Preparing for My Test

Most Dynacare tests start with a trained laboratory technician taking a sample of your blood, urine, feces or other specimen. Being prepared for this procedure can help make sure that the whole process runs smoothly and, more importantly, that you get accurate test results. For example, you may be asked to refrain from specific activities that could affect certain tests - things like recent or excessive exercise, not drinking enough fluids, excessive eating or recent sexual activity, etc.

Here are some of the ways that you can be better prepared before coming to Dynacare:

• Find out if your test requires an appointment
• Find out if you need to fast before your test
• Urine Collections
• Stool Collections
• Sputum Collection
• Other Collections (Glucose Tolerance, Pinworm, Sperm analysis)
• ECG and Holter Monitor tests

Find out if your test requires an appointment

You can usually come to a Dynacare Laboratory and Health Services Centre without an appointment, unless you need any of the following tests:

• Oral Glucose Tolerance Tests (GTTs)
• Lactose and Xylose Tolerance Tests
• Holter Monitoring
• US Department of Transportation (DOT) urine procedures
• Ultrasound Imaging (available in Roxboro, Quebec only)
• Spermogram (Quebec)

Find out if you need to fast before your test

The level of certain chemicals in your bloodstream change when you eat, drink or engage in certain activities. These changes can, in turn, affect the accuracy of your test results. That's why certain tests require you to fast beforehand.

If you are coming to Dynacare for any of the following tests, it is recommended that you avoid food, including chewing gum, and drinks other than water for several hours prior to specimen collection.

10- to 12-hour fast

• ACTH (Adrenocorticotropic Hormone)
• Bile Acids
• C-peptide
• Carotene
• Cortisol fasting
• Free Fatty Acids
• Ghrelin
• Lactic Acid
• Lipoprotein Subfractionation
• Proinsulin
• Vitamin A
• Vitamin E

8-hour fast

• Ammonia
• Catecholamines
• Cholesterol (lipids) (if determined by physician)
• Glucagon
• Glucose
• Oral Glucose Tolerance (GTT) (12 hrs Saskatchewan)
• Homocysteine
• Insulin
• Lactose Tolerance
• Thiamine
• Xylose Absorption

4-hour fast

• H. pylori
• Plasma Metanephrines

Urine Collections

24-HOUR URINE

For this test you need:

• To follow the instructions to the last detail. Any deviation will invalidate the results.

To collect specimen for this test, you'll need containers provided at Dynacare Laboratory and Health Services Centres. Do not remove any tablets or other preservatives that are in the bottles. Containers may contain strong acids. Be aware of any warnings or instructions printed on the container. This test depends on the accuracy of timing and the collection of the entire 24-hour specimen. This procedure must be followed without deviation.

• Clearly label containers with your full first and last name, date of birth and date of collection.
• In the morning, completely empty the bladder into the toilet as usual. This specimen is not collected for testing. Print “collection started” and time and date in appropriate space on container label.
• Add all urine passed over the next 24 hours to container. Always place urine into container immediately.
• Prior to any bowel movement, completely empty bladder and add urine to container to prevent any loss.
• The following morning, exactly 24 hours later (to the hour) empty bladder completely and add final specimen to container. Print “collection completed” and time and date in appropriate space on the container label. This final addition completes the 24-hour collection period started the day before. If a second specimen is required, collection can begin from this time and continue over the next 24-hour period.
• Keep collection bottle in cool place or refrigerate.
• Return 24-hour collection as soon as possible to a Dynacare Laboratory and Health Services Centre or to your clinician’s office, along with the requisition.

Urine for Culture and Sensitivity

For this test you will need:

• Collection of the first morning urine
• To bring urine samples to a Dynacare Laboratory and Health Services Centre within two hours of collection. If this is not possible the samples must be refrigerated immediately and received by Dynacare within 24 hours from collection.

To collect specimens for this test you’ll need containers provided at Dynacare Laboratory and Health Services Centres. The first morning urine should be collected. If not, the urine should be held in the bladder as long as possible before collection.

