a radiologist. You can expect follow-up from your provider regarding the results of your test.
  

BILLING

You will receive two bills for your radiology examination. Western Wisconsin Health will bill for the examination. There will be a separate bill for the interpretation.

We thank you for allowing us to serve you and welcome any questions or comments you may have.

PATIENTS RIGHTS

As a patient you have the right to know about and discuss with your family, your doctor and your nurse exactly what type of treatment and care you will be receiving.

The healthcare team of Western Wisconsin Health accepts the responsibility to ensure that you are adequately informed about all procedures. We hope the enclosed information will help.

Please arrive 15 minutes early.
If you need to reschedule or cancel your appointment, please call the Western Wisconsin Health Imaging Department at 715-684-1395.

We will call you the day before your scheduled procedure to confirm your appointment. If your procedure is on a Monday, we will call you the Friday before.

Enter through the Western Wisconsin Health main entrance and report to the Imaging Department 15 minutes prior to your scheduled appointment. After registering, you will be asked to wait in the waiting room until all of your paperwork is done. A technologist will then take you to the imaging area.

PREP BEFORE YOUR EXAM

You will receive a handout with additional information.

SAFETY OF PET/CT EXAMS

Be assured that PET/CT exams are a safe and effective diagnostic procedure. The radiopharmaceuticals used in PET do not remain in your system long, so there’s no reason to avoid interacting with other people once you’ve left. To be extra safe, wait for a few hours before getting too close to an infant or anyone who is pregnant.

WHAT IS A PET/CT?

PET/CT combines the functional information from a Positron Emission Tomography (PET) exam with anatomical information from a Computed Tomography (CT) exam in one single exam.

A PET scan detects changes in cellular function- specifically, how your cells are utilizing nutrients like sugar and oxygen. Since these functional changes take place before physical changes occur, PET can
provide information that enables your physician to make an early diagnosis.

The advantage of CT is its ability to take cross sectional images of your body. These are combined with the information from the PET scan to provide more anatomic details of the metabolic changes in your body.

The PET exam pinpoints metabolic activity in cells and the CT exam provides an anatomical reference. When these two scans are fused together, your physician can view metabolic changes in the proper
anatomical context of your body.

WHY DO I NEED THIS EXAM?

Your PET/CT exam results may have a major impact on your diagnosis, and course of treatment selected by your physician.

A PET/CT study not only helps your physician diagnose a problem, it also helps your physician predict the likely outcome of various therapeutic alternatives, pinpoint the best approach to treatment, and monitor your progress. If you are not responding as well as expected, you may be switched to an alternative therapy.

Ask your physician what he or she hopes to learn from your PET/CT exam.

WHAT SHOULD I EXPECT WHEN I ARRIVE?

When you arrive, we will review your history and any past exams.

For the PET portion of the exam, you will receive an injection of radioactive material similar to what is used for bone scans and other nuclear medicine exams. This is a radioactive tracer that must pass multiple quality control measures before it is used for any patient injection.

PET radiopharmaceuticals lose their radioactivity very quickly (two hours) and only very small amounts are injected. In all cases, the majority of radioactivity will be eliminated from the body approximately 6 hours after injection.

After your injection, you will be asked to wait in our injection suite for one hour while the radiopharmaceutical distributes. During this time you will be asked to relax.

During the exam, you will lie very still on a comfortable table that will move slowly through the scanner as it acquires the information needed to generate diagnostic images.

HOW LONG WILL IT TAKE?

The PET/CT scan should last between 20 and 45 minutes. The exam can vary depending on what we are looking for and what we discover along the way. Plan to spend two to three hours with us.

AFTER THE EXAM

• The technologist cannot give you any test results. But, he or she can answer any general questions you may have.
  
• You will be able to go home and return to normal activities.
  
• The scan will be read by a radiologist. You can expect follow-up from your provider regarding the results of your test.
  
• Unless you’ve received special instructions, you will be able to eat and drink immediately. Drinking lots of fluids soon after the exam will help remove any of the radiopharmaceutical that may still be in your system.

BILLING

You will receive two bills for your examination. Western Wisconsin Health will bill for the examination. There will be a separate bill for the interpretation.

We thank you for allowing us to serve you and welcome any questions or comments you may have.

PATIENTS RIGHTS

As a patient you have the right to know about and discuss with your family, your doctor and your nurse exactly what type of treatment and care you will be receiving.

The healthcare team of Western Wisconsin Health accepts the responsibility to ensure that you are adequately informed about all procedures. We hope the enclosed information will help.

Please arrive 15 minutes early.
If you need to reschedule or cancel your appointment, please call the Western Wisconsin Health Imaging Department at 715-684-1395. If you are calling after 4:00 pm or on a weekend to cancel your test, please call CMI at 1-800-236-0084.

We will call you the day before your scheduled test to confirm your appointment. If your test is on a Monday, we will call you the Friday before.

Enter through the Western Wisconsin Health main entrance and report to the Imaging Department 15 minutes prior to your scheduled appointment.

STRESS TESTS ARE ORDERED FOR MANY REASONS:

• Diagnose Coronary Artery Disease
  
• Evaluate symptoms such as chest pain, shortness of breath, or fatigue
  
• Evaluate abnormal EKG
  
• Prior to a surgical procedure
  
• Determine exercise tolerance
  

Since you are unable to exercise, your doctor would like you to have a Pharmacological Stress Test. This test allows your physician to see how well blood is flowing to your heart during rest and with medication.

The test is completed in the Imaging Department. It takes about 3-4 hours. Please plan your day accordingly. Specially trained staff will be with you throughout the procedure.

THINGS TO KEEP IN MIND BEFORE YOUR TEST:

• Do not eat or drink anything that has caffeine (such as regular or decaffeinated coffee, tea, pop, energy drinks, Crystal Light, or chocolate) for 12 hours before your test.
  
• No alcohol for 24 hours before the test.
  
• Take your medications as directed unless otherwise instructed.
  
• Do not smoke for 4 hours before arriving for your test.
• You may eat a light breakfast 2 hours before your arrival.
  
• You should not have had any other nuclear medicine exams within 24 hours preceding your cardiac stress test.
  
• If you need to cancel your test, 24 hours notification is required.
  

DURING YOUR TEST

• When you arrive for your test, a brief medical history will be completed and an intravenous (IV) line will be inserted for the injection of a small dose of nuclear tracer. During this time, you will be able to read or watch television while you wait.
  
• A series of pictures lasting about 15 minutes will be taken at rest and again after the medication portion of the test.
  
