Document:

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                                                                    EXHIBIT 4.13

                 AMENDMENT NO. 1 TO LOAN AND SECURITY AGREEMENT

                  AMENDMENT NO. 1 TO LOAN AND SECURITY AGREEMENT (this
"AMENDMENT NO. 1"), dated as of December 31, 2002, by and between HFG HEALTHCO-4
LLC, a Delaware limited liability company (together with its successors and
assigns, the "LENDER") and MATRIA HEALTHCARE, INC., as authorized representative
of the Borrowers (in such capacity, together with its permitted successors and
assigns, the "AUTHORIZED REPRESENTATIVE").

                  PRELIMINARY STATEMENTS.

                  (A)      Matria Healthcare, Inc., a Delaware corporation
(together with its permitted successors and assigns, the "PARENT"), Diabetes
Acquisition, Inc., a Georgia corporation and wholly-owned subsidiary of the
Parent (together with its permitted successors and assigns, "DAI"), Gainor
Medical Acquisition Company, a Georgia corporation and wholly-owned subsidiary
of DAI (together with its permitted successors and assigns, "GAINOR"), Diabetes
Management Solutions, Inc., a Delaware corporation and wholly-owned subsidiary
of Gainor (together with its permitted successors and assigns, "DMS"), Diabetes
Self Care, Inc., a Virginia corporation and wholly-owned subsidiary of Gainor
(together with its permitted successors and assigns, "DSC"), Matria
Laboratories, Inc., a Delaware corporation and wholly-owned subsidiary of DSC
(together with its permitted successors and assigns, "MLI"), Facet Technologies,
LLC, a Georgia limited liability company whose interests are wholly-owned by the
Parent (together with its permitted successors and assigns, "FACET"), Matria of
New York, Inc., a New York corporation and wholly-owned subsidiary of the Parent
(together with its permitted successors and assigns, "MNY"), Matria Healthcare
of Illinois, Inc., a Georgia corporation and wholly-owned subsidiary of the
Parent (together with its permitted successors and assigns, "MII"), Quality
Oncology, Inc., a Delaware corporation and wholly-owned subsidiary of the Parent
(together with its permitted successors and assigns, "QO") (the Parent, DAI,
Gainor, DMS, DSC, MLI, Facet, MNY, MII and QO, each individually a "BORROWER"
and jointly and severally, the "BORROWERS"), the Authorized Representative and
the Lender entered into a Loan and Security Agreement dated as of October 22,
2002 (as amended, restated, modified or supplemented from time to time, the
"AGREEMENT"). Terms not defined herein are used as defined in the Agreement.

                  (B)      The parties to the Agreement have agreed to amend the
Agreement as described herein.

                  NOW, THEREFORE, the parties hereto hereby acknowledge and
agree as follows:

                  1.       Exhibit I to the Agreement is amended by adding the
following additional defined term in the appropriate alphabetical order:

                  "TEST PERIOD" means, for any determination of the ratio of
         Debt to EBITDA or the Fixed Charge Coverage Ratio, the period of four
         consecutive fiscal quarters of the Parent ended at the end of the
         relevant fiscal quarter or fiscal year of the Parent, except that for
         purposes of calculating the ratio of Debt to

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         EBITDA and the Fixed Charge Coverage Ratio for the three fiscal
         quarters ending March 31, 2003, June 30, 2003, and September 30, 2003,
         the "TEST PERIOD" shall be the period commencing on January 1, 2003,
         and ending on the last day of such respective fiscal quarter of Parent.
         In clarification of the foregoing, for purposes of calculating the
         ratio of Debt to EBITDA and the Fixed Charge Coverage Ratio for the
         period ending December 31, 2002, "TEST PERIOD" shall mean the
         twelve-month period ending on such date.

                  2.       Exhibit I to the Agreement is further amended by
amending the definition of "Fixed Charge Coverage Ratio" in its entirety to read
as follows:

                  "FIXED CHARGE COVERAGE RATIO" means, as determined as of the
         end of each Test Period, for the Test Period then ended, the quotient
         obtained by dividing (i) EBITDA for such period, by (ii) the sum of (x)
         Interest Expense for such period, (y) the current portion of long term
         Debt as of the end of such period, and (z) capital expenditures for
         such period, provided, that for any such determination to be made as of
         the Test Periods ending March 31, 2003, June 30, 2003, and September
         30, 2003, EBITDA, Interest Expense, the current portion of long term
         Debt and capital expenditures for such period shall be annualized.