If you are a female:

• Clearly label containers with your full first and last name, date of birth and date of collection.
• Wash and dry hands thoroughly.
• Wash the area from which you pass urine. Soak sponge or washcloth with soap. Using one sponge or washcloth at a time, wipe only from the front to the back between the folds of your skin.
• After washing with soap, rinse with warm water using a clean sponge or washcloth.
• Remove lid from container and set lid upside down. Do not touch inner surface.
• Squat over toilet, separating skin of the vulva. Continue to hold skin apart and pass a small amount of urine into the toilet, then collect in container.
• Secure lid tightly.
• Return container to a Dynacare Laboratory and Health Services Centre or to your clinician’s office, along with the requisition.
• Refrigerate sample if not returned to a Dynacare Laboratory and Health Services Centre or to your clinician’s office immediately.

If you are a male:

• Clearly label containers with your full first and last name, date of birth and date of collection.
• Wash and dry hands thoroughly.
• Expose penis, retract foreskin (if not circumcised) and, if necessary, wash with sponge or washcloth soaked with soap.
• Rinse with a clean sponge or washcloth soaked with warm water.
• Remove lid from container and set lid upside down. Do not touch inner surface.
• Pass a small amount of urine into the toilet, then collect into container. Do not touch container opening.
• Secure lid tightly.
• Return container to a Dynacare Laboratory and Health Services Centre or to your clinician’s office, along with the requisition.
• Refrigerate sample if not returned to a Dynacare Laboratory and Health Services Centre or to your clinician’s office immediately.

Urine Collection for Schistosoma haematobium

For this test you need:

• Urine collected between noon and mid-afternoon each day for up to three consecutive days.

To collect specimens for this test you’ll need containers provided at Dynacare Laboratory and Health Services Centres. Early morning urine will not yield accurate results.

• Clearly label containers with your full first and last name, date of birth and date of collection.
• Between noon and mid-afternoon, urinate into a toilet. When you get to the last portion of the urine flow, collect it by urinating into the specimen container.
• Put the lid on and make sure it is tightly secured.
• Return container to a Dynacare Laboratory and Health Services Centre or to your clinician’s office, along with the requisition.

Urine for Cytology

For this test you need:

• Three specimens collected on three consecutive days (do not collect more than one sample in a single day)
• Five to six eight-ounce glasses of water consumed over a period of three hours, for each day during the testing period

To collect specimens for this test you need containers provided at Dynacare Laboratory and Health Services Centres. If you are in Manitoba or Saskatchewan, call your local Dynacare lab as containers and instructions for this test are different in these areas.

• Clearly label containers with your full first and last name, date of birth and date of collection.
• Discard your first morning urine. This specimen is not suitable for testing.
• Drink five to six eight-ounce glasses of water over a period of three hours. Urinate and discard.
• When the urge to urinate arises again, urinate into an empty sterile specimen container and then carefully pour an amount of urine into the container equal to the volume of the preservative. You need to do this promptly because the specimen needs to be “fixed” as soon as possible in the container.
• Make sure the lid is tightly secured and mix by tipping container upside down. Refrigerate immediately if you are not dropping off the specimen within a few hours at a Dynacare Laboratory and Health Services Centre.
• Return the specimen to a Dynacare Laboratory and Health Services Centre or to your clinician’s office within a few hours, along with the completed cytology requisition.

Stool Collection

Stool Collection for Culture

For this test you need:

• One stool collection per day for the entire testing period

To collect this sample you’ll need an enteric pathogen transport media container, which is provided at Dynacare Laboratory and Health Services Centres.

• Clearly label containers with your full first and last name, date of birth and date of collection.
• Collect stool in a dry, clean container such as a chamber pot, plastic bag, plastic jar, wide-mouth jar, or on waxed paper. Avoid stool contact with urine or toilet water.
• Add a teaspoonful of the stool to transport container immediately after bowel movement. Select sample from bloody or mucous-covered areas if applicable.
• Screw cap tightly onto container.
• Mix the stool with transport medium in container and refrigerate immediately.
• Return container to Dynacare Laboratory and Health Services Centre or to your clinician’s office as soon as possible, along with the requisition.