• During the stress portion of the stress test, electrodes will be placed on your chest to evaluate your heart rhythm. Your heart rate, rhythm, and blood pressure will be monitored closely.
  
• Medication is given through your IV. You may experience flushing, headache, chest discomfort, shortness of breath, or other symptoms. These symptoms are expected and usually resolve within 1-2 minutes after the medication is given. Following the medication, a second dose of nuclear tracer is injected.
  
• The reading physician will be able to compare the “rest” and the “stress” pictures and be able to see if there are any areas where blood flow to the heart muscle is decreased.
  
• This test is done in conjunction with Computerized Medical Imaging, Inc. (CMI)
  

AFTER YOUR TEST

• You may leave after your test is completed. There are no restrictions on driving associated with this test.
  
• The technologist cannot give you any test results. But, he or she can answer any general questions you may have.
  
• The scan will be read and interpreted by a specialist in nuclear radiology.
  
• Make a follow-up appointment with your provider one week after your test to discuss your results.
  
• Do not exercise or exert yourself until you have received your test results.

BILLING

You will receive two bills for your radiology examination. Western Wisconsin Health will bill for the examination. There will be a separate bill for theinterpretation.

We thank you for allowing us to serve you and welcome any questions or comments you may have.

PATIENTS RIGHTS

As a patient you have the right to know about and discuss with your family, your doctor and your nurse exactly what type of treatment and care you will be receiving.

The healthcare team of Western Wisconsin Health accepts the responsibility to ensure that you are adequately informed about all procedures. We hope the enclosed information will help.

Please arrive 15 minutes early.
If you need to reschedule or cancel your appointment, please call the Western Wisconsin Health Cardiac Rehab Department at 715-684-1485. If you are calling after 4:00 pm or on a weekend to cancel your test, please call CMI at 1-800-236-0084.

We will call you the day before your scheduled procedure to confirm your appointment. If your procedure is on a Monday, we will call you the Friday before.

Enter through the Western Wisconsin Health main entrance and report to the Imaging Department 15 minutes prior to your scheduled appointment. After registering, you will be asked to wait in the waiting room until all of your paperwork is done. A technologist will then take you to the imaging area.

STRESS TESTS ARE ORDERED FOR MANY REASONS:

• To diagnose Coronary Artery Disorder
  
• To evaluate symptoms such as chest pain, shortness of breath, or abnormal fatigue
  
• If you’ve had an abnormal EKG
  
• Prior to a surgical procedure
  

Since you are unable to exercise, your doctor would like you to have a Pharmacological Stress Test. This test allows your physician to see how well blood is flowing to your heart during rest and with medication.

The test requires two appointments and is completed in the Imaging Department. The rest scan appointment will take approximately one hour. The stress appointment will take approximately two
hours. Please plan accordingly. Specially trained staff will be with you throughout the procedure.

THINGS TO KEEP IN MIND BEFORE YOUR TEST:

• Do not eat or drink anything that has caffeine (such as regular or decaffeinated coffee, tea, pop, energy drinks, Crystal Light, or chocolate) for 12 hours before your test.
  
• No alcohol for 24 hours before the test.
  
• Take your medications as directed unless otherwise instructed.
  
• Do not smoke for 4 hours before arriving for your test.
  
• You may eat a light breakfast 2 hours before your arrival.
  
• You should not have had any other nuclear medicine exams within 24 hours preceding your cardiac stress test.
  

DURING YOUR TEST

• When you arrive for your rest scan, you will receive an injection of a small dose of nuclear tracer, which will need to absorb for a short period of time. During this time, you will be able to read or watch TV. Once the tracer is absorbed, a series of pictures lasting about 30 minutes will be taken.
  
• When you arrive for your stress scan, a brief medical history will be completed and an intravenous (IV) line will be started for the injection of the stress medication. Electrodes will be placed on your chest; your heart rate and rhythm will be continuously monitored throughout the test as medication is given through your IV. You may experience flushing, headache, chest discomfort, shortness of breath, or other symptoms. These symptoms are expected and usually resolve within 1-2 minutes after the injection is complete. Following the medication, small does of nuclear tracer will be injected. It will require a short amount of time to absorb and then you will have one last set of pictures taken.
  
• The reading physician will be able to compare the “rest” and the “stress” pictures and be able to see if there are any areas where blood flow to the heart muscle is decreased.
  

AFTER YOUR TEST

• You may leave after your test is completed. There are no restrictions on driving associated with this test.
  
• The technologist cannot give you any test results. But, he or she can answer any general questions you may have.
  
• The scan will be read and interpreted by a specialist in nuclear radiology.
  
• Make a follow-up appointment with your provider one week after your test to discuss your results.
  
• Do not exercise or exert yourself until you have received your test results.

BILLING

You will receive two bills for your radiology examination. Western Wisconsin Health will bill for the examination. There will be a separate bill for the interpretation.

We thank you for allowing us to serve you and welcome any questions or comments you may have.

PATIENTS RIGHTS

As a patient you have the right to know about and discuss with your family, your doctor and your nurse exactly what type of treatment and care you will be receiving.

The healthcare team of Western Wisconsin Health accepts the responsibility to ensure that you are adequately informed about all procedures. We hope the enclosed information will help.

Please arrive 15 minutes early.
If you need to reschedule or cancel your appointment, please call the Western Wisconsin Health Cardiac Rehab Department at 715-684-1485.

We will call you the day before your scheduled procedure to confirm your appointment. If your procedure is on a Monday, we will call you the Friday before.

Enter through the Western Wisconsin Health main entrance and report to the Imaging Department 15 minutes prior to your scheduled appointment. After registering, you will be asked to wait in the waiting room until all of your paperwork is done. A technologist will then take you to the imaging area.

STRESS TESTS ARE ORDERED FOR MANY REASONS:

• To diagnose Coronary Artery Disease
  
• To evaluate symptoms such as chest pain, shortness of breath, or abnormal fatigue
  
• If you’ve had an abnormal EKG
  
• Prior to a surgical procedure
  
• To determine exercise tolerance
  

Your doctor would like you to have a Stress Echocardiogram to see how your heart is functioning. This imaging test combines electrocardiogram (EKG) and echocardiogram (an ultrasound of the heart) technologies to evaluate your heart under the stress of exercise.

This test takes 1-1/2 hours. Please plan your day accordingly.

THINGS TO KEEP IN MIND BEFORE THE TEST:

• Do not eat, drink caffeinated beverages or smoke for 2 hours before your test.
  
• No alcohol intake for 24 hours.
  
