The Doctor's Consultation: A Coronary Conclusion. Are you next?
by Dr. Iain Corness
With thanks to Mrs. Malaprop, the real problem I will
address this week is that of a Coronary Occlusion. While this is a fancy name
for blockage of the Coronary arteries, the end result is not fancy at all. It
can be death, generally referred to as a ‘Heart Attack’.
Before launching into the real factors in the situation, a
little understanding of what constitutes a ‘heart attack’ is in order. I
think everyone understands that you have both red blood cells and white blood
cells. The function of the red ones is to carry oxygen to the tissues, so that
the tissues can survive. The heart muscle is no exception to this rule. This
hollow muscular pump needs oxygen just like all the other organs you keep
inside you - spleen, kidneys, lungs, bowel and so forth.
However, the inside lining of the heart (muscle) is smooth
and impermeable to the oxygen tied to the red cells. In other words, the heart
does not get its nutrition from the blood it pumps through it. In fact, the
blood supply to the heart is through the specialized arteries called the
“Coronary” arteries. These run along the outer surface of the heart muscle
and then split up into smaller tributaries which dip into the muscle to supply
it with oxygen.
Now if we are to consider that the heart muscle is probably
the most important muscle in the human body (well, physiologically it outranks
the other much more highly publicized muscle in males!) then it become
important that this heart muscle gets a good supply of blood. And the quickest
way that the supply can get altered is by blocking off the coronary arteries.
This is most usually done via a slow process by which a small obstruction in
the artery slowly gets bigger and bigger until eventually it blocks off
totally and the heart muscle “starves” of oxygen and that section of the
heart muscle, supplied by that artery, just dies.
This event of blocking is called a Coronary Occlusion,
which may end up as a coronary conclusion if the section of dead muscle is
large enough! The actual death of the muscle resulting from this is called a
Myocardial Infarction, often shortened to the simple M.I. (The heart muscle is
called the Myocardium.) The simpler name is ‘Heart Attack’.
In short, cardiac health is mainly involved in keeping the
coronary arteries clean and clear. This is where our old friend Cholesterol
comes in. You see, the deposits inside the artery are generally made up of
this chemical and other blood fats. This makes a “sticky” patch in the
artery and some blood cells get stuck there. This causes a clot to form and
you have all the precursors needed to block the artery, with the occlusion
leading to the infarction, to your family claiming early on your life
To be able to keep your arteries clear you need to have a
nice low cholesterol, which can be done by diet plus medication if required.
But first you need to know what your cholesterol level is. This requires a
blood test, which can be done at your favourite hospital.
The most likely candidates for a heart attack are
overweight, hypertensive smokers, with high cholesterol. If this is you, do
something about it today. Well, perhaps that’s being a little bit too
melodramatic, but you are certainly one of the cardiac high risk people in the
Thai girls seem to still be very much into the mini-skirt fashion, but our
office girl is taking the cake. Her skirts are getting shorter and shorter
and she doesn’t squat down any more, she bends over the filing cabinet
draws (sic). This has raised some interest in the lads in the office. Is
this normal behaviour for a Thai office girl? Or is this being done for
effect? I am her supervisor and wonder if I should be saying something?
It’s being done for effect, Petal. Despite what many expats think, Thai
girls are modest - the immodest behaviour in bars is not the ‘norm’
for Thailand. As you point out, her hem length has raised some interest in
the lads, and it sounds as if she has raised more than just interest! If
this is inappropriate for your office, then you should bring this to her
notice, but discreetly. If it is you that the ‘show’ is meant for,
make sure she doesn’t get the wrong vibes from you. By the way, it’s
I think I’ve done something really stupid. I remember you saying not to
give money to the girls round here. I loaned ten thousand baht to one lady
I know who said she would pay it back within three weeks. Well it’s a
month now and I haven’t seen her or heard from her and her friends say
she has gone up country. Do you think I’ve lost the money? What should I
You haven’t “lost” your money. You know perfectly well where it is.
It’s with some girl up country, you silly fellow. You gave it away,
that’s what you did with it. Mind you, I didn’t say you shouldn’t
give your money away, I said you shouldn’t lend it. There’s a big
difference. Yes, Hillary doesn’t think you’ll see that money again (or
the girl). Next time give it to Hillary for “safe” keeping. At least
you’ll know I’m enjoying it as French champagne and Belgian chocolates
are expensive these days. In the meantime, what you should do is to buy
one of those T-shirts that says, “I spent all my money on women and
booze. The rest I wasted.” It fits. Hope the T-shirt does too.
