HEADLINES [click on headline to view story]:

The Doctor's Consultation

Agony Column

Camera Class by Snapshot

Money Matters

Life in Chiang Mai

Let's Go To The Movies

Bridge in Paradise

The Doctor's Consultation:  by Dr. Iain Corness

Sliced and diced for the over-50’s

This week I was asked by a gentleman in his 50’s about the 64-Slice CT examination. Since he was unsure of what it was, I suspect many others of you may be in the same boat, so I thought I should demystify it.
If you are over 50, and particularly between 50 and 60, coronary heart disease is one of the most likely causes of your being struck down, other than a blow from a rampant song taew baht bus (of course, if you get through the dangerous decade and get to be 61 you are automatically 10 foot tall and bullet-proof).
Coronary heart disease refers to the gradual build up of ‘plaque’ (and it is not the dental kind) in the inside of the coronary arteries, the arteries that ‘feed’ the heart muscle.
What is often not realized is that the heart muscle does not get its oxygenation from the blood inside its chambers, but through separate arteries that run around the heart and supply the heart muscle directly. These are called the coronary arteries. If the inside diameter of the coronary arteries is reduced by 50 percent, it means that the oxygen required cannot be supplied in enough quantities to keep the heart muscle alive when it is called to perform extra work, such as running to (or out of the way of) a baht bus, for example. Viagorous exercise could also come under this heading. Constriction greater than 50 percent means that the heart muscle ‘starves’ of oxygen even more quickly.
We know these days that the ‘plaque’ build-up is made of cholesterol and calcium, and that the likelihood of deposits depends on many factors, including diabetes, high blood pressure, high cholesterol levels, stress and cigarette smoking. This is why we advocate regular testing for those physical factors, and strongly advise you to give up smoking! We actually do want you to live a little longer, with a good quality of life.
To diagnose coronary artery disease, we will evaluate a patient’s risk factors and perform some tests and then divide the patients suspected to be at risk into the two groups; high and low risk. After that, there are two main diagnostic procedures that will usually be performed, conventional coronary angiography (CAG) or the 64-Slice CT.
However, whilst CAG might be the gold standard, it is also expensive (like gold) and time consuming, as it requires a stay in hospital of four to six hours. Being a direct intervention, with cardiac catheters, there can also be a risk of hemorrhage, though this is not usually the case. But it can happen.
The alternative is the 64-Slice CT. This is the latest variation of CT scanning, with the original known as 16-slice CT. This was fine for assessing organs which did not move, but was not as accurate in demonstrating coronary artery problems, because the heart is moving and beating inside the chest (unless, of course, if you have died already and please advise the technician beforehand). However today, with the advent of the most advanced form of this imaging, the multi-slice detectors and high powered computer programs called the 64-Slice CT, we can efficiently get information on the coronary arteries in as few beats as possible, in around 4 seconds. And this comes with 90 percent accuracy.
The 64-Slice CT has many advantages. First off, nobody is actually slicing you open to insert cardiac catheters into your arteries. The 64 ‘virtual’ slices are done of your cardiac image and the coronary arteries by the computer program, not physically. Each slice is 0.625 mm, so will be able to pinpoint calcium deposits. It is a quick and painless procedure. You do not have to wait around in hospital afterwards, other than perhaps wait for the radiologist’s report. A boon for the busy 50-60 year old businessman (the group most at risk). And finally, it is much cheaper than having a coronary angiogram.
If you have no risk factors, other than being over 50, I would seriously consider the 64-Slice CT.


Heart to Heart  with Hillary

Dear Hillary,
I read the letter from the chap up north about his local monk who makes petrodiesel. Is this not bio-diesel? And how can he make petrol and LPG from one kilo of plastic? We should all be wanting to save the planet, but I don’t think the young abbot of Wat Doi Noi in Ban Jambon in Lamphun can really do all this without the technology training to do it.
The Chemical Engineer
Dear Chemical Engineer,
The letter you are referring to was from a long-time reader, Delboy. He is not prone to exaggeration and seems to have his feet well and truly on the ground (other than when he is riding his motorcycle). It is not only Buddhism that teaches that if you really want to do something, you can do it if you apply yourself properly. I would agree with Delboy that Khru Bah Noi is an amazing man, he has so much energy, and puts it all into helping the local people of his district. Perhaps you should go and visit him before commenting further, my Petal.