• Take your medications as directed unless otherwise instructed.
  
• Bring or wear comfortable clothing and shoes to exercise in.
  

DURING THE TEST

• Staff will place electrodes on your chest to monitor your heart rate and rhythm continuously throughout your test.
  
• A cardiac sonographer will complete an ultrasound of your heart before you begin to walk on the treadmill.
  
• You will exercise on a special treadmill. The speed and elevation of the treadmill will increase to make your heart work harder.
  
• The average exercise time on the treadmill is 6-10 minutes.
  
• When your Target Heart Rate is attained or when you feel you need to stop, you will be assisted off the treadmill and onto a cart. The sonographer will quickly complete another set of ultrasound images of your heart. You may be asked to hold your breath at times.
  

AFTER THE EXAM

• You may leave after the test is done.
  
• The technologist cannot give you any test results. But, he or she can answer any general questions you may have.
  
• The scan will be read by a cardiologist. You can expect follow-up from your provider regarding the results of your test.
  
• Make a follow-up appointment with your provider one week after your test to discuss your results.
  
• Do not exercise or exert yourself until you have received your test results.
  
• If you have any questions, please call 715-684-1485.
  

BILLING

You will receive two bills for your examination. Western Wisconsin Health will bill for the examination. The
cardiologist will bill separately for his interpretation, consultation with the physician and report.

We thank you for allowing us to serve you and welcome any questions or comments you may have.

PATIENTS RIGHTS

As a patient you have the right to know about and discuss with your family, your doctor and your nurse exactly what type of treatment and care you will be receiving.

The healthcare team of Western Wisconsin Health accepts the responsibility to ensure that you are adequately informed about all procedures. We hope the enclosed information will help.

Please arrive 15 minutes early.
If you need to reschedule or cancel your appointment, please call the Western Wisconsin Health Imaging Department at 715-684-1395.

We will call you the day before your scheduled procedure to confirm your appointment. If your procedure is on a Monday, we will call you the Friday before.

Enter through the Western Wisconsin Health main entrance and report to the Imaging Department 15 minutes prior to your scheduled appointment. After registering, you will be asked to wait in the waiting room until all of your paperwork is done. A technologist will then take you to the imaging area.

WHAT IS AN ULTRASOUND OF THE BREAST?

1. Ultrasound is safe and painless, and produces pictures of the inside of the body using sound waves. Ultrasound imaging involves the use of a small transducer (probe) and ultrasound gel placed directly on the skin. High-frequency sound waves are transmitted from the probe through the gel into the body. The transducer collects the sounds that bounce back and a computer then uses those sound waves to create an image. Ultrasound examinations do not use ionizing radiation (as used in x-rays), thus there is no radiation exposure to the patient.
   
2. Ultrasound imaging is a noninvasive medical test that helps physicians diagnose and treat medical conditions.
   
3. Ultrasound imaging of the breast produces a picture of the internal structures of the breast. It’s primarily used to help diagnose breast lumps or other abnormalities your doctor may have found during a physical exam, mammogram or breast MRI. Ultrasound is safe, noninvasive and does not use ionizing radiation.
   

PREPARATION

• Wear comfortable, loose-fitting clothing. Leave jewelry at home.
  
• You may be asked to change into a gown.
  
• You will be asked to undress from the waist up and to wear a gown during the procedure.
  
• You may eat and resume your normal activities unless your doctor gives you other directions.
  
• Take any prescribed medicines by your doctor as directed.
• You may spend up to 45 minutes to one hour in the Radiology department.
  

AFTER THE EXAM

• The technologist cannot give you any test results. But, he or she can answer any general questions you may have.
• You will be able to go home and return to normal activities.
• The scan will be read by a radiologist.
• You can expect follow-up from your provider regarding the results of your test.
  

BILLING

You will receive two bills for your radiology examination. Western Wisconsin Health will bill for the examination. There will be a separate bill for the interpretation.

We thank you for allowing us to serve you and welcome any questions or comments you may have.

PATIENTS RIGHTS

As a patient you have the right to know about and discuss with your family, your doctor and your nurse exactly what type of treatment and care you will be receiving.

The healthcare team of Western Wisconsin Health accepts the responsibility to ensure that you are adequately informed about all procedures. We hope the enclosed information will help.

Please arrive 15 minutes early.
If you need to reschedule or cancel your appointment, please call the Western Wisconsin Health Imaging Department at 715-684-1395.

We will call you the day before your scheduled procedure to confirm your appointment. If your procedure is on a Monday, we will call you the Friday before.

Enter through the Western Wisconsin Health main entrance and report to the Imaging Department 15 minutes prior to your scheduled appointment. After registering, you will be asked to wait in the waiting room until all of your paperwork is done. A technologist will then take you to the imaging area.

WHAT IS CAROTID ULTRASOUND IMAGING?

1. Ultrasound is safe and painless, and produces pictures of the inside of the body using sound waves. Ultrasound imaging, also called ultrasound scanning or sonography, involves the use of a small transducer (probe) and ultrasound gel placed directly on the skin. High-frequency sound waves are transmitted from the probe through the gel into the body. The transducer collects the sounds that bounce back and a computer then uses those sound waves to create an image. Ultrasound examinations do not use ionizing radiation (as used in x-rays), thus there is no radiation exposure to the patient. Because ultrasound images are captured in real-time, they can show the structure and movement of the body’s internal organs, as well as blood flowing through blood vessels.
   
2. Ultrasound imaging is a noninvasive medical test that helps physicians diagnose and treat medical conditions.
   
3. An ultrasound of the body’s two carotid arteries, which are located on each side of the neck and carry blood from the heart to the brain, provides detailed pictures of these blood vessels and information about the blood flowing through them. A Doppler ultrasound study is usually an integral part of a carotid ultrasound examination.
   

PREPARATION

• Wear comfortable, loose-fitting clothing, loose-fitting open neck shirt or blouse is ideal.
  
• You may be asked to change into a gown.
  
• You may eat and resume your normal activities unless your doctor gives you other directions.
  
• Take any prescribed medicines by your doctor as directed.
  
• You may spend up to 45 minutes to one hour in the Radiology department.
  

AFTER THE EXAM

• The technologist cannot give you any test results. But, he or she can answer any general questions you may have.
  
• You will be able to go home and return to normal activities.
  
• The scan will be read by a radiologist.
  
• You can expect follow-up from your provider regarding the results of your test.
  

BILLING

You will receive two bills for your radiology examination. Western Wisconsin Health will bill for the examination. There will be a separate bill for the interpretation, consultation with the physician and report.

