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Visions of sugar plums may be dancing in your children’s heads this holiday season, but when visions become reality, the children themselves can be dancing and bouncing as they take in the sugar. Holiday treats are great for memory-making, area medical experts said, and there …
From Ruth Habrecht, 5 Healthy Towns The rates of childhood obesity as well as mental health concerns have been steadily rising over the past decade. Recent studies indicate soaring rates of depression, anxiety, and loneliness. Young children have had limited opportunity to restore and build …
Longmont United Hospital nurse Brooke Schroeder holds a sign supporting nurses December 2, 2021. Nurses say the hospital is severely understaffed and they’re trying to form a union.
Hart Van Denburg/CPR News
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Longmont United Hospital nurse Brooke Schroeder holds a sign supporting nurses December 2, 2021. Nurses say the hospital is severely understaffed and they’re trying to form a union.
Hart Van Denburg/CPR News
Harold Burch lives in a home with a spectacular view in Paonia, a rural part of Colorado’s Western Slope. But that’s been little consolation to Burch, 60, as he’s battled a cascade of health problems during the pandemic.
“It’s been a real rodeo,” Burch says. “It’s been a lot of ups and downs and lately it’s been mostly just downers.”
Burch has battled chronic osteoarthritis, rheumatoid arthritis and had two major intestinal surgeries. One specialist he was seeing left her practice last year. Another wouldn’t accept his insurance. Then, Nov. 1, he started experiencing major stomach pain.
“When we talk terrible problems, I can’t leave the house,” he says. He says he hasn’t eaten anything substantial in three weeks.
Burch had to wait that long to be seen by a primary care doctor. He says the doctor told him: “‘If things were different, I would tell you to go to the hospital and be diagnosed, have some tests run and see what’s going on with you.’ But he says, ‘as of today, Delta County hospital is clear full. There are no beds available.'”
The COVID variant delta has overwhelmed the Colorado county of the same name. Hospitals on the Western Slope have been slammed for weeks, and the statewide picture is similarly grim. As of Monday, 1,294 patients were hospitalized with COVID-19, according to the state’s coronavirus website. Half of the state’s hospitals said they anticipated a staffing shortage in mid-December; more than a third of them anticipated ICU bed shortages at the same time.
And behind those numbers, patients — and health care workers — are feeling the impact.
Burch’s doctor told him he might have to wait hours in the ER, perhaps with people who have flu or COVID-19 symptoms. So Burch stayed home.
He’s fully vaccinated. But just 57{b574a629d83ad7698d9c0ca2d3a10ad895e8e51aa97c347fc42e9508f0e4325d} of people in Delta County have at least one dose of vaccine. And 84{b574a629d83ad7698d9c0ca2d3a10ad895e8e51aa97c347fc42e9508f0e4325d} of hospitalized COVID-19 patients in Colorado are not vaccinated.
“It’s really frustrating because I did the right thing and like so many other people have, and we’re being just kind of like told, ‘unless you have a really serious problem, like a heart attack, a stroke or something like that, we really don’t have time to mess with you,'” Burch says.
Diann Cullen is a 72-year-old retiree from Broomfield, Colorado, whose doctor told her that her hernia surgery would have to be postponed for weeks feels similarly. She says her reaction was: “Extreme frustration, actually anger … He flat out told me we can’t even do it because of too many COVID patients.”
Burch’s situation is not uncommon this fall, as the state faces its second-worst COVID-19 surge for hospitalizations and deaths. Hospitals are under tremendous strain and that means delays and changes from normal care, as strapped providers do more with less.
“Hospitals across Colorado are in critical condition. We have been at 90{b574a629d83ad7698d9c0ca2d3a10ad895e8e51aa97c347fc42e9508f0e4325d}-plus capacity in our ICU and acute care beds for weeks now. And unfortunately, there doesn’t appear to be an end to that situation in the near future,” says Cara Welch, a spokesperson for the Colorado Hospital Association.
Longmont High School teacher and coach Jeff Kloster holds a sign in support of Longmont United Hospital nurses on December 2, 2021, outside the hospital. His wife Kris, a nurse there, was one of the speakers at the protest.
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Longmont High School teacher and coach Jeff Kloster holds a sign in support of Longmont United Hospital nurses on December 2, 2021, outside the hospital. His wife Kris, a nurse there, was one of the speakers at the protest.