Why do some of the expat women say there’s so much for them to do here?
I am complaining that I’m bored all the time and nothing like what they
say. I am so bored that this makes me start drinking every everyday. Is it
because they are pampered too much and are easily pleased? Or is it
something else. What’s your take on it, Ms. Hillary?
Dear Bored Barbara,
The expat women who say there is lots for them to do have discovered the
secret of life, my Petal. There really is so much, even for retirees to
do, that they have to ration their time. Far from being easily pleased,
the expat women I meet are strong characters who make life happen the way
they want, and it is that that pleases them. It’s about time you really
looked at your situation and look at why you have found nothing to do. I
guess that you’re not really looking, but using ‘boredom’ as an
excuse for the drinking. Am I right? You should go and get some
professional help from a psychologist or a doctor. There is a reason that
you are acting this way and you should realize this, and do something
about it. Now.
I am coming over to your neck of the woods at Christmas and was wondering
if you could help me with accommodation? I want to keep enough money so
that I can go trekking and I want to ride an elephant. Is Malaysia very
far away, as I would like to try surfing? I only want to spend about seven
quid a day for the place, is this possible? I know it’s probably a funny
question, but I’m serious.
Dear Trekker Tom,
Don’t worry, my little impecunious one, Hillary has had sillier
questions than yours over the years. When I first read your letter, I
thought you were asking to come and stay with me, and I was about to
suggest that if you brought enough bottles of bubbly, I might just be able
to help you. Having said that, I must point out that Hillary is not a
travel agency, a real estate office or an elephant mahout. Then I read the
“seven quid” line. By “seven quid” I presume you are from the UK
and this is about 500 baht in Thai money. Yes, you will get accommodation
for that amount. Reasonable, basic, but clean, and with air-conditioning,
which you will probably need, coming from the UK, not known for its
blistering temperatures in December. Malaysia is the next country hanging
off the bottom Thailand, getting closer to the equator, which you could
have easily worked out by looking at your old school atlas. However,
trekking and Malaysia do not go together at that well. Stick to
Thailand’s north, where you can do everything you want to do, other than
surfing, but white water rafting is here.
Camera Class: Goodbye
by Harry Flashman
Howard Greene, one of Pattaya’s photographic people has
departed from the scene. Unfortunately by his own hand, after he reached the end
of his acceptance of his situation in this country.
This was a great shame, as Howard did have a rare talent in
photographing people, with children and ladies, in particular. The images he
left behind from the Jester’s Children’s Charity Fair each year and the
UNICEF golf tournaments are testament to his photographic eye.
We all have our time on this earth, I hope Howard enjoyed most of his. I
publish Howard’s photographs as my final goodbyes.
Dogs - Man’s best friend:The deadly killer Ehrlichiosis Canis
Tick Fever claims many household pets
Multiple trips to the vet with my pet dog Lucky, always
ended up with improvement in her condition after treatment, but then a few
months later she would be sick again. This continued for many months, till
finally the vet pronounced the diagnosis of chronic E. Canis.
three months before her death, looked in perfect health.
Ehrlichiosis Canis (E. Canis) is an infectious disease
caused by a blood borne parasite, which lives and multiplies in the white
blood cells causing them to die, ultimately weakening the immune system by
inhibiting the basic function of the bone marrow - that of making new cells
to replace the old and dying ones. This is followed by a devastating effect
on the lymphatic system and other systems.
The disease has spread world-wide and has already claimed
the lives of many dogs. In Thailand, the disease is known as Tick Fever.
Transmission is through the bite of the brown dog-tick. A wide variety of
wild and domesticated animals serve as the reservoir.