                  3.       Clause (p) of Exhibit V to the Agreement is amended
in its entirety to read as follows:

                  (p)      The ratio of Debt to EBITDA for the Parent and its
         Subsidiaries for (x) the Test Periods prior to and including the fiscal
         quarter ending September 30, 2003, is greater than 4.5:1.0, and (y) all
         Test Periods thereafter, is greater than 3.5:1.0; provided, that, for
         any such determination to be made as of the Test Periods ending March
         31, 2003, June 30, 2003, and September 30, 2003, EBITDA for such period
         shall be annualized.

                  4.       Clause (q) of Exhibit V to the Agreement is amended
in its entirety to read as follows:

                  (q)      The Fixed Charge Coverage Ratio for the Parent and
         its Subsidiaries for (x) the Test Period ending December 31, 2002, is
         less than 0.85:1.0, (y) the Test Period ending March 31, 2003, is less
         than 1.1:1.0, and (z) all Test Periods thereafter is less than 1.2:1.0.

                  5.       This Amendment No. 1 is effective as of the date
first above written.

                  6.       The Authorized Representative, for itself and on
behalf of each of the Borrowers, reaffirms and restates the representations and
warranties contained in Exhibits III and VII to the Agreement, as amended by
this Amendment No. 1, and all such representations and warranties shall be true
and correct on the date hereof with the same force and effect as if made on such
date (except to the extent that any such representation and warranty is
expressly stated to have been made as of a specific date, in which case such
representation and warranty shall be true and correct in all material respects
as of such date). The Authorized Representative, for

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itself and on behalf of each of the Borrowers, represents and warrants (which
representations and warranties shall survive the execution and delivery hereof)
to the Lender that:

                  a.       No event has occurred and is continuing, or would
                           result from the execution of this Amendment No. 1,
                           that constitutes a Default or an Event of Default;

                  b.       It has the power and authority to execute, deliver
                           and carry out the terms and provisions of this
                           Amendment No. 1 for itself and on behalf of the
                           Borrowers, and it and each of the Borrowers has taken
                           or caused to be taken all necessary action to
                           authorize the execution, delivery and performance of
                           this Amendment No. 1;

                  c.       No consent of any other person (including, without
                           limitation, shareholders or creditors of the
                           Authorized Representative or any of the Borrowers),
                           and no action of, or filing with any governmental or
                           public body or authority is required to authorize, or
                           is otherwise required in connection with the
                           execution, delivery and performance of this Amendment
                           No. 1;

                  d.       This Amendment No. 1 and any other instruments and
                           documents contemplated hereby have been duly executed
                           and delivered by a duly authorized officer on behalf
                           of the Authorized Representative, and constitutes a
                           legal, valid and binding obligation of the Authorized
                           Representative and each of the Borrowers enforceable
                           against each such party in accordance with its terms,
                           subject to bankruptcy, reorganization, insolvency,
                           moratorium and other similar laws affecting the
                           enforcement of creditors' rights generally and the
                           exercise of judicial discretion in accordance with
                           general principles of equity; and

                  e.       The execution, delivery and performance of this
                           Amendment No. 1 and any other instruments and
                           documents contemplated hereby will not violate any
                           law, statute or regulation, or any order or decree of
                           any court or governmental instrumentality, or
                           conflict with, or result in the breach of, or
                           constitute a default under any contractual obligation
                           of the Authorized Representative or any Borrower.

                  7.       The Borrowers shall pay to the Lender an amendment
fee in the amount of $25,000 upon the execution of this Amendment No. 1.

                  8.       Nothing herein shall be deemed to be a waiver of any
Default or Event of Default, or any covenant or agreement contained in the
Agreement, and the Authorized Representative, for itself and each of the
Borrowers, hereby agrees that all of the covenants and agreements contained in
the Agreement, as amended hereby, and the other Documents are hereby ratified
and confirmed in all respects and shall remain in full force and effect in
accordance with their respective terms.

