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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

Hypertension and summer swallows

Hypertension, or in plain English, High Blood Pressure, is a potentially dangerous condition which can lead to strokes, heart failure, renal failure, hemorrhages and even more. Hypertension is definitely something you don’t need or want. However, it is actually a difficult condition to diagnose, even though it is relatively easy to measure the pressure and treat the condition these days.
Blood pressure itself is something we all have. If you haven’t got Blood Pressure, then you are dead because your heart (the pump) has stopped pumping.
While we all have Blood Pressure (BP), high blood pressure is not good for us in the long run. Hypertension is life threatening. Normal tension is not.
Blood pressure is the measure of the force inside an artery. We get this number by putting pressure around the arm with an inflatable cuff until the artery is squashed flat, then slowly lower the cuff pressure and when we hear the blood squirting through again, that is the peak pressure, called the Systolic. The actual units of measurement are called millimeters of mercury, and come from the old sphygmomanometers (BP recorders) that measured pressure with a column of mercury.
However, there is another pressure we measure, and this is the resting (or ambient) pressure, called the Diastolic. With today’s automated home blood pressure recorders the screen will indicate this one too. This is the lower of the two readings and BP is expressed as systolic over diastolic, and is shown as, say for example, 140/90.
High blood pressure is often referred to as the “silent killer” because it usually has no obvious symptoms and most people cannot tell if their own blood pressure is high unless it is measured. Home blood pressure monitors make it easy for you to measure your BP.
Electronic battery-operated monitors use a microphone to detect blood pulsing in the artery instead of having to listen with a stethoscope. The cuff, which is attached to your upper arm, is connected to an electronic monitor that automatically inflates and deflates the cuff when you press the start button. First you place your upper arm inside the cuff. Then press the start button on the monitor and wait for the reading to be displayed. The monitor also records your pulse as well as your blood pressure. While these electronic devices are by far the easiest to use, they are also the most expensive, but can be an invaluable tool in self-monitoring.
There are a few rules, or guides, to getting reproducible results from home monitoring. You should not have just eaten or used any tobacco products. Do not take medications known to raise BP (such as certain nasal decongestant sprays), or do strenuous exercise before taking your BP readings. Avoid taking your blood pressure if you are nervous or upset. Rest at least 15 minutes before taking a reading.
Other important factors are that BP is higher in the mornings and lower at night, so take your recordings at the same time of day. There can also be differences between your two arms, so use the same one each time too.
The very rough guide as to “normal” and “high” BP is as follows. If your BP is less than 140/90 then it is most likely of no problem. If however, either the systolic or diastolic is over 140/90, then this ‘may’ indicate a problem.
Now here is a very important fact. One high blood pressure reading does not mean that you have hypertension. If your doctor tells you that you have Hypertension on one reading, tell him you do not agree, and that you will come back in one week to recheck, and one week after that. If the pressure is high for all three readings, then you will accept it. If it fluctuates above and below 140/90, don’t accept the “Hypertension” label. This is very important where health insurance is concerned, as insurance companies will seize on the “Hypertension” label and cause all sorts of exclusions to be added to your policy. One swallow doesn’t make a summer, remember!

 

Heart to Heart  with Hillary

Dear Hillary,
A few weeks back you published a couple of letters from blokes calling themselves “Rip Toff”. They poured their stupid hearts out about how they had lost hundreds of thousands of baht that they had honestly thought was an investment in their future life in Thailand, with the girl of their dreams. They were kidding themselves. The investment was the girl’s, not the blokes. They weren’t ripped off, they dove in the water before they could swim. Deserve all they get, these kinda people.
Reality Reg
Dear Reality Reg,
Aren’t you full of the milk of human kindness today, Petal. Who said you were so smart that you can call other people stupid? Sure, they went into the situations with their eyes closed, but that doesn’t make them stupid. And they were clever enough and charitable enough to write in as a warning to others. I hope nobody takes advantage of your kind nature some day - but there’s no real hope of that, as you have already shown that you don’t have a kind nature. Enjoy your loneliness Reality Reg, that’s the ‘real’ reality of it all. You are destined to be on your own, as you can’t see that there can be good relationships with Thai girls - you just don’t find them in the bar beers.

Dear Hillary,
We are really new here, and a bit at sea about the tipping thing. I know that the Thai people don’t get all that good wages, but when should we tip? And when not?
Newbies
Dear Newbies,
I think I dealt with this problem recently, but maybe you are so new you didn’t read it. Tipping is exactly the same as in your own country. If you have had service above and beyond what would be expected, then tip, but beware - if the establishment already adds on a percentage (usually 10 percent) for “service”, then that is the tip, you don’t need to tip on top of that, unless you feel the service was so exceptional the service personnel deserved even more. At small ‘roadside’ eating places, you generally leave any coins on the plate when your change comes. Thank you for thinking about the local Thais, who do depend upon their tips to love a somewhat better life.

Dear Hillary,
I am staying with a Thai family, friends of my parents in the US. They are nice people but they have this shrine in the house that they place sacrifices in front of. Chickens and such aren’t too bad, but the one this week was a pig. A pig’s head to be truthful, but I am wondering if this means they have some funny religion or something. I can’t ask them and I don’t want to ask my parents either. Can you advise me please, Hillary.
Amelia
Dear Amelia,
You will find there are many different aspects to life over here, and the one you describe is a form of animism, a very ancient belief, and small ‘offerings’ are placed in front of the shrine, spirit house or even just a sacred tree. There is no ritual sacrifice, if that is what you are worried about, and the people buy such items as pig’s heads and chickens at the local market, to later cook and eat themselves. You will often find fruits such as bananas displayed, as well as betel nut and a red drink. They are merely thanking the spirits for the good things that have happened (even your coming to stay for a while), and asking for future good luck. In many ways this is similar to lucky rabbit’s foot charms, lucky shark’s teeth, Vedic talismans and a whole host of similar items common in the western world. Just go with the flow, Amelia. There’s no witchcraft going on here.