Dear Hillary,
Regarding your “Very Tempted” 40 year old with the hots for the waitress who wrote in a couple of weeks ago. Does she think that just because the waitress is a woman this makes it more difficult before “planning the next move”? I’m just glad I’m a bloke and I don’t have these hang-ups, or I hope I don’t get them when I’m 40. All she has to do is go back there one night without her husband and she’ll soon know, that’s for sure. If she’s too scared, then I’m happy to help her out!
Dear Jack,
Who is it you want to help out, Petal? The 40 year old or the waitress? Or perhaps at your age, you’re ready for both? You will find out, Jack my young lad, that personal relationships become a difficult and personal matter when you get older. The ‘bull in the china shop’ approach will not stand you in good stead all your life, Jack. Read your response again in another 20 years and see if you still feel the same way.

Dear Hillary,
As I am thinking about retiring here, I was hoping you could advise me on a couple of points. It has always been one of my ambitions to have my own little pub (I’ve spent a fair deal of time in little pubs and bars after work). There seems to be a few very successful bars for sale and they only want about 600,000 baht for most of them. Since I will be getting a nice tidy sum for my retirement, I thought I might invest in one by buying a half share or something. It would be nice to make money at a bar, rather than spending money at a bar, don’t you reckon, Hillary! My only worry is that I have heard that foreigners have been ripped off and I am hoping you can advise me on what to watch for.
Dear Geordie,
With apologies to the Charge of the Light Brigade - “Into the valley of death rode the six hundred” (thousand baht). Geordie, Geordie! For a start, there are very few successful bar owners who learned the trade from propping up the outside of the bar. Even with half shares for sale, have you stopped to think why the owner of such a successful establishment would want to give half of it away? Things to watch for? There is always the third or fourth 50 percent share that gets sold. Unfortunately, with the economic downturn, tourist cancellations etc., etc., etc., the bar will pay no dividend this year and the regretful owner will buy your 50 percent share back for 100,000 baht. Yes, there are quick profits to be made in the bar bizz - for the seller, not the purchaser. Mind you, if you can get a half share in Jameson’s for 600,000 baht, count Hillary in too!

Dear Hillary,
For the last two years I have been based here but I have taken another off-shore posting to go to Malaysia for the next year. Should I keep the lease going on the condominium and keep my girlfriend in it, or just tell her that I will let the lease run out (there is another four months to go) and she will have to go back to live with her mother till I come back. I don’t want her to go back to the bar. What do you think I should do?
Dear Paul,
Your question is appalling, Petal. Surely you know by now whether this is the girl for you. Stop dithering and make a decision. How much does this girl mean to you? Not much it seems. From the kindness of your heart you will let her stay on at the condo you have signed a tenancy agreement on for the next four months - so you have got to pay anyway! After that she can do anything except go back to the bar (where you got her from) for the next eight months. Sounds to me as if she should go back there right now and hope that someone who thinks more about her, rather than himself, comes along.

Camera Class:  by Harry Flashman

f8 and be there

Winter trees

The photojournalist’s creed used to be “f8 and be there” and that still is relevant today. Even with today’s auto-everything cameras, when you don’t have to set the f8 side of things, or even the focus, you still have to “be there”.
I was reminded of this the other day when I was touring the UK. I had spotted a rainbow and was chasing it, hoping to get a great shot. Rainbows are not easy to get, as when you get the exposure right for the actual rainbow, it is generally not enough light for the foreground or background. Try it yourself one day.

Wind Farm
Anyway, I was getting increasingly frustrated with the rainbow, but suddenly there was a break in the trees and I told my driver to stop and I leapt out. A bracket of three shots was done, but when I checked the exposures on the LCD monitor, I was again disappointed. I turned back towards the car and suddenly, there was an absolutely surreal image which had been behind me. The birch forest in the late winter’s afternoon frosty light was the shot of a lifetime. The three shot bracket produced the photo I have used with the column this week. It was certainly a case of “being there” to get that photo.
We traveled further and came across a wind farm. These are quite fantastic, almost science fiction when you get up close. Again I was “there” and it was just a case of getting close enough, but yet far enough to try and show the height of these things. The blades rotate very slowly, so a fast shutter speed is not necessary, but I again did my customary three shot bracket. When shooting something against the sky, it can be difficult to get the best exposure, so try f8 and be there.
So what I am suggesting now is just “be there” to get good shots. It also helps if you have a theme. This is true “editorial” photography, where you, the photographer are illustrating a story.
Try for example, “Early Morning at the Beach”. Firstly because there is great light at that time and secondly because beaches are a wonderful hive of activity as people get ready for the new day.
The following subjects are all there for you to shoot and you should try and get them all. There are monks doing their morning rounds. You will find the local people offering the monks their food for the day. Get two shots here - one of the woman giving the food to him and another of the monk in his robes walking slowly down the street with his alms bowl.
Next subject should be the beach vendors, preparing their area, raking and collecting rubbish, putting up the umbrellas and placing the deck chairs. Try to make sure you have the man or woman in the overall shot. Human interest always appeals. In the early morning, the sunlight is with you, not against you, so there is no tricky exposure compensations to be done.
More workers - the beach boys and the speedboats. There are several shots here. Firstly take the line of boats and water scooters being towed slowly to the boat ramps. Again a rear shot of them going away from you is best, especially if they have the young boys sitting on them, holding them down! Looking down the road, as the second last trailer in the string goes past, pop the shutter. That will be a good shot - guaranteed!
Mount them all together, and you have “Early Morning at the Beach”!