Hart Van Denburg/CPR News
What’s pushing hospitals into crisis is dealing with a surge of COVID patients on top of other patients who have delayed care, all with a shortage of staff, says Robin Wittenstein, the CEO of Denver Health, which runs one of the state’s biggest hospital and clinic systems.
“They’re coming into hospitals now sicker than ever before. And they’re coming in larger numbers than we’ve ever seen before,” Wittenstein says. “Our system is on the brink of collapse.”
At the academic medical center UCHealth, ICU Dr. Abbey Lara says the crush of unvaccinated patients means patients face longer waits or they don’t get much-needed diagnostic tests. In the worst-case scenario, “patients who could have survived something had their life cut short because they weren’t able to access care,” she says.
And when there are too many patients being treated by too few staff, Lara says, that ratchets up the difficulty for health care workers.
“I just worry that there’s going to be not only a lot of turnover in the near future,” Lara says. “But I think that access to health care is just going to get even worse in the future.”
The situation is driving more nurses to speak out, like at an event earlier this month held across the street from Longmont United Hospital, in Longmont, Colorado, about 50 miles north of Denver.
Critical care nurse Stephanie Chrisley told a crowd that normally a registered nurse would care for two ventilated, sedated, critical care patients.
“And the last few weeks we have regularly had RNs taking three, and sometimes four patients, at a time,” she says, which prompted boos from the crowd.
That’s unsafe, she says, and now the nurses are looking to unionize. Longmont United says it is focused on the well-being of patients and staff and that its top priority is high-quality care.
Chrisley, a mother of two, says nurses need more hands on deck.
“I have lately been in a state of chronic stress over the crushing guilt that I feel to ensure my patients get the care they need. And yet, somehow still care for myself and my family,” Chrisley says.
Kris Kloster has been a nurse for 32 years, much of that in the ICU. So she’s seen layoffs and staff reductions even before the pandemic hit. Now ICU nurses are dealing with colleagues quitting, restrictions on visitors, worries about catching the virus, anger from some patients who do not believe they have COVID-19.
At the same time, they must cope with suffering and deaths. It’s been “soul sucking,” she says. “That’s the hardest I’ve ever worked.”
Kloster has been speaking out in hopes that Coloradans will understand the physical, emotional and psychological toll on nurses.
“This kind of staffing, this kind of stress is not sustainable,” Kloster says. “And something has to change.”
Longmont United Hospital nurse Kris Kloster speaks to other nurses and supporters December 2, 2021, outside the hospital. They say the hospital is severely understaffed, their workload is unsustainable, and the hospital is trying to block them from forming a union.
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Longmont United Hospital nurse Kris Kloster speaks to other nurses and supporters December 2, 2021, outside the hospital. They say the hospital is severely understaffed, their workload is unsustainable, and the hospital is trying to block them from forming a union.
Hart Van Denburg/CPR News
Nearly a third of the hospital’s registered nurse staff has left since the start of July and many have not been replaced, she says.
The stress nurses and doctors feel is compounded when they feel powerless to take what they regard as an ethically correct action in treating a patient.
There’s a term for that, “moral distress,” says Dr. Barbara Statland, a hospitalist at Denver Health. The tension comes “because you can’t do what you feel is ethically proper. And I’d say that health care workers have been riddled with this.”
Despite the stress and distress, many frontline providers are hanging in there, continuing to care for patients every day. That made the difference for at least one COVID-19 patient who said he was able to get care — just in time.
Rob Blessin from Fort Collins caught the virus this fall and spent 30 days in an ICU ward with pneumonia at North Colorado Medical Center in Greeley. The 58-year-old described the efforts of his doctors and nurses as heroic, some working nine or 10 days in a row, many taking overtime.
“They saved my life. I do feel grateful for everything they did,” says
Blessin says as more coronavirus patients got admitted staff struggled to keep up. “There was just so many people there and very few staff,” he says.
Blessin says he landed in the hospital because he was swayed by internet misinformation and didn’t get vaccinated. It’s a decision he came to regret.
“I guess my recommendation would be to get vaxxed, you know, even if you’re totally against it. Don’t fall into the internet hype,” Blessin says.
After his experience being hospitalized for a month due to the coronavirus, and having talked with his physicians there, he now plans to get vaccinated.
This story was produced in partnership with KHN and Colorado Public Radio.
