The Doctor's Consultation: by Dr. Iain Corness
Grub for Gout
A few weeks ago I covered a
diet for dentures. This week it is a diet for those with gout, and there are
far more of you than you might imagine. If you are a sufferer, then you join
with Henry VIII, Benjamin Franklin and Thomas Jefferson.
It is indicated in around five percent of all cases of arthritis and is
present in around three to five percent of the population, with males
outnumbering women around nine to one. Afro-Americans and many Asian races
also have higher incidence than Caucasians.
Gout is in its simplest fashion, a recurrent form of arthritis, and which
generally affects just one joint - most commonly the joint in the big toe.
This arthritis, or inflammation, occurs in association with high uric acid
levels in the blood.
It is a condition that is still being researched, and there is still no
complete agreement on the preventive treatment for this condition.
The higher the concentration of serum uric acid (SUA), the more likely you
are to get an acute attack. The ‘normal’ range for SUA is taken as less than
0.42 mmol/L (called ‘milli moles’ per liter), but if your concentration is
0.54 mmol/L then you are five times more likely to get gout.
Basically what happens is that with high concentrations of uric acid it
crystallizes out into the joint, leaving very sharp, needle-like crystals
crunching inside the articular surface of the joint. Very painful!
The typical gout sufferer is male in his 50’s, overweight, with high blood
pressure, carnivorous and consumes large quantities of alcohol. Is that you?
Gout affects almost four million men in the USA. It has long been thought
that purine-rich foods and a high protein intake are risk factors, and
sufferers are advised to avoid meats, seafood, purine-rich vegetables, and
animal protein. But this advice was based more on the theory of how excess
blood uric acid can occur, rather than actual clinical studies.
One of the newer studies began on over 50,000 men from health professions in
1986. Food-frequency questionnaires were sent out at baseline, and in 1990
and 1994. Weight, medications, and medical conditions were recorded every
The participants were assigned to groups according to the total intake of
meat, their consumption of seafood, purine-rich vegetables, dairy products,
low-fat dairy products, total protein, and animal protein.
During the study, there were 730 new cases of gout during the 12 years of
follow-up. Most of them were aged 55 to 64.
When total meat consumption was analyzed, the risk of acquiring gout was
1.41 times greater in the high meat eaters; in other words, eating more meat
was a risk factor for gout. Similarly, high seafood eaters were 1.51 times
as likely to develop gout. (Grass should be fairly safe to eat!)
In contrast, gout was less common in those taking more dairy products. Men
who drank two glasses a day of skim milk, or ate a serving of low-fat yogurt
more than twice a week, halved their risk of developing gout.
In this study at least, purine-rich vegetables, and total protein had no
influence on the chances of getting gout.
This large study confirmed that a diet high in meat and seafood increases
the likelihood that a susceptible person will develop gout. It also showed
that milk proteins increase the excretion or uric acid in the urine.
So, to avoid developing gout, try to limit your intake of meat (beef, pork,
lamb, and offal) and seafood, while increasing your intake of low-fat dairy
produce (skim milk, yogurt).
This is all very important, as the long term outlook is not good for the
unrepentant gout sufferer. Constant high levels can lead to uric acid
‘stones’ being deposited in the kidneys (producing renal problems) and even
discharging lumps (called ‘tophi’) around joints, on the forearms and even
on the outer ears. Really a most bleak and depressing future, and not one
I’d like to have.
Note too, that it is low-fat milk that is being proposed, as high fat milk
introduces the cholesterol problems again! It really is a fine line that we
must all tread!
Heart to Heart
Did you see Dorian Farmer’s cartoon in the mail recently? He shows you
to have frizzy hair and wearing a flowery dress, and kicking the place
down because of spelling mistakes. I have cut it out of the paper and
stuck it on my wall. Is that really you?
Wonder no more, my Petal. Despite what is portrayed in that cartoon, I
was not snapped by a spy cam. It is all a figment of Dorian’s fertile
imagination. However, it is correct that I am appalled by the spelling
of some of my letter writers. I get annoyed because they expect Thai
people to be able to be proficient in English, but they are not
proficient themselves. The give-away is the fact that normally I wear a
beautifully tailored outfit with Victorian collared blouse to work, and
my office is not as salubrious as the one in the picture. How I wish I
had a door with “Heart to Heart with Hillary” inscribed on it. In fact,
how I wish I had my own office, the broom cupboard I work out of has no
mod cons, but the broken chair does look accurate!
Would you care to take a break from the usual bar girl related problems?