Money Matters:  Paul Gambles MBMG International Ltd.

Water - 21st Century’s Oil

We have written on this subject before. Please check previous articles in the Pattaya Mail for further information. However, this is a subject worth reviewing again.
The Western world is consuming water like never before. This is at a time when we have never had so little of it. On top of this, the method of distribution, in many cases, is still in the 19th Century and not even the twentieth. This means that there is also a lot of wastage. As president Lyndon B Johnson said in 1968, “A nation that fails to plan intelligently for the development and protection of its precious waters will be condemned to wither because of its short-sightedness. The hard lessons of history are clear, written on the deserted sands and ruins of once proud civilizations.”
A well known study last year gave a doom and gloom forecast of what would happen if there was a collapse in infrastructure around the world. The costing of a total updating of what was needed came to over USD40 trillion. This is at a time when the world’s population is growing faster than ever before. That figure alone is worrying enough. The really bad news is that over half of it relates to water infrastructure. If we just look at America, then you will start to understand the problem.
There are over 700,000 miles of water pipelines in the USA. If you then add the sewage system to that then there are nearly 1,500,000 miles. That fact is stunning in itself but what if it was admitted that if things were to carry on as they are now then it would take almost a millennium to replace everything there is now? Well, this is what is happening and the fact has been confirmed.
As the citizens of London know only too well from experience, water systems for both drinking and waste should be replaced at least every one hundred years - preferably less than this. Most countries in the west take at least twice this time to do this. This is why they are losing between 15%-45% of potable water.
So far we have just talked about the problems in the western world. Many cities elsewhere still rely on something that was built well over a century ago. If you look at places like New Delhi in India then they actually lose four fifths of their drinking water due to poor infrastructure. This is because very little has been done to update things since the 1950s.
Hong Kong is not as bad but still loses over a third of what is available as does Sydney in Australia. To put this into perspective, even places like California can lose a quarter of what runs through its pipes and this is meant to be one of the most sophisticated places in the world. Everywhere in the world is losing water unnecessarily and people turn a blind eye even though it costs them a fortune.
However, times are a-changing. Due to global warming, politicians now realize there are votes to be had due to environmental issues. Even the Chinese have got onto the bandwagon. When China was awarded the Olympic Games for 2008, the country realized that it needed to supply good quality drinking water for all the visitors. Thus, it built a canal from the south of the country to the north as the latter has no real water facilities itself. This cost USD60 billion or twice as much as the Three Gorges Dam.
The problems go on, as an anonymous Jordanian said a few years ago in the Washington Post, “(If) you think we have bad fights over oil. Just wait until we start fighting over water. It’s predicted in the Koran.”
This is not surprising if you consider the Middle East itself. Many politicians in this area agree with the above quote; for example, Palestine has to get its water from Israel. This leads us back to infrastructure as water cannot be transported via vehicles, it is just not financially viable. It is a lot easier to go to war over who owns what. Being cynical, this will also reduce the amount of people who will be around to drink what has been won.
Another important factor is that water and energy are becoming more and more interlinked. It takes an enormous amount of water to create energy and vice versa. The power industry needs three things:
1. A fuel source
2. A transmission line
3. A water source
Going back to America, nearly half of the water taken from rivers goes to cooling power generation as you cannot have electricity power stations without water.
The situation is close to getting out of hand. It is not just the Third World that is suffering but also the so called developed world. Big changes are going to be needed in the near future but will they come?
Again, the cynical hat comes on, by investing in water and water related infrastructure projects, there is good money to be made.
Let the last word be from Ismial Serageldin, World Band vice president for environmental affairs, quoted in Marq de Villiers’ Water, 2000 - “The wars of the twenty-first century will be fought over water.”