Doctors, patients and company leaders fully supportive of a Bayonne Medical Center operated by CarePoint Health’s chosen successor dominated a state Department of Health public hearing Tuesday night in the city’s library. The hearing represented a standard step in New Jersey’s Certificate of Need process …
Want to get healthy and age better? Superheroes might be your fitness inspiration. Or not. In a new study, published in BMJ, University of Queensland researchers compared the lifestyles, personalities and behaviours of superheroes in 24 Marvel films – and discovered they aren’t exactly fitness …
Epileptic seizure frequency fell by an average of 86{b574a629d83ad7698d9c0ca2d3a10ad895e8e51aa97c347fc42e9508f0e4325d} among 10 children treated with whole-plant medicinal cannabis, even though none of the children had responded to other conventional treatments, and some had failed to respond to a cannabidiol (CBD) product that is licensed for their condition. Findings from the case study have prompted the U.K.-based researchers to call for further exploration of the potential therapeutic benefits of whole-plant medicinal cannabis products.
Rayyan Zafar, PhD, at the Centre for Psychedelic Research and Neuropsychopharmacology, department of brain sciences, Imperial College London, and colleagues reported on their clinical study in BMJ Paediatrics Open, in a paper titled, “Medical cannabis for severe treatment-resistant epilepsy in children: a case-series of 10 patients,” in which they concluded, “This study establishes the feasibility of whole-plant medical cannabis as an effective and well-tolerated medicine for reducing seizure frequency in children suffering with intractable epilepsies.” Zafar, together with Imperial co-authors Anne Schlag, David J Nutt, and Lawrence Phillips, at the London School of Economics and Political Science, list their affiliation with DrugScience, which was founded by professor Nutt in 2010.
Whole-plant cannabis includes tetrahydrocannabinol (THC), which is the main psychoactive compound that is responsible for the characteristic “high” associated with recreational cannabis use. The plant also contains cannabidiol, other neuroactive cannabinoids, and molecules such as terpenes. Substantial anecdotal evidence as to the value of medicinal cannabis for treating childhood epilepsies has been accumulating since the 1800s, the authors wrote. However, they further explained, both recreational and medical cannabis were made illegal in the U.K. under the Misuse of Drugs Act 1971, so cannabis research largely ceased.
However, prompted by parents whose children had responded well to whole-plant medicinal cannabis extracts, but not to conventional antiepileptic drugs or purified cannabidiol (CBD oil), medicinal (whole plant) cannabis was designated a prescription medicine for the treatment of severe childhood epilepsy in 2018. “Led by parents whose children had responded well to whole-plant medical cannabis extracts but who had failed on conventional antiepileptic drugs (AEDs) and purified cannabidiol (Epidiolex), medical cannabis was re-initiated as a medicine in the British pharmacopeia in 2018,” the authors wrote.
Doctors in the U.K. have been extremely reluctant to prescribe whole-plant medicinal cannabis extracts to children with severe epilepsy, largely because of the lack of confirmatory clinical trial data, the team noted. “Despite the change in legal status of medical cannabis, most of these children have not benefited as to date there has been only three National Health Service (NHS) CBMPs [cannabis-based medicinal products] prescriptions made in total and only two in children,” the team noted. One of the reasons for resistance that is most argued by clinicians who might be prescribers, is the lack of evidence for efficacy of medical cannabis. “By this they usually mean that there are no randomized controlled trials (RCTs) that prove efficacy and without these they are not prepared to prescribe,” the authors wrote. However, they continued, it is generally accepted that RCTs are not the only way of generating evidence to the value of treatments.
The U.K.’s National Institute for Health and Clinical Excellence (NICE), which provides guidance on which treatments and therapies the health service in England should adopt, did recently put out a position statement accepting that real-world data, including case series, are valid sources of evidence, particularly where it’s difficult to carry out clinical trials—in children, for example. Zafar’s team suggested that patient case-series studies with before and after outcome measures, are, in fact “… particularly useful for conditions where RCTs are unlikely or impossible to perform in examples of rare and idiopathic conditions and especially in paediatric medicine.”
In light of NICE acceptance of case studies as valid evidence, the researchers carried out a study to evaluate the use of whole-plant medicinal cannabis in 10 children whose severe epilepsy hadn’t responded to conventional treatment, including two who hadn’t responded to the only pharmaceutical grade, purified CBD oil licensed for the condition in children (Epidyolex). The team wanted to assess the percentage change in monthly seizure frequency and the impact of medicinal cannabis on changes in conventional AED use. They also wanted to report the strengths and doses used and the costs incurred.
