You are scheduled to have a bronchoscopy: on: ___/___/___ at: _________
You will need to arrive at Stanford University Medical Center
The procedure will take about 1 hour but you will need to remain in the recovery room for 2 hours after. You should arrange for someone to drive you home after the procedure. If they don't wish to wait at the hospital, they can call (650) 723-5163 to find out when you will be ready to leave.
This procedure will allow me to look into your lungs and see the surface of all the breathing tubes, as well as see your nose, throat, sinus openings, vocal cords and esophagus. I will also be able to take samples for culture and check for signs of cancer. I may also take biopsies of the lung itself. The flexible bronchoscope is about as thick as a pencil. Photos will be taken during the procedure and we will be able to look at these together during your follow-up visit.
1. Please do not have anything to eat or drink after midnight the night before the procedure. This includes no coffee or water on the morning of the exam.
Anesthetics: There will be a number of different anesthetics used to numb your mouth and throat before we begin the procedure. I will first ask you to breath in a mist of a topical anesthetic xylocaine for a few minutes. This may make you cough a little until your throat becomes numb. Following this I will spray the back of your throat with more local anesthetic (Xylocaine) which is fairly poor tasting. I may also hold some cotton soaked in cocaine in the lower part of your throat. By this point your mouth will be completely numb. It may feel like there is a lump in your throat and your lips or gums may tingle. You may feel that it is difficult to swallow, but in fact it is only your sensation that is altered.
You will receive a combination of Versed and Morphine or Fentanyl intravenously once your mouth and throat are completely numb. These medicines will put you to sleep and you will not feel anything during the procedure. The procedure itself will take about 1 hour.
After the Procedure
You will stay in the Bronchoscopy Suite for observation until you wake up. You will then be taken to the recovery room for 1 1/2 to 2 hours for more observation. You will be awake during this time but you may not remember this later because of all the medicines. Before you leave, the nurses will check that you can take liquids without problems. You will need someone to drive you home because of the medicines that I have given you. In addition, your memory may not be up to speed for the rest of the day so I suggest that you do not try to do any work for the rest of the day.
Back at Home
Once you get home, you are free to be up and about as tolerated and may begin eating light foods and then later in the day anything that you like. If there are any questions or problems, you should call me immediately at 650-328-5222. If it is at night, you should tell our answering service that you had surgery today and that you need to talk to me directly, not the person who is on call. They know how to locate me at all times. You should schedule a follow-up appointment with me 4 - 5 days after the procedure to discuss the initial results.
Most people have no adverse effects from a bronchoscopy. Rarely people will have a mild sore throat or hoarseness or more mucus production for 1 - 2 days after the procedure. Sometimes people will cough up a little blood or dark brown mucus for 1 - 2 days following the procedure. The 2 significant complications, bleeding or collapse of a lung, occur in less than 1 in 100,000 cases. Both of these complications can be dealt with easily during the procedure, without any long-term problems.
I hope that this answers most of your questions about your upcoming bronchoscopy, but please feel free to call or email me with any other questions or concerns. (Remember that I would prefer to be called too often than not enough.)
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