I have a different subject for you. A Thai man a couple of blocks from
our house beats his dog. Not just a smack with a rolled up newspaper or
a hit now and then, but this guy severely and unmercifully beats the
hell out of his dog. Last week my wife saw this guy walking his dog in
front of our house, and for no apparent reason he started to beat the
dog with a stick. I wasn’t home at the time and my Thai wife hearing the
bloodcurdling howls ran out to see what was going on. Later I asked her
if she tried to interfere and she said it’s not her business. This
morning at 07:00 I was returning from a bicycle ride and heard a dog
howling (I think the same dog) with such pain and fright that a cold
chill went up my back. I made a U turn and went to the house where all
the commotion was coming from. I got off my bike and watched this guy
beat his dog senseless with a shoe and then when the dog started to
revive he continued to severely beat him. I yelled and hollered at him
to stop. This guy gave me a very nasty look and yelled to mind my own
business and to leave. If this was in the U.S. such as California, I
would make a call to the Humane Society and an officer would be out
there posthaste. But in Thailand there is no such thing as a humane
society. I’ve seen this exhibition of unbridled male anger several times
in this “the land of smiles”. It’s like the males and females are from
different cultures. Two times a saw a father hit and slap his young boy
because he was afraid to ride on the family motorbike. I was walking
past a kick boxing match for very young boys and a father was hitting
and slapping his kid because he was afraid to fight. And, in the parking
lot at Lotus a young man was beating the hell out of his girl friend.
She was so terrified that she refused to get in the car, or, maybe
that’s why he was beating her. I started to walk over but my wife pulled
me back and said not to get involved. Thai women never try to run me off
the road when I’m on my motorcycle but Thai men have actually ran me off
the road more than once. Here’s how they do it. Don’t try this at home.
A car or p/u truck that’s following me swings out like he’s going to
pass or go around. Then when he’s abreast of me, he pulls over into my
lane and there is no place for me to go. The bar girls seem to have the
same story, I like farang men, Thai men are too violent. So, I have two
questions; am I misinformed or maybe biased that Thai men are so full of
anger, and, if I do get involved and do more that just yell but punch
someone’s lights out, what kind of trouble would I be in?
Dear Uncle Bill,
You are asking my advice as to whether you should “punch someone’s
lights out” because “Thai men are so full of anger”. What can I say,
Uncle Bill, other than the fact you are also full of pent-up aggression.
I think your wife has a better understanding of the situations than you
do, so follow her advice. It will keep you out of trouble.
by Harry Flashman
Children’s pix - for all the Dads
I think all parents are proud of their children - initially at
least! Parents also like to keep a photographic record of their
children growing up, and as such there are many milestones in a
child’s development that are worth recording.
Obviously events such as birthdays must rate high, but there are
also so many others, like first day at school, first day at “big
school”, concerts and dances. With childhood spanning around 17
years on average, there are plenty of opportunities.
This week I will look at how to take great children’s pictures,
ones that will still bring a smile to Dad’s face many years
later. Many of the tips are relevant to all photography, but
there are some specific tricks you have to put into play when
photographing young children in particular.
Take a look at the photo with this week’s article which is the
picture of a small child during Songkran and first note the
background. That’s right, there isn’t one, other than the yellow
ochre color of a wall and some grass. By removing confusing
backgrounds (and not photographing them in the first place), you
have immediately given more importance to the subject of the
picture. All very basic, but all very important for any good
portrait. In this particular shot, the photographer moved his
position to get the innocuous background. This is generally
easier than trying to shift the subject. In addition, by using
an aperture in the f2.8- f4 range it will also throw any
background out of focus, even confusing ones.
The next tip to extract from that photograph is the relativity
in height between the subject and the camera. By getting down to
the same level when taking the portrait, this again assists in
making the subject the ‘hero’ and not someone insignificant
being ‘looked down’ upon. The photographer here was sitting on
the ground to get this viewpoint and the camera lens was at head
I have written before about the problems associated with the
short attention span demonstrated by animals and children. The
music hall adage of never sharing the stage with kids or animals
still holds good today. With this shot, where the little girl
was filling the green plastic container with water, it was
necessary for the photographer to sit patiently and wait for one
of the famous photographer Cartier Bresson’s ‘decisive moments’.
This came after a couple of minutes when the subject looked up
and saw she was being observed and spontaneously broke into a
grin, giving this totally natural photograph. By trying to coax
the child into sitting there and then smile would be an
invitation to disaster. Photographically at least!
This type of photograph can be obtained while running the camera
in fully automatic mode, so even if you are hesitant to shift
the mode from the A for Auto, you can still get good
photographs. However, to make it even easier for the novices out
there, try running the camera in the ‘Portrait’ mode, or if you
can’t find that, then in the ‘Aperture priority’ mode and set
the aperture to f4, and let the camera do the rest. All you have
to do is compose the picture correctly in the viewfinder.