We thank you for allowing us to serve you and welcome any questions or comments you may have.

PATIENTS RIGHTS

As a patient you have the right to know about and discuss with your family, your doctor and your nurse exactly what type of treatment and care you will be receiving.

The healthcare team of Western Wisconsin Health accepts the responsibility to ensure that you are adequately informed about all procedures. We hope the enclosed information will help.

Please arrive 15 minutes early.
If you need to reschedule or cancel your appointment, please call the Western Wisconsin Health Imaging Department at 715-684-1395.

We will call you the day before your scheduled procedure to confirm your appointment. If your procedure is on a Monday, we will call you the Friday before.

Enter through the Western Wisconsin Health main entrance and report to the Imaging Department 15 minutes prior to your scheduled appointment. After registering, you will be asked to wait in the waiting room until all of your paperwork is done. A technologist will then take you to the imaging area.

WHAT IS AN ULTRASOUND?

1. Ultrasound is a modern medical diagnostic procedure that uses sound waves to make images. These images then detect disease and changes inside the human body.
   
2. There is no pain in an ultrasound examination. You will feel the transducer being moved back and forth over the skin surface.
   
3. You will be positioned on the table and a gel will be applied to your skin, to eliminate air between the transducer and skin. You need only to rest quietly.
   
4. Sound waves are transmitted through the transducer, touching organs deep within your body. The waves bounce back and are received by the transducer. An image is then displayed on a TV monitor. Several images are taken and interpreted by a radiologist.
   

PREPARATION

• Do not eat, drink, smoke or chew gum eight hours before the exam until after the exam is completed.
  
• You may spend up to 30 minutes to one hour in the Radiology department.
  

AFTER THE EXAM

• The technologist cannot give you any test results. But, he or she can answer any general questions you may have.
  
• You will be able to go home and return to normal activities.
  
• The scan will be read by a radiologist.
  
• You can expect follow-up from your provider regarding the results of your test.
  

BILLING

You will receive two bills for your radiology examination. Western Wisconsin Health will bill for the examination. There will be a separate bill for the interpretation, consultation with the physician and report.

We thank you for allowing us to serve you and welcome any questions or comments you may have.

PATIENTS RIGHTS

As a patient you have the right to know about and discuss with your family, your doctor and your nurse exactly what type of treatment and care you will be receiving.

The healthcare team of Western Wisconsin Health accepts the responsibility to ensure that you are adequately informed about all procedures. We hope the enclosed information will help.

Please arrive 15 minutes early.
If you need to reschedule or cancel your appointment, please call the Western Wisconsin Health Imaging Department at 715-684-1395.

We will contact you the day before your scheduled procedure to confirm your appointment. If your procedure is on a Monday, we will contact you the Friday before.

Enter through the Western Wisconsin Health main entrance and report to the Imaging Department 15 minutes prior to your scheduled appointment. After registering, you will be asked to wait in the waiting room until all of your paperwork is done. A technologist will then take you to the imaging area.

WHAT IS AN ULTRASOUND?

1. Ultrasound is a modern medical diagnostic procedure that uses sound waves to make images. These images then detect disease and changes inside the human body.
   
2. There is no pain in an ultrasound examination. You will feel the transducer being moved back and forth over the skin surface.
   
3. You will be positioned on the table and a gel will be applied to your skin, to eliminate air between the transducer and skin. You need only to rest quietly.
   
4. Sound waves are transmitted through the transducer, touching organs deep within your body. The waves bounce back and are received by the transducer. An image is then displayed on a TV monitor. Several images are taken and interpreted by a radiologist.
   

PREPARATION

You should be finished drinking 32 oz. of water one hour before exam time. Example: If your exam is scheduled for 8:00 am, have the 32 oz. of water finished by 7:00 am. It takes approximately one hour for the water to filter through the kidneys and travel down to the bladder. Your bladder must be full at exam time, do not empty your bladder.

DURING THE EXAM

• 1st portion – transabdominal/transpelvic scan
  
• 2nd portion – endovaginal scan
  

Transabdominal/Transpelvic Scan:
The transducer probe is scanned across the lower abdomen and pelvic skin surface. A full urinary bladder is needed to view the pelvic structures (uterus, ovaries, and fetus).

A full bladder does three things:

1. The fluid in the bladder helps transmit the sound waves.
   
2. The full bladder helps to flatten out the uterus for better viewing.
   
3. The full bladder pushes the overlying bowel up and out of the way for viewing the pelvic structures.
   

Endovaginal Scan:
Is used for viewing and imaging the female pelvis and first trimester pregnancies.

1. A full urinary bladder is not needed.
   
2. The endovaginal probe (transducer) is inserted into the vaginal canal. This allows the transducer to come closer to the structures of interest (uterus, ovaries and early fetus).
   

After the first portion of the exam is completed, the patient is allowed to empty her bladder. The patient will be asked to change into a hospital gown, and then will be brought back to the ultrasound room. Lying on the ultrasound table, the patient will be fully draped. The patient will be asked to insert the sterilized and
sheath-covered endovaginal probe into the vaginal canal 2 – 3 inches. The size and discomfort of the probe is similar to that of a tampon. The sonographer will then handle the probe for viewing of the pelvic
structures.

Plan to spend up to one hour in the Imaging Department.

AFTER THE EXAM

• The technologist cannot give you any test results. But, he or she can answer any general questions you may have.
  
• You will be able to go home and return to normal activities.
  
• The scan will be read by a radiologist.
  
• You can expect follow-up from your provider regarding the results of your test.
  

BILLING

You will receive two bills for your examination. Western Wisconsin Health will bill for the examination. There will be a separate bill for the interpretation.

We thank you for allowing us to serve you and welcome any questions or comments you may have.

PATIENTS RIGHTS

As a patient you have the right to know about and discuss with your family, your doctor and your nurse exactly what type of treatment and care you will be receiving.

The healthcare team of Western Wisconsin Health accepts the responsibility to ensure that you are adequately informed about all procedures. We hope the enclosed information will help.

Please arrive 15 minutes early.
If you need to reschedule or cancel your appointment, please call the Western Wisconsin Health Imaging Department at 715-684-1395.

We will contact you the day before your scheduled procedure to confirm your appointment. If your procedure is on a Monday, we will contact you the Friday before.

Enter through the Western Wisconsin Health main entrance and report to the Imaging Department 15 minutes prior to your scheduled appointment. After registering, you will be asked to wait in the waiting room until all of your paperwork is done. A technologist will then take you to the imaging area.

