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We've all been told the importance of a healthy lifestyle in adulthood to help prevent heart attacks and type 2 diabetes. But did you know that the risk begins way before we become "grownups?" This is especially true for children who have a family history of cardiovascular disease, diabetes and other risk factors that can contribute to heart disease later in life.
Here at the Cook Children's Risk Evaluation to Achieve Cardiovascular Health (REACH) clinic, we're dedicated to providing excellent, patient-centered care, as well as access to the most up-to-date therapies and clinical research. Our REACH team is committed to improving the lives and well-being of children who are at risk or affected by obesity, high blood pressure or high blood fats. We do this through a complete medical history, as well as changes in lifestyle, education and, when necessary, medication.
Cardiovascular disease is the leading cause of death in the U.S. And while it is rare for children or teens to have a heart attack, many of the preventable cardiovascular problems that develop in adulthood begin in childhood. Fortunately, reducing the risk of heart attack can also begin very early in life.
The REACH program at Cook Children's Medical Center works with children and their families to prevent premature heart disease and diabetes. Treatments include changes in lifestyle and, when necessary, medications. First, each child undergoes a complete checkup, looking for medical reasons that can cause weight gain, high blood pressure, high blood fats, and other problems that may result in premature heart disease as children grow into adulthood. When appropriate, other tests may be preformed, such as checking your child's fitness level, ability to exercise and need for a special diet. Families are offered education and coaching to help make the changes necessary to improve your child's health.
Depending on your child's diagnosis, our team may recommend that you, your child and family members will take one or more classes between each follow-up visit. Each class is one hour in length. Classes offered include:
Health risks that may result in heart attacks or type 2 diabetes in the future, may be caused by many conditions, among them:
Here at the Cook Children's REACH clinic, the main conditions we see are:
There is strong evidence linking diabetes, high blood pressure and elevated blood levels of "bad fats" (e.g. total and LDL-cholesterol) to early heart disease. When present in children, the damage to blood vessels from cardiovascular risk factors are often made worst by excessive weight gain, a low level of physical activity and poor diet.
To help make your first visit to our office a little easier, please print and fill out the new patient form below and bring it with you to your appointment. We've also provided a checklist that will help you prepare for your visit and save time and stress.
Before your child's first visit to our clinic, we will discuss with you required medical testing and information that we will need. This will include:
The REACH team may also recommend other tests as part of a comprehensive diagnostic evaluation. The panel includes:
We look forward to helping you and your child achieve and maintain a heart healthy lifestyle. To help make sure your visit to our clinic goes smoothly and your child gets the most benefit from each visit, here are some suggestions:
For the initial visit, your child will not need to fast (that is, has had nothing to eat or drink). Please have him/her eat as usual and take any medications that have been prescribed by your child's doctor.
During your first clinic visit, a member of our REACH staff will:
Your child will also see a specially trained physician who will:
Once your visit is complete, our team may recommend a more comprehensive diagnostic evaluation for your child. This allows the team to create a program that is custom-fit to the needs of your child, thus helping him or her to reach their health goals.
To better understand each child's current health and future risk of cardiovascular disease and diabetes, our REACH team may recommend a comprehensive diagnostic evaluation if your child's diagnostic evaluation has not been completed by your primary care physician before your first REACH clinic appointment. If not, it will be scheduled on a separate day after your child has fasted (that is, has had nothing to eat or drink) for at least 9 hours.
A panel of tests is obtained during the diagnostic evaluation to help show your child's risk for heart problems, often referred to as cardiovascular risk factors. As the parent or caregiver, we consider you an important part of our team. So, if you don't understand the purpose of a test, what your child can expect, or any of the test results, we encourage you to ask your child's primary care doctor or our REACH team to explain. Tests that are often recommended are:
Because many children who have health problems or concerns may have poor self-esteem, depression, and/or feelings of fatigue, all children undergo a screening test to determine if one or more of these problems are present.
Many of the problems associated with being overweight/obese, having high blood pressure or high blood fats are improved by a heart healthy lifestyle and maybe medicine. To be successful, children and their families should be willing to take the time and effort to make changes in lifestyle that will help your child and your entire family. This is measured by:
Following your child's diagnostic evaluation, our REACH team will contact you, your child and family to discuss the results and create a plan that fits your child's and your family's needs.At this time, we will also work with you to schedule your follow-up clinic visits.
Based on your child's specific needs, your child's follow-up visits will be scheduled every 3-6 months.
New patients are generally seen in our REACH Clinic on Mondays. Follow-up appointments, if needed, are scheduled on Tuesdays and Thursdays.
During your child's follow-up appointment, we will:
Learning to eat properly is a very important part of the REACH program at Cook Children's. For that reason, our dietitians plays a key role in your child's treatment plan.
What and how we eat is very personal, and even when we know other choices may be healthier, it is hard to change what we are used to.
Healthy eating is important. We work with the family and the patient to create a plan everyone will love.
With specialized training in the dietary needs of children, our dietitian will provide a detailed plan for improving your child's diet and will encourage him or her to be more active. Our team understands that what and how kids and families eat is very personal, and sometimes filled with tradition.
Even when we know other choices may be healthier, it can be hard to change what we are used to. For that reason, as part of our program, the REACH Team is committed to continuing to support each family in making necessary changes through education and counseling.
Based upon the needs of your child and family, follow-up REACH clinic visits are scheduled about every 3 to 6 months. During clinic visits we will:
Our REACH team is committed to improving the lives and well-being of children who are at risk or affected by high blood fats or pre-diabetes. Your child will have the support of our specially trained doctors, nurses, dietitians, clinical therapist and social services specialist. Together, we look forward to helping every child reach the goal of being heart healthy ... both in childhood and well into the future!
Here you'll find fun, helpful resources and educational information for the whole family. And lots of useful tools to help you on your journey to a heart healthy life:
Cardiovascular disease (CVD) is the leading cause of morbidity and mortality in the United States, and the antecedents of CVD emerge early in life. While many of these children with increased risk have a genetic cause, such as familial hypercholesterolemia, increasingly unhealthy lifestyle behaviors play a significant role as well.
CVD risk factors in youth, like in adults, are exacerbated by dyslipidemia, insulin resistance, prehypertension / hypertension and unhealthy lifestyle behaviors such as low physical activity and poor diet. Moreover, CVD risk factors in childhood persist into adulthood and predict cardiovascular outcomes decades later. Unless children with genetic CVD risk factors are found early and appropriate intervention and prevention efforts are implemented, coupled with the current epidemic of obesity among children and adolescents, these children are at substantial risk of premature heart attack and stroke during adulthood.
To help address these emerging trends, the Endocrinology Program at Cook Children's developed the REACH (Risk Evaluation to Assure Cardiovascular Health) Clinic . The clinic was established to better understand the cause(s) of premature cardiovascular diseases, including genetic and acquired forms of dyslipidemia, insulin resistance and "prediabetes", childhood obesity and weight related health risks; developing effective means of prevention through health education, early detection of those at risk and timely treatment.
The REACH clinic is committed to:
The Division of Endocrinology also collaborates with a variety of leading regional and national clinicians and scientists to improve the health and well-being of children and adolescents by finding better diagnostic tests, effective measures of prevention and treatments for children at risk for premature cardiovascular disease.
Children and adolescents who:
Cook Children's Endocrinology
1500 Cooper St., Second floor
Fort Worth, Texas 76104-2724
Don Wilson, Cook Children's endowed chair, medical director, REACH (Risk Evaluation to Achieve Cardiovascular Health) program talks about the genetic forms of hypercholesterolemia and screening guidelines. He shares how mandatory screening can not only prevent cardiovascular disease in children, but also their parents and other family members.
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If your child has been diagnosed, you probably have lots of questions. We can help. If you would like to schedule an appointment, refer a patient or speak to our staff, please call our offices at 682-885-7960.