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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
If Marjory Stoneman Douglas High School were like any other school, you wouldn't think much of the freshly-painted burgundy hallways or the newly-installed 20-foot tall fences around the freshman building.If this were a normal student body, the eyes of the nation wouldn't be trained on their every move, and their summer break stories wouldn't include a tally of rallies, summits, nationwide tours and TV appearances.In any other place, in any other new school year, things would be as they were.But when your school is also the site of one of the deadliest school shootings in American history, nothing is ever really normal.Those fences, covered with "MSD Strong" and "Parkland Strong" banners, surround the shuttered building where a former student opened fire almost exactly six months ago. Those hallways are the same ones students rushed through on Valentine's Day as the gunshots rang out across campus.There are other changes, too.The school's swimming coach is now the athletic director, because the former AD was among those killed that day. There are now two principals at MSD, because the basic demands of running a school are now joined by the demands of managing a community in crisis.It's the little things like this; a change in paint color or a change in command, that reverberate outward like strange ripples, hinting at something bigger under the surface. 1383

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
House Republicans are unveiling key details and the text behind their tax legislation Thursday, but not without some reservations from rank-and-file members.In advance of the bill's release -- which will be called the "Tax Cuts and Jobs Act," according to a source in a meeting with GOP members Thursday -- a source shared a summary of the plan, which permanently lowers the lowers the corporate tax rate to 20% and limits the home interest deduction to loans up to 0,000.The bill will also increase the standard deduction for individuals and households, repeals the alternative minimum tax and increased the child tax credit to ,600. The House GOP bill will also finally repeal the estate tax in 2024.Members will see the tax framework Thursday morning when the House ways and means committee releases its bill that is expected to expand the child tax credit, repeal the estate tax, lower the corporate tax rate and reduce the number of individual tax brackets from seven to four.But there are still key questions about what will be in the bill and whether the leadership can wrangle the votes they will need to deliver President Donald Trump a major legislative victory by the end of the year. 1208
If you're in your mid-40s and haven't had your colon checked, it might be time.The American Cancer Society's newly updated guidelines for colon and rectal cancer screening recommend that adults at average risk get screened starting at age 45 instead of 50, as previously advised.The updated guidelines come on the heels of what seems to be a rise in colorectal cancer among younger adults.Those at higher risk include African Americans, Alaska Natives, and people with a family history or a personal history of colon or rectal polyps; risk factors such as these could require screening earlier.Published in CA: A Cancer Journal for Clinicians on Wednesday, the updated guidelines also indicate that there are six screening test options for adults, ranging from noninvasive stool tests to visual exams like colonoscopy, depending on the preference of the patient and availability of the test.Other health organizations in the United States -- such as the US Preventive Services Task Force -- still recommend routine screening for colon and rectal cancers starting at age 50. 1081
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