HOSPICE PROGRAM FOR CHILDREN.(Spotlight on Health & Fitness) - Rocky Mountain News (Denver, CO)

Byline: Jenny Deam News Staff Writer

While there is probably nothing to lift a family's burden when a child is dying, a new hospice program may help to ease the load.

Children's Hospital Home Care, in connection with Centura Porter Hospice, has launched a new program designed for terminally ill children and their families.

It is called The Butterfly Program, borrowing from the symbolism of transition. In this case it is the transition into the final stages of life.

When a child is gravely ill, experts say, the family most often simply wants him or her to be comfortable and in familiar surroundings. That means home. But because of the child's condition as well as the emotional stress on all involved, families need help.

That's where The Butterfly Program comes in, said Dee Mueller, a spokeswoman for Centura Home Care and Hospice. Included in the hospice program are pediatric nursing services, therapy - both physical and emotional - and respite care for parents and siblings of the ill child. That can include anything from sitting at the child's bedside so parents can get some sleep to running errands and playing with other children in the family, who often feel neglected.

The program also provides bereavement counseling for the family after the child dies.

MOM'S MENTAL HEALTH KEY IN MURDER CASE WOMAN ACCUSED OF KILLING HER TWO CHILDREN HAD BEEN TREATED FOR POSTPARTUM DEPRESSION.(Local) - Rocky Mountain News (Denver, CO)

Byline: Kevin Vaughan Rocky Mountain News Staff Writer

JEFFERSON COUNTY -- A mother accused of killing her two children goes to court Monday, beginning a legal proceeding that experts said will hinge on her mental health.

Bethe Feltman remained under police guard Friday at Centura Health Porter Hospital in Denver, where she is undergoing a psychological evaluation. She has been charged with two counts of first-degree murder in the April 9 slayings of Ben, 3, and Moriah, 3 months.

``Unlike most cases, where some hedging of the bets is appropriate, I would say there's a 100-percent, take-it-to-the-bank guarantee that the sole defense at any trial will be mental status,'' said Denver attorney Scott Robinson.

Robinson said his belief is rooted in what he knows about the case.

According to court documents, Bethe Feltman had struggled with postpartum depression since the Moriah's birth New Year's Day.

Her husband, Wade, had come home April 9 to find both children dead and Bethe incoherent in the couple's Jefferson County home.

Coroner's investigators concluded that both children were given drugs, and that Ben was strangled and Moriah suffocated.

Bethe Feltman had spent time in the hospital in the week before the children were killed and was scheduled to see a doctor again the next day, according to court documents.

She is scheduled to appear in court at 1:30 p.m. Monday. There, her mental competency is expected to be raised. A judge will be asked to determine whether she is able to understand the proceedings and assist her lawyer, Craig Truman, in her defense.

Truman declined to discuss the details of the case.

If the court determines Feltman is not competent, the proceedings would be on hold until her competency is restored.

A separate issue would be her sanity when the killings occurred. If she were to plead not guilty by reason of insanity, she would likely undergo an extensive psychiatric evaluation.

``If she's ruled sane, the chances are great the defense will ask for a second opinion - 100 percent,'' Robinson said. ``But if she's ruled insane, it's not inconceivable that the district attorney . . . might accept that.''

In that case, Feltman would be sent to the state mental hospital until she could demonstrate she wasn't a threat.

HEALTH AND FITNESS BRIEFS.(Lifestyles/Spotlight) - Rocky Mountain News (Denver, CO)

Byline: Compiled by Debra Melani

Magazine ranks Denver 6th fittest city in U.S.

Denver ranked as the nation's sixth fittest city in Men's Fitness magazine's ``America's Fattest Cities'' report, escaping the dreaded ``fattest'' list.

That designation - fattest city in America - went to Houston, followed by Detroit, Philadelphia, New Orleans and Columbus, Ohio, in that order.

Bumping Denver down to sixth place on the ``fittest city'' list were San Diego at No. 1, followed by a tie for the No. 2 spot with Honolulu and San Francisco. Seattle made the fourth spot, followed by Minneapolis at No. 5.

Men's Fitness found some key factors, such as the amount of open space and parks, commute time, availability of junk food and the quality of air and water, made a difference in a city's fitness level.

Health care systems join forces to help needy

Metro-area community programs in need of wheelchairs, beds and other medical supplies soon will have some headed their way, thanks to a medical partnership announced recently by Centura Health, Exempla Healthcare and HealthONE.