Another factor, particularly with the composition, is to get in
close enough to fill the frame. You can see with the photograph
here, the entire frame is taken up with child and the one prop
to show what was being celebrated - the plastic container with
water. Also note that the Rule of Thirds has been adhered to -
with the child’s eyes one third down from the top of the frame.
This ‘rule’ always produces better and more interesting
photographs, especially portraits.
By the way, if you look very closely at the green plastic
container it has a sticker saying “Superstar” (you may need some
enlargement or a magnifying glass to see it in the newsprint).
That was a serendipitous accident and not planned for in any way
whatsoever! But for that Dad, the photograph is one of his
Why don’t you photograph your Superstar this weekend?
Money Matters: Paul Gambles MBMG International Ltd.
Just Depressed or is it a Depression?
For the first time on record,
all 50 states contracted at the same time, according to the state coincident
indicators for February 2009, released by the Federal Reserve Bank of
Philadelphia last month. The state-by-state indicators have been tracked by
economists at the bank since 1979.
This is stunning enough but there is more. “The Great Depression in the United
States,” wrote Milton Friedman, “...is a testament to how much harm can be done
by mistakes on the part of a few men when they wield vast power over the
monetary system of a country.”
What should not have been a surprise was the fact that people were shocked when
they lost money. This is what capitalism is - boom and bust. Make a fortune,
lose a fortune. Just when people think it is a cure-all it needs medicine
Regular readers of this column will know that we have been saying that even
bankers should have seen this present crisis coming from a mile off. When
someone lends money, they usually want it back, preferably with interest. When
money is lent to those who cannot afford to pay it back then most people know
that trouble is just round the corner but not these bankers who then go running
to governments crying “foul”. The powers that be then put up well over USD10
trillion to stop capitalism from correcting itself by sorting out the wheat from
the chaff and allowing the weak to die off naturally thus leaving those that
survive to be leaner, meaner and stronger. They are trying to stop the natural
cycle of business. They will not succeed. It is like using an Elastoplast for a
Protectionism is becoming more and more prevalent - despite what governments
say. In the UK, banks have had to be saved. The best is in Europe where they are
reducing the life expectancy of cars and trucks (like it is different to what it
was in 2008!). In America, everything has had to be rescued. The government is
now basically running the car industry, the largest insurance company, the
largest mortgage lender, the largest… whatever next?
Without doubt, markets do not work as they should without regulation. Just like
a game of rugby, things can get a tad rough when there is no-one there to
enforce the laws. Roosevelt realized this is the 1930s. Clinton and Bush forgot
the lessons of history and took the referee away. Look where we are now. Who
shall we look to for help? How about the person who said, “Owners of capital
will stimulate the working class to buy more and more of expensive goods, houses
and technology, pushing them to take more and more expensive credits, until
their debt becomes unbearable. The unpaid debt will lead to bankruptcy of banks,
which will have to be nationalized…” This is good stuff as it pretty well sums
up what has happened. Who said it? Obama? Buffett? Gates? Well no actually, the
last line of the quotation may help, “...and the State will have to take the
road which will eventually lead to communism.” No? Well it was Karl Marx in
So, who can save capitalism? The communists? After having banged on for ages
about the fact that we are not ready for de-coupling yet, I could not be so
hypocritical as to say we are now. This is not the case but the Chinese central
bank came out with this little Marxian nugget recently: “Market forces, if left
unchecked, will lead to asset bubbles and ultimately a disastrous market
clearing in the form of a financial crisis like the current one.”
China is about the only country in the world that actually has money at the
moment, well real money that is not being printed at a stupid rate. As they do
not have free markets and do have strict regulations, is it possible that China
could show us the way?
Before I go further and rush out to buy a red badge, let me take a reality
check. Why should the Chinese Communists or the American Democrats be any better
than anyone else? It is only the perception that they should know what they are
talking about which allows us to give them the power to lead us out of this
present mess. But let us look at this more closely, It took the Russians seventy
years to realize that Lenin was wrong, Friedman wrote about the Great Depression
thirty years after the fact and by the time the present regimes realize what has
happened we could well be in another great depression.
The optimists will be stuffed when the Dow Jones falls to below 5,000. The
pessimists will sulk even more when those in charge cannot stop deflation.
Spenders will not spend due to too much debt and savers will not save as there
will be no incentive to do so.
