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Patient Diary

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BravoTM pH System Patient Insert INSTRUCTIONS FOR BRAVO MONITOR DIARY In order to best interpret the data from your transmitter, you must record on the diary the times you sleep or lie down, have a snack or beverage, take your medications and most importantly when you have symptoms. You can put a description of your symptoms in the comment box. Entering your symptoms into the diary with start and end time is critical to the understanding of your symptoms. Please always use the time indicated on the monitor. Do not use the time on your wristwatch, microwave clock, or your wall clock. You will see that is a 24 hr. (military time) clock. You do not need to translate the time. Just use the time that you read. For example, if your watch may say 4:15 and the monitor says 16:22 please write 16:22. You need to record the time that you start eating and the time that you finish eating. Put a check mark in the column labeled meal. For example, you may put down 16:20 start, 16:50 end, and write supper. You need to record the time you go to bed, or lie down, and the time that you wake up and get out of bed. Specifically, if you are reclining in the La-Z-Boy it is just like sleeping, and you would record that. If you go to bed and lie down reading a book for half an hour before you go to sleep, you would write the time that you laid down and the time you arose in the morning. For example, you may put down start time 22:10, end time 7:13, sleep. Put a check in the sleep column. If you have symptoms, please record the start time and end time of your symptoms. If you have heartburn at 14:30, and it lasts for 10 minutes put a check in the heartburn column and mark 14:30 start, 14:40 end. Keep the monitor within 3 feet of your body. If you shower, please put it somewhere that is not likely to fall or get very wet but still close to you. If you walk away from the monitor, it will beep and have an error message such as C2. Hold it close to your chest until the beeping stops and you should then see that the error message is replaced by a pH reading after 20 seconds. Be Well, Data Transmission To ensure reliable, uninterrupted transmission of data from the Bravo capsule to the receiver, you should pay attention to the following: Receiver Out of Range „ If the receiver is too far from the Bravo capsule, a beep will be heard for 30 seconds and the display will flash C1 or C2 (P1 or P2 may flash depending on receiver version). This indicates that the receiver is out of range and may not be receiving information from the pH capsule. Move the Receiver to your chest until the beep stops and the C1 or C2 is no longer visible. „ If the C1 or C2 display continues or if you have any problems or questions during your test, call your doctor. „ At the completion of your pH test, return the Bravo pH receiver and your diary to _____________on _______________. NOTE Stay within one meter (3 feet) of the receiver during your pH test External Interference As with any radiotelemetry device, the Bravo pH capsule's signal may be interrupted by other electronic or electrical devices operating at the same or similar frequencies. Solution: If the Bravo receiver beeps and the message C1 or C2 appears on the display, you should move away from the device(s) that appear(s) to cause the beep and C1/C2 message. Patient Diary During the test, it is important that you eat, drink, work, and exercise as you normally would so your doctor gets reliable data to diagnose your condition. Record meals, sleep, and other important activities during your test in your Patient Diary using the time on the receiver’s display. Using the Patient Diary During your pH test, you should record your symptoms (Heartburn, Regurgitation, Chest Pain, Coughing etc.) in the Patient Diary. Using the Symptom Buttons Besides using the Patient Diary, you may also record your symptoms electronically on the receiver by pressing the appropriate symptom button. A green indicator light remains lit for 3 seconds after a button is pushed. You may hear a beep when a symptom button is pushed. Not all clinicians select this feature: therefore your receiver may not beep. Symptom Button Symptom Heartburn Regurgitation Chest Pain Start Time ____:____ End Time ____:____ BRAVO PATIENT DIARY Patient _____________________________________ Receiver ____________________________________ Day 1 ___ / ___ 20__ Start Time End Time Day 2 ___ / ___ 20__ Heartburn Regurg. Chest Meal Sleep Other Symptoms Comments Start Time ____:____ End Time ____:____ BRAVO PATIENT DIARY Patient _____________________________________ Receiver ____________________________________ Day 2 ___ / ___ 20__ Start Time End Time Day 3 ___ / ___ 20__ Heartburn Regurg. Chest Meal Sleep Other Symptoms Comments