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    <title>David T. Chuljian DDS</title>
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      <title>David T. Chuljian DDS</title>
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    <item>
 <title>Phone problems January 31</title>
 <link>http://www.chuljiandds.com/news/index.php?itemid=28</link>
<description><![CDATA[We are experiencing telephone line problems and have a call to the phone repair service as of 1:30 pm today.  If you get a "no answer" or "busy" signal, please wait a few minutes and try again.  Due to a heavy volume of recent repair requests, it will be at least February 1st before we have fully functioning phones again.]]></description>
 <category>Update</category>
<comments>http://www.chuljiandds.com/news/index.php?itemid=28</comments>
 <pubDate>Tue, 31 Jan 2012 13:46:33 -0800</pubDate>
</item><item>
 <title>Another year, another parrot</title>
 <link>http://www.chuljiandds.com/news/index.php?itemid=27</link>
<description><![CDATA[As seems to happen every January, I lost another parrot companion this week.  Chicken Little died last night, apparently from multiple strokes. He had been declining since the first of the year, eating less and becoming more affectionate--out of character for him.  By Monday he was sometimes lethargic, but would still perk up and chow down on grapes at some point during the day.  On Tuesday I called the vet, who came and took a blood sample, and then took him to an animal hospital.  After being hydrated with subcutaneous fluids, he perked up a bit, even eating on his own, so we decided to bring him home, but late in the day he took another turn for the worse, becoming unable to raise his head.  He survived the trip home, and I put him in an incubator, but a couple of hours later his eyes opened wide and he died in my hands.  We plan a quiet sendoff tonight, but not at the beach cabin where we've gone with our other birds--my Chimacum property is where my own heart is these days.<br />
 <br />
Chicken Little was rather like an adopted juvenile delinquent, who only tolerates your other kids, doesn't much care for you, and requires you to stay on top of him to make sure he doesn't start stealing cars.  He had a rough life--wild caught in the 1980's, imported to the US, bought by someone unfamiliar with birds who wasn't prepared for a noisy, messy, noncuddly pet.  At some point he apparently had meningitis, which left him with a permanently crooked neck, thus his name--he had a "the sky is falling" gaze.  He was taken in by a parrot rescuer who eventually found him a home in a group aviary for several years.  When his new owner died, he went back to the rescue center, and came to live with us a few months after Chick Eastwood's death in January of 2010.  He and Rose (Chick's mate) tolerated each other, but never really hit it off.  When Rose died last January, I adopted Echo, a Blue Headed Pionus through a rescue shelter.  Chicken Little and Echo soon bonded, with Echo even gagging up food at times.  At first, Chicken violently refused any handling, but since he needed medication twice a day, I did interact with him (and got bitten a lot at first).  Eventually he developed a routine for his medicine that didn't involve a towel and fighting, and after several months he would tolerate mild cuddling.  In his final weeks he become a passionate grape eater, going through almost a dozen a day.<br />
 <br />
His death will leave a small parrot-shaped void in the family.  Our friendship was very unlike that of Chick Eastwood and Rosebutt, who were with me almost 20 years, but he was still an important member of the household.  I'm missing the morning medicine ritual, and that little beak snatching grapes out of my fingers.<br />
]]></description>
 <category>Update</category>
<comments>http://www.chuljiandds.com/news/index.php?itemid=27</comments>
 <pubDate>Thu, 12 Jan 2012 13:07:52 -0800</pubDate>
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 <title>The Evenings are Longer Already!</title>
 <link>http://www.chuljiandds.com/news/index.php?itemid=26</link>