Is this the end of the world as we know it? No, but it will take careful
management of your money to make sure that you can still afford to live. Trust
no one asset class and make no long term commitment. You will still be able to
make money and save for the future. It can be done, so even if there is a
depression there is no reason to be depressed.
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
Let's Go To The Movies:
by Mark Gernpy
Alert: Major Cineplex at Airport Plaza still has their 20 baht
surcharge for Wolverine, because “it’s an expensive film.” But if you’re
over 60 you can get a good senior discount at Major Cineplex.
The new website for Major Cineplex is:
http://www.majorcineplex.com/showtimepage.php. It’s basically a mixture of
Thai and English, and this is how you work it: The link above gets you to
the “Showtime” page. On the right two-thirds of the screen you will see two
lists: movies, and theaters.
At the top of the list of movies, click “Select All Movie” unless you’re
really only interested in one movie. On the list of theaters, click
“Chiangmai.” This is one of four cities in the “Zone UPC-North” section,
which is the 6th region down, or the 4th from the bottom.
Then hit “go” either at the top or the bottom of the lists, and almost
immediately you will get at the very bottom of the page a list of the
movies, the cinemas they are in, and their remaining times for the day.
If you do this after midnight and in the early morning, you will get a
blank. Times are posted later in the morning. You have no way at the
moment for getting any times except for the current day, and only the
Now playing in Chiang Mai
Star Trek (2009): US/ Germany, Sci-Fi/ Adventure/ Action – All
new! And I think it’s a great deal of fun, for fans of the series, and also
for those who are not. This much-anticipated film is a reboot of the
series, going back to the series’ ’60s roots by depicting the formative
experiences of the legendary heroes Kirk and Spock. The young James
Tiberius Kirk is played by Chris Pine as a wild Iowa boy whose father
sacrificed himself at the helm of a spaceship at the very moment the child
was being born. He is convinced to attend the Starfleet Academy with an eye
to joining the crew of the Enterprise.
Headed for the same destination is Spock, played by Zachary Quinto, who has
had a troubled background as a half-human, half-Vulcan. How these two very
opposite figures become mutually trusted colleagues is the basic story of
the film. From director J.J. Abrams (Mission: Impossible III,
Lost, and Alias). It’s very well done, and I found it
engrossing. Early reviews: Universal acclaim.
Horsemen: Canada/ USA, Horror/ Mystery/ Thriller – Aidan Breslin is a
bitter detective emotionally distanced from his two young sons following the
death of his wife. While investigating a series of murders of rare
violence, he discovers a terrifying link between himself and the suspects in
a chain of murders that seem to be based on the Biblical prophecies
concerning the Four Horsemen of the Apocalypse: War, Famine, Pestilence, and
Death. Rated R in the US for grisly and disturbing content, some sexual
images, and language.
X-Men Origins: Wolverine: US/ New Zealand, Action/ Fantasy – Though
early reviews are lukewarm, I think it’s simply brilliant, starting out with
eight minutes of nigh perfect popular filmmaking, a sequence that is
thrilling, sensible, and, wonder of wonders, deeply intriguing! It then
veers into a quiet sequence building up a love-interest, which might seem to
be just padding, but no, get involved with it, because the love relationship
leads to some real emotional payoffs down the line. Really, it’s a superb
action film for anyone who likes the genre, with excellent performances by
Hugh Jackman, Liev Schreiber, and many others. There are two very short
additional scenes during the closing credits. A 20 baht surcharge at Major
Cineplex, none at Vista.
Mor 3 Pee 4: Thai, Romance/ Comedy – A nice little advertisement for
MSN: Four teenagers make friends and chat online on MSN, and maybe fall in
love. (Note: shown in Thai only, with no English subtitles).
Saranae Howpeng: Thai, Comedy – Movie version of “Saranae Show” – a
popular Thai comedy TV show that has been on the air for 11 years. With
many well-known Thai comedians.
May 14 - Slumdog Millionaire: US/ UK, Crime/ Drama/ Romance –
Breathless, exciting, heartbreaking but exhilarating at the same time, this
film won Oscar best picture and best director – and awards for adapted
screenplay, original score, film editing, original song, sound mixing, and
cinematography. Definitely to be seen! Rated R in the US for some
violence, disturbing images, and language. Reviews: Universal acclaim. At
Vista only, and good for them!
May 14 - Angels & Demons: US, Crime/ Drama/ Mystery/ Thriller – Tom
Hanks plays Harvard symbologist Robert Langdon once again, as he works to
solve a murder and prevent a terrorist act against the Vatican. Note that
although the novel upon which the film is based is set before the events of
the novel The Da Vinci Code, the film has been written as a sequel to
follow after events in The Da Vinci Code.