The three major health care systems each expect to donate about $100,000 worth of surplus items a year through the initiative called ``Hospital Attic.'' Providers' Resource Clearinghouse, a local nonprofit, will provide transportation, storage and distribution of donated goods and will act as a central referring point. Colorado nonprofits with 501(c)(3) status can contact the clearinghouse at (303) 296-8580.

Carbon monoxide poisoning increases in winter

What seems like the flu might be a deadlier poison making people sick this time of year, according to the American College of Emergency Physicians.

Carbon-monoxide poisonings increase during the winter months, when houses are sealed tightly and heaters, stoves and furnaces are continually in use. The gas is invisible and odorless and can kill quickly.

Symptoms of poisoning can mimic the flu, including headache, fatigue, nausea, dizziness, confusion and irritability. Continued exposure can lead to vomiting, weakness, miscarriage, brain damage, heart attack, breathing problems and death.

The ACEP offered the following precautions:

* Have fuel-burning appliances professionally checked annually.

* Choose appliances that vent fumes outside.

* Make sure appliances are properly installed, following proper venting directions.

* Never use a gas oven to heat your home.

A TURN FOR THE BETTER SYMPOSIUM AIMS TO HELP WOMEN TAKE CHARGE OF CHANGE.(Spotlight on Health & Fitness) - Rocky Mountain News (Denver, CO)

Byline: Leslie A. Young Rocky Mountain News Staff Writer

Change is one of life's few certainties.

At 31, Tracey Brummett of Denver knows that all too well.

For months she's been organizing Embracing Transitions: A Women's Health Symposium. During that time she's become the woman for whom she designed the conference.

In short, she and her husband have just hit a wall in their plans to have children.

``Intellectually, I thought I was prepared, but emotionally, I found it hit me really hard,'' she says.

Throughout the turmoil, Brummett has worked to maintain control. One thing that's helped is an emotional-fitness test designed by Susan Heitler, a Denver clinical psychologist.

Heitler will be the keynote speaker at the health symposium, to be held March 14 on the Auraria campus. The conference focuses on inevitable health crossroads women face and their options.

The conference goal is ``to raise women's consciousness about change and the fact that they have choices and they can help affect the changes in their lives,'' Brummett says. ``It doesn't just have to happen to them.''

Empowering women to face change represents a shift in psychotherapy, Heitler says.

``Initially, the field of psychotherapy looked at people who were emotionally injured and how to help them heal,'' she says. ``Emotional fitness looks at how people can prevent injuries.''

Heitler's test has 10 questions. A high score reflects a resilience that's like money in the bank for the challenges around the bend, she says. The woman probably possesses useful tools: a positive attitude toward herself; an openness not only to her own feelings but to the feelings of others; a talent for saying what's on her mind in a tactful way; an ability to take care of herself physically.

If your score indicates you're emotionally weak, that means you're susceptible to emotional injuries that ``show up as depression, anxiety disorders, excessive anger, angry outbursts or irritability,'' Heitler says.

The test isn't highly scientific, she says. ``It's more like a quick little checklist to get a very quick overview of where you stand emotionally at this point in your life.''

Brummett took the test during the symposium's initial planning phase, then again after her crisis.

``My score is lower right now,'' she says. ``I'm in a more emotionally brittle state.''

This self-understanding isn't trivial, Heitler says, because emotions are like traffic signals: ``Emotional fitness involves the abiliy to accurit from emn street ce up in orhere. Soment is happening here.' ''

Heitler sashe also us the ``RTD system'': R means gs, T is to think abtably, humhree level, she says. Recognizing feelings can be difficult. For some, it's easy to ignore them, but ``there's enormous power in being able to put a label on something.''

And if you don't think through your feelings, ``you're at risk for letting feelings go straight from your gut to your mouth,'' Heitler says.

The ``doing'' applies to yourself, she emphasizes. It's easy to decide what someone else should do, she says, but taking responsibility for your actions is empowering.

In sorting through her crisis, Brummett doesn't need traffic signals to tell her she's in pain, but she says the emotional-fitness test has helped her understand how she handles problems, and most important, it's helped her identify her support systems.

INFOBOX

IF YOU GO:

Embracing Transitions: A Women's Health Symposium, 11 a.m. to 5:30 p.m. March 14, University of Colorado at Denver, North Building. The conference is sponsored by Bea Romer's Colorado Women's Health Campaign, American WholeHealth, Colorado Parent and Centura Health. Cost: $35, with proceeds donated to the Colorado Women's Health Campaign. On-site parking: $2. Registration: 320-1000.