<description><![CDATA[For those depressed by the short days of winter, we have good news.  The earliest sunset this year was apparently on December 12th.  Even though solstice--the shortest day overall--isn't until the 21st, the evenings are already getting longer.  Not much, only about one minute, but it's a start.  By Christmas, the sun will be setting almost five minutes later than it did on the 12th.  If you're an early riser, you've still got reason to be depressed:  the latest sunrise is not until January 1st.  It will be the 13th or so before you'll see sunrises five minutes earlier than the worst one, by which date sunsets will be over 20 minutes later than on December 12th.<br />
 <br />
This shows that if you want to avoid winter depression, don't get up early.  I hope this helps you get through the winter:  spring's return is already evident well before solstice!  For those who want more details, here's a website that explains the effect.  (I don't know how durable the link is, maybe he only posts it around solstice, but the effect is due to the tilt of the earth and its elliptical orbit around the sun.)<br />
<br />
http://larry.denenberg.com/earliest-sunset.html<br />
<br />
<a href="http://larry.denenberg.com/earliest-sunset.html"></a><br />
]]></description>
 <category>Update</category>
<comments>http://www.chuljiandds.com/news/index.php?itemid=26</comments>
 <pubDate>Mon, 19 Dec 2011 12:24:41 -0800</pubDate>
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 <title>Delta Insurance Update</title>
 <link>http://www.chuljiandds.com/news/index.php?itemid=25</link>
<description><![CDATA[We've now got a track record of how Delta is reimbursing our existing patients.  Unfortunately, they are all over the map, covering some people almost the same as before we withdrew, some at reduced percentages, some at the same percentage but reduced limits, and some with reduced everything.  There seems to be no pattern to the reimbursements, although an astrologer we checked with said  reimbursements are best if you're Virgo with the moon in Aries, and worst for all Capricorns.  (That didn't help as much as I'd hoped, and I wish I hadn't paid him in advance.)<br />
<br />
     We are still waiting to process repeat claims on 6-month recalls, to see if the reimbursement levels are at least stable for the same person.  It appears that WDS is doing their best to make it difficult for patients to see an out-of-network dentist.  Note that out of network coverage is worst for preventive care:  X-rays, exams, and cleanings.  When it comes to crowns, fillings, etc. the fact that our fees are generally fairly low means that, even with the lower coverage percentage, copays at our office are comparable to most network dentists.  Since preventive care used to be covered 100%, that's where most people are noticing the bite.  We have increased our pay-at-the-time discount to 15% (20% over age 60) for all preventive care to help mitigate that, and encourage more of our patients to stay with us.<br />
<br />
     We again urge you to speak with your employers about choosing another carrier for your dental coverage, even if you choose to switch to an in-network provider.  It's not in anyone's long term best interest to deal with an insurance carrier that plays dirty.]]></description>
 <category>Update</category>
<comments>http://www.chuljiandds.com/news/index.php?itemid=25</comments>
 <pubDate>Mon, 19 Dec 2011 12:00:11 -0800</pubDate>
</item><item>
 <title>Delta Dental Insurance</title>
 <link>http://www.chuljiandds.com/news/index.php?itemid=24</link>
<description><![CDATA[This is an interesting website about recent WDS actions:<br />
<br />
<a href="http://www.concerneddentistsofwashingtonstate.org/files/Response.pdf"></a><br />
<br />
It's worth reading.  The website of the group has more information as well.  There is some problem with the linking of this blog, so you may need to type in the address, or copy and paste from this:<br />
<br />
http://www.concerneddentistsofwashingtonstate.org/files/Response.pdf]]></description>
 <category>Update</category>
<comments>http://www.chuljiandds.com/news/index.php?itemid=24</comments>
 <pubDate>Thu, 20 Oct 2011 11:23:11 -0700</pubDate>
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 <title>Delta Dental Insurance update</title>
 <link>http://www.chuljiandds.com/news/index.php?itemid=23</link>
<description><![CDATA[     As noted below, we have withdrawn from the Delta network effective May 15/June 15.  This does not mean that you can't come to us if you have your dental insurance by Delta.  We will continue to process Delta insurance claims, and Delta is legally obligated to pay claims based on the fees they have on file with the state insurance commissioner (but see below--we don't know what those fees are yet).  The difference is that if our fees exceed their filed fees, patients are responsible to pay any difference.  Since our fees are on the low side, we don't anticipate the increased co-pays being significant.  For the first month (May 15 - June 15) we will waive any co-pays resulting from the WDS changes, for routine cleanings, exams, and X-rays.  By then, we should have a decent idea of the secret WDS fee list, and be able to predict what if any co-pays to expect.  For other routine care, we can predetermine benefits so that you can know exactly what to expecct.<br />
     Also, you should be aware that Delta underwrites dental insurance for several other companies, so even if you're not directly covered by Delta, you might still be a Delta customer.  You should have received a letter from Delta this week notifying you of our withdrawal from the network.  The letter seemed to imply you would have to file your own claims, but that is misleading.  We are no longer legally <b>required </b>to file them for you, but of course will continue to provide that service.  WDS just wanted to scare people away from out-of-network dental offices.]]></description>
 <category>Update</category>
<comments>http://www.chuljiandds.com/news/index.php?itemid=23</comments>
 <pubDate>Thu, 28 Apr 2011 13:32:46 -0700</pubDate>
</item><item>
 <title>Our office is no longer a member of the WDS PPO plan</title>
 <link>http://www.chuljiandds.com/news/index.php?itemid=22</link>
<description><![CDATA[As of May 15th, we will no longer be a member of the WDS PPO (Participating Provider Organization).  Our patients who are members of this PPO have the option of choosing a new dentist who is a member of the PPO, or continuing with our office and no longer receiving the discounted fee schedule.  Because of its unusual nature--in this PPO, every office has a unique fee schedule--it is difficult to determine in advance if changing to a PPO office will save you money or not.  WDS has its own secret non-PPO schedule, and reimbursement is based on a percentage of those numbers.  Currently, Dr. Savidge, Dr. Nichols, and Dr. Nutter are PPO offices, as well as Dr. Hagen in Port Ludlow, but Dr. Nichols and Dr. Savidge have significantly higher fees than we do.  WDS has significantly changed its general reimbursement levels to dentists, and other dentists may be withdrawing from the program as well.  Please contact our office at 385-3100 and ask for our detailed letter explaining how this works.<br />
<br />
<b>Breaking Update -- WDS Premier</b><br />
After reviewing the new WDS reimbursement levels, we have made the difficult decision to withdraw from that program as well, as of June 15th.  In effect, we will be treating WDS the same as we do other insurance companies--we charge our regular fee, they pay a certain amount, and you pay the balance.<br />
]]></description>
 <category>Update</category>
<comments>http://www.chuljiandds.com/news/index.php?itemid=22</comments>
 <pubDate>Mon, 11 Apr 2011 17:29:49 -0700</pubDate>
</item><item>
 <title>Kicking and Screaming . . .</title>
 <link>http://www.chuljiandds.com/news/index.php?itemid=21</link>
<description><![CDATA[. . . we are being dragged into the 20th century (we're still resisting the 21st for now).  After much foot dragging we have finally gone to a digital X-ray system.  There are some disadvantages to digital X-rays--the resolution is not nearly as good as with conventional film, and they can be subjected to manipulation by Photoshop--but it's the direction everyone is going, so we broke down and bit the bullet.  You will notice a computer is in the room when you get your X-rays now, and that the sensor is on a wire, rather than being a thin piece of film.  The radiation exposure is about 1/3 what it was with film, which is a good thing, because typically more retakes are required.  And until we get the hang of it, it takes longer than with film.  Maybe even after we get the hang of it.<br />
<br />
     The impetus for going digital was that our film processor was going belly up.  It was either spend $5000 on a new processor, or spend $15,000 on digital X-rays, so I figured it was time.  Of course, it wound up costing considerably more than it was supposed to, but what else is new.  Anyway, I must admit it's nice having the X-ray the size of a computer screen, and it's a whole lot easier pointing out problems now, when the problem area isn't a half millimeter spec on the film.  We can also forward records digitally without having to scan them in first.  But it's disconcerting when I ask the assistant to take a film--I'm barely down the hall before they say "OK, here it is, please look at it."  There's not even time to go into the staff room and eat a cookie!]]></description>
 <category>Update</category>
<comments>http://www.chuljiandds.com/news/index.php?itemid=21</comments>
 <pubDate>Fri, 11 Feb 2011 09:32:48 -0800</pubDate>
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 <title>Rose, June 1991 - January 14, 2011</title>
 <link>http://www.chuljiandds.com/news/index.php?itemid=20</link>
<description><![CDATA[<a href="http://www.chuljiandds.com/news/media/1/20110114-smallbirds.jpg">null</a><br />
     My little green buddy, Rosebutt, died today in surgery.  Last year Chick Eastwood had to be put to sleep on New Year's Day, so it was with relief January 1st came and went uneventfully this year.  On January 2nd, however, Sweet Sadie was badly injured, losing a toe and nearly bleeding to death.  And that day, I noticed Rose did not eat much.  She didn't eat on the 3rd, either, so I took her to the vet.  Dr. Ford detected an abdominal mass, which was blocking the passage of food through her intestines.  Exploratory surgery on the 5th revealed multiple adhesions, probably from internal ovulation (eggs that missed the oviduct and got loose in her abdominal cavity).  The surgery went well, although she had a few rough days.  Sadie, meanwhile, recovered enough to have corrective surgery on her foot, and came home on the 13th.  When I got home with Sadie, I noticed Rose was wheezing as though she had something caught in her throat, sneezing and shaking her head.  I thought some food might have gone down wrong, but she kept it up and was in obvious distress.  I gave her oxygen, which stabilized her somewhat, then drove her back to the animal hospital in Bremerton, where Dr. Ford checked her.  The differential diagnosis was (a) aspirated food, (b) fungal infection, or (c) tracheal constricture.  Dr. Ford took her to an advanced clinic and ran a tiny scope down her throat this afternoon.  He discovered it was indeed tracheal constricture, possibly resulting from the several prolonged periods of intubation she'd undergone in diagnosis and surgery.  While it is possible to bypass the stricture, I couldn't see putting Rose through yet another surgery and recovery--she wouldn't understand what was going on, and would be miserable.  Regretfully, I had Dr. Ford put her all the way to sleep without bringing her out of the anesthesia.  I wish I could have been there with her when she died, but it would have been unfair to bring her back, then just put her to sleep yet again.  I did talk to her on the phone at the start of the procedure, at least.<br />
     We are planning the same cremation service we gave Chick Eastwood, her mate of 18+ years, visible in the photo behind Rose.  She had a good life, and perhaps it's just as well she didn't outlive Chick by too long, as she clearly missed him.  I will miss her too, caring for her was a way of keeping Chick's memory alive, and she was a sweet bird in her own right.]]></description>
 <category>Update</category>
<comments>http://www.chuljiandds.com/news/index.php?itemid=20</comments>
 <pubDate>Fri, 14 Jan 2011 22:19:17 -0800</pubDate>
</item><item>
 <title>Ho Ho Ho</title>
 <link>http://www.chuljiandds.com/news/index.php?itemid=19</link>
<description><![CDATA[<a href="http://www.chuljiandds.com/news/media/1/20101201-small houses.jpg">null</a><br />
It's that time of year again, when our hygienist, Candace, spends an entire weekend setting up her Christmas display in our office waiting room.  (The amazing thing is, there's only room for half of it!)  Next time you're at the Post Office, stop by and check it out--this year she put up the "Dickens" collection, which has pretty much every building you can imagine, except for a dental office.  Even if we've gone for the day, the display lights are still on, and you can get a great look through the front door glass.  The display will be up through the end of January, and the photo above is just one corner of the display, about 5% of the total  :-)]]></description>
 <category>Update</category>
<comments>http://www.chuljiandds.com/news/index.php?itemid=19</comments>
 <pubDate>Wed, 1 Dec 2010 13:02:00 -0800</pubDate>
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