2G Clinic, McMaster Children's Hospital
Phone: 905-521-2100, ext. 78515.
Cystic Fibrosis (CF) is one of the most commonly inherited disorders in childhood, affecting approximately 1 in every 3,200 children born in Canada. CF occurs in all racial groups with the highest incidence in Caucasians. CF is a multi-organ disease affecting mainly the lungs and digestive system.
Patients with CF are born with a genetic defect that causes a malfunction of the cystic fibrosis transmembrane conductance regulator protein (CFTR), a chloride channel in the cell membrane that plays an important role in maintaining water and salt balance across many body tissues like sweat glands, lungs, liver, pancreas and reproductive organs. Due to this malfunction, there is a build-up of thick mucous which makes it difficult to clear bacteria and leads to cycles of infection and inflammation which over time, damages the lungs. As a result, people with cystic fibrosis must follow a daily routine of physiotherapy to keep their lungs clear of mucous and infection. In the digestive tract, CF makes it difficult to digest and absorb adequate nutrients from food eaten. Most people with CF must swallow digestive enzymes (on average 20 pills a day) with every meal and snack to maximize absorption of their food and to gain weight.
CF is inherited in an Autosomal Recessive pattern, meaning in order to be affected with CF, an individual must have 2 copies of a CFTR mutation (one from each parent). Approximately 1 in 25 Canadians carries a defective version of the gene responsible for CF. Carriers do not have and can never get CF. However, when two carriers have a child, there is a
25% chance the child will have CF
50% chance of the child being a gene carrier
25% chance they will not have the faulty CF gene
more than 1,900 mutations have been identified
nearly 90% of people with CF in Canada carry at least one copy of the most common CF-causing mutation – DF508
treatments focus on nutrition, physiotherapy, exercise, and medication
early diagnosis and treatment for CF improves weight, height, and lung function which optimizes health and increases longevity
86% of people with CF must take pancreatic enzymes to digest food and absorb nutrients
in the 1960s, most children with CF did not live long enough to attend kindergarten, but today, half of all Canadians with CF are expected to live into their 40s and beyond
approximately 4,000 people with CF attend one of the 42 specialized cystic fibrosis clinics across Canada, McMaster being one of those specialized clinics
ongoing research focuses on finding a cure and together we can make this happen
Currently visits are scheduled every 3 months with an increased frequency of appointments for infants and toddlers. The earlier 1300h appointment times are booked for infants and small toddlers. For all families, extra appointments are added when there are health issues or concerns.
The McMaster CF clinic works in conjunction with the RSV clinic to offer all patients less than 2 years of age RSV immunization. This government funded immunization program entails monthly visits from November to April.
Our routine clinic practice has most patients that are over 6 years of age undergoing spirometry (breathing test) prior to each clinic visit. The pulmonary function laboratory for breathing testing is on the third floor of the hospital--3U. Sputum or throat cultures are done at clinic visits and these are specially processed by our lab. Patients are also scheduled for yearly chest x-rays and blood-work.
Patients aged 10 years and older also do yearly oral glucose tolerance testing (OGTT) blood-work. The clinic’s Child Life Specialist can assist children and adolescents coping with blood tests as needed.
The Children’s Exercise and Nutrition Centre (CENC) provides exercise testing on a regular basis. Clinic appointments for exercise are coordinated with CF clinic appointments.
Appointments with other services and clinics are coordinated when possible. It is often dependent on which days these clinics operate. This may include appointments with Diabetes, ENT, G.I. and Adolescent Medicine.
Newborn Screening Centre:
The hospital is located at 1200 Main St. W., Hamilton, ON, L8N 3Z5.
2G Clinic, McMaster Children's Hospital
2nd Floor, Red Section
When you arrive to the clinic please check in with the Business clerk at the reception desk. The business clerk will let the team know that you have arrived.
Staff will do their best to make sure you are seen at your appointment time. If you feel you have been waiting a long time please speak with a business clerk at the reception desk.