HOW DOES YOUR GARDEN GROW?: Stuart Rodger
Regal wonders of the plant world
Two of the premier plant
discoveries which took place during the great Victorian search for and
classification of unknown plants can be grown easily here in Thailand.
Named after Queen Victoria herself, the first, Victoria amazonica is
the largest water lily in the world, found in the Amazon River basin, with
its white fading to pink flowers measuring 12 inches across. Even more
spectacularly, its floating leaves measure up to 5 feet in diameter, and are
able to support the weight of a 5 year-old child! This amazing plant was
given pride of place at the Great Exhibition of 1861, held in the Crystal
Palace in London, England.
The strong, air-filled network of ribs which can be clearly seen on the
underside of the leaf supporting the thin chlorophyll membrane of
photosynthesising cells inspired Sir Joseph Paxton to design the exhibition
hall itself, the largest glass and iron structure in the world, its cast
metal struts supporting the thin glass panes.
A special greenhouse was built at the famous Kew Gardens to display
Victoria amazonica to an astounded public on a permanent basis - the
water lily house remains to the present day, located at the side of the
newly restored Great Palm House. So fast growing is the water lily that it
is re-grown every year from seed, taking just that time to cover the entire
Although the greatest architectural wonder at Kew Gardens is the Great Palm
House, it does not contain the second of my choices, possibly because it is,
again very large and fast growing, but possibly due to historically
political reasons. This giant palm is named after the warrior-statesman and
German chancellor, Bismarck, who successfully unified the disparate petty
principalities of Germany into the most powerful country in Europe during
the early years of the 20th century.
Originating in Madagascar, Bismarkia nobilis is also popular here in
Thailand. Perhaps this magnificent palm, which swiftly grows into one of
the strongest and most powerful trees, dominating everything in its vicinity
with its massively thick trunk and huge, metallic-grey leaves, appealed to
the veteran war-lord for its power and majesty.
As a young plant in your garden, its fabulous blue-grey leaves make a
spectacular background for varied objects, plants and flowers - as a
colour, grey accentuates any other colour placed in association with it.
Stand in front of those radiating leaves, and your skin colour, hair and
clothes will never have looked more radiant to the human eye!
Bridge in Paradise :
by Neil Robinson
The Bridge Club of Chiang Mai holds an afternoon session on Fridays which
combines a duplicate game with a lively discussion of the hands. Chris
Hedges provides helpful coaching for newer players or those who are a bit
rusty. Many of the hands played are ones which were previously played in a
tournament.One of the many interesting hands played recently came from the
finals of the prestigious Vanderbilt knockout tournament played in 1997.
The board is shown below with South the dealer and E-W vulnerable:
S: AJ10854 S: Q63
H: A H: J843
D: 9 D:
C: K9873 C: 104
When this was played at the
Vanderbilt, the bidding at table one was as follows:
South West North East
2N 3S Dbl P
4H 4S Dbl All pass
The lead was the jack of
clubs. This was an unfortunate lead for the defence (an initial trump lead
followed by a trump as soon as the defence are in again is a more successful
defence). Declarer can take a second club lead with the king and then trump
a low club on board (over ruffing North if necessary).
Declarer returns to hand with the ace of hearts and leads another low club
to ruff on board. Now, a trump lead from dummy to the jack wins and the ace
of trumps then fells the king. Declarer lost only the aces of clubs and
The contract made a doubled vulnerable overtrick for +990 for E-W. It is
clear that North looked at his four points, added them to his partner’s
blockbuster, and was too optimistic in counting his chickens. E-W have only
15 high card points but are cold for eleven tricks after the club lead.
At the second table in the Vanderbilt, the bidding was a bit different, but
the final contract was the same, 4S doubled. Only ten tricks were made this
time, but still a big score for E-W +790.
In Chiang Mai the contract was played by an international foursome: Sheila
and Martin Bagnall of England were N-S and Jean-Claude Barrett of New
Caledonia and Dennis Hudson of Wales were E-W. The bidding was:
South West North East
2N 3S 4D 4S
5D P P Dbl
The final contract was 5
diamonds doubled by North. The lead was the queen of spades and the defence
took two spades, the ace of hearts and the king of clubs for down two and
+300 for E-W. Still a positive score for E-W, but a much better result for
N-S than at either table at the Vanderbilt. Good judgement by N-S here in
finding the diamond fit and pushing on to the five level!
For information on the Bridge Club of Chiang Mai please contact Chris Hedges
at: [email protected] If you have bridge questions, or to
send me your interesting hands, please contact me at: