Continued from cover Transitioning from Pediatric to Adult Healthcare Care Program. “But planning these transitions early is crucial because adolescents with complex, chronic conditions need uninterrupted access to appropriate, high-quality healthcare, or they risk becoming very sick.” and attached to a heart-bypass machine, which creates high-pressure suction. Once connected, the device acts like a vacuum cleaner, sucking out the clot. The system then recirculates the patient’s blood through a blood vessel near the groin, eliminating the need for a transfusion. Dr. Moriarty notes that the AngioVac can take about half as long to perform as open-heart surgery. Because it is minimally invasive, patients usually experience less pain and discomfort and have a much quicker recovery. Approximately one in 500 Americans will develop blood clots in their leg veins, a condition called deep-vein thrombosis, and nearly 100,000 people die each year of a pulmonary embolism, when a clot breaks away from the blood-vessel wall and lodges in the lungs or heart. The clot-busting drug tPA is effective at breaking up clots, but it can take up to four days to work and is not always able to do the job; in the UCLA patient’s case, the clot was too large and dense. In addition, certain patients, such as those who have had a stomach ulcer or stroke and are at high risk for bleeding, are not good candidates for tPA. “The AngioVac procedure is ideal for patients with large clots in areas where it’s not safe to operate, or the operations would be very difficult,” Dr. Moriarty says. “Such patients, if they can’t benefit from medication, should be evaluated because they may now have a much better option than they had before.” To view a video about AngioVac, go to: uclahealth.org/ angiovac Approximately 15 percent of children in the United States aged 17 and younger have complex medical conditions, ranging from asthma, diabetes and congenital heart disease to juvenile inflammatory arthritis, cystic fibrosis, neurological disabilities and organ transplantation. As many as 60 percent of these patients experience gaps in medical care, health-insurance coverage or both during their transition from adolescence to adulthood. To avoid these problems, patients should begin the transition to adult-based healthcare between the ages of 12 and 18, Dr. Lotstein says: “Early planning prevents problems and helps to decrease anxiety for the patients and their parents.” At UCLA’s Med-Peds Transition Care Program, preparing for the transition involves evaluating patients’ current and future healthcare needs and connecting patients with appropriate providers to meet those needs; addressing insurance-related issues to prevent gaps in health coverage when children are no longer eligible for coverage under their parents’ health plans; educating patients about self-care related to their conditions; and helping patients plan realistic education and career goals. children with congenital heart defects are surviving into adulthood and leading active, productive lives, they may still face certain challenges related to lifestyle and career choices. “Some patients don’t understand why they should anticipate future challenges such as the potential detrimental effects of pregnancy or certain types of exercise,” he says. “Discussing their personal goals and recommendations early on helps to prevent them from being disappointed or from unintentionally hurting themselves later.” Another important goal in the transition process, Dr. Reardon says, is helping young patients develop medical independence. “There’s an interesting dynamic that occurs when an adolescent takes ownership of their healthcare from their parents. They often feel empowered and begin participating in their care in ways that make them feel that they are not defined by their medical condition,” Dr. Reardon says. “Simple steps like scheduling appointments or refilling prescriptions can help make the transition to the adult setting much more successful. Ultimately, we promote independence so that our patients can learn how to make positive choices for their lives and participate in their own care and decision-making as they become adults.” In the Adolescent/Young Adult Transitional Care Program for Congenital Heart Disease at UCLA, “we try to help patients and their parents understand their condition using an age and developmentally tailored approach,” says pediatric cardiologist, Leigh Reardon, MD, program director. “Many years after heart surgery, some of our patients believe they’re living on borrowed time, while others feel like they’re invincible.” Although an increasing percentage of Vital Signs Spring 2014 Vol. 62 7 Continued from cover Transitioning from Pediatric to Adult Healthcare Care Program. “But planning these children with congenital heart defects transitions early is crucial because are surviving into adulthood and leading adolescents with complex, chronic active, productive lives, they may still face conditions need uninterrupted access certain challenges related to lifestyle and to appropriate, high-quality healthcare, career choices. or they risk becoming very sick.” “Some patients don’t understand why and attached to a heart-bypass machine, Approximately 15 percent of children in they should anticipate future challenges which creates high-pressure suction. Once the United States aged 17 and younger have such as the potential detrimental effects of connected, the device acts like a vacuum complex medical conditions, ranging from pregnancy or certain types of exercise,” he cleaner, sucking out the clot. The system then asthma, diabetes and congenital heart says. “Discussing their personal goals and recirculates the patient’s blood through a disease to juvenile inflammatory arthritis, recommendations early on helps to prevent blood vessel near the groin, eliminating the cystic fibrosis, neurological disabilities them from being disappointed or from need for a transfusion. and organ transplantation. As many as unintentionally hurting themselves later.” Dr. Moriarty notes that the AngioVac can take 60 percent of these patients experience Another important goal in the transition about half as long to perform as open-heart gaps in medical care, health-insurance process, Dr. Reardon says, is helping young surgery. Because it is minimally invasive, coverage or both during their transition patients develop medical independence. patients usually experience less pain and from adolescence to adulthood. To avoid “There’s an interesting dynamic that occurs discomfort and have a much quicker recovery. these problems, patients should begin when an adolescent takes ownership the transition to adult-based healthcare Approximately one in 500 Americans will of their healthcare from their parents. between the ages of 12 and 18, Dr. Lotstein develop blood clots in their leg veins, a They often feel empowered and begin says: “Early planning prevents problems condition called deep-vein thrombosis, participating in their care in ways that