To allow the sonographer to focus on the fetal imaging, we strongly encourage adult supervision for any child under the age of 5 who is accompanying you.

WHAT IS A BASIC FETAL ANATOMY SCREEN?

Ultrasound uses sound waves to make a picture of your baby inside your uterus (womb). An ultrasound scan can help your healthcare provider check the health of the baby. Your provider can also use it to look
at your uterus, amniotic sac, placenta, and ovaries. It is a very safe test. It will not hurt you or the baby.

A basic fetal anatomy screen is a set protocol that can help your healthcare provider assess:

• Fetal number
  
• Fetal growth and weight
  
• For some birth defects
  
• Placenta location
  
• Surrounding maternal structures
  

A basic fetal anatomy screen is preferred to be performed no earlier than 21 weeks unless your provider requests it to be performed earlier. If performed earlier than 21 weeks there is a chance the sonographer
will not get all of the required images and you will have to return for an additional scan, causing additional costs to you.

The sonographer will attempt to see gender if desired, however it is not a guarantee and a repeat ultrasound WILL NOT be warranted to evaluate for gender only.

Sonographer will attempt to get a few pictures for you, including 3D/4D however the position of the baby may not make that possible. If you are not familiar with looking at ultrasound images, it may be hard for you to know what you are seeing. Your healthcare provider can help explain those images to you. Please talk to your healthcare provider if you have any questions.

PREPARATION

You should be finished drinking 32 oz. of water one hour before exam time. Example: If your exam is scheduled for 8:00 am, have the 32 oz. of water finished by 7:00 am. It takes approximately one hour for the water to filter through the kidneys and travel down to the bladder. Your bladder must be full at exam time, do not empty your bladder.

DURING THE EXAM

Transabdominal/Transpelvic Scan:
The transducer probe is scanned across the lower abdomen and pelvic skin surface. A full urinary bladder is needed to view the pelvic structures (cervix, uterus, ovaries, and fetus). After obtaining these images you should be able to void.

A full bladder does three things:

1. The fluid in the bladder helps transmit the sound waves.
   
2. The full bladder helps to flatten out the uterus for better viewing.
   
3. The full bladder pushes the overlying bowel up and out of the way for viewing the pelvic structures.
   

Plan to spend up to 1 hour in the Imaging Department.

AFTER THE EXAM

• The technologist cannot give you any test results. But, he or she can
  answer any general questions you may have.
  
• You will be able to go home and return to normal activities.
  
• The scan will be read by a radiologist.
  
• You can expect follow-up from your provider regarding the results of your test.
  

BILLING

You will receive two bills for your examination. Western Wisconsin Health will bill for the examination. There will be a separate bill for the interpretation.

We thank you for allowing us to serve you and welcome any questions or comments you may have.

PATIENTS RIGHTS

As a patient you have the right to know about and discuss with your family, your doctor and your nurse exactly what type of treatment and care you will be receiving.

The healthcare team of Western Wisconsin Health accepts the responsibility to ensure that you are adequately informed about all procedures. We hope the enclosed information will help.

Please arrive 15 minutes early.
If you need to reschedule or cancel your appointment, please call the Western Wisconsin Health Imaging Department at 715-684-1395.

We will contact you the day before your scheduled procedure to confirm your appointment. If your procedure is on a Monday, we will contact you the Friday before.

Enter through the Western Wisconsin Health main entrance and report to the Imaging Department 15 minutes prior to your scheduled appointment. After registering, you will be asked to wait in the waiting room until all of your paperwork is done. A technologist will then take you to the imaging area.

WHAT IS A BIOPHYSICAL PROFILE?

A biophysical profile (BPP) is a way to check the health of your baby some time before birth. An ultrasound test is done to check how the baby is behaving (muscle tone, movements and whether the baby is practicing breathing) and the amount of fluid around the baby. Sometimes a non-stress test is performed. A non-stress test uses a machine called a fetal monitor to watch the baby heart-rate patterns for at least 20 minutes. The non-stress test may be used separately or together with the ultrasound portion of the biophysical profile.

The test results are given a score of 0 to 10. This score helps your healthcare provider know more about your baby’s health. If the result of a non-stress test of the baby is nonreactive, a biophysical profile may be done. Nonreactive means that the baby didn’t move enough during the test or the baby’s heart rate did not change the way it should have when the baby did move. However, sometimes the biophysical profile is used without the non-stress test.

Healthcare providers usually recommend a biophysical profile during the third trimester of high-risk pregnancies. In some high-risk pregnancies a biophysical profile is done once or twice a week. The goal of
this testing is to detect problems your baby may have as early as possible.

PREPARATION

Your healthcare provider will discuss the procedure with you and give you any special instructions.

DURING THE EXAM

If a non-stress test is ordered, it uses an external fetal monitor which is attached to your abdomen with belts to look at how the baby’s heart rate changes when the baby moves.

During the ultrasound exam four things are checked:

• The amount of amniotic fluid
  
• Movements of the baby’s body
  
• The baby’s muscle tone
  
• Practice breathing movements made by the baby
  

The biophysical profile:

• Helps detect problems the unborn baby might have. When these problems are detected, your provider may decide to deliver the baby before the due date for the baby’s safety.
  
• May prevent premature birth by giving reassurance that it is safe to continue a pregnancy. A pregnancy may be high risk because, for example, the mother has a chronic illness or other serious
  problems. These problems could affect the baby. A normal biophysical profile can reassure the mother and provider that the baby is doing OK and the pregnancy can continue until closer to the due date, when the baby will be more mature.
  
• Helps reduce the risk of death of the baby after 24 weeks of pregnancy.

There are no known risks associated with this test. The sound waves used for ultrasound scanning are not dangerous.

Plan to spend up to 1 hour in the Imaging Department.

AFTER THE EXAM

• The technologist cannot give you any test results. But, he or she can answer any general questions you may have.
  
• You will be able to go home and return to normal activities.
  
• The scan will be read by a radiologist.
  
• You can expect follow-up from your provider regarding the results of your test.
  

BILLING

You will receive two bills for your examination. Western Wisconsin Health will bill for the examination. There will be a separate bill for the interpretation.

We thank you for allowing us to serve you and welcome any questions or comments you may have.

PATIENTS RIGHTS

As a patient you have the right to know about and discuss with your family, your doctor and your nurse exactly what type of treatment and care you will be receiving.

The healthcare team of Western Wisconsin Health accepts the responsibility to ensure that you are adequately informed about all procedures. We hope the enclosed information will help.