All the participants were recruited from two charities representing children using medicinal cannabis to treat their severe epilepsy. The children’s average age was 6 years, but ranged from 1–13 years. They had a range of epilepsies and three had other concurrent issues, including infantile spasms, learning disabilities, and global developmental delay. Data were collected from their parents or carers via phone or video conference calls between January and May 2021. All the participants received whole-plant extract cannabis-based medicinal products either through private prescription, or through the NHS. “The CBMPs used included Bedrolite (<1{b574a629d83ad7698d9c0ca2d3a10ad895e8e51aa97c347fc42e9508f0e4325d} THC and 9{b574a629d83ad7698d9c0ca2d3a10ad895e8e51aa97c347fc42e9508f0e4325d} CBD), Bedica (14{b574a629d83ad7698d9c0ca2d3a10ad895e8e51aa97c347fc42e9508f0e4325d} THC and <1{b574a629d83ad7698d9c0ca2d3a10ad895e8e51aa97c347fc42e9508f0e4325d} CBD), Celixir 20 (<1{b574a629d83ad7698d9c0ca2d3a10ad895e8e51aa97c347fc42e9508f0e4325d} THC and 20{b574a629d83ad7698d9c0ca2d3a10ad895e8e51aa97c347fc42e9508f0e4325d} CBD), Sweet Pink CBD (<1{b574a629d83ad7698d9c0ca2d3a10ad895e8e51aa97c347fc42e9508f0e4325d} THC and 10.6{b574a629d83ad7698d9c0ca2d3a10ad895e8e51aa97c347fc42e9508f0e4325d} CBD), and Althea 100 (<1{b574a629d83ad7698d9c0ca2d3a10ad895e8e51aa97c347fc42e9508f0e4325d} THC and 10{b574a629d83ad7698d9c0ca2d3a10ad895e8e51aa97c347fc42e9508f0e4325d} CBD),” the team wrote.
The children had tried an average of seven conventional epilepsy drugs. After starting to take medicinal cannabis, this fell to an average of one each, with seven of the children stopping them completely. Monthly seizure frequency reduced for all 10 children by an overall average of 86{b574a629d83ad7698d9c0ca2d3a10ad895e8e51aa97c347fc42e9508f0e4325d}. The researchers say that full chemical analysis of the whole-plant medicinal cannabis products used is ongoing, but they were able to assess the THC and CBD content. This showed that the children took an average of 5.15 mg THC and 171.8 mg CBD every day.
Parents and carers reported significant improvements in the health and wellbeing of their children, including in sleep, eating, behavior, and cognition after they started to take whole-plant medicinal cannabis products. “Our patient group almost universally reported highly improved cognitive and behavioral outcomes, likely due both to reduced seizure frequency and reduced use of other AEDs,” the researchers noted. They further stressed that the results “ … suggest that whole-plant medical cannabis products are superior to isolated CBD products in the patients examined.” Moreover, only a few minor side effects, such as tiredness, were reported. The average monthly cost of the medicinal cannabis products was £874. One child had obtained their prescription for free on the NHS.
The authors acknowledged limitations to their study, in that it was observational and involved a small number of participants. They also noted that the trial was retrospective and relied on parental recall, with no comparator group. So it’s possible that only those parents in whom medicinal cannabis worked well decided to take part.
The investigators further commented that additional research will be required to define the mechanisms by which the respective additive constituents of whole-plant products lead to improved clinical results. And this must include comparing the unwanted effects of whole-plant medicinal cannabis with the known harmful effects of conventional epilepsy medicines, they said. Despite the trial limitations, the researchers concluded, “Our findings are in line with several observational and controlled interventional studies that have seen significant reductions in seizure frequency following treatment with medical cannabis …”
The authors pointed out that two of the children in their sample had failed on Epidyolex. And for this reason, they said, “NICE guidance has recently been updated to clarify that this should not deter clinicians from prescribing off-license medical cannabis products such as the whole-plant cannabis medicines of which our data support for such prescribing.”
They further stated, “We believe that our data on whole-plant medical cannabis in childhood-onset severe treatment-resistant epilepsy provides evidence to support its introduction into the NHS within current NICE prescribing guidelines … Such a move would be hugely beneficial to the families, who in addition to having the psychological distress of looking after their chronically ill children, have also to cover the crippling financial burden of their medication.”
