This is based on a study performed by two researchers out of Boston. Dr. Peter Lee and Dr. Atul Gawande, bestselling author, analyzed hospital and ambulatory center data provided by the Agency of Healthcare Research and Quality. The hospital data acquired in 2002 were collected from three representative states: Colorado, Florida, and New Jersey. The researchers assumed an average lifespan of 85 years. This study is the first of its kind to quantify the average number of surgeries the average American will undergo in his or her lifetime.  The three states had similar numbers in terms of the number of surgeries done in that year. There were some regional variations in the types of procedures. For example, Colorado had a significantly higher number of orthopedic procedures than in the other two states. In this startling finding, it was found that six of those procedures will be done in a hospital operating room, while the remaining three are done as an outpatient. The study also highlights that the traditional notion of surgery is also changing. A number of those procedures are done by nonsurgeons such as cataract surgery by ophthalmologists and coronary stent placement by cardiologists. So while the overall number of surgery is fairly large, the trend is toward minimally invasive surgery. The number of surgeries, not surprisingly, increases with age. Women's reproductive years are associated with an increase in the number of surgeries as are the years between 45 and 75 for both men and women. Not surprisingly, three of the top ten most common procedures for women are on the reproductive organs. The top ten most common procedures were stratified according to gender. For men, the top ten procedures included: percutaneous transluminal coronary angioplasty, wound debridement, inguinal and femoral hernia repair, lens and cataract procedures, coronary artery bypass graft (CABG), knee arthroplasty, procedures on muscles and tendons, peripheral vessel procedures, cholecystectomy (gallbladder surgery), and transurethral procedures. For women, cesarean section ranked as the most common procedure. The following procedures round out the top ten: cholecystectomy, lens and cataract procedures, breast lumpectomy, wound debridement, percutaneous transluminal coronary angioplasty, knee arthroplasty, diagnostic dilatation and curettage, hip replacement, and procedures on muscles and tendons. The authors in their October 2008 presentation at the annual meeting of the American College of Surgeons in San Francisco, California were reluctant to make any health policy recommendations based on their data, citing the fact that the data was drawn from 2002. The number of surgeries may have increased since then, particularly the minimally invasive procedures. Nonetheless, it does give us some insight into how our health care dollars are being spent and will be spent in the future.

Abdominal aortic aneurysms (AAA) are life-threatening in that all aneurysms have a risk of rupture. Rupture risk is mostly dependent on size of the aneurysm. Many people who are told that they have a AAA feel like they have been told that they have a ticking time bomb in their belly. One study conducted by Dr. Brian Nolan from Dartmouth-Hitchcock Medical Center found that nearly half of all patients undergoing surveillance for their abdominal aortic aneurysm reported feeling anxious since their diagnosis. Almost all patients will ask what they can do to reduce their risk of rupture. In Dr. Nolan's study, 30% modified their lifestyle by limiting their activities for fear that physical exercise can induce rupture. The truth is no on really knows how much physical activity is safe. The reality is that aneurysms take years to develop, so suddently altering your lifestyle is unlikely to change the rupture risk at all. In addition, patients that come in with a ruptured aneurysm rarely say that their abdominal pain was preceded by a bout of physical activity or heavy lifting. There are some studies that suggest that better blood pressure management with beta-blockers and ace-inhibitors reduces the rupture risk of aneurysm. But there is not yet enough data to make any firm guidelines on blood pressure management for people with aneurysms. Another notable finding of Dr. Nolan's study is that despite a rupture risk of 4%, many of the respondents in his study reported that their rupture risk was 22%. The higher the rupture risk the respondent quoted, the more likely they were to report feeling anxious. I have been asked on several occasions as well if it is okay to get a stress test when you have an aneurysm. Stress test "stress" the heart by elevating the heart rate to see how the heart responds. The heart rate increase is only temporary. Once you have been given a diagnosis of a AAA, the best thing you can do is maintain a healthy diet, continue with low-impact exercise, and watch your blood pressure and exercise. And, keep your doctor appointments. The famous actor, George C. Scott, died of a ruptured abdominal aortic aneurysm because he ignored a diagnosis of a AAA made years earlier.