Please arrive 15 minutes early.
If you need to reschedule or cancel your appointment, please call the Western Wisconsin Health Imaging Department at 715-684-1395.

We will contact you the day before your scheduled procedure to confirm your appointment. If your procedure is on a Monday, we will contact you the Friday before.

Enter through the Western Wisconsin Health main entrance and report to the Imaging Department 15 minutes prior to your scheduled appointment. After registering, you will be asked to wait in the waiting room until all of your paperwork is done. A technologist will then take you to the imaging area.

WHAT IS AN ULTRASOUND?

1. Ultrasound is a modern medical diagnostic procedure that uses sound waves to make images. These images then detect disease and changes inside the human body.
   
2. There is no pain in an ultrasound examination. You will feel the transducer being moved back and forth over the skin surface.
   
3. You will be positioned on the table and a gel will be applied to your skin, to eliminate air between the transducer and skin. You need only to rest quietly.
   
4. Sound waves are transmitted through the transducer, touching organs deep within your body. The waves bounce back and are received by the transducer. An image is then displayed on a TV monitor. Several images are taken and interpreted by a radiologist.
   

PREPARATION

You should be finished drinking 32 oz. of water one hour before exam time. Example: If your exam is scheduled for 8:00 am, have the 32 oz. of water finished by 7:00 am. It takes approximately one hour
for the water to filter through the kidneys and travel down to the bladder. Your bladder must be full at exam time, do not empty your bladder.

DURING THE EXAM

• 1st portion – transabdominal/transpelvic scan
  
• 2nd portion – endovaginal scan
  

Transabdominal/Transpelvic Scan:
The transducer probe is scanned across the lower abdomen and pelvic skin surface. A full urinary bladder is needed to view the pelvic structures (uterus and ovaries).

A full bladder does three things:

1. The fluid in the bladder helps transmit the sound waves.
   
2. The full bladder helps to flatten out the uterus for better viewing.
   
3. The full bladder pushes the overlying bowel up and out of the way for viewing the pelvic structures.
   

Endovaginal Scan:
Is used for viewing and imaging the female pelvis.

1. A full urinary bladder is not needed.
   
2. The endovaginal probe (transducer) is inserted into the vaginal canal. This allows the transducer to come closer to the structures of interest (uterus and ovaries).
   

After the first portion of the exam is completed, the patient is allowed to empty their bladder. The patient will be asked to change into a hospital gown, and then will be brought back to the ultrasound room. Lying on the ultrasound table, the patient will be fully draped. The patient will be asked to insert the sterilized and sheath-covered endovaginal probe into the vaginal canal 2 – 3 inches. The size and discomfort of the probe is similar to that of a tampon. The sonographer will then handle the probe for viewing of the pelvic
structures.

Plan to spend up to 45 minutes to one hour in the Imaging Department.

AFTER THE EXAM

• The technologist cannot give you any test results. But, he or she can answer any general questions you may have.
• You will be able to go home and return to normal activities.
• The scan will be read by a radiologist.
• You can expect follow-up from your provider regarding the results of your test.
  

BILLING

You will receive two bills for your radiology examination. Western Wisconsin Health will bill for the examination. There will be a separate bill for the interpretation.

We thank you for allowing us to serve you and welcome any questions or comments you may have.

PATIENTS RIGHTS

As a patient you have the right to know about and discuss with your family, your doctor and your nurse exactly what type of treatment and care you will be receiving.

The healthcare team of Western Wisconsin Health accepts the responsibility to ensure that you are adequately informed about all procedures. We hope the enclosed information will help.

Please arrive 15 minutes early.
If you need to reschedule or cancel your appointment, please call the Western Wisconsin Health Imaging Department at 715-684-1395.

We will call you the day before your scheduled procedure to confirm your appointment. If your procedure is on a Monday, we will call you the Friday before.

Enter through the Western Wisconsin Health main entrance and report to the Imaging Department 15 minutes prior to your scheduled appointment. After registering, you will be asked to wait in the waiting room until all of your paperwork is done. A technologist will then take you to the imaging area.

WHAT IS AN ULTRASOUND GUIDED PROSTATE BIOPSY?

1. The procedure is done in the Imaging Department with local anesthesia. A thumb shaped ultrasound probe that uses sound waves, is inserted into the rectum. The prostate is visualized to highlight areas suspicious for stones or tumors.
   
2. If there has been either a suspicious exam of the prostate and/or elevated Prostate Specific Antigen or PSA level, your surgeon will do a biopsy to rule out cancer.
   
3. The ultrasound guides the doctor for accurate biopsies. The biopsies are taken with a spring loaded fine needle placed through the ultrasound probe. Twelve biopsies are usually taken. The entire procedure takes approximately 10-20 minutes.
   

POSSIBLE RISKS

• You may have some soreness around the rectum. you may have blood in the urine, ejaculation and stool for a few days after the biopsy. Rarely, bleeding could be severe enough to obstruct the flow of urine, requiring a catheter to be placed to irrigate the clots.
  
• You will be given an antibiotic or a prescription for an antibiotic. It is vital that you take this medication as ordered to prevent infection.
  

PREPARATION

• There is no need to fast for this procedure, so you may eat a normal diet.
  
• Give yourself a Fleet enema at home two hours before the procedure. This can be purchased at most drugstores. Follow the directions on the enema box.
  
• A prescription for antibiotics will be ordered for you. Follow the instructions as prescribed.
  
• Your physician may or may not order an additional antibiotic given by injection prior to your procedure. You will be advised whether or not your physician has ordered this for you.
  
• We suggest you have someone to drive you home from the procedure.
  
• Fourteen days prior to the procedure, discontinue the following herbal medications:
  

Danshen                Gingseng
Dong Quai             Goldenseal
Echinacea              Kava
Ephedra                 Licorice
Feverfew                St. Johns Wort
Fish Oil                  Valerian
Garlic                     Vitamin K
Ginger                    Yohimbe
Gingko

• Seven days prior to the procedure, discontinue these medications:
  

Aspirin and all aspirin containing
medicines (Anacin, Excedrin,
Pepto Bismal). Before taking any
pain or cold medications, check all
bottles for aspirin.
Vitamin E
Ticlid
Plavix
Trental
Aggrenox (Dipyridamole/ASA
Multivitamins
Calcium supplements
Nonsteroidal anti-inflammatory
medications (NSAIDS)
Arthritis medications such as:
celecoxib (Celebrex)
etodolac (Lodine)
fenoprofen (Nalfon)
ibuprofen (Advil, Motrin, Nuprin)
ketorolac (Toradol)
meclofenamate (Meclomen
mefenamic acid (Ponstel)
naproxen (Aleve, Anaprox,
Naprosyn) piroxicam (Feldene)
sulindac (Clinoril)

• Five days prior to the procedure, discontinue medications such as Warfarin (Coumadin). Please contact your prescribing physician before your procedure.
  
