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If you've ever had a surgical procedure, you know it can often mean a high hospital bill. Now, more people are turning to surgery centers for a lower cost.Sandi Bowen is one of those people.Something as simple as picking out a shirt is more challenging for Bowen than she ever thought it'd be. On Easter, she found a lump in her breast. Doctors told her it was cancer."It was very very very confusing," Bowen says. "It still is. It brings tears to my eyes, because I don't understand how I got it."Instead of a lumpectomy, she decided to remove her entire breast. And instead of going to a hospital for breast reconstruction, Bowen opted for the Kaiser Permanente Ambulatory Surgery Center, where she got the surgery. In less than 24 hours, she was back home recovering.  "I felt very special," Bowen says. "They were there every time I moved. They came in and talked to me, even goofed around with me."Dr. Mike Sawyer, the director at the center, says they've worked hard to address concerns regarding patient care."If it's a patient that just needs physicians to kind of come to the bedside, and maybe we have to have some kind of intervention, we're able to do that because are here and we are present," Dr. Sawyer says. "On site, as they say. If it's really something that requires a higher level of care, that again allows us to do a pretty quick transfer process over to one of our partner hospitals."Compared with hospitals, Kaiser Permanente says its patients are seeing an average cost savings of 30 percent on their procedures. It can be anything from simple orthopedic procedure to joint procedures.However, Dr. Sawyer says there are important questions you need to ask before determining if a surgery center is the best option for you."Does your physician feel comfortable with this operation there?" Dr. Sawyer says. "Have you and your physician discussed all the ramifications of that procedure? And then what sort of plans does that ambulatory surgery center have if you were required a higher level of care?" 2037

Hurricane Lane's outer bands have been pummeling Hawaii's Big Island with rain Thursday, triggering landslides and threatening serious flooding as the Category 4 cyclone moves perilously close to the Aloha State.The center of the storm — which could become the first major cyclone to make landfall in the state in 26 years — is expected to move very close to the main islands or cross land Thursday through Friday, forecasters said.It could be so devastating that authorities are urging residents to set aside two weeks' worth of food and water."Be prepared to shelter in place with 14 days of food supplies and water and any other necessities," Hawaii Gov. David Ige said at a news conference Wednesday.Track the stormThe storm's center, with maximum sustained winds near 130 mph, was in the Pacific about 210 miles south-southwest of the Big Island town of Kailua-Kona around 5 a.m. HT Thursday (11 a.m. ET).Landslides are a concern, with 10-30 inches of rain forecast through the weekend -- and slides already were happening on the Big Island as the storm's outer bands hit Thursday morning.On the Big Island's northern tip, landslides were blocking parts of Route 19, the county civil defense agency said.About 7 to 12 inches of rain already had fallen on parts of the Big Island by early Thursday, the National Weather Service office in Honolulu said.Buses around Honolulu have been picking up residents in need and taking them to shelters. All public schools canceled classes until further notice, and many state employees have been asked to stay home.Tropical storm force winds (39-73 mph) stretch out to 140 miles, so even if the hurricane doesn't make landfall, it could have widespread impact. Lane threatens to bring dangerous winds, landslides, rough surf and major flooding.All of the islands are under weather alerts.A hurricane warning is in effect for the Big Island as well as Maui County and Oahu -- meaning hurricane conditions are expected there. Kauai and Niihau are under a hurricane watch, meaning hurricane conditions are possible and that winds of at least 39 mph are anticipated in the comings days. 2133