Any referrals can be faxed directly to the clinic as noted on the referral form.
The clinics are not for emergencies. If your child needs to be seen on an urgent basis, please contact your family doctor or go to your local emergency department.
(closed on holidays)
Monday 1:00 p.m. - 4:00 p.m.
Tuesday 9:00 a.m. -12:00 p.m.
Thursday 1:00 p.m. - 4:00 p.m. (Newborn Screening Only with sweat testing)
Please contact the 2G clinic #78515 if you need to change or cancel your child's appointment.
If the patient is ill with any antibiotic resistant organism, MRSA, a communicable disease (such as Chicken Pox), or a respiratory infection, please notify reception staff prior to your scheduled appointment.
List of medications and supplements you are taking
Your PEP device for regular re-assessment of technique and settings with the clinic physiotherapist
Health Card for your child - the Ministry of Health requires us to validate your health card at every clinic visit
Any relevant x-rays or letters from your doctor or pediatrician
Any notes or questions that you may have
Please call in your request for orders of routine medications (those used on a regular basis such as enzymes, vitamins, Ventolin, etc.) at least one week in advance of your clinic visit to pharmacy #75019
This will provide time for these orders to be ready the day of your clinic visit.
If you wait for the day of your clinic visit to order your medications then your full order may not be available at that time
A specialist trained to provide care for patients with Cystic Fibrosis.
develop comprehensive multi-system CF care plan
directs Best Practices in CF care in the clinic
maintains current CF standard of care guidelines
works with your primary care doctor (family doctor / pediatrician) ongoing basis
Works with patients and families and all CF team members
collaborate with other specialty physicians when needed
directs quality improvement initiatives in the CF clinic
educates Residents and Health professionals on CF care
A nurse that specializes in CF care.
CF program coordinator working with all members of the CF care team to ensure that the CF program runs smoothly
primary contact to address your concerns, answer questions or direct you to the right CF care team member when discussing a specific part of your treatment plan.
Work with the family and child to develop a customized treatment plan for airway clearance, movement, therapeutic exercise and the application of technological equipment along the continuum of childhood
Provide ongoing education and support to prevent and / or maintain respiratory, neuromuscular, musculoskeletal and cardiovascular systems that may affect your child
Assist with treatment adherence challenges to help maintain health and wellbeing for the entire family
Work with the family and child to understand critical infection control procedures
Optimal nutrition has been shown to be vital in maintaining good health in CF
Advise and educate patients and care givers about the principles of nutritional management in CF
Monitoring growth and ensuring each child is eating well enough to grow properly through each stage of life
Prevention of vitamin and mineral deficiencies
Help manage pancreatic insufficiency issues and adjust enzyme dosing when required to help with the digestion and absorption of food
Communicating and working with the other members of the CF interdisciplinary team to help keep each child healthy and to manage issues on an individual basis
Counselling families regarding feeding difficulties
Helping patients manage CFRD from a nutrition standpoint
Child Life Specialist:
Helps you, your child and family adjust to life with Cystic Fibrosis
Helps your child understand Cystic Fibrosis and cope with treatment through medical play
Provides ways for your child to safely express his or her feelings through play
Helps your child overcome challenges they may face as they develop and grow
Understands how children develop and how family members interact etc
Helps children cope with tests and procedures
Assist the patient and family adjust to life with Cystic Fibrosis
Facilitate family and team communication
Assist with patient education (i.e. provide education to patient/family on impact of illness on family and friend relationships)
Explore and advocate for resources and services
Provide crisis intervention and assist in mediating conflict
Assist patients and families with developing healthy coping skills and strategies
Our philosophy is family- centered care. We strive to provide the best care possible
Cystic Fibrosis Canada
Kids Health Website
Ontario Disability Support Program
Disability Tax Credit Forms
Introduction for Parents
Taking Charge of Your Health