The Doctor's Consultation: Hello!.....Hello! Is this an Echo?
by Dr. Iain Corness
In medicine’s grab bag of diagnostic procedures, there is
one called an “Echo”. This is short for Echocardiogram and is one of the
procedures that can yield much information on the workings of the heart, with
pictures produced by Ultrasound.
This type of ultrasound test uses high-pitched sound waves to produce the
image of the heart. The sound waves are sent through a device called a
transducer and are reflected off the various structures of the heart. These
echoes are converted into pictures of the heart that can be viewed on a
monitor similar to a TV screen.
The difference between an X-Ray and an Echo is that the X-Ray is a static
picture, whilst the Echo shows dynamic ‘action’ images of the functioning
heart. The former is similar to taking a photograph of your car engine, while
the Echo is the same as measuring your car engine’s workings on a rolling
The echocardiogram is used to evaluate how well the heart chambers fill with
blood and pump blood to the rest of the body. It can also be used to estimate
the amount of blood pumped out of the left ventricle with each heartbeat
(called the ejection fraction). It helps evaluate heart size and heart valve
function. Echocardiography can help identify areas of poor blood flow in the
heart, areas of heart muscle that are not contracting normally, previous
injury to the heart muscle caused by impaired blood flow, or evidence of
congestive heart failure, especially in people with chest pain or a possible
heart attack. In addition, ECHO can identify some heart defects that have been
present since birth (congenital heart defects).
There are several different types of echocardiograms, including the
Transthoracic echocardiogram (TTE). This is the standard, most commonly used
method of echocardiography. Views of the heart are obtained by moving the
transducer to different locations on the chest or abdomen wall. This is a
totally painless procedure.
Another is the Transesophageal echocardiogram (TEE). In this case, the
transducer is passed down the esophagus instead of being moved over the
outside of the chest wall. A TEE may show clearer pictures of the heart,
because the transducer is located closer to the heart and because the lungs
and bones of the chest wall do not interfere with the sound waves produced by
the transducer. A TEE requires a sedative and anesthetic applied to the throat
to ease discomfort.
The main reasons for carrying out an Echocardiogram are to evaluate abnormal
heart sounds (murmurs or clicks), a possibly enlarged heart, unexplained chest
pains, shortness of breath, or irregular heartbeats. It can also diagnose or
monitor a heart valve problem or evaluate the function of an artificial heart
valve, detect blood clots and tumors inside the heart, measure the size of the
heart’s chambers, evaluate heart defects present since birth (congenital
heart defects), evaluate how well the heart is functioning after a heart
attack, and to determine whether the person is at increased risk of developing
heart failure. It can also show some specific causes of heart failure, detect
an abnormal amount of fluid surrounding the heart (pericardial effusion) or a
thickening of the lining (pericardium) around the heart.
Echocardiography is a painless procedure. You will not be able to hear the
sound waves, since they are above the range of human hearing. The gel may feel
a bit cold and slippery when rubbed on your chest. The transducer head is also
pressed firmly against your chest, but this is not uncomfortable.
There are no known risks associated with transthoracic echocardiography. You
are not exposed to X-rays, radiation, or any electrical current during this
test. However, there are some risks associated with transesophageal
echocardiography, including the possibility of a tear of the esophagus,
bleeding, and discomfort of the mouth and throat.
Unfortunately, Echocardiography may not be accurate in between 10 to 18
percent of people because of technical difficulties. These are found in people
who are overweight, women who have large breasts, or people with lung disease.
You keep saying to look in the right places if you want to find a good
relationship with a better class girl in Thailand, but I don’t think
it’s just that simple. Look in the shops, offices and the like and ask
one of these “good” women out and they turn you down. I’m from the
UK and I gave up trying and like us all ended up in the red light area
where you really do get to feel like a “sexy man” and you never get
knocked back. You get a really sexy girl who looks stunning, and who will
look after you. Maybe they aren’t “in love” with you, but they sure
make out like they do.
Happy in the Beer Bars
Dear Happy in the Beer Bars,
I am delighted that you are happy, down there in the male paradise, being
thought of as a “sexy man”. Well, you think you are being thought of
as a “sexy man”, but is that what your attentive, stunning, sexy girl
really thinks of you? You are certainly correct when you say that they
aren’t “in love”, but never let it be thought that they are without
emotions. They love your wallet, my Petal. And even more importantly, the
contents of your wallet. It has been said many times before, but you are
their own personal ATM and your pin number is easily found nestling down
there in the undershorts. Wake him up, watch the investment grow and wait
for the (financial) withdrawals. You say you get turned down by the better
class girls. That is a shame, but have you ever stopped to think why?
