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The Doctor's Consultation

Agony Column

Camera Class by Snapshot

Money Matters

Life in the Laugh Lane

The Doctor's Consultation:Colonoscopy - just another pain in the bottom?

by Dr. Iain Corness

Cancer, the big “C” word that brings fear and dread to us all, is most usually a disease of aging. Now that people are living longer, they are more likely to have lived long enough to develop a cancer. A sort of, what you gain on the swings, you can lose on the roundabouts.

To try and see if you are a candidate, quietly growing a cancer somewhere in the bowel, there are many tests available to us. One of the most “popular” (if you can consider any invasive test as being “popular”) screens is the colonoscopy. I was actually reminded of this the other day when a friend asked who they should see about getting one of these screening tests done.

Colonoscopy is used to examine your entire colon and rectum under direct vision, for abnormalities. Now to be able to do this requires some preparation beforehand. To prepare your colon during the 24 hours before the exam you must stop taking iron pills or medications containing iron, as iron can alter the color of your colon lining. Take laxatives and sometimes even enemas prescribed by your doctor. Avoid eating solid foods and opaque liquids. Drink and eat only clear, nonalcoholic liquids such as black coffee, tea, water, or clear broth and juices. Avoid liquids that are red in color, as they can appear as red in the colon and be confused with blood.

If you have diabetes or take blood thinners, including aspirin, your preparation for colonoscopy may be slightly different, and you should inform the doctor of any chronic conditions you may have.

So what is involved? Basically, a long, flexible tube about the thickness of an adult finger (the colonoscope), is inserted into your rectum. The colonoscope is long enough to view the entire length of your colon. It contains a fiber-optic light and a channel that allows your doctor to pump air into your colon, inflating it to get a better view. The colonoscope also contains a small video camera that transmits images to an external monitor. It is also possible to insert instruments through the colonoscope’s channel to remove polyps, take tissue samples, inject solutions or destroy (cauterize) tissues.

A colonoscopy is relatively painless, but the exam can cause sufficient anxiety that people generally tolerate the procedure better when they have some form of mild sedative beforehand. This does mean that you should not drive yourself home after the procedure, and perhaps it is safer not to drive for the rest of the day.

During the exam you lie on your left side. The doctor inserts the colonoscope into your rectum and watches as the video camera shows the condition of your bowel. If a polyp or abnormal tissue is found, the doctor may choose to remove it with a snare or cautery, or may take a biopsy.

After the procedure, you may see a small amount of blood with your first bowel movement. Usually this is no cause for alarm, but see your doctor if you continue to pass blood or blood clots, have persistent abdominal pain or have a fever of 38 C or higher.

If no abnormalities are found, you can probably wait several years before repeating the colonoscopy. The American College of Gastroenterology recommends another colonoscopy in three years if you had more than two small polyps (less than 1 cm in diameter) or a large polyp (larger than 1 cm diameter), if the polyp removed shows cell changes, or if you have a first-degree relative - a sibling, parent, or child, with a family history of colorectal cancer. If only one or two small polyps are found and you’re otherwise at average risk, you can probably wait five years before having another exam.


Agony Column

Dear Hillary,
I have been here for two years and have just bought a car. As I didn’t have a Thai license I said my Thai girlfriend would drive the car when I took out the insurance. I had done the right thing and made sure it was insured, but after we had an accident the insurance company refused to pay up. They said that the reason was because my girlfriend didn’t have a license, even though she’d been driving for 15 years! I wasn’t to know, so surely I’m not at fault. They accepted the money quickly enough. I pay for the insurance in good faith and everything, but they won’t pay. Is there something I can do, or is it another case of TIT?
Uninsured It Seems

Dear Uninsured It Seems,
This is not really Hillary’s field of expertise, Petal, but when I asked an insurance broker, he said that this is a standard requirement. It is not the insurance company’s responsibility to make sure that the driver of your car has a license. It is yours, unfortunately. There’s nothing you can do about this accident, but make sure your girlfriend gets a license before she gets back behind the wheel. The old way used to be ‘get your license first and learn to drive later’, and while that would have got you out of this predicament, you probably would have had more accidents. Get her a license, and get one yourself too. You never know when you might need it.

Dear Hillary,
There are some really fantastic looking birds in this town, and it’s hard to walk down the street without turning around and following some of these cuties. I know what everyone says, that they’re just trying to get your money, but they can’t all be like that? What advice, Hillary?
Stunned by Beauty

Dear Stunned by Beauty,
Petal, how long have you been here? It sounds like 10 minutes. Here’s the tip while following your “fantastic looking birds”. The best looking ladies in town are almost always men, the second-best looking ladies who indicate they are available are professionals. There are many dangers from all this, including communicable diseases. If you don’t want to catch it, don’t get too close to these “birds” as you put it. You might get “bird flew”, generally taking your money as well!