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 Paul Gambles on [email protected]

Life in Chiang Mai: by Mark Whitman

Facing up to bullies – Burmese and Thai

My thanks to the reader of last week’s piece about the ongoing – and deteriorating – situation in Burma, for reminding me of an oft-quoted but important saying by Edmund Burke: ‘All that is needed for evil is that decent human beings do nothing.’ It’s another version of a more modern suggestion – if you’re not against something then you are for it.
The saddest news since the incarceration of more political opponents to that vile regime (some for up to 65 years) is that the UN, under the so-called stewardship of Ban Ki-moon, decided not to present the petition asking for the release of political prisoners to the Burmese generals. This letter signed by well over 100 of the world’s most prominent people (including three former Prime Ministers of the UK and two former US Presidents and others of comparable distinction) was an echo of a letter signed by 60 or so people last year, following the crackdown on the peaceful monks who had dared to march against their oppressors.
Ban felt – with some justification, I suppose – that the generals would ignore the petition. This follows the humiliation suffered by his envoy there who has achieved nothing after several visits. In order to avoid such a rebuff he seems to have decided not to make his planned official visit to Burma in December. In other words, he is a decent person ‘doing nothing.’ My argument against ignoring the letter from 122 important people is that at least they are trying to do something and if – or when – they are ignored, it is one more assault on the regime, which might serve to affect other people and prompt them into action. Current leaders instead of past ones and possibly the ASEAN conference, which has so sadly been a casualty to Chiang Mai following the bully boy tactics of the PAD in Bangkok.
These bullies are not in the world class league of those across the border, but they have certainly done incalculable harm to both the economy and the image of the Kingdom. And harmed themselves in the process, especially by employing people to sit in at the airports alongside the genuine – if misguided – PAD supporters.
Their actions at Government House were deplorable and should have been brought to an end long before early December. Equally their actions at Suvarnabhumi and Don Mueang should never have been allowed to happen and should certainly have been curtailed with all necessary force. They were described nationally and internationally as terrorists and now their money men face prosecution. Too late to undo the horrendous damage, which will be a financial disaster in terms of tourism to rank with that of the tsunami.
The effect on travel to and from Bangkok and then beyond affected hundreds of thousands of people, but resonated with many more. Some countries took it worse than others, it appears. I received a frantic mail from a New Zealander asking whether I was safe in Chiang Mai (ditto from family but less frantic). And a friend who lives on North Island during our unpleasant British winter sent me a somewhat humorous mail, which has an underlying message that the actions at the airports were viewed very seriously abroad and reflected very badly on Thailand. He wrote, “The ‘plight’ of the handful of NZ tourists who did not get on planes before the shutdown has been filling the press and the TV news for days. You would think that, rather than being delayed and inconvenienced, they had been used as human shields by a latter day Saddam Hussein from the reaction here. Very insular in their thinking….” Sounds funny, but there is sure to be a sting in the tail. Sad, when the world economy is bringing tourism into freefall, that these people should give it a push in the wrong direction. Of course it will be the ordinary working people who will suffer most, not the Bangkok middle classes.