Perhaps you are not the sort of person a young university graduate wants
to go out with? Thai women value politeness highly. And personal hygiene.
However, if you have a short time viewpoint, then stay where you are, my
Petal, but don’t expect to find your life’s partner there. Otherwise
you will be writing to me again in a couple of years complaining about the
treatment you have received at the hands of the stunning, sexy one.
I know I sent you a letter a few days ago, but I had to mention this.
I have seen more miracles in this World Cup than ever took place in the
Bible! I’ve seen players writhing in agony on the ground, and you think
for sure they will never be able to play football again, but, lo and
behold, when a penalty, yellow or red card is given to their opponents
within seconds they are running around like chooks with their heads cut
off! Surely a miracle Hillary. Leaves the Bible for dead don’t you
Yours tongue in cheek.
You can keep your tongue out of my cheek for a start, my Petal. However,
it is good to hear from you again and we are enjoying your reviews of the
actors, sorry, soccer players. Mind you, whether or not I would wish to
draw allegories from the bible is something else I don’t really want to
pursue too deeply either. You might like to try and view this video:
ItalianTrainingCamp.mpg, as it will add some weight to your parable of the
My husband and I have been invited to a Thai wedding up country and we
are a little unsure of what to do, or even more importantly, what not to
do. Are there any special things we should watch out for? We enjoy your
advice column and appreciate your help.
Just be guided by your hosts, they will indicate what happens next. As
regards, “what to do”, just have some money in an envelope to give to
the happy couple at the appropriate time - you will see everyone doing
this, so you will know when. As regards “what not to do”, since this
will be a full ceremony with the monks sitting in pride of place, do avoid
falling asleep during the chanting. This would be exceptionally bad karma.
Just remember that Thais are very tolerant and understand that you will
not know what to do. Just go with the flow and you will have a most
enjoyable time. Try eating everything at the feast – just don’t ask
what each item is!
We girls feel that Thailand is far too much geared up for the males in
this society. Why is there nothing for us? Do you agree, or are you one of
Honestly my heart goes out to you all. How terrible it must be to be
totally blind, deaf and dumb and forced to live here. Just what in
tarnation is it that you girls want to do? The male dominated areas are
usually go-go driven, but there are places for us too. The bars too male?
Women have been drinking in bars since Emily Pankhurst. The beaches? You
can get more attention there than any man. So, sorry, Hillary does not
agree with you, nor do I really understand what you mean by your phrase,
one of “them”. I am not one of “them” – I am Hillary!
Camera Class: Stage photography for amateurs
by Harry Flashman
As a photographer, you are a window to the world for everyone
to look through. Everything that goes on around us can be captured on film (or
digitally), though sometimes this is harder than you would imagine. Stage
photography is one of these.
Have you ever looked at the credits at the end of a movie? They have one person,
a photographer, whose job is just to take the stills of the movie which can
later be used as reference points and for publicity. Remember that much of a
movie is shot with stage “sets” so movie stills is really just another
branch of stage photography, but the lighting has been done for you.
Now when you go to a stage performance and would like to capture some of the
action, you have to keep it in your mind that it is indeed a “performance”.
You cannot ask the ballet dancer to hold that pose, or Mick Jagger to stand
still for a minute while you check the focus.
This is one branch of photography where you have to be prepared and ready to
anticipate what is coming next. If possible, it is good sense to make notes at a
Now one of the first things the average photographer will do is to bolt on his
megawatt donnerundblitzen flash gun with enough power to light up the far side
of the moon. While understandable, I do not necessarily endorse that approach to
stage photography. Again it is the old adage of “Walk several meters closer”
for this type of photography too. Use a standard lens and get close. If needs be
find which row seat you need to be able to do this. All part of the being
Now, what about the lighting? What about a flash? For my money, you use fast
film, possibly 400 or even 800 ASA, and let the stage lighting itself do the
illumination. The lighting too is quite different from that you normally
experience. Stage lighting is generally tungsten based and sharp (what we call
“spectral” lighting). Spots for the performers and floods for the background
are the hallmarks of the usual stage lighting. The use of spots in particular is
used to highlight the principal performer or action on stage. Successful
“stage” photographs are then ones that have managed to retain that
“stagey” lighting feel to them, so that instantly you look at the image you
know it is of a performer on a stage somewhere.