and helps to decrease anxiety for the and nearly 100,000 people die each year of make them feel that they are not defined by patients and their parents.” a pulmonary embolism, when a clot breaks their medical condition,” Dr. Reardon says. away from the blood-vessel wall and lodges At UCLA’s Med-Peds Transition Care “Simple steps like scheduling appointments in the lungs or heart. The clot-busting drug Program, preparing for the transition or refilling prescriptions can help make tPA is effective at breaking up clots, but it can involves evaluating patients’ current and the transition to the adult setting much take up to four days to work and is not always future healthcare needs and connecting more successful. Ultimately, we promote able to do the job; in the UCLA patient’s case, patients with appropriate providers to meet independence so that our patients can the clot was too large and dense. In addition, those needs; addressing insurance-related learn how to make positive choices for their certain patients, such as those who have had a issues to prevent gaps in health coverage lives and participate in their own care and stomach ulcer or stroke and are at high risk for when children are no longer eligible for decision-making as they become adults.” bleeding, are not good candidates for tPA. coverage under their parents’ health plans; educating patients about self-care related “The AngioVac procedure is ideal for patients to their conditions; and helping patients with large clots in areas where it’s not safe plan realistic education and career goals. to operate, or the operations would be very difficult,” Dr. Moriarty says. “Such patients, if In the Adolescent/Young Adult they can’t benefit from medication, should be Transitional Care Program for Congenital evaluated because they may now have a much Heart Disease at UCLA, “we try to help better option than they had before.” patients and their parents understand their condition using an age and developmentally tailored approach,” says pediatric cardiologist, Leigh Reardon, MD, program director. “Many years To view a video about AngioVac, go to: after heart surgery, some of our patients uclahealth.org/ believe they’re living on borrowed time, angiovac while others feel like they’re invincible.” Although an increasing percentage of Vital Signs Spring 2014 Vol. 62 7 Continued from cover Transitioning from Pediatric to Adult Healthcare Care Program. “But planning these transitions early is crucial because adolescents with complex, chronic conditions need uninterrupted access to appropriate, high-quality healthcare, or they risk becoming very sick.” and attached to a heart-bypass machine, which creates high-pressure suction. Once connected, the device acts like a vacuum cleaner, sucking out the clot. The system then recirculates the patient’s blood through a blood vessel near the groin, eliminating the need for a transfusion. Dr. Moriarty notes that the AngioVac can take about half as long to perform as open-heart surgery. Because it is minimally invasive, patients usually experience less pain and discomfort and have a much quicker recovery. Approximately one in 500 Americans will develop blood clots in their leg veins, a condition called deep-vein thrombosis, and nearly 100,000 people die each year of a pulmonary embolism, when a clot breaks away from the blood-vessel wall and lodges in the lungs or heart. The clot-busting drug tPA is effective at breaking up clots, but it can take up to four days to work and is not always able to do the job; in the UCLA patient’s case, the clot was too large and dense. In addition, certain patients, such as those who have had a stomach ulcer or stroke and are at high risk for bleeding, are not good candidates for tPA. “The AngioVac procedure is ideal for patients with large clots in areas where it’s not safe to operate, or the operations would be very difficult,” Dr. Moriarty says. “Such patients, if they can’t benefit from medication, should be evaluated because they may now have a much better option than they had before.” To view a video about AngioVac, go to: uclahealth.org/ angiovac Approximately 15 percent of children in the United States aged 17 and younger have complex medical conditions, ranging from asthma, diabetes and congenital heart disease to juvenile inflammatory arthritis, cystic fibrosis, neurological disabilities and organ transplantation. As many as 60 percent of these patients experience gaps in medical care, health-insurance coverage or both during their transition from adolescence to adulthood. To avoid these problems, patients should begin the transition to adult-based healthcare between the ages of 12 and 18, Dr. Lotstein says: “Early planning prevents problems and helps to decrease anxiety for the patients and their parents.” At UCLA’s Med-Peds Transition Care Program, preparing for the transition involves evaluating patients’ current and future healthcare needs and connecting patients with appropriate providers to meet those needs; addressing insurance-related issues to prevent gaps in health coverage when children are no longer eligible for coverage under their parents’ health plans; educating patients about self-care related to their conditions; and helping patients plan realistic education and career goals. children with congenital heart defects are surviving into adulthood and leading active, productive lives, they may still face certain challenges related to lifestyle and career choices. “Some patients don’t understand why they should anticipate future challenges such as the potential detrimental effects of pregnancy or certain types of exercise,” he says. “Discussing their personal goals and recommendations early on helps to prevent them from being disappointed or from unintentionally hurting themselves later.” Another important goal in the transition process, Dr. Reardon says, is helping young patients develop medical independence. “There’s an interesting dynamic that occurs when an adolescent takes ownership of their healthcare from their parents. They often feel empowered and begin participating in their care in ways that make them feel that they are not defined by their medical condition,” Dr. Reardon says. “Simple steps like scheduling appointments or refilling prescriptions can help make the transition to the adult setting much more successful. Ultimately, we promote independence so that our patients can learn how to make positive choices for their lives and participate in their own care and decision-making as they become adults.” In the Adolescent/Young Adult Transitional Care Program for Congenital Heart Disease at UCLA, “we try to help patients and their parents understand their condition using an age and developmentally tailored approach,” says pediatric cardiologist, Leigh Reardon, MD, program director. “Many years after heart surgery, some of our patients believe they’re living on borrowed time, while others feel like they’re invincible.” Although an increasing percentage of Vital Signs Spring 2014 Vol. 62 7