Dear Hillary,
Is there something that can be done about telephones in this country? So many times when I ring a company looking to buy something I get a recorded voice (in Thai) and I have no idea what they are talking about and eventually I give up in disgust. They miss on a sale and I don’t get what I want. Why don’t they take a leaf out of the Australian tele-marketing sales book? If they want to sell to me, they have to speak my language. Surely this is obvious? What is your answer to my problems, sweet Hillary?
Cheesed Off
Dear Cheesed Off,
So what do you want the tele-marketing people to do for the Germans, the French, the Russians and many other ex-pats? Speak their languages too? But back to your problem. You have lots of options, Petal. First off you can get somebody who speaks Thai to ring up for you. Secondly, you could try learning enough Thai so you can do it yourself - after all, this country is called Thai-land, if you hadn’t noticed, and the native language is called Thai. Surely this should be obvious, even to you. Or thirdly, you can ring Australia and order what you want from there direct, in that quaint dialect called “Australian” English. Or fourthly, and probably the best option in your case, is to go back to Australia, where life will be simpler for you.


Camera Class:  by Harry Flashman

Panning - with some digital difficulties

Shooting moving objects? Try panning for the best effect. Panning is the most popular technique for action sports photographers, because it is one of the best ways to really show “action”. Now many of you will have cameras with an “Action” or “Sports” mode that you can select at the flick of a switch. Despite what the camera manufacturer would have you believe, professional action sports photographers don’t use it! Forget about it and blot it from your consciousness.

Too early!
The reason for this is simply that the selection of the “Action” mode puts the camera on to a fast shutter speed to “freeze” the action. “Isn’t that what I want?” I hear you cry. No, I’m sorry, you will get a very static shot of your moving subject - a shot which does not imply movement or action at all. A shot of a dog running can end up looking as if Rover was frozen to the spot with its legs in a strange position.
Contrary to that which you would imagine, the technique to show speed and action is not a super fast 1/1000th of a second shutter speed or even faster with some of today’s super SLRs - but rather something around 1/15th to 1/30th. Now that really is surprising, isn’t it? However, for this to work, the technique to handle this slow shutter speed is called “panning”.

Got it right this time!
The objective with panning is to be able to “stop” the moving subject, but leave the background a blurred smear. This is carried out by moving the camera in time with the moving subject, so that the subject is in the center of the frame at all times, while the background “moves” behind the subject. Moving the camera to keep the subject in the center means that the slow shutter speed is “fast” enough to stop the subject’s action, but too “slow” to stop the effect of the movement of the camera on the background.
This, by the way, is not an easy technique and will require that thing called “practice”. Begin by picking on an easy subject, like motorcycles going past you down the road. Start by selecting 1/30th of a second for the exposure and practice turning your body as the subject moves past you. You have to synchronize your movement with that of the moving subject, and when you press the shutter you must continue to move at the same speed especially when the viewfinder goes black as the shutter fires and you cannot see the subject for a brief instant - the most important brief instant.
When you have become good at this technique at 1/30th of a second, it is time to then try 1/15th of a second. At the slower shutter speed, the background will become even more of a streaky blur, giving an even greater impression of speed and action.
With SLR film cameras, where you could use the WYSIWYG feature (What You See Is What You Get) and see directly in the viewfinder what the final image would be, panning was difficult, but not impossible. With the new digital age of ‘easier’ photography, it turns out that panning is actually slightly harder. The reason is that the electronic image you see is not quite “real time”, but there is a split second difference, and in that split second you can lose a moving image.
Take a look at this week’s photos. A classic car, doing around 100 kilometers per hour. In the first shot, the shutter was tripped too early, so we have lost the back half of the subject. In the second shot, the photographer managed to get the car central as he moved the camera in time with the car.
To sum up, to show action and movement, select a slow shutter speed and stand side on to the action. Turn your body as the subject goes past, keeping the subject in the center of the viewfinder. When the subject is directly opposite your position pop the shutter, while still continuing to turn your body in time with the subject. With luck, you’ve got it!


Money Matters:  Paul Gambles MBMG International Ltd.

Water - 21st Century Oil?

As regular readers of this column know, we have covered this topic before but it is still worth revisiting. In 2000, Ismial Serageldin, World Bank Vice President for Environmental Affairs, was quoted in Marq de Villiers’ Water - “The wars of the twenty-first century will be fought over water.” When he said this, almost a decade ago, his main thoughts were focused on the Middle East. This can be borne out by the fact that an anonymous Jordanian wrote to the Washington Post saying, “You think we have bad fights over oil. Just wait until we start fighting over water. It’s predicted in the Koran.” Not pleasant reading.
What was not thrown into the melting pot at the time was the Chinese factor. China has been suffering from the ravages of a severe drought for quite a long time now. Also, they hardly charge for it and so people use more than they should and is thus wasted needlessly. The Wall Street Journal recently published water rates. Germany charges USD3.01 per cubic meter and in the UK the cost is USD2.37. This is not so bad, as these are western countries but compare China with South Africa at