The secret of retaining that stage feel is just in the lighting. Because it
tends to be dark, we all break out the super-pro flash gear, or activate the
in-built flash that comes with the camera. Unfortunately, what happens is that
the flash can overpower the stage lights and you lose the effect. All you get is
someone dressed in strange garb, flash-lit at night. Not Mick Jagger at all!
Going back to getting as close to the action as you can. I know the pro types
get to walk right up on stage, shoot the performer clean in the eye and shuffle
off stage left. You will probably be thrown out on your ear if you try it, so
please don’t. However, do get a seat as close to the action as you can, a seat
where by using a standard lens you can fill the frame with the performers. If
all you have is a fixed lens point and shooter, get as close to the front of the
stage as you can. You can still get the scene stopping shot – you just need to
get very close.
Now then, f stops. If you are confident, then monitor for the central subject.
If you are unsure, just set the camera on “Auto” – with the 400 ASA film
loaded there will be enough light to run the “auto” settings. You will be
surprised just how strong stage lighting can be.
So there you are. Get close, use fast film and no flash. Have fun.
Money Matters: The end of the Western World
we have known since 1945
Part 1 - The Iranian Oil Bourse
MBMG International Ltd.
In response to claims that March 20- 25th
2006 would be the beginning of the most significant political crisis since
the fall of the Iron Curtain and the creation of an economic and financial
crisis comparable with that of 1929, we need to consider the 2 key themes
that have led commentators / conspiracy theorists to make this assertion:
1) March 20th being the Iranian decision to open the first oil bourse prices
in Euros in Teheran.
2) March 23rd, the Federal Reserve ceases publishing M3 figures.
The Iranian Oil Bourse
Firstly, considering the oil bourse and some of the real concerns behind it,
is it about oil or nuclear capability? Iran recently instigated talks in
Vienna with EU negotiators who are pessimistic about reaching a solution to
Iran pursuing its uranium enrichment programme.
Iran has consistently said it intends to use nuclear power for civilian uses
only. Whether or not you believe this is irrelevant, the fact is that the
under the Nuclear Non-Proliferation treaty, they have yet to break a single
international law in their pursuit of civilian nuclear power capabilities.
If we assume they have no nuclear weapons it will take them some time to
actually be a nuclear state – or one that even begins to approach the
level of supremacy of the US. The IAEA has yet to produce any evidence that
Iran is using this program to develop nuclear weapons. But just as with
Iraq, they are also behaving like a state that is conscious that the very
survival of their state is under threat of military invasion. The creation
of the Iranian Oil Bourse is similar to what Iraq did in 2000 before the
invasion when oil for food revenue was converted to euros, therefore moving
trade from US dollars.
However, whether this is really about nuclear ability or the US dollar is
probably a better question in terms of the economy. The oil bourse will be
based on a euro-oil trading mechanism that naturally implies payment for oil
in euro. In economic terms, this represents a significant threat to the
dollar because it will allow anyone willing either to buy or to sell oil for
euro to transact on the exchange, thus circumventing the U.S. dollar
It is then highly dependent on how other nations respond to the opportunity
to buy oil in euros. Hypothetically speaking, the following reactions could
be seen: The Europeans will not have to buy and hold dollars in order to
secure their payment for oil, but would instead pay with their own
currencies. The adoption of the euro for oil transactions could provide the
European currency with a reserve status that will benefit the Europeans at
the expense of the Americans.
The Chinese and Japanese currently have huge dollar reserves, the new
exchange will allow them to drastically lower their enormous dollar reserves
and diversify with euros, thus protecting themselves against the
depreciation of the dollar. The Russians have an inherent economic interest
in adopting the euro, the majority of trade is with European countries, with
oil-exporting countries or with China, and with Japan. Transferring to the
euro makes sense in relation to the first 2 and in the future will improve
trade relations with China and Japan.
In the Middle East the main oil exporters will view the bourse as a means of
diversifying against a huge exposure to depreciating dollars. The majority
of trade is already with Europe and the new currency provides stability and
a method of reducing currency risk, not to mention the fact that they have a
tendency to view America as the ‘enemy’.
