ATTENTION: As of Feb. 27th 2018, our HAMILTON location has moved.

We are now located at the brand new Southmount facility: 35 Upper Centennial Pkwy, Stoney Creek, ON L8J 3W2

Appointment Preparation

 

Preparing for your upcoming test? KMH is dedicated to making your medical diagnostic process as easy as possible, but there are some things you’ll need to do to ensure your appointment runs smoothly. Different tests require different preparations to ensure the most accurate results. Select from the list to find out what you need to know before you take your test.

KMH centres are reduced fragrance environments. Please refrain from using fragrances or heavily scented products.

MRI

Patients are required to arrive at least 30 minutes prior to the start of their scheduled exam.

If you have had a significant eye injury while working with metal, you will require an X-Ray of your eyes ordered by your physician to ensure there are no metallic foreign bodies present. You may not be suitable for an MRI if there are certain types of implants or medical devices in your body, have a pacemaker, or if you are pregnant.

Before the Test: You will be required to fill out a few forms. Depending on which part of your body is being scanned, you may need to change into a gown during the procedure. If you prefer to wear your own clothes, they should not have metal zippers, fasteners, buttons, underwire (bras), belts or buckles, as the MRI scanner produces strong magnetic fields. It is also important to remove any loose metal objects from your body, including:

  • Watches
  • Jewelry (such as earrings and necklaces)
  • Piercings (such as ear, nipple and nose rings)
  • Dentures (false teeth)
  • Hearing Aids
  • Wigs (some wigs contain traces of metal)
  • We recommend that patients show up without wearing any jewelry, hair pins, piercings or makeup for their exam.

Some MRI scans involve having an injection of contrast dye. This makes certain tissues and blood vessels show up more clearly and in greater detail. The contrast dye is administered through an IV in your arm.

During the Test: During the MRI scan you will be asked to lay very still for a prolonged period of time. You may also be asked to hold your breath for a few seconds while the scan is being taken. MRI scans usually require 20 minutes, but some types of exams can take longer to finish.

What to Bring: To avoid delays on the day of your test, ensure that you bring your health card and your requisition.

AMBULATORY BLOOD PRESSURE MONITORING

An ambulatory blood pressure monitor is a small unit worn on your arm that takes your blood pressure and records changes or fluctuations over a period of time (usually 24 hours). It is usually ordered for the evaluation of hypertension or hypotension and for the evaluation of blood pressure medication.

Before the Test: There is no preparation for this procedure. However, please wear comfortable clothing with easy access to your upper arms. Please note: this test is not covered by OHIP and there is an $75 fee required.

During the Test: A blood pressure monitor will be attached to your arm and a small recording device will be placed around your waist. The blood pressure cuff will inflate every 30 minutes on your arm during the day and every 60 minutes during the evening. You cannot shower or bathe while the monitor is attached to you.

After the Test: You will be able to return to your normal activities when the test is complete, unless your physician or technician tells you otherwise.

What to Bring: To avoid delays on the day of your test, ensure that you bring your health card and your requisition. As well, bring your current list of medications.

BONE MINERAL DENSITY

A Bone Mineral Density (BMD) test is a non-invasive and pain-free test that measures the density of your bones in order to determine your likelihood of developing osteoporosis or enduring an osteoporosis-related fracture.

Before the Test: Bone density scans require minimal preparation. You should avoid wearing jewelry or any other metallic objects on your body. Please avoid wearing clothes with metal clips, snaps, buttons or zippers on the day of your test.

Do not take calcium/vitamin supplements for 24 hours prior to examination.

If you have had a nuclear medicine dye injection or a barium study within 2 weeks, please reschedule your Bone Mineral Density test.

During the Test: During a bone density scan you may be required to wear a gown for the procedure. An X-ray machine will scan the areas that are common to bone degradation including the back and hips. There is minimal physical contact with the machine during the test.

After the Test: Once the test is completed, you will be able to return to your normal activities.

What to Bring: To avoid delays on the day of your test, ensure that you bring your health card and your requisition.

BONE SCAN

A bone scan is most commonly performed to detect areas of abnormal bone growth due to tumours, fractures, infection or other bone diseases.

Before the Test: No preparation is required for these examinations.

During the Test: The bone scan is a 2 part test. During part 1 you will receive an injection containing the radioisotope Technetium-99m MDP. The first set of images will be taken at this time for about 15-20 minutes. You will be instructed to drink 3-4 glasses of fluids and void frequently. You will then be asked to return at the second appointment time for the second part of the test, which consists only of images being taken and lasts about 1-1.5 hours.