Dear Hillary,
I have read the books and the letters, but thought I was smarter than all the other guys. I had found the girl who was different from all the others, even though I had met her in the go go bar. She was drop dead gorgeous, and I thought I was just so lucky. She really was beautiful and always looked after me very well. House clean, reasonable cook and good in the bedroom. Her salary was 20,000 baht a month, and she never asked for one baht more. She was smart and I trusted her. Then one day I come home and she wasn’t there. I thought she must have been with one of her girlfriends, but when it became dinner time I started to worry. I went through to the bedroom and all her clothes were gone, and everything that she owned. There was no note, nothing to say why or what was wrong, nothing. For a couple of days I tried her mobile, but it was off. I went back to the bar, but nobody knew, or weren’t saying. It was only three months, but the best three months I’d ever had. I bumped into her about six months later and all she said was that her old boyfriend had come back, so she went back to be with him. Are they all like this, or what? I want to try again, but I don’t want to end up like this one did. 20,000 baht a month for three months, down the drain. How do you tell if they are honest?
Dumped

Dear Dumped,
You have to grow up a little, my Petal, and decide what you want. Do you want a chief cook and bottle-washer and live-in lover and want me to fix her salary for you, or find you a replacement? The simple answer is that there isn’t one! If you go looking for your paragon of virtue and housekeeping, you won’t find one in the chrome pole palaces. These are the hangouts of the professional ladies who will market their commodities to the highest bidder. Your 20,000 baht wasn’t enough, Petal. If you are looking for a long term relationship, you don’t start at the a Go-Go. Those relationships soon turn into a Gone-Gone, as you have already found out. However, you may take solace in the old adage that used to be on the Bangkok Rules website (unfortunately long gone also) which stated “You never lose your girl, you only lose your turn.” If you really are looking for a long term loving relationship, then do as you would do in your own country. Stay away from “professional” ladies and give any relationship time to develop. Try to let some emotion come into your relationships with women, not just blue diamond lust. Finally, you don’t measure your relationship like paying a monthly salary to the maid. If you want someone to share your life, then you have to realize that means everything! Beware. I think you’re still a little young for this.


Camera Class: The secret of super-sharp landscape photographs

by Harry Flashman

Landscape by Ansel Adams

Landscape photography is far more than just snapping a tree in a field, with mountains in the background, and then moving on to the next beer garden! All photographers have to avoid complacency, taking a shot, “because it is there”, without any real input yourself. Like all good shots, great landscapes are “made”, they just don’t happen. And I am not talking about being “made” by some creator many zillions of years ago. You have to create the shot!

Unfortunately, taking a good landscape requires just as much thought, creative ability and visual “eye” as taking any other type of great photograph. However, owing to the sheer size of it, taking landscapes can be even more difficult, coupled with the fact that you cannot tell a tree to move to its left by a couple of meters!

The first aspect to master is composition. The golden rule with landscapes is to include some foreground interest as well as all the other items in the shot. Sharp foreground items like fence posts, bushes or even old farm equipment gives depth and scale to the photograph. The other good reason is that the foreground item will draw the eye into the picture.

It is always best to avoid putting the horizon line slap bang in the centre of the photograph, so move the camera to only have about 33 percent of the picture sky, and even experiment by making the sky 66 percent of the picture you see in the viewfinder. This is otherwise known as “The Rule of Thirds” and although not absolute, when applied to your photographs it will definitely improve them.

Another very interesting variant in landscape shots is to turn your camera 90 degrees and take the landscape in the “portrait” (vertical) mode. Of course, the Rule of Thirds still stands!

Landscapes should also be very sharp, right the way through from the foreground to the very back of the scene. The way to ensure this is to run as small an aperture as you can. Try using f16 to f22 or even f32 if your camera can get down that far.

Now this will give you slow shutter speeds, especially in lower light situations, so this is one time where you really need your tripod. The slow shutter speed will also give you that flowing look to moving water, such as streams or rivers.

Time of day is particularly important for landscapes. Early morning for that cold blue light and late afternoon for the warm glow. Get those into a landscape and you are starting to put together a good photograph.

Another little trick is not to pack up and go home as soon as the sun disappears. There is often enough light to catch some stunningly coloured different kinds of shots after sundown. You can really put in some creative flair at this time by lighting the foreground, while exposing for the background. You can do this by shining your car’s headlights on the aforementioned fence posts, bushes or old farm equipment. The yellow light on the foreground item will make for a very pleasant effect.

Even when the sun’s influence has completely gone, you can still take interesting shots with just the moon as the light source. You will get an eerie atmospheric feel to shots taken that way. The exposure details are a bit “hit and miss” I’m afraid, but try taking some shots at 5 minutes time exposure. You’ll get something different, I’ll guarantee.