Outside the US probably only the British would see this as a real threat,
finding themselves torn between an old alliance and their geographic pull
towards Europe. The 2 major oil exchanges, NYMEX in New York and IPE in
London could be affected by such events and if the British adopt the euro
system they would effectively be damaging their own exchange. From an
economic perspective should the Iranian Oil Bourse gain credence, it could
be widely adopted and become a precursor to the demise of the dollar and
create further inflationary issues.
Continued next week with: Federal Reserve ceases publishing M3 figures
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: The Klutz Klub: Chapter 459
by Scott Jones
As you’ve been reading my last four
columns, I’ve been trying to survive in the USA and recover from
self-inflicted wounds before I left. While washing dishes, a glass shattered
and severed my skin to the bone, similar to someone slicing meat off a chicken.
Although I clean the cut regularly, the tell-tale red signs of infection caused
by nasty Thai germs that laugh heartily at American antibiotics spread in both
directions from under the bandage. My friends keep their distance, convinced I
have Asian Bird Finger. Protruding from my sandals is the still swollen and
disfigured toe resulting from a close-encounter with a spiky cement block near
my bungalow which didn’t budge one millimeter when I rammed it with my bare
foot, leaving me with a mangled big toe that appears to have been attacked by
rabid rats. They assume this is Asian Bird Foot.
These injuries remind my friends and family of previous klutz moves I had
forgotten, and they revel in the story-telling: 1) After putting groceries in
the fridge, including a dozen eggs in the drop-down egg tray, I close the door
forcefully, neglecting to put the tray up again, which catapults the eggs
throughout the inside of the fridge. We consider two options: eight hours of
cleaning egg goo coating everything before it becomes stronger than Super Glue
or just moving to another apartment. 2) While carrying two stuffed grocery bags
into a friend’s kitchen, I excitedly see their new baby at the end of the
hall, set the bags down on the counter and walk towards the baby.
Unfortunately, I miss the counter and the bags smash to the floor creating an
extraordinary hodgepodge of broken bottles, sauces and sodden packages. I am
banned from touching the baby, but allowed to view her through the window while
strapped to a lawn chair in the front yard. 3) During the first meeting of a
new girlfriend’s parents at their family barbeque, Dad passes me the
industrial-sized bowl of baked beans across the table to begin the meal, but I
dump the entire contents onto the heaping plate of chicken which he has just
spent hours marinating and grilling. My girlfriend “loses” my email and
changes her phone number. 4) On a busy holiday weekend at a golf course, just
below the tee stand where several foursomes are backed-up, I lean over to pick
my ball out of the water trap. I put one hand in the water, expecting it to
rest on the mud bottom of the trap, but encounter a thick, black plastic, very
slippery trap liner, and disappear into the very deep water trap, very unable
to swim while wearing spiked golf shoes while holding the retrieved ball and my
club. Completely drenched, I walk up to the next tee through the crowd of
guffawing golfers that have witnessed the humiliating event. My friends sneak
through the woods to the next hole.
Luckily I can blame my father for the hereditary origins of this behavior.
I’d forgotten about his birthday party for me when he prepared a lovely roast
surrounded by vegetables, and, just before placing it in the oven, liberally
doused the dish with red wine. We pointed out to him that his bottle actually
contained Sloe Gin, a sweet, syrupy liquor capable of making your teeth
vibrate. An orange frosting stripe decorated his shirt and the kitchen wall
because he had lifted the electric mixer above the bowl while whipping the
orange frosting. While serving my birthday cake, difficult because his frosting
had the consistency of eleven year old spackling compound, the cake poured out
of the cut like sand in an hourglass, as if he’d forgotten to add one
molecule of moisture to the recipe. We didn’t have pieces of cake, only piles
My aunt related an incident during my father’s job as construction equipment
salesman when he was demonstrating a street sweeper/vacuum. The clients stood
on the sidewalk as Dad drove the machine by them, however, he had neglected to
attach a necessary hose to the bag to catch the sweepings, and a dark cloud
from his street “cleaner” covered his clients with leaves and debris. He
didn’t have that job long.
If anyone from Thai Immigration reads this series of articles, I imagine I’ll
be detained at the airport and given this message: “We have determined you
are a danger to yourself and anyone in your immediate vicinity. You may enter
Thailand, but must remain naked in your own personal refugee camp on a deserted
island without any visitors, machines, electrical devices, sharp objects or
groceries. Your father will not be allowed in Thailand.”