After the Test: You will be able to return to your normal activities when the test is complete, unless your physician or technician tells you otherwise.

What to Bring: To avoid delays on the day of your test, ensure that you bring your health card and your requisition.

DIGITAL MAMMOGRAPHY

Mammography is a low dose X-ray that plays an essential role in the early detection and screening of breast cancer.

Before the Test: Do not wear lotion deodorant or talcum powders near your breasts on your test day. Rinsing prior to exam does not eliminate all residue. If your breasts experience tenderness prior to your menstrual period you should try to schedule your examination for a time when your breasts will not be tender. It is important to tell your physician if you have breast implants.

During the Test: Prior to a mammogram, you will need to remove jewelry and metal objects. You will also be asked to remove clothing above the waist and put on a gown. During the examination, one of your breasts will be placed between X-ray plates that will gradually compress. For some people, the process can be mildly uncomfortable, however, compressing the breast tissue ensures clear images. Two images will be taken of each breast, one from top to bottom and the other from side to side. More images and/or ultrasound of the breast(s) may be required to complete the exam.

After the Test: Once the test is completed, your breasts may be tender; however, you are able to return to your normal activities.

What to Bring: To avoid delays on the day of your test, ensure that you bring your health card and your requisition.

ECHOCARDIOGRAPHY

Echocardiography involves an ultrasound of your heart, referred to as an echocardiogram. The walls, valves of the heart and blood flow are examined.

Before the Test: There is no preparation for this procedure.

During the Test: You may be required to remove some of your clothing and put on a gown. The technician will place lubricating gel onto the area being examined. During the test, the technician will use a device called a transducer and make contact with your skin, sweeping back and forth over the area being examined.

After the Test: You will be able to return to your normal activities when the test is complete, unless your physician or technician tells you otherwise.

What to Bring: To avoid delays on the day of your test, ensure that you bring your health card and your requisition.

HOLTER MONITORING

Holter monitoring is a continuous tape recording of the a patient’s EKG for 24 to 48 hours. Since it is worn during your regular daily activities, it will help your physician correlate symptoms of dizziness, palpitations or “black outs”.

Before the Test: There is no preparation for this test. We recommend you wear comfortable clothing so it is easy to dress after the monitor has been hooked up.

During the Test: ECG electrodes will be placed on your chest and connected to a lightweight monitor that will be connected around your waist. You will carry this monitor around with you for 24, 28 or 72 hours, depending how long your doctor requests.

After the Test: You will be able to return to your normal activities when the test is complete, unless your physician or technician tells you otherwise.

What to Bring: To avoid delays on the day of your test, ensure that you bring your health card and your requisition.

NUCLEAR CARDIOLOGY (MYOCARDIAL PERFUSION IMAGING)

Myocardial Perfusion Imaging (MPI), also known as a Nuclear Medicine Stress Test, is done to determine how well the coronary arteries are delivering blood to your heart. We will be able to determine if a particular artery is blocked and therefore limiting the circulation to your heart. We will also assess heart wall motion and ejection fraction, and see if the heart muscle has been damaged from a previous heart attack. All of this information will assist your physician in making management and treatment decisions. We image the blood flow using a radiopharmaceutical. This is a myocardial perfusion agent used for detection of coronary artery disease (CAD).

Before the Test:

  1. 1. Patient may have a light breakfast/lunch (e.g. toast, jam, fruit, juice, water) and then nothing to eat 1 hour prior to the test.
  2. 2. Discontinue all caffeine products 12 hours prior to the test. This includes all tea, coffee, decaffeinated tea/coffee, pop, chocolate, Tylenol 1, 2 & 3 and/or medications containing caffeine.
  3. 3. Insulin-dependent diabetics should take their insulin and a light meal 1 hour prior to the test.
  4. 4. Wear loose fitting clothing (e.g. T-shirt, track pants, athletic shoes, etc.)
  5. 5. Bring a list of all current prescription medications and check with your physician regarding the discontinuation of any heart medications (e.g. Beta-Blockers like Metroprolol or Atenolol, as well as Calcium Channel Blockers like Diltiazem or Verapamil).
  6. 6. Do not take erectile dysfunction medications (e.g. Viagra, Cialis, Levitra, etc.) for 48 hours prior to the test.

*For female patients, if you are pregnant or there is a possibility of pregnancy, or are breastfeeding, Nuclear Medicine Stress Testing may not be appropriate for you at this time. Please consult with your physician.

During the Test:

The technologist will place an intravenous line into your arm or hand which is used to inject a small amount of Cardiolite, a radiopharmaceutical, which is carried by the blood stream to your heart. Approximately 1 hour after your injection, the technologist will take pictures of your heart for approximately 20 minutes with a special gamma camera that detects radiation. While the pictures are being taken, you will be lying on a bed and it is important to remain very still during this time to avoid blurring the images.

Once the first set of images has been taken, you will be prepared for a Stress Test. ECG electrodes will be placed on your chest to monitor your heart rhythm throughout the test. You will begin to exercise on a treadmill during which your heart rate and blood pressure will rise. These are normal responses that are being closely monitored with your ECG.

If you are unable to exercise adequately on a treadmill, similar results can be achieved using a drug called Persantine. Persantine mimics the effects of exercise by dilating the blood vessels of the heart, allowing for increased blood flow.

Once you have reached your maximum level of exercise, a second dose of Cardiolite will be injected and you will continue exercising for an additional 1-2 minutes. If blood flow to the heart is limited due to Coronary Artery Disease, then the amount of Cardiolite in your heart is reduced. Following the Stress Test, the IV will be removed.

A second set of pictures taken with the gamma camera is required to complete the test. The technologist will advise you when to return for this last portion (anywhere from 15 minutes to 2 hours after the Stress Test is completed). It is very important that the second set of pictures is taken in order to compare to the first set and assess the amount of blood supply to the heart at rest and during stress (exercise).

The test will last approximately 3 to 4 hours.

After the Test:

You will be able to return to your normal activities when the test is complete, unless your physician or technician tells you otherwise. You can drive after the test. If you are travelling by plane, train or crossing the border within one week after your test, please inform the technologist.

What to Bring:

To avoid delays on the day of your test, ensure that you bring your health card and your requisition.

NUCLEAR MEDICINE

A nuclear medicine scan is a non-invasive procedure that uses a small and safe amount of radioactive material to help produce detailed images of the body. The material is inserted intravenously, swallowed, or inhaled into the body and travels through the areas that are being tested. The radioactive material (radiotracer) gives off energy and a device detects that energy. A computer measures and produces special images that allow the information to be interpreted.

Before the Test: There are many different types of nuclear medicine exams each with different methods of preparation. Consult your physician or the nuclear medicine clinic for more details on how to prepare for your specific exam.

You should avoid wearing jewelry or metallic items on your clothing to your test, as these affect the testing process.

During the Test: Depending on the type of test, you may be asked to remove your clothing and put on a gown. A technician or nurse may insert an intravenous line (IV) into your vein to administer the radiotracer. (Note: In some cases the radiotracer may need several days to travel through your body; in such instances, this step will be performed prior to your test date). You may experience minor sensations due to the insertion of the IV.

Once the radiotracer has accumulated in the testing area, a gamma camera will be positioned to the examination area and a series of images will be taken. You will be required to remain still, as movement will affect the scan. The time required for a nuclear medicine scan can vary greatly, from several minutes to several days. In some cases, you may leave and return when necessary.

You may also be asked to wait until the technician checks the images in the event that more images are required. This does not mean that there are abnormalities in your testing, but only that better visualization is needed.

Some tests may require you to perform exercise on a treadmill or stationary bicycle. (You may be required to take medication that will increase blood flow if you are not able to exercise.)

After the Test: You will be able to return to your normal activities when the test is complete, unless your physician or technician tells you otherwise. If a radiotracer was used, drink plenty of water to help flush it from your system.

What to Bring: To avoid delays on the day of your test, ensure that you bring your health card and your requisition.

POSITRON EMISSON TOMOGRAPHY/COMPUTED TOMOGRAPHY (PET/CT)

Positron Emission Tomography (PET) scanning is an exam that shows the function and structure of organs and tissues. Patients are injected with a glucose solution, known as FDG (18-Fluoro-deoxyglucose). Cells that require more glucose (sugar) than normal will show up on the images to have an increased uptake. Cancer cells require more glucose than normal cells and scar tissue, which is why this type of scan is used mainly for oncology.

To improve accuracy of the interpretation, we have integrated a CT (computed tomography) scanner. The result is a fusion of two sets of images, one that depicts the functional images of biochemically active cells (PET) and the other demonstrates the structure of the tissues and organs (CT). The combination of images improves the interpreting physician’s ability to determine exactly where in the body the changes are taking place.

Before the Test:

Do not eat or drink anything other than plain water for 6 hours prior to your scan.

You may take your regular medications, unless they contain caffeine.

Do not chew gum or have breath mints/candies for 6 hours prior to your scan.

Do not exercise for 12 hours prior to the scan, and minimize your physical activity the full day prior to your PET scan.

DO NOT EAT OR DRINK sugary foods/drinks like cakes, pastries, white bread and rice, and pasta at dinner the night before your test. Choose higher protein foods such as nuts, seeds, meat, poultry, fish, eggs, cheese and dairy products, beans and vegetables for the full day prior to your test.

Discontinue caffeine at dinnertime the evening before your PET scan.

Discontinue vitamins and supplements at dinnertime the evening before your PET scan.

Wear loose, comfortable layers of clothing free of metal buttons/zippers.

No children under the age of 18 are allowed on-site, as we are a nuclear medicine facility.

Notify the clinic if you or someone accompanying you may be pregnant/breast-feeding.

Please try not to wear perfume or other fragrances on the day of your scan.

Notify the clinic if you are suffering from any flu-like symptoms (fever, vomiting, diarrhea, cough, etc.)

If you are claustrophobic and require something to calm your nerves, please obtain this from your family physician prior to your appointment. Please also ensure you have someone available to drive you home following your scan if this is the case

*If you are diabetic, please contact us for the additional fasting instructions and restrictions on your diabetic medications. Print guide for additional instructions for diabetic patients

During the Test:

You will first be given a consent form and questionnaire to read and complete.

Your blood sugar level will be measured using a glucometer.

A radioactive, sugar-based, saline solution will be injected intravenously, which will enter the bloodstream. You will then be instructed to rest for approximately 45 minutes to allow the solution to distribute throughout the body.

Once rested, you will be asked to lie as still as you can during the scan. The imaging process takes approximately 30 minutes. You will be able to remain in communication with the technologist throughout the scan.

After your scan, the results of your test will be sent to your referring physician within 2 business days.

Please allow 2 – 2.5 hours for your entire appointment.

What to Bring:

Please ensure that you bring your health card and a list of all of the medications you are currently taking.

RENAL SCAN

A renal scan is performed to see how the kidneys are functioning. Renal scans may also be performed in conjunction with Lasix (to assess any obstruction in the urinary system) or Captopril (to rule out high blood pressure caused by renal artery stenosis).

Before the Test: There should be nothing to eat for 4 hours prior to the test and you should drink 4 glasses of water 1 hour prior to the test.

Consult with your physician regarding the temporary discontinuation of medication. At the time of booking, patients will be informed regarding the discontinuation of Ace Inhibitors, diuretics and other anti-hypertensive medications.

During the Test: Imaging for renal studies with or without Lasix last approximately 1 hour. Studies with Captopril consist of 2 days and imaging takes approximately 2 hours on each day.

After the Test: You will be able to return to your normal activities when the test is complete, unless your physician or technician tells you otherwise.

What to Bring: To avoid delays on the day of your test, ensure that you bring your health card and your requisition. Please bring a list of your current medications.

ULTRASOUND

An ultrasound is a non-invasive procedure that uses high frequency sound waves to assess different structures in the body. During the procedure, an ultrasound transducer that produces these sound waves in placed on the skin. The sound waves bounce off of internal tissues or organs and an image is created by the ultrasound machine.

Before the Test: There are different types of ultrasound tests. Some tests will require no preparation, some will require you to drink large amounts of liquid prior to the test, and others will require you to not eat or drink for hours before the test. Consult your physician for any specific instructions for your particular test.

Abdomen: No eating, drinking, smoking or chewing gum 8 hours prior to appointment. Drink 1 litre of water 1 hour prior to appointment. Do not go to the washroom. You must have a full bladder for this test. For afternoon appointments, you are allowed to eat a light breakfast (dry toast, black tea or coffee with no milk or cream). You must have nothing to eat 6 hours before your appointment. Absolutely no meat or dairy products.

Anorectal: You must use one (1) Dulcolax suppository 2 hours before your appointment. This is an over-the-counter medication, available at most pharmacies. This medication should cause you to have a bowel movement, usually within 15-30 minutes. About 60 minutes before your appointment, drink 1 litre of any clear fluid before your appointment. Do not go to the washroom. You must have a full bladder for this test. You may eat as usual.