NEW Stool Culture Collection Instructions (Ontario Only) - click here

NEW Stool Culture Collection Instructions (Quebec Only) - click here

Stool for Clostridium difficile Toxin

For this test, you will need:

• Containers provided at Dynacare Laboratory and Health Services Centres. ​
• Clearly label containers with your full first and last name, date of birth and date of collection.
• Return container to a Dynacare Laboratory and Health Services Centre or your clinician’s office, along with the requisition. If you cannot return the specimen immediately, please refrigerate it.

Stool for Ova and Parasites

For this test you need:

• Abstinence from consuming any laxatives, enemas or antibiotics for one week before stool collection, unless otherwise directed by your clinician

To collect this sample, you’ll need containers provided at Dynacare Laboratory and Health Services Centres. These containers will hold a fluid with small small amounts of formaldehyde and acetic acid. Do not ingest and avoid prolonged contact with skin. No more than two specimens, properly collected and preserved, are recommended for this test.

• Clearly label containers with your full first and last name, date of birth and date of collection.
• Pass stool onto clean, dry surface, such as a chamber pot, plastic bag, plastic wrap or waxed paper. Avoid stool contact with urine or toilet water.
• Use scoop attached to container lid or use sticks provided. Add about one teaspoonful of fresh stool to the fluid inside the container immediately after bowel movement. Be sure to take small samples from all parts of the stool, and especially from any parts with blood or mucous.
• Break up stool pieces in the fluid as much as possible.
• Screw lid on tightly and shake container to emulsify stool. The specimen should be completely emulsified in the liquid.
• Return bottle to plastic bag and reseal.
• Wash your hands immediately and thoroughly.
• Return container to a Dynacare Laboratory and Health Services Centre or to your clinician’s office, along with the requisition.

Stool for Occult Blood

For this test you will need:

• Two days of eating a high-fibre diet free of red meat prior to the test, with this diet continuing through the test period

To collect this specimen you'll need a kit provided at Dynacare Laboratory and Health Services Centres. Do not collect the specimen if the following applies to you:

• You are having your menstrual period or have just finished your period within the last three days.
• You have blood in your urine.
• You have bleeding hemorrhoids.
• You had dental work within the last three days.

At least two days before you start collecting the specimen, change or maintain your diet to exclude any red meat and include the following foods. If any of these recommended foods cause you discomfort, do not consume them. Consult your clinician.

• Generous portions of cooked and raw vegetables, especially lettuce, corn and spinach
• Plenty of fruits such as prunes, plums, grapes and apples
• Moderate portions of high-fibre foods such as bran cereal, popcorn, whole-wheat bread and peanuts
• Tuna fish, well-cooked poultry or pork.

Foods, vitamins and drugs to avoid:

• Red or lightly cooked meats such as beef or lamb
• Turnips, broccoli, horseradish, cantaloupes, parsnips and radishes
• Vitamin C in excess of 250mg per day
• Iron supplements
• Aspirin (acetylsalycytic acid) and medications that can cause gastrointestinal irritation

Once you have been on this diet for two days, you can start collecting the sample.

• Clearly print your full name on each card with a ballpoint pen.
• Before a bowel movement, flush toilet to clear water. Do not use bowl with automatic cleansers or bluing agents.
• Place plastic wrap or several layers of toilet paper over rim of bowl to ease collecting stools.
• Lift front flap of test pack from one test slide. Defecate and use applicator stick to apply very thin smear of stool to “Oval I.”
• Use same stick to apply a thin smear from a different area of feces to “Oval II.” Discard stick in trash. Do not flush down toilet.
• Close flap by sliding tab into crescent-slit. Enter date on front of slide. Place completed test slide into specially provided envelope. Make sure you protect test slides from heat, light or volatile liquids (iodine, bleach).
• Repeat procedure for three consecutive bowel movements.
• Seal envelope by removing tape strip and folding as shown. Return to a Dynacare Laboratory and Health Services Centre or to your clinician’s office, along with the requisition. Please note that it is against postal regulations to mail specimens in a standard paper envelope.

Sputum Collection

Sputum for Culture and Sensitivity

For this test you will need:

• Sputum collected in the morning before eating

Sputum is material collected from the lower respiratory tract. Be careful not to confuse it with saliva, which accumulates in the mouth and is unsuitable for this test. To collect this sample, you should have containers provided by a Dynacare Laboratory and Health Services Centre.

• Clearly label containers with your full first and last name, date of birth and date of collection.
• Before eating breakfast or brushing teeth, assume an elbow-to-knee position on the bed for five minutes so your lungs are higher than your windpipe.
• Inhale and exhale several times. Cough deeply from the chest/diaphragm to obtain secretions from the bronchial tree instead of saliva. Make sure you do not spit into the collection container as this could result in a rejected sample and delayed results.
• Collect specimen directly into a Dynacare sterile container and refrigerate immediately.
• Deliver specimen within 24 hours of collection to a Dynacare Laboratory and Health Services Centre or to your clinician’s office, along with the requisition.

Sputum for Cytology

For this test you will need:

• Sputum collected on three consecutive mornings before eating
• 50% alcohol if you are unable to drop samples immediately at a Dynacare laboratory

Sputum is material collected from the lower respiratory tract. Be careful not to confuse it with saliva, which accumulates in the mouth and is unsuitable for cytological examination. To collect this sample, you should have containers provided by a Dynacare Laboratory and Health Services Centre.

• Clearly label containers with your full first and last name, date of birth and date of collection.
• Before eating breakfast or brushing teeth, assume an elbow-to-knee position on the bed for five minutes so your lungs are higher than your windpipe.
• Inhale and exhale several times. Cough deeply from the chest/diaphragm to obtain secretions from the bronchial tree instead of saliva.
• Collect specimen directly into a Dynacare sterile container and refrigerate immediately.
• Deliver sputum sample to a Dynacare Laboratory and Health Services Centre or to your clinician’s office as soon as possible, along with the requisition. If there is a delay, keep the specimen refrigerated or fix in 50% alcohol. Fresh specimens are preferred.

Other Collections

Oral Glucose Tolerance Test

For this test you will need:

• An appointment with a Dynacare Laboratory and Health Services Centre
• Eight to 12 hours of fasting (10 to 12 hours if you are in Saskatchewan) prior to the test

You must not eat or drink anything except water during the fasting period required for this test. No other liquids – including coffee, tea, milk, cream, alcohol and other beverages – are allowed. Even chewing gum is not permitted. Avoid smoking if possible, and report any medication taken on the requisition.

Pinworm Examination

For this test you will need:

• Specimen collected upon waking, before using the toilet or taking a shower or bath

Pinworm ova are deposited on the skin near the anus, usually overnight while you're asleep. To collect samples, you’ll need containers included as part of a kit provided at Dynacare Laboratory and Health Services Centres. These kits contain a clear polystyrene paddle, with one side coated in a non-toxic, mildly adhesive material.

• Clearly label containers with your full first and last name, date of birth and date of collection.
• Upon waking, before using the toilet or taking a shower or bath, start collecting the sample. Make sure you do not wipe or wash the sample area.
• Remove container cap and select the sticky side of paddle – the one coated with adhesive. Hold paddle by rounded end, taking care not to touch any part of the sticky surface
• Press the sticky surface of the paddle’s square end firmly against skin around and across the anal opening. Do not insert paddle into the rectum, and make sure you do not get any stool on the paddle.
• Place the paddle into the tube, with the square end at the bottom of the tube.
• Place container in the plastic bag provided with the kit and reseal.
• Wash and dry your hands immediately and thoroughly. Pinworm eggs are easily transferred by contaminated hands during collection and can infect others.
• Return the sample to a Dynacare Laboratory and Health Services Centre or to your clinician’s office.

Sperm Analysis

For this test you will need:

• Abstinence from intercourse two to seven days before the test
• An appointment with a Dynacare Laboratory and Health Services Centre if you are doing a fertility test

Dynacare Laboratory and Health Services Centres provide the containers needed to collect samples for this test.

• Ejaculate specimen by means of self-stimulation. Do not use a condom. If you are doing a fertility test, you will be collecting this sample in the Dynacare Laboratory and Health Services Centre.
• Collect all seminal fluid into the sterile container provided. This is important because the greatest concentration of sperm is found in first portion of ejaculate.
• Clearly label containers with your full first and last name, date of birth and date of collection, taking care to ensure your writing is neat and easy to understand.
• If you are doing a fertility test, hand your specimen to a lab employee. If you are collecting the sample at home for post-vasectomy or culture and susceptibility testing, you can drop off the specimen at any Dynacare Laboratory and Health Services Centre within 24 hours, except in the Ottawa region where LHSC drop-off is no longer available. In Manitoba, specimens must be dropped off at the main lab in Winnipeg within one hour of collection.

ECG and HOLTER MONITOR Tests

A healthy heart is vital at any age. At Dynacare Laboratory and Health Services Centres, we help you take care of your heart by providing the gold standard in heart testing: electrocardiogram and Holter monitor test.

What’s an electrocardiogram?

Commonly referred to as ECG or EKG, an electrocardiogram (ECG) is a relatively simple, non-invasive diagnostic tool that measures the rate and rhythm of the heartbeat as well. It also provides indirect evidence of blood flow to the heart muscle to diagnose types of heart disease.

For a routine ECG, 10 electrodes are used to produce 12 electrical views of the heart. The signals received from each electrode are recorded and the printed view of these recordings is the electrocardiogram.

Reasons to have an ECG

ECGs are often performed for symptoms that include lightheadedness, palpitations, or passing out. The ECG is used to assess heart function, to see if heart attack is present. Even if there is no heart attack, the ECG can help determine if the pain is due to angina or narrowing of blood vessels to the heart muscle. It is important to know that an initial ECG may be normal even if there is heart disease present. Serial ECGs may be needed over time to find an abnormality.

What to expect before and during an ECG

No preparation is required before an ECG but exercise immediately before an ECG is not recommended because it may increase heart rate. During the ECG, you will be asked to remove clothing from the waist up and to lie down on an examination table where you will be covered with a sheet. You may be asked to remove jewellery. An electrode lead or sticky patch will be placed, with a gel, on each arm and leg and six more will be placed across the chest wall. The entire process usually takes approximately 20 minutes to complete.

Interpreting ECG findings

A normal ECG does not exclude heart disease and an abnormal ECG may be the normal baseline for the patient. To diagnose heart disease, your physician will also need to do a thorough physical examination and analyze your medical history.

What is a Holter monitor test?

Holter monitoring is a painless and non-invasive test that measures the rate and rhythm of all your heartbeats for 24, 48 or 72 hours. Three electrodes are placed on your chest and each arm and attached to a battery-operated recorder – the size of a deck of cards – that you carry in your pocket, on your belt or strapped to you. You can hide the electrodes and wires under your clothes.

While you are wearing the monitor, you will keep a diary of your activities and symptoms. Your doctor will compare the diary with the electrical recordings to help determine what triggers your symptoms. When the monitoring period is over, you will be advised to return to have the Holter recorder and electrodes removed. There may be some discomfort as the adhesive is pulled off your skin.

Reasons to have a Holter monitor test

A Holter monitor test is usually performed when a traditional electrocardiogram or ECG test does not give your doctor enough information about your heart's condition. Sometimes an electrocardiogram doesn't detect irregularities in your heart rhythm because you're only hooked up to the machine for a short time. Your doctor may also order a Holter monitor if you have a heart condition that increases your risk of an abnormal heart rhythm or if you have other symptoms that need to be investigated.

What to expect before and during the test

While an appointment is necessary, you don't need to do anything to prepare for a Holter monitor test. It’s a good idea to wear loose clothing and to avoid showering or bathing during the process. The Holter monitor will be damaged if it gets wet and it must always be kept on, take even when you sleep.

There is a small chance that some electrical devices may interrupt signals from the electrodes to the device. Keep your mobile phone and other electronic devices at least six inches away from the monitor. You should also minimize or avoid using items such as electric razors or electric toothbrushes.

Frequently Asked Questions (FAQ)

We get it. Going for a medical test can make feel worried. You may be wondering if the specimen collection process will be painful, or if it takes a long time to get results. To help ease your mind before your test, we’ve put together some of the questions we hear most often from our clients. They should give you a good idea of what to expect before, during and after your Dynacare test.