it is SPARC sling bladder suspension procedure. nm

• Anyone familiar with Spark procedure ... - rmb
  • it is SPARC sling bladder suspension procedure. nm - VREditor
  • I have heard of that before, - Acutecare

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he told me it was caused directly by smoking.  He told me I would have to quit immediately.  I continued to sneak and smoke for the next two weeks while undergoing an extensive workup including multiple office visits, x-rays, 3 cystoscopies (1 in the office, 2 in the hospital), blood work, MRIs, CTs, bone scan,.....

I had an in-patient cysto on a Monday, and my oncologic urologist told me I had 4 bladder tumors that needed to be removed, but he wanted me smoke free for two complete weeks due to the extensive nature of the surgery.  I was discharged on a Tuesday morning and puffed my very last cig on the way home.  The next two weeks were spent crying...out of fear of what was going to happen to me as well as desperately wanting a cigarette and knowing I couldn't have one.  Following surgery (removal of entire bladder and lymph nodes, a complete hysterectomy, removal of most of my terminal ileum, and creation of a neobladder) I spent 1-1/2 weeks in the hospital and was too busy praying that I would die (morphine barely touched the excruciating, never-ending pain...) to even think about wanting a cigarette.  Today (18 months later) I am smoke free.  Every once in a while I'll think I'd like to have a cigarette, but then I remember all the terrible pain I had; I remember hearing my husband and daughter crying as they stood at my bedside; I remember the fear that gripped me; I remember hearing my doctor say if I smoke again I have a 70% chance of developing mets to liver, lung, or bone over the next five years.  By not smoking, I've given myself a $120 a month raise ($4 a pack x 30 days).

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I have an account who asked me to provide them with a form that could use for standard outpatient procedure notes.  I personally feel that there are too many variations for them to use one paper form and offered for me to do it for them at a discount since almost the entire thing would be a standard that I don't have to type in its entirety.  This account is a great account and I figured it isn't a big deal say to chage 25 cents instead of a $1 (example) for the form since I only have to type a couple letters to pull up the form and insert any changes.

I really don't know the easiest way to keep track of this discount or what amount to discount.  Any ideas?  I'd rather see me getting a small amount for doing the form then to get nothing for them using a paper form.  Plus, the account is newer to me and I thought it might look like a plus for me to offer them a discount and to make their life easier by not having to dictate the entire note.

Thoughts...ideas???  TIA