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                  9.       All references to the Agreement in the Agreement and
the other Documents shall mean the Agreement as amended hereby and as it may in
the future be amended, restated, supplemented or modified from time to time.

                  10.      This Amendment No. 1 may be executed in any number of
counterparts and by different parties hereto in separate counterparts, each of
which when so executed and delivered shall be deemed to be an original and all
of which taken together shall constitute one and the same agreement. Delivery of
an executed counterpart of a signature page to this Amendment No. 1 by
telecopier shall be effective as delivery of a manually executed counterpart of
this Amendment No. 1.

                  11.      THIS AMENDMENT NO. 1 SHALL, IN ACCORDANCE WITH
SECTION 5-1401 OF THE GENERAL OBLIGATIONS LAW OF THE STATE OF NEW YORK, BE
GOVERNED BY THE LAWS OF THE STATE OF NEW YORK, WITHOUT REGARD TO ANY CONFLICTS
OF LAWS PRINCIPLES THEREOF THAT WOULD CALL FOR THE APPLICATION OF THE LAWS OF
ANY OTHER JURISDICTION.

               [Remainder of this page intentionally left blank.]

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                  IN WITNESS WHEREOF, the undersigned parties have caused this
Amendment No. 1 to be duly executed by their authorized officers thereunto duly
authorized, as of the date first above written.

LENDER:                                      HFG HEALTHCO-4 LLC

                                             By: _______________________________
                                                 Name: Orlando Figueroa
                                                 Title: Vice President

AUTHORIZED REPRESENTATIVE:                   MATRIA HEALTHCARE, INC.

                                             By: _______________________________
                                                 Name: _________________________
                                                 Title: ________________________<PAGE>

                                                                   EXHIBIT 10.27

                       SPLIT-DOLLAR TERMINATION AGREEMENT

         This Agreement is entered into as of January 1, 2003 by and between
Matria Healthcare, Inc., a Delaware corporation (the "Company"), and Roberta L.
McCaw (the "Executive") as follows:

                              W I T N E S S E T H:

         WHEREAS, effective July 1, 1998, the Company and the Executive entered
into a Split-Dollar Life Insurance Agreement (the "Split-Dollar Agreement"), a
Collateral Security Agreement (the "Collateral Security Agreement"), and a
related letter agreement (the "Letter Agreement") (the Split-Dollar Agreement,
the Collateral Security Agreement and the Letter Agreement are hereinafter
referred to collectively as the "Split-Dollar Program"); and

         WHEREAS, pursuant to the Split-Dollar Agreement, the Company caused
Aetna Life Insurance and Annuity Company or any successor thereto (the
"Insurance Company") to issue and deliver to the Executive Policy Number
I0003335 (the "Policy") on the life of the Executive; and

         WHEREAS, because of recent legislation, proposed Internal Revenue
Service ("IRS") regulations and other economic factors, the Board of Directors
of the Company has directed that the Split-Dollar Program be terminated; and

         WHEREAS, the Executive has agreed to the termination of the
Split-Dollar Program on the terms and conditions set forth below:

         NOW, THEREFORE, in consideration of the facts set forth above and the
various promises and covenants set forth below, the parties to this Agreement
agree as follows:

         1.       TERMINATION. The Executive agrees that, pursuant to the terms
and conditions set forth herein, the Split-Dollar Program, and any and all
covenants and agreements of the parties included therein, are hereby terminated
in all respects.

         2.       TRANSFER OF POLICY. The Executive, as owner of the Policy,
agrees to execute such forms and take such steps as are reasonably requested by
the Company to transfer sole ownership of the Policy into the name of the
Company. The Executive by this Agreement does release and forever discharge the
Company and its successors and assigns of and from any obligation or liability
of any kind arising from or relating to all prior transactions, relationships
and dealings relating to or under the terms of the Split-Dollar Program,
including, without limitation, the Company's obligations to pay premiums under
the Split-Dollar Agreement and to pay additional premiums under the Letter
Agreement; provided, however, that the Executive does not release any of the
Company's obligations under this Agreement or the SERP (as hereinafter defined).