• Please note: If these guidelines are not followed, the procedure may be cancelled.
  

AFTER THE EXAM

• Please see the separate form outlining the specific restrictions after the biopsy. Your provider will call you with the biopsy result. Please call your provider if you have not been called after 5 working days – 651-999-6800.
  

We thank you for allowing us to serve you and welcome any questions or comments you may have.

PATIENTS RIGHTS

As a patient you have the right to know about and discuss with your family, your doctor and your nurse exactly what type of treatment and care you will be receiving.

The healthcare team of Western Wisconsin Health accepts the responsibility to ensure that you are adequately informed about all procedures. We hope the enclosed information will help.

Please arrive 15 minutes early.
If you need to reschedule or cancel your appointment, please call the Western Wisconsin Health Imaging Department at 715-684-1395.

We will call you the day before your scheduled procedure to confirm your appointment. If your procedure is on a Monday, we will call you the Friday before.

Enter through the Western Wisconsin Health main entrance and report to the Imaging Department 15 minutes prior to your scheduled appointment. After registering, you will be asked to wait in the waiting room until all of your paperwork is done. A technologist will then take you to the imaging area.

WHAT IS ULTRASOUND IMAGING OF THE SCROTUM?

1. Ultrasound imaging of the scrotum uses sound waves to produce pictures of a man’s testicles and surrounding tissue. It is the primary method used to help evaluate disorders of the testicles, epididymis (a tube immediately next to a testicle that collects sperm) and scrotum.
   
2. Ultrasound is safe and painless, and produces pictures of the inside of the body using sound waves.
   Ultrasound imaging, also called ultrasound scanning or sonography, involves the use of a small transducer (probe) and ultrasound gel placed directly on the skin. High-frequency sound waves are transmitted from the probe through the gel into the body. The transducer collects the sounds that bounce back and a computer then uses those sound waves to create an image. Ultrasound examinations do not use ionizing radiation (as used in x-rays), thus there is no radiation exposure to the patient. Because ultrasound images are captured in real-time, they can show the structure and movement of the body’s internal organs, as well as blood flowing through blood vessels.
   
3. 3. Ultrasound imaging is a noninvasive medical test that helps physicians diagnose and treat medical conditions.
   

PREPARATION

• Wear comfortable, loose-fitting clothes for your exam.
  
• You will be asked to change clothes during the procedure.
  
• You may eat and resume your normal activities unless your doctor gives you other directions.
  
• Take any prescribed medicines by your doctor as directed.
  
• You may spend 30 to 45 minutes in the Radiology department.
  

AFTER THE EXAM

• The technologist cannot give you any test results. But, he or she can answer any general questions you may have.
  
• You will be able to go home and return to normal activities.
  
• The scan will be read by a radiologist.
  
• You can expect follow-up from your provider regarding the results of your test.
  

BILLING

You will receive two bills for your examination. Western Wisconsin Health will bill for the examination. There will be a separate bill for the interpretation.

We thank you for allowing us to serve you and welcome any questions or comments you may have.

PATIENTS RIGHTS

As a patient you have the right to know about and discuss with your family, your doctor and your nurse exactly what type of treatment and care you will be receiving.

The healthcare team of Western Wisconsin Health accepts the responsibility to ensure that you are adequately informed about all procedures. We hope the enclosed information will help.

Please arrive 15 minutes early.
If you need to reschedule or cancel your appointment, please call the Western Wisconsin Health Imaging Department at 715-684-1395.

We will call you the day before your scheduled procedure to confirm your appointment. If your procedure is on a Monday, we will call you the Friday before.

Enter through the Western Wisconsin Health main entrance and report to the Imaging Department 15 minutes prior to your scheduled appointment. After registering, you will be asked to wait in the waiting room until all of your paperwork is done. A technologist will then take you to the imaging area.

WHAT IS AN ULTRASOUND OF THE THYROID?

1. Ultrasound is safe and painless, and produces pictures of the inside of the body using sound waves. Ultrasound involves the use of a small transducer (probe) and ultrasound gel placed directly on the skin. High-frequency sound waves are transmitted from the probe through the gel into the body. The transducer collects the sounds that bounce back and a computer then uses those sound waves to create an image. Ultrasound examinations do not use ionizing radiation (as used in x-rays), thus there is no radiation exposure to the patient.
   
2. Ultrasound imaging is a noninvasive medical test that helps physicians diagnose and treat medical conditions.
   
3. An ultrasound of the thyroid produces pictures of the thyroid gland and the adjacent structures in the neck. The thyroid gland is located in front of the neck just above the collar bones and is shaped like a butterfly, with one lobe on either side of the neck connected by a narrow band of tissue.
   
4. It is very common for patchy areas or nodules to develop in the thyroid that may or may not be felt on the skin surface. About five to 10 percent of adults will have lumps in their thyroid that a doctor can identify on an exam. These are called palpable nodules. Ultrasound is very sensitive and shows many nodules that cannot be felt.
   

PREPARATION

• Wear comfortable, loose-fitting clothing, loose-fitting open neck shirt or blouse is ideal.
  
• You may be asked to change into a gown.
  
• You may eat and resume your normal activities unless your doctor gives you other directions.
  
• Take any prescribed medicines by your doctor as directed.
  
• You may spend up to 30-45 minutes in the Radiology department.
  

AFTER THE EXAM

• The technologist cannot give you any test results. But, he or she can answer any general questions you may have.
  
• You will be able to go home and return to normal activities.
  
• The scan will be read by a radiologist.
  
• You can expect follow-up from your provider regarding the results of your test.
  

BILLING

You will receive two bills for your examination. Western Wisconsin Health will bill for the examination. There will be a separate bill for the interpretation.

We thank you for allowing us to serve you and welcome any questions or comments you may have.

PATIENTS RIGHTS

As a patient you have the right to know about and discuss with your family, your doctor and your nurse exactly what type of treatment and care you will be receiving.

The healthcare team of Western Wisconsin Health accepts the responsibility to ensure that you are adequately informed about all procedures. We hope the enclosed information will help.

Please arrive 15 minutes early.
If you need to reschedule or cancel your appointment, please call the Western Wisconsin Health Imaging Department at 715-684-1395.

We will call you the day before your scheduled procedure to confirm your appointment. If your procedure is on a Monday, we will call you the Friday before.

