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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: 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 road dynamometer.
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.


Agony Column

Dear Hillary,
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.

Dear Hillary,
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 think?
Yours tongue in cheek.
Delboy

Dear Delboy,
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 miracles.

Dear Hillary,
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.
Janet

Dear Janet,
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!

Dear Hillary,
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 “them” too?
The Girls.

Dear Girls,
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 prior performance.
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 prepared.
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

Alan Hall
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 altogether.
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 of cake.
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.”