Questions from the Emotional Fitness Test:

* I feel irritated at home, at work or on the road: (1) pretty much every day, (2) from once to a few times a week, (3) rarely

* I find that I smile warmly, talk openly and express affection to people close to me: (1) less than once a week, (2) several times a week, (3) pretty much every day.

* I think negative thoughts about myself (thoughts like, ``That was dumb!''): (1) often, (2) sometimes, (3) rarely.

- By Susan Heitler, Ph.D.

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HEALTH WORKERS FACE SMALLPOX DECISION; 1ST SHOTS ON FRIDAY.(NATION/WORLD) - The Capital Times

Byline: Associated Press

Across the country, doctors, nurses and public health officials are making some hard choices about whether to get the smallpox shot for the good of the country.

In the coming weeks, health care workers will be deciding whether to volunteer to be vaccinated so they can be ready to respond to a smallpox bioterrorist attack. The first shots will be given Friday in Connecticut, the first state ready with the vaccine.

Nebraska, Vermont and Los Angeles County also had received vaccine shipments by Wednesday but were waiting at least until next week to begin vaccinating.

Worries about the vaccine's fierce side effects and the threat that it may even sicken people near those vaccinated have prompted a number of nurses to refuse.

As an emergency room nurse in Milwaukee, Lisa Hass-Peters knows she is a prime candidate for a smallpox response team.

But her husband, Jeff, has had two liver transplants, leaving his immune system weakened. That means the smallpox vaccine - made from a live virus related to smallpox - could make him sick. He could be infected from the scab on her arm caused by the vaccine.

'I didn't hesitate to decline,' said Hass-Peters, who works at Milwaukee's Froedtert Memorial Lutheran Hospital. 'If I truly was exposed, I guess I would be weighing my options again. But I don't feel a threat at this particular moment.'

In a recent survey, 63 percent of 2,600 nurses responding said they would get the smallpox shot, 13 percent said they wouldn't and 24 percent were undecided, according to the National Network for Immunization Information, a coalition of several health trade groups.

Ultimately, the government plans to vaccinate nearly 500,000 health workers. But even some major hospitals are refusing the vaccine, including Colorado's largest chain, Centura Health with 10 hospitals; and Grady Memorial Hospital in Atlanta, home of the Centers for Disease Control and Prevention, which is shipping vaccine to the states.

The risk of a smallpox attack is unknown, and the chance that any given person will be exposed is small, an advisory panel for the Institute of Medicine said recently.

But the risks of the vaccine are well-known. Some people may have sore arms and fever or feel sick enough to miss work. As many as 40 people out of every million vaccinated for the first time will face life-threatening reactions, and one or two will die.

The vaccine is not recommended for people with skin problems, such as eczema, or those with weak immune systems, such as HIV, transplant or cancer patients.

Memorial Health Systems in Colorado Springs looking at ways to expand market share - Colorado Springs Business Journal

Memorial Health Systems has an opportunity to expand its marketshare through expanding to other parts of Colorado -- even toKansas.

The hospital system is beginning to reinvent itself as a regionalcenter, and is building the infrastructure to compete, said MikeScialdone, CFO for the system at Memorial's monthly update to thecity council.

After spending the last two years recouping form a devastatingfinancial hit in 2008, Memorial is ready to begin spending oninfrastructure and reorganization, he said.

'We've lost a great number of outpatient visits for imaging andradiology,' he said. 'Insurance companies are sending more people tothe freestanding centers, and not the hospital. We're reorganizingthe department -- to be more competitive and more efficient.'

That's just one way the hospital plans to compete in a complexhealth care environment. It needs to stop thinking of itself as a'hospital,' only, said CEO Larry McEvoy.

'We need to move away from thinking of ourselves as a bricks-and-mortar building and move toward thinking of ourselves as a networkof physicians who are providing regional care.'

Currently, 87 percent of Memorial's patients come from itsprimary area -- El Paso County. There's an opportunity to expand tothe secondary and tertiary markets, which include counties on theeastern plains, western slope and even into Kansas.

The way to do that is to provide those communities with expertisethey don't already have, he said.

'Then, when they have a deep-water issue -- like heart surgery orcancer -- they'll come to us,' he said. 'We don't want to do this ina predatory way, but we do want to be good neighbors.'

The move to focus regionally makes sense locally, McEvoy said.

'If we grow our business regionally, then it brings resourceshome to take care of people here,' he said. 'It's what hospitals aredoing now.'