         3.       RELEASE OF EXECUTIVE'S OBLIGATIONS. The Company by this
Agreement does release and forever discharge the Executive and his or her heirs,
executors, administrators,

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successors and assigns of and from any obligation or liability of any kind
arising from or relating to all prior transactions, relationships and dealings
relating to or under the terms of the Split-Dollar Program.

         4.       ESTABLISHMENT OF SERP AND TRUST.

                  Simultaneously with the execution of this Agreement, the
Company will execute and deliver to the Executive a supplemental executive
retirement agreement (the "SERP"), in the form and substance of the attached
Exhibit A. The Company will establish a rabbi trust (the "Trust"), in the form
and substance of the attached Exhibit B, for the benefit of the Executive on or
before January 29, 2003.

         5.       AUTHORIZATION. The Company represents and warrants that this
Agreement has been duly authorized by all necessary corporate action and
constitutes a valid and legally binding obligation of the Company in accordance
with its terms.

         6.       MISCELLANEOUS.

                  (a)      Notices. All notices and other communications under
         this Agreement shall be in writing and shall be given by facsimile
         followed by first-class mail, or by certified or registered mail with
         return receipt requested, and shall be deemed to have been duly given
         three (3) days after certified or registered mailing or twelve (12)
         hours after transmission of a facsimile to the respective persons named
         below:

                  If to the Company:                 Chief Executive Officer
                                                     Matria Healthcare, Inc.
                                                     1850 Parkway Place
                                                     Marietta, Georgia 30067
                                                     Phone: (770) 767-4510
                                                     Fax No.: (770) 767-4530

                  With a copy to:                           General Counsel
                                                     Matria Healthcare, Inc.
                                                     1850 Parkway Place
                                                     Marietta, Georgia 30067
                                                     Phone: (770) 767-8332
                                                     Fax No.: (770) 767-7769

                  If to Executive:                         Roberta L. McCaw
                                                     810 Millsbee Drive
                                                     Roswell, Georgia 30075
                                                     Phone: (770) 643-9874
                                                     Fax No.: (770) 594-8374

         Any party my change such party's address for notices by notice duly
         given pursuant to this Section 6.

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                  (b)      Headings. The Section headings herein are intended
         for reference and shall not by themselves determine the construction or
         interpretation of this Agreement.

                  (c)      Governing Law. This Agreement shall be governed by
         and construed in accordance with the laws of the State of Georgia.

                  (d)      No Admissions. This Agreement is not and shall not be
         construed as evidence of or an admission by the parties hereto of any
         liability on either of their parts, nor shall it be deemed as an
         admission of, or construed as evidence of the truth of any of the
         allegations made by either of the parties hereto.

                  (e)      Successors and Assigns. This Agreement shall be
         binding upon and shall inure to the benefit of the parties hereto and
         their respective heirs, executors, administrators, successors and
         assigns; provided, however, that this Agreement may not be assigned by
         any party hereto without the prior written consent of the other party
         or parties.

                  (f)      Entire Agreement. This Agreement supersedes all prior
         discussions and agreements between the parties with respect to the
         matters contained herein, and this Agreement contains the sole and
         entire agreement among the parties hereto with respect to the subject
         matter hereof and the transactions contemplated herein.

                  (g)      Further Assurances. The parties to this Agreement
         agree to execute and deliver in a timely fashion any and all additional
         documents to effectuate the purposes of this Agreement.

                  (h)      Counterparts. This Agreement may be executed in one
         (1) or more counterparts which, taken together, shall constitute one
         and the same Agreement.

                  (i)      Fax Signature. This Agreement may be executed via
         facsimile, and facsimile signature pages shall be deemed to be binding
         and as effective as delivery of original signature pages.

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         IN WITNESS WHEREOF, the parties hereto have executed this Agreement as
of the day and year first above written.

                                          ______________________________
                                                 Roberta L. McCaw

                                          MATRIA HEALTHCARE, INC.

                                          By: ________________________________
                                          Title: _______________________________

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                                    EXHIBIT A

                     SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN

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                                    EXHIBIT B

                                      TRUST

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