Three clinical stages are observed: acute, sub-clinical
and chronic. The acute stage can be very subtle, usually mimicking a mild
viral infection, and often goes unnoticed. Multiple symptoms can include
weakness, intermittent fever, loss of appetite, eye and nasal discharge,
swelling of the limbs, cough, vomiting bile, soft feces, diarrhea, weight
loss, arthritis, neck or back pain, muscle wasting, rash, increased thirst
and urination, incontinence, sensitivity of the skin, depleted coat,
depression, pale gums, bleeding tendencies or seizures. The acute stage
often lasts 2 to 4 weeks, followed by the dog either recovering but
remaining persistently infected (the sub-clinical stage, which can last up
to 5 years) or enters the chronic stage where the parasite enters the bone
Diagnosis of E. Canis is usually made on the basis of the
history, clinical signs and the support of laboratory tests. However, the
chance of detecting the parasite in the white blood cells is less then 30
percent. There is now a special test kit called the SNAP test, where the
blood is tested for antibodies to the parasite. This method is much more
Treatment is through specific kinds of antibiotics and
supplementation of liver supporting vitamins. It is during the acute stage
that treatment is most effective and most damage can be reversed and a full
recovery is possible. Once the parasite has entered the bone marrow, the
damage is irreversible.
One peculiarity with the disease is that the dogs often
do not look or act sick until their final hour, even though they are in a
terminal stage of disease.
That is why alertness to the first symptoms is so
important. But, of course, prevention is the best cure. However, this is an
extremely difficult task, as ticks thrive in the hot and humid climate of
this country and in many areas have shown resistance to tick control
medicines such as Frontline and Revolution.
In case of doubt consult you veterinarian or just do the
For more information on dog issues, boarding or training contact
LuckyDogs: 09 99 78 146 or [email protected] yahoo.com
Dr Byte's Computer Conundrums
by Dr Byte, Citec Asia
In the last edition we explored what is actually going on
with Thailand’s Internet. In this issue, I ask if we have any real options
with the choice of internet connection? Are there any reliable ISP’s and is
one better than another? Lastly, what choices do we have to connect anyway? The
answer is broken down into groups of connection options to make it easy to
There are plenty of offerings here, but all suffer from the
same antique telephone system that still uses 50 year old telephone lines and
analogue telephone exchanges. More of an issue outside the major city areas, the
rest of us have a plethora of choice and decisions we can make.
While your PC may be reporting a connection of 44-48K (the
connection speed), and modern computers usually have the latest 56K modems, I
guarantee the reality is significantly less as signal strength is degraded by
poor line quality and so on.
Web Connection Kits vary widely but two examples include the
Inet Access Kit 500 baht (as low as 5 baht per hour after office hours) and
CSLoxinfo’s Biz Kit 30 providing 30hrs for 720 baht. Don’t forget that most
ISPs here and overseas use a ratio of 9:1 when they set up modems for users to
connect through. That’s why at peak times, you only get online after dialling
a few times. For every 9 of you, there’s only 1 modem.
(The other thing people constantly complain about is, after
spending 30 mns getting on line, the connection hangs after 10 seconds). This is
usually caused because you connected to a faulty modem or this could also be
caused by Thai Internet connections to the outside world. Dial-Up Modem gets a
2.5 star rating (because the infrastructure is so old). I am amazed how many of
us still rely on it. Tip: Those of you living outside the city area should
consider slowing your modem connection speed to 28K or 33K. Believe me it works
and I will explain why another time.
Expensive and not everyone can afford this, but there are
better and newer options anyway. This gets 2 stars because only someone with
very deep pockets is going to be able to afford it.
Broadband can be equated to the size of the highway. The
bigger the highway, the more traffic that can be handled at the same time. Clog
up with too much traffic during rush hour and your speed will drop dramatically.
Broadband is the not so new, but new for Thailand, hi tech
connection solution and this can be broken down into 3 real choices. Satellite,
ADSL and Cable. There are currently two fibber optic connections out of
Thailand. A superhighway and a small country lane.
Chiang Mai seems to be in a black hole and the early offering
from CSCOMs iPTV was not good at best. A 256K down and 56K up connection was
around 6,000 baht (approx. $150 US) per month at the time. Major issues seem to
have been resolved by using larger satellite dishes and different
configurations. Bear in mind the cost of the satellite dish, the special modem,
the installation and your bandwidth use. For example, you are given 2GB download
as part of the mid-size package. But every Mb downloaded over 2GB adds to the
monthly charge. Upload is limited to the speed of your modem unless you can
afford the more expensive Satellite Down and Up choice (and what happens if
Our customer support at the time dropped this bombshell by
mistake: the modem speed is actually limited to 33K not the 56K advertised. The
iPStar package seems to have resolved the early iPTV issue and I am advised that
the connection is now stable and works well, especially for out of town
customers. Satellite gets 3 Stars.
All the main players are now offering broadband of one kind
or another. What I find interesting is that the concept of broadband here is not
the same as back home. So forget whatever you think it should be and face the
reality of what is considered Broadband in Thailand. Also remember that ADSL
comes hand in hand with the telephone line.
For example if your telephone line is provided by TOT, they
will partner with the ISP to bring this to you and will have their own costs
which will be charged monthly. The advantage is you only pay one fixed fee per
month and not 3 baht for each dial up connection because the line is connected
all the time. Not all ISPs have relations with both TOT and TT&NT, so check
who provides your phone line before heading off to see an ISP.
One other thing to note down is that TT&NT collect a node
full of customers first before setting anyone up. In this way they actually
provide a more stable service than TOT. You may have to wait a long time till
your node can be set up.
The costs are all pretty much the same and you will be
looking at a small business connection of around 6,500 baht (approx $160 US) per
month for an unlimited 256K down and 128K upload per month. The giddy speed of
512K down and 256K up will lighten your wallet around 9,500 baht (approx $235
US) per month. Plus VAT and of-course the phone company charges. Don’t forget
there will be connection costs, set up costs and the cost of an ADSL modem.
ADSL: TOT only gets 3.0 stars. Try to get a stable connection
on Friday afternoon with a TOT phone line and you will understand why. ADSL:
TT&NT loses in the ratings because of their policy regarding local nodes,
sharing bandwidth and only gets 3.5 stars. They should be around 4 stars.
In the next edition of Dr Byte, we will look at the Home ADSL
and cable alternatives.
If you have any tips or tricks that you’d like to share, or
any questions about your internet or pc experience, contact me: Dr Byte,
Beer and More: Beer in the early middle ages
Cervisiam Bibat - You shall drink beer!
by Karl Eichhorn,
Chiangmai Malting product manager
In the early Middle Ages baking and brewing was a woman’s
job. Later the monasteries explored the art of brewing. During this time, Carl
the Great became Emperor (800 A.D.) and 300 monasteries were counted in Bavaria
alone, of which some had engaged in making beer 150 years earlier.
still get it everywhere - Weihenstephan Beer (Photo courtesy of Horeca Chiang
The reason why monks took up brewing beer was apparently
their longing for a tasty and nutritious beverage complementing their meals
which were rather simple, especially during periods of fasting. Liquids, they
argued, do not break the rules of fasting (liquida non frangunt ieunum). Thus
partaking of beer was always permitted, so the consumption of beer in
monasteries rose considerably.
It may, in part, have been stimulated by the hard physical
work monks were undertaking, as well as by their demanding and rigorous
religious exercises. It has been documented that monks were permitted to drink 5
liters of beer a day.
Soon, beer was not only brewed by monks, but also sold by
them in inns belonging to monasteries. Through their increasing involvement in
brewing beer, monks developed their skills, boosting the quality of their
Not only monks attended to beer, as we can read from a famous
nun by the name of Hildegard von Bingen (1098-1179 A.D.) who emphasized in her
book ‘Causa et Cura’ (cause and treatment of diseases),”cervisiam bibat”
- you shall drink beer!
In 1040 A.D., the Bishop of Freising bestowed the right to
brew and serve beer on the monastery of Weihenstephan. Today, Weihenstephan is
still the oldest existing brewery of the world.
Let me end today with one of the many beer jokes which has probably been
heard for centuries: A man walks into a bar and orders a beer. While chatting
with the bartender the man says: “I have a method that will enable you to
double the amount of beer you sell every day.” “Really?” says the
bartender, “How?” “Very simple. Just pour full glasses.”
Money Matters: MBMG Special Report – Cinderella without a clock
MBMG International Ltd.
Our currency view for some time has been that there would be
a short term US$ rally in the second quarter of this year (which we have already
seen) but that from that peak we would see either a gradual orderly fall back in
the value of the Dollar to around 10% below the pre-rally levels against the
average value of the international basket or an uncontrolled major drop in the
value of the US$.