Let's Go To The Movies: : Mark Gernpy

Now playing in Chiang Mai
The Day the Earth Stood Still:
US Drama/ Sci-Fi/ Thriller – I enjoyed this!  If you like sci-fi thrillers, you should too.  Of course, you have to be willing to accept a lot of the “aliens invade Earth” conventions.  I did, and found it a lot of fun.  And as for Keanu Reeves, he’s perfect for the part of the alien.  Absolutely perfect, because he really is an alien himself!  I think all of us have always known that.  Think about him in any movie he’s ever been in.  He is not human.  He’s truly an alien himself, a little spooky, but accessible, and lovable.
This is a remake of the landmark film of 1951 with Michael Rennie, Patricia Neal, and Sam Jaffe, directed by Robert Wise.  This time Keanu Reeves plays Klaatu, a mysterious alien who travels to Earth with a simple mission: to save the planet.  He lands his vast space ship in Central Park, New York, and tries without success to announce his plans to the world via a speech at the United Nations.  He’s taken into custody instead.  Thus rebuffed, to goes to his backup plan: He will destroy everything on earth, then re-populate our planet with clones of the current species.  All, that is, except humans who he feels are responsible for Earth’s destruction and must be permanently eradicated.  He unleashes swarms of dust size robots who sweep through New York and the surrounding area dissolving everything in their path.  As mankind fights to survive, one female scientist tries to convince Klaatu to stop the earth’s destruction and give us all a second chance.
Transporter 3:
France Action/ Crime – I’ve seen it, and I can attest that it’s an action movie – meaning that there are a lot of explosions, car crashes, and men being violent and assertive.  And it’s all quite brilliantly done, and seasoned with just the slightest bit of plot and humor.  If that’s what you like, this is for you.  It stars Jason Statham, returning again as Frank Martin, a former British Special Forces soldier turned mercenary, whose specialty is delivering risky items in a timely fashion.  In this third installment, Frank, just relocated to Paris, awakes to find a bomb strapped to his wrist which threatens to blow up should he try to remove it.  Mixed or average reviews.
Ong-Bak 2:
Thai Action/ Adventure – With Tony Jaa, who also directed.  I’m not sure what your reaction will be to this film, for it’s rather difficult and really not too much fun to watch.  It’s quite dark, and exceptionally violent.  Not for children!  But it’s extraordinary in many respects, and approaches almost every aspect of an action film in a new way.  And it seems a terribly personal film for Tony Jaa, in which he apparently is trying to exorcise some inner demons.  A fascinating attempt.
US Drama/Thriller – With Don Cheadle.  At Vista only, and probably in its last days.  See it while you can.  Another serious look at the world of moral uncertainty amid the war on terror.  I am very fond of this movie, but only mixed or average reviews.
  US Vampire love – It’s quite well done overall, and I rather enjoyed it.  Robert Pattinson is indeed a handsome, smoldering devil as the vampire.  It’s a complex story, in three volumes so far and more to come.  Mixed or average reviews.  Vista has a Thai-dubbed version only, with no English subtitles.  Airport Plaza has it in the original English, with Thai subtitles.
Beverly Hills Chihuahua:
US Comedy/ Adventure/ Family – In this Disney talking-animal comedy (not an animated movie), a pampered Beverly Hills Chihuahua finds herself accidentally lost in the mean streets of Mexico.  Overall, mixed or average reviews.  I found it amusing with some parts quite a lot of fun.
007 – Quantum of Solace:
UK/US Action/ Adventure/ Thriller – A continuation of the 2006 Casino Royale, which was a reinvention of the James Bond film series for present-day audiences.  Here, with a different director, I found the undertaking greatly diminished in charm and style and elegance, with the action sequences more mindless and muddled, the plot more convoluted and confusing, but with much to still like if you’re a fan of Bond films.  Generally favorable reviews.
The House Bunny
: US Comedy – About the travails of an ex-Playboy Bunny.  Appallingly nauseous.  Mixed or average reviews.
Scheduled for Dec 18
Happy Birthday:
Thai Drama/ Romance – Starring Ananda Everingham.  Looks like a real weepy love story.  This time Ananda is a travel photographer who travels around Thailand with his guide/girlfriend, until she has a terrible car accident and ends up in a hospital in a coma, while Ananda waits endlessly at her bedside for her to wake up.  From the previews, I have to say it looks perfectly tedious, despite the fact that I’m a fan of Ananda.

Bridge in Paradise : by Neil Robinson

Last week’s column was about defence, and so is this week’s. When I read about this hand (reported by Andrew Robson), it struck me as an example of good defence – nothing spectacular, just good solid partnership play to take advantage of declarer’s stumble. The hand occurred four boards from the end of a long match. But this was not just any match – it was the final of the Women’s Bridge World Championship held in Beijing recently. The English team was playing the Chinese team. The overall match was eventually won by a margin of just one IMP – the equivalent of a single overtrick. This board was worth five IMPs to the eventual winners, so it turned out to be critical to the championship.
At the table where the English team sat NS, they bid 2H and made 3H, for an overtrick.. Now watch what happened at the table where the Chinese team were sitting NS. The bidding is shown below. The Chinese South made a try for game by bidding 3H. North declined the invitation and 3H was the eventual contract.

South      West           North        East

1H            P                  1NT           P

2D            P                  2H              P

3H            All pass                        

Dealer: South, all vulnerable

                      S: A94
                        H: Q10
                        D: 862
                        C: QJ974    
S: 10832                               S: Q765
H: 83                                    H: AJ4
D: A975                                D: 43
C: K32                                  C: A1086
                        S: KJ
                        H: K97652
                        D: KQJ10
                        C: 5             

West led the two of spades. Dummy played low and declarer beat East’s queen with the king. Now, declarer led a low trump. If she had put in dummy’s queen, she would have made the contract. However, she played the ten and East won the jack. It still looks like declarer only has four losers, two trump tricks, the ace of diamonds and one club (since she only has a singleton club) and therefore she will make the contract. So can you see how the defence could score the critical fifth trick to get the contract down? The English pair at the table did.

East switched to the four of diamonds. West won the ace and returned the diamond five – her lowest card, asking for a club lead. Declarer won and led a second trump to the queen and East’s ace. Now East, trusting her partner, made the key play. She underled her ace of clubs. West won the king and led a third diamond. East ruffed, taking the contract down one and showing the power of good communications in effective defence. Four hands later, the English team were holding the gold medal..
Please send me your interesting hands at: [email protected]