Even bad weather should not put you off having a go at some landscapes. On a completely foul day try putting some black and white film in the camera and see what you get. You may be very surprised with the end result. Another little wriggle is to use the flash when taking shots in the rain. You can stop the rain drops as bright splashes of light in an otherwise grey shot.

With a little creative thought you can manipulate the final landscape images in many varied ways. Not all will be successful, but some shots will turn out to be show stoppers. Try some of these tricks this weekend.


Money Matters: A brief(ish) history of stocks (Part 4)

Alan Hall
MBMG International Ltd.

Undoubtedly the US is the place for stock action today. The New York Stock Exchange (NYSE) is the largest stock exchange in the world by capitalization, although in those hazy crazy days of dot coms its trading volume was exceeded by that of NASDAQ during the 1990s, even though the total market capitalization of the NYSE (total number of shares multiplied by their price) is five times that of NASDAQ.

The NYSE is located at 18 Broad Street, at the corner of Wall Street (with a bull and a bear famously at either end). The 2,800 companies listed on the NYSE are valued at nearly $20,000,000,000,000 (that’s trillion in American or million in English) global market capitalization. As of July 2004, of the thirty companies in the Dow Jones Industrial Average only Intel and Microsoft were NOT listed on the NYSE.

The origin of the NYSE can be traced to May 17, 1792. The NYSE is not, however, the oldest stock market in the USA - that distinction belongs to the Philadelphia Stock Exchange (PHLX) in Pennsylvania (which dates back to 1790 but subsequently merged with the exchanges at Baltimore and Washington in 1949 and 1954 respectively as the regional exchanges consolidated) when the Buttonwood Agreement was signed by twenty-four stock brokers outside of 68 Wall Street in New York under a buttonwood tree. On March 8, 1817 the organization rented a room for $200 a month at 40 Wall Street and drafted a constitution in which it renamed itself the “New York Stock & Exchange Board”.

The third oldest US exchange, the Boston Stock Exchange in Massachusetts was founded in 1834. The NYSE took on its acronym in 1863. The exchange installed its first ticker in 1867 and telephones were first seen in the exchange in 1878. The NYSE first installed electric lights in 1882. Also in 1882 the San Francisco Stock and Bond was formed (as was seven years later, the LA Oil Exchange. The 2 merged in 1957).

On September 16, 1920, a bomb exploded outside the NYSE building on Wall Street in a terrorist attack, killing 33 people and injuring more than 400 (sadly even terrorist attacks aren’t new). The perpetrators were never found. The NYSE building and some buildings nearby, such as the JP Morgan building still have marks in the facade caused by the bombing.

Arguably even more damaging to the Exchange was the great crash that began with Black Thursday (October 24, 1929) and the subsequent sell-off panic of Black Tuesday, October 29, which precipitated the Great Depression. In an effort to try to restore investor confidence, the Exchange unveiled a fifteen-point program aimed to upgrade protection for the investing public on October 31, 1938.

The frequently seen electronic display boards mounted on the walls of the exchange were first installed in 1966, along with radio pagers. A highly technical wireless data system increasing the speed in which trades were executed was introduced in 1996. [NYSE trades, unlike those on electronic exchanges (e.g. NASDAQ), always involve face-to-face communication in a particular physical location. The human interaction and expert judgement as to order execution differentiates the NYSE from fully electronic markets and does give the place its unique flavour, which you can sense even from the visitor’s gallery, bringing to mind the furious actions in movies like “Wall Street”.]

Although 1974 also saw a major crash it was the then record 554.26 point drop in the Dow Jones Industrial Average (DJIA) on October 27, 1987 that led officials at the Exchange for the first time to invoke the “circuit breaker” rule to stop trading. This was very controversial and prompted a quick change in the rule so that trading now halts for an hour, two hours, or the rest of the day when the DJIA drops 10, 20, or 30 percent, respectively.

In the afternoon, the 10 and 20% drops will halt trading for a shorter period of time, but a 30% drop will always close the exchange for the day. The rationale behind the trading halt was to give investors a chance to cool off and re-evaluate their positions in an attempt to forestall the kind of panic seen in 1929.

For any readers from Illinois we’d better point out that Chicago is the United States’ second major financial city. Although the Chicago Board of Trade (CBOT) and the Chicago Mercantile Exchange (CME) were both founded as grain markets, the CBOT now handles heavy trading in financial futures and options, including those based on United States government and agency bonds.