Either way, being out of Dollars is a smart short term move
and moving back again when the picture is clearer and the fall has occurred
would be a good long term strategy. This has long been our view and that of our
preferred analysts, but this was summed up extremely neatly by John Taylor of
Market Insights in one of his more recent weekly reports.
“Last month Warren Buffet caught our fancy, while
encapsulating our outlook, by commenting that the carry trade was ‘like
Cinderella at a party with no clocks.’ In that case, he commented, ‘it is
very hard to leave early.’”
With the violent recent downward correction in emerging
market bonds and equities, and the twitchiness in most developed equity markets
as well, it is possible that the clock is starting to chime midnight. But, we
think it is too early. The problem is, as Buffet stated, we can’t be sure. We
don’t know what time it is. We are using the term “carry trade” in a broad
way, as financing a house with floating rate debt is a carry trade. When a
corporation issues fixed rate debt, and then swaps it into paper whose rate is
based on one month Libor, it is entering a carry trade.
Banks have been in this business for years, but now many
near-banks, non-banks, and hedge funds are in it too. Everyone participates in
this strategy because the payoff is so high, and looking back over the past few
years, the risk has been so low. Today overnight money is near 1.00% while five
year US Notes are around 4.00%. With returns like these, leveraged many times
over, the whole world sits up and pays attention.
Because the carry trade is so profitable, and capital
projects are so easily financed, the economy is running away with excitement.
Nominal growth rates over 6% are way above the cost of short-term money, and
this leads to more growth. To slow the economy, short rates should be around 4%,
which is the rate that would not stimulate more borrowing, the so-called
“neutral” rate. The problem as we see it is that the Fed cannot move rates
anywhere near the 4% level without causing a massive financial dislocation.
Because the various carry strategies have been so profitable for so long, many
of the structures that have been created for them would fail with higher rates.
One clear example is the housing market. If floating rate mortgages, now roughly
4.10% - which is 1.10% base plus a 3.00% spread, went to 7.10% - prices would
collapse, builders would go broke, and Congress would be up in arms. Many hedge
funds and other financial institutions have followed LTCM’s path, a bit more
circumspectly perhaps, but there will be many market disruptions when rates
The Fed is walking a fine line, and it is possible that their
goal is unattainable. In that case, the economy will either expand further in an
uncontrollable fashion or will collapse under the weight of higher rates. The
Fed has told us that rates will rise slowly, but the market has forced them up
rapidly, and there are the mini -panics in various weak spots, like Brazil and
We believe the Fed will follow this gradual path, but the
crises will grow. Even a ผ point move could be enough to cause a global
dislocation and turn the US economy down. Our cycles, the best clock we know,
say this will happen in the third quarter. As the economy buckles, rates will
begin to drop again and the dollar will plummet. The US dollar is presently
being supported by the strengthening US economy and its out-performance of
Europe and Japan. Because of the economic growth, dollar interest rates have
been rising, both in absolute and relative terms when compared with the euro and
the yen. It is clear that the US rates have been strengthening against European
rates for more than 1ฝ years.
US rates began to rally in the fourth quarter of 2002, along
with the US equity market, but the increasing attractiveness of dollar deposits
did not begin to affect the dollar until the beginning of this year. This lag,
which we have discussed before, is a consistent factor in the foreign exchange
market. As the lag is somewhere between one and two years on average, the rising
interest rate spreads today should translate into a stronger dollar next year -
all else being equal. As we are forecasting a peak in US interest rates after
July and a decline to new lows in 2005, there will be a further dollar decline
ahead. The question is when?
Of course, this is not the only factor impacting the value of the dollar.
However, even if we just look at these differentials, they point in favour of a
weak dollar. Although US rates have been climbing for a year and a half,
Eurodollar rates are still below Euribor rates and have been that way for almost
4 years. When US rates are below European rates, taking the lag into
consideration, the dollar also tends to weaken. As we expect US rates to drop
further below Europe after July, the dollar will decline again.
The above data and research was compiled from sources believed to be
reliable. However, neither MBMG International Ltd nor its officers can accept
any liability for any errors or omissions in the above article nor bear any
responsibility for any losses achieved as a result of any actions taken or not
taken as a consequence of reading the above article. For more information please
contact Graham Macdonald on [email protected]