House lawmakers on Wednesday overwhelmingly passed legislation expanding veterans' access to private care at taxpayer expense, a campaign promise of President Donald Trump, and adding more money to the "Choice program" weeks before VA officials said it could run out of money.The billion plan that passed 347-70 Wednesday includes .2 billion for the VA Choice program that funds private care. VA officials have warned that the program could run out of money as early as the end of the month, disrupting care for patients.Hours before the House vote, Trump weighed in, urging lawmakers to back the bill."House votes today on Choice/MISSION Act," Trump tweeted on Wednesday. "Who will stand with our Great Vets, caregivers, and Veterans Service Organizations? Must get Choice passed by Memorial Day!"A similar plan almost became law as part of the omnibus spending bill in March, but was blocked by some Democrats concerned about privatization of services for the nation's veterans.There has been a long simmering debate about the extent to which veterans obtain care in the private sector. Many veterans groups say they don't want to see too many resources shifted outside the VA, a move they say would fundamentally bleed the health system dry.The legislation is moving forward in Congress as the sprawling agency remains without a permanent leader after Trump ousted former Secretary David Shulkin and the nomination of Rear Adm. Ronny Jackson, the White House physician, unraveled amid allegations about his professional conduct.It would also launch a review of VA facilities with an eye toward closing under-performing institutions and would expand a VA caregivers program to cover the families of pre-9/11 veterans. 1733

If you’re among the 40 million people online looking for love, you know it can be tough finding the perfect match. It might be your fault, but one little change could send you down the aisle. The problem? You may be dating out of your league. A new study found that users who messaged people out of their league typically waited a lot longer to get a reply back or even get a reply at all. "A lot of people try to date out of their league, and they use that terminology," says Chief love officer Michelle Frankel, with New York City Matchmaking. "But it may not result in the end relationship they are looking for; but it might not even be what they perceive it to be."  According to Urban Dictionary, dating out of your league simply means you’ve got no shot. However, Frankel says that’s not true all the time. For example, look at Christie Brinkley and Billy Joel, back in the 1980's.Frankel says dating up like Billy Joel did can work, but it can’t be based on looks alone. “Look what he brought to the table," explains Frankel. "Clearly he was financially set at the time and also he had so much unique talent."  If you date out of your league simply to find someone better looking than you, Frankel says good luck finding a match. "That's not a recipe for a lasting relationship in and of itself. There has to be more compatibility, shared values, same interests and both going in the same direction." Whether you are dating online or in person, Frankel says to stop trying to find your Disney movie moment. "You are never going to find perfection; it doesn't exist," Frankel says.   1707

House Speaker Paul Ryan called allegations leveled against Alabama Republican Senate candidate Roy Moore about pursuing relationships with teenage girls and committing sexual assault "credible" and that he should step aside."He should step aside," Ryan told CNN Tuesday morning. "Number one, these allegations are credible. Number two, if he cares about the values that he claims to care about, then he should step aside."Ryan becomes the latest high-profile Republican voice to call on Moore to step aside, following more than two dozen Republican senators, including some of whom have suggested voting to expel Moore from the Senate should he win the December 12 special election.The flood of condemnation and calls to step down replaced what had been days of heavily caveated statements defined by senators calling for Moore to step aside "if" the allegations "were true." Starting Monday with Ryan's counterpart, Senate Majority Leader Mitch McConnell, the tone from national Republicans shifted dramatically.An Alabama woman alleged Monday that Moore sexually assaulted her when she was a teenager. Moore called the accusation "absolutely false" in a statement in Gallant, Alabama, later Monday, denying that he knew the woman.The accusations came after The Washington Post published a report last week based on interviews with more than 30 people, saying Moore pursued relationships with teenagers while he was in his 30s. One woman said she was 14 years old when Moore initiated sexual contact with her. Moore also denied those allegations and has threatened to sue the Post.For now, GOP leaders are stuck in an increasingly difficult position. Moore has repeatedly said he has no intention of stepping down and views the stories themselves -- and the GOP senators that have condemned him in its wake -- are nothing but political attacks. Senate Republicans made clear they are weighing several options on how to go forward, ranging from pushing for a write-in campaign to trying to vote Moore out of the Senate should he win.One Republican senator, Jeff Flake, the Arizonan who announced last month he would retire at the end of his term, became the first to present another choice Monday night: support Moore's opponent."If the choice is between Roy Moore and a Democrat, a Democrat no doubt," Flake told reporters.  2338