It's a switch from past thinking about the health care industry,he said. Hospitals used to only think about the local market.

'But we don't want to grow by hurting Penrose (St. Francis HealthServices),' he said. 'We view them as a partner. But we do want togrow, and this is the way to do it.'

It's also an opportunity Penrose doesn't have. It's part ofCentura Health, which already has hospitals in Canon City andPueblo.

'They don't have as much room to expand as we do,' Scialdonesaid. 'It's another reason this makes sense.'

Scialdone and McEvoy made their pitch to council as they alsogave them number from 2010 and April 2011. Those numbers showdeclining inpatient volumes and fewer outpatient visits.

In 2010, the hospital saw an 8 percent decrease in admissions forinpatient admissions, and a 6.6 decrease in outpatient visits. Thebright areas of the financial picture: emergency room visits were up4.2 percent and the net income margin grew to 5.8 percent, showing ahealthy hospital environment.

'Our days of cash on hand and our overall net income increased,'Scialdone said. 'That was due to the health of our investments in2010. The markets were strong, so we did well.'

Net revenues were down for the year, from the anticipated $574million to $536 million, he said.

The monthly snapshot for April 2011 was a little brighter.Admissions were down 9.4 percent from what the hospital budgeted and8.8 percent for the same month in 2010.

Outpatient visits for April were up 1.1 percent from budget and4.2 percent from April 2010.

Overall, net patient revenue for the month was $180 million, downfrom the $198 million budgeted by 8.7 percent, but up from the sametime last year by 1.9 percent. April 2010 saw net patient revenuesof $177.5 million.

'These numbers show we can't put off changes,' Scialdone said.'We have to invest now, and we have to invest in the right places.That's what we're doing in 2011 to prepare for the future.'

If the hospital hopes to expand to other markets outside ColoradoSprings, it will have to be free of city control. As a municipallyowned system, city law prohibits expansion beyond El Paso County.

Health workers weigh vaccine - The Columbian (Vancouver, WA)

The needle that delivers smallpox vaccine is only about 3 incheslong, with two tiny prongs at one end. But for legions of healthcare workers nationwide, it symbolizes a complex personal choice.

These doctors, nurses and public health officials must decidewhether to volunteer for the vaccine some as early as Friday sothey could treat patients in a bioterrorist smallpox attack. But thevaccine itself can cause fierce side effects and even sicken othersclose to those vaccinated.

As an emergency-room nurse in Milwaukee, Lisa Hass-Peters knowsshe is a prime candidate for a smallpox response team.

But her husband, Jeff, has had two liver transplants, leaving hisimmune system weakened. That means the smallpox vaccine made from alive virus related to smallpox could make him sick. He could beinfected from the scab on her arm caused by the vaccine.

'I didn't hesitate to decline,' said Hass-Peters, who works atMilwaukee's Froedtert Memorial Lutheran Hospital. 'If I truly wasexposed, I guess I would be weighing my options again. But I don'tfeel a threat at this particular moment.'

The government plans to vaccinate nearly 500,000 health workers.So far, only Connecticut said it was ready to begin vaccinations onFriday, the day a law protecting those giving the shots fromlawsuits takes effect. Los Angeles County, Vermont and Nebraska arethe only other locations that had received the vaccine shipmentsWednesday.

Strictly voluntary, the vaccine is aimed at creating smallpoxresponse teams for treating patients in an attack. But some healthcare workers and hospitals are refusing because of the risks fromthe vaccine itself.

Though in the minority, major hospitals refusing to vaccinatetheir workers range from Colorado's largest chain, Centura Healthwith 10 hospitals, to Grady Memorial Hospital in Atlanta, home ofthe Centers for Disease Control and Prevention, which is shippingvaccine to the states.

The risk of a smallpox attack is unknown, and the chance that anygiven person will be exposed is small, an advisory panel for theInstitute of Medicine said recently in urging the government to goslower with the vaccinations.

But the risks of the vaccine are well-known. Some people may havesore arms and fever or feel sick enough to miss work. As many as 40people out of every million vaccinated for the first time will facelife-threatening reactions, and one or two will die.

The vaccine is not recommended for people with skin problems,such as eczema, or those with weak immune systems, such as HIV,transplant or cancer patients. The government says even people withfamily members in those categories should be screened out.

Health care unions have criticized the Bush administration,accusing it of cutting corners on screening and training. They alsoworry that people who have side effects or miss work may not befully compensated; the government says it is working on a plan.

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