Enter through the Western Wisconsin Health main entrance and report to the Imaging Department 15 minutes prior to your scheduled appointment. After registering, you will be asked to wait in the waiting room until all of your paperwork is done. A technologist will then take you to the imaging area.

WHAT IS VENOUS ULTRASOUND IMAGING?

1. Ultrasound is safe and painless, and produces pictures of the inside of the body using sound waves. Ultrasound imaging involves the use of a small transducer (probe) and ultrasound gel placed directly on the skin. High-frequency sound waves are transmitted from the probe through the gel into the body. The transducer collects the sounds that bounce back and a computer then uses those sound waves to create an image. Ultrasound examinations do not use ionizing radiation (as used in x-rays), thus there is no radiation exposure to the patient.
   
2. Ultrasound imaging is a noninvasive medical test that helps physicians diagnose and treat medical conditions.
   
3. Doppler ultrasound, also called color Doppler ultrasonography, is a special ultrasound technique that allows the physician to see and evaluate blood flow through arteries and veins in the abdomen, arms, legs, and neck or within various body organs such as the liver or kidneys.
   

WHAT ARE SOME COMMON USES OF THE PROCEDURE?

1. The most common reason for a venous ultrasound exam is to search for blood clots, especially in the veins of the leg. This condition is often referred to as deep vein thrombosis or DVT. These clots may break off and pass into the lungs, where they can cause a dangerous condition called pulmonary embolism. If the blood clot in the leg is found early enough, treatment can be started to prevent it from passing to the lung.
   
2. A venous ultrasound study is also performed to:
   

• Determine the cause of long-standing leg swelling. In people with a common condition called “varicose veins”, the valves that normally keep blood flowing back to the heart may be damaged,
  and venous insufficiency ultrasound can help identify the damaged valves and abnormal blood flow.
  
• Aid in guiding placement of a needle or catheter into a vein. Sonography can help locate the exact site of the vein and avoid complications, such as bleeding or damage to a nearby nerve or artery.
  

PREPARATION

• Wear comfortable, loose-fitting clothing.
  
• You may be asked to change into a gown.
  
• You may eat and resume your normal activities unless your doctor gives you other directions.
  
• Take any prescribed medicines by your doctor as directed.
  
• You may spend up to one hour in the Radiology department.
  

AFTER THE EXAM

• The technologist cannot give you any test results. But, he or she can answer any general questions you may have.
  
• You will be able to go home and return to normal activities.
  
• The scan will be read by a radiologist.
  
• You can expect follow-up from your provider regarding the results of your test.
  

BILLING

You will receive two bills for your radiology examination. Western Wisconsin Health will bill for the examination. There will be a separate bill for the interpretation.

We thank you for allowing us to serve you and welcome any questions or comments you may have.

PATIENTS RIGHTS

As a patient you have the right to know about and discuss with your family, your doctor and your nurse exactly what type of treatment and care you will be receiving.

The healthcare team of Western Wisconsin Health accepts the responsibility to ensure that you are adequately informed about all procedures. We hope the enclosed information will help.

Please arrive 15 minutes early.
If you need to reschedule or cancel your appointment, please call the Western Wisconsin Health Imaging Department at 715-684-1395.

We will call you the day before your scheduled procedure to confirm your appointment. If your procedure is on a Monday, we will call you the Friday before.

Enter through the Western Wisconsin Health main entrance and report to the Imaging Department 15 minutes prior to your scheduled appointment. After registering, you will be asked to wait in the waiting room until all of your paperwork is done. A technologist will then take you to the imaging area.

PURPOSE

To visualize the esophagus, stomach, and the small intestine after drinking a barium solution (chalky liquid) under fluoroscopic control (action camera).

ESOPHAGUS:
A muscular tube which conveys food from your throat to the stomach.

STOMACH:
An organ which receives food and produces chemicals that mixes with the food in order to promote digestion.

SMALL INTESTINE:
Made up of three parts: the duodenum, next the jejunum, and finally the ileum. This small bowel mixed with digestive juices, bile from the liver, and pancreatic juices to complete digestion. Almost all nutrients are absorbed in the small intestine.

BEFORE THE EXAM

• It is important that these organs be completely clear of food and fluids. For this reason, you will not be permitted to eat, drink, smoke, or chew gum eight hours before the exam is completed.
  
• The morning of the exam you may brush your teeth and gargle, being very careful not to swallow any water.
  

THE EXAM

Esophogram & Upper GI:

1. The x-ray technologist will explain the exam to you.
   
2. You will be asked to stand in front of our fluoroscope. You may first be given sour white crystals with water, which will distend the stomach with air. Then you will be asked to drink chalky liquid called barium.
   
3. As the barium descends, the radiologist will use the x-ray fluoroscope to visualize these organs. You will spend approximately 30 minutes to 1 hour in the Radiology Dept.
   

Upper GI Small Bowel Follow-Through:

1. The x-ray technologist will explain the exam to you.
   
2. You will be asked to stand in front of our fluoroscope. You may first be given sour white crystals with water, which will distend the stomach with air. Then you will be asked to drink chalky liquid called barium.
   
3. As the barium descends, the radiologist will use the x-ray fluoroscope to visualize these organs. The technologist will then take overhead films of the stomach. After filming, a second glass of barium will be given.
   
4. The small intestine is over 20 feet long and lies between the stomach and colon. Consequently, the barium may take up to 1 – 4 hours to pass through the small bowel to the colon.
   
5. To examine the small intestine, periodic films will be taken during this 1 – 4 hour period. In between filming, you will be asked to remain in the x-ray department.
   

AFTER THE EXAM

The barium may accumulate in your bowel, causing you to become constipated. To eliminate any possibility of constipation, usually adding extra liquids to your diet is all that is necessary. If problems develop, please consult your physician.

• The technologist cannot give you any test results. But, he or she can answer any general questions you may have.
  
• You will be able to go home and return to normal activities.
  
• The scan will be read by a radiologist. You can expect follow-up from your provider regarding the results of your test.
  

BILLING

You will receive two bills for your radiology examination. Western Wisconsin Health will bill for the examination. There will be a separate bill for the interpretation.

We thank you for allowing us to serve you and welcome any questions or comments you may have.

PATIENTS RIGHTS

As a patient you have the right to know about and discuss with your family, your doctor and your nurse exactly what type of treatment and care you will be receiving.

The healthcare team of Western Wisconsin Health accepts the responsibility to ensure that you are adequately informed about all procedures. We hope the enclosed information will help.