Hysterosonogram: This test can only be booked during day 5-10 of your menstrual cycle. This test is used to diagnose abnormalities of the uterus. It involves the placement of a speculum into the vagina through which a catheter is positioned in the uterus. A saline solution is injected into the uterine cavity while a transvaginal ultrasound is being per-formed. This is a 2-day test: DAY 1 – Please follow the instructions for a Pelvic ultrasound. DAY 2 – Take 1 or 2 Advils one hour prior to your appointment. You will be required to wait in the office 15 minutes after the procedure has been finished.

Pelvic: About 90 minutes before your appointment, go to the washroom and empty your bladder. Drink 1 liter of any clear fluid starting 90 minutes before your appointment time and finishing at least 60 minutes before your appointment. Do not go to the washroom. You must have a full bladder for this test. You may eat as usual.

Pregnancy: About 90 minutes before your appointment, go to the washroom and empty your bladder. Drink 1 litre of any clear fluid starting 90 minutes before your appointment time and finishing at least 60 minutes before your appointment. Do not go to the washroom. You must have a full bladder for this test. If you are in the later stages of pregnancy (22 weeks onwards), drink only 500 mL of any clear fluid.

Prostate (Transrectal): Fleet enema 2 hours before the examination (kit may be purchased at your pharmacy.) Drink 1 liter of water starting 90 minutes before your appointment time and finishing 1 hour prior to appointment. Do not go to the washroom. You must have a full bladder for this test. You may eat as usual.

Renal/Bladder: 3 hr fast and follow the pelvic preparation.

Transvaginal: About 90 minutes before your appointment, go to the washroom and empty your bladder. Drink 1 litre of any clear fluid at least 60 minutes before your appointment. Do not go to the washroom. You must have a full bladder for this test. You may eat as usual.

All Others: No preparation is required for these examinations.

During the Test: An ultrasound may require you to remove some or all of your clothing and put on a gown. The technician will place lubricating gel onto the area being exam-ined. During the test, the technician will use a device called a transducer and make contact with your skin, sweeping back and forth over the area being examined.

In some ultrasound tests, the transducer is inserted into a natural opening in the body.

After the Test: Once the test is completed, you are able to return to your normal activities.

What to Bring: To avoid delays on the day of your test, ensure that you bring your health card and your requisition.

VASCULAR ULTRASOUND

About Vascular Ultrasound: This ultrasound is used to examine blood flow in arteries and veins. This includes Carotid Doppler, Arterial Doppler of the Extremities (Arms and Legs) and Venous Doppler of the Extremities (Arms and Legs).

Before the test: No preparation is required for these examinations.

During the test: You may be required to wear a gown for the procedure. The technologist will apply water based jelly to the skin surface and use an ultrasound probe to acquire images of the blood circulation. With certain types of vascular exams, the technologist will be required to take your blood pressure on you arms and legs. All vascular studies are non-invasive; they do not require the use of needles, dyes, radiation or anesthesia.

After the test: You will be able to return to your normal activities when the test is complete, unless your physician or technician tells you otherwise.

What to Bring: To avoid delays on the day of your test, ensure that you bring your health card and your requisition.

X-RAY

X-rays are a common type of imaging scan used to view the body beyond soft tissue. Bone and dense tissue appear on the image as a lighter area. It is used to detect bone fractures or other abnormalities in the body.

Before the Test: There is no physical preparation for an X-ray test. You should avoid wearing jewelry or clothing with metallic items on your test date. We allow walk-in patients for X-ray, therefore you may have to wait for your turn.
Please inform the technologist if you are or think you may be pregnant. You should not have an xray during the last 2 weeks of their menstrual period.

During the Test: You may also be required to remove your clothing and put on a paper gown. Some X-ray tests may require an x-ray dye to be injected or ingested. You may experience discomfort from the injection.

Let your physician or technician know if you have had an allergic reaction to X-ray dyes in the past.

During an X-ray, you will be asked to remain still while the process is being performed. The X-ray process is quick and usually lasts only a few seconds to a few minutes depending on the number of images required.

After the Test: Once the test is completed, you are able to return to your normal activities. You may be asked to remain at the facility for additional x-rays while they are being developed. This is not a sign of abnormality, but only to ensure clarity of the images.

What to Bring: To avoid delays on the day of your test, ensure that you bring your health card and your requisition.