Other markets exist without physical exchanges - the NASDAQ (National Association of Securities Dealers Automated Quotation System - why isn’t it the NASDAQS?) is not an exchange in this sense. It is an ongoing computer record of stock quotes (current buy and sell prices) for a large number of companies. Brokers can use these quotes to guide them in filling their clients’ orders. It also has a quotation system for the stocks of smaller companies, which is called the OTC (Over the Counter) Bulletin Board. A company does not have to meet very high standards to be listed there, although the NASDAQ has since January 1999 required that listed companies at least file current financial information with the SEC or other regulatory agencies. (The National Quotation Bureau publishes weekly “pink sheets” of trade information about stocks of 3,600 or so companies that do not even meet the listing requirements of the OTC Bulletin Board.)

Although companies such as Microsoft grew from OTC listings, many of the companies listed in these secondary sources are in poor shape and OTC BB (bottom board) tends to be prone to price-manipulating frauds, such as boiler rooms. Some, however, are sound businesses with stocks that do not trade at high enough prices or in large enough volumes to require listing on major exchanges.

In the tech-stock recession of spring 2001, some computer and internet companies were de-listed by the NASDAQ and added to the OTC Bulletin Board because the price of their stocks fell to pennies on the dollar. Some of these have been subsequently re-listed. AMEX, the American Stock Exchange, is also now a subsidiary of the Association and arguably represents a broader spectrum of American business than the NYSE because it handles the offerings of companies that do not qualify for listing on “the big board.”

NYSE Vital statistics

Listed companies: 2,780
Market cap: $19.7 trillion
Members: 1,366
DJIA Highest Close: 11,722.98 January 14, 2000
DJIA Largest Daily Gain: 499.19 March 16, 2000
DJIA Largest Daily Loss: 617.78 April 14, 2000
Highest Volume Day: 3,115,805,723 shares June 24, 2005
Lowest Volume Day: 31 shares March 16, 1830
Thanks to www.wikipe dia.com for some of the above facts.
That’s enough history but, as the philosopher Santayana said, “Those who cannot remember the past are condemned to repeat it.”

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 Alan Hall on [email protected]


Life in the Laugh Lane: Again and Again

by Scott Jones

Enjoy the moment. It may be your last one.

Some tourists and expats seem to spend half their time enjoying and the other half complaining. It’s not America. It’s not Europe. If that’s what you want, stay home, go to a museum, view Thailand under glass, get into your big, safe, government-inspected car and drive to a western Thai restaurant.

If you want the exotic Thai experience, you have to accept the fact that motor bikers and mosquitoes are inadvertently trying to kill you, restaurants may be as slow as glaciers and if you want something repaired, it may be fixed by the time your grandchildren are grandparents. That’s just the way it is. It’s going to happen again and again, so get over it.

There are often no rational reasons for what happens here. At a restaurant at home, you expect drinks first and everyone’s meal served simultaneously soon after. Here dishes arrive randomly depending on sunspot activity or the nap schedule of the help. You and your friends order breakfast, expecting your drinks to come first. Eventually one plate of sticky rice is delivered. By lunchtime another dish arrives and your rice now has the consistency and temperature of a soccer ball. As the saying goes, “When life gives you lemons, make lemonade.” Take the sticky rice home as a souvenir and use it as a door stop. Chant the national Thai mantra “Mai pen rai” which means “whatever” or “no problem” but translated literally means “no is what” which makes no sense whatsoever. Embrace the nonsense. You’re in charge of your peace of mind, not them. Get mad enough and you’ll go mad.

It’s nothing personal or discriminatory just because you’re a farang. A Thai friend took her TV to be repaired. After several answers of “tomorrow”, “next month” or “It’s in Bangkok”, she finally got “We don’t know where it is” as if it was her or the TV’s fault, like she’d never brought it in or the TV was so defective that it exploded in the shop. Not wanting to lose face, they become two-faced. Hey, at least one of them has that famous Thai smile. Say to yourself: “jai yen yen” = “heart cool cool” or “calm down and have another Chang beer”. Okay, three more Chang and twenty-three mai pen rai’s.

Some dude on a scooter
A wife in the rear
A baby on her shoulder
A cell phone in his ear
He cuts right in front of you
Gives you a heart attack
You want to kill this fool
You’re ‘bout to blow your stack
Say mai pen rai, say jai yen yen
You’ll go insane complainin’
It’s gonna happen
Again and again and again and again
The cook took your order
You’re dyin’ to eat
It’s taking forever
The cook is fast asleep
The waitress puts on lipstick
Then she combs her hair
You want to take your chopsticks
And shove them up her derriere
It needed repairing
You took it to the shop
When you ask how it’s doing
They say it’s in Bangkok
They smile and say “Tomorrow”
But tomorrow never comes
You’re sick and tired of yes means no
You wish you had a gun
Between a rock and a hard place
You return the grin
He’s about to lose face
’Cause you’re gonna smash it in
Say mai pen rai, say jai yen yen
You’ll go insane complainin’
It’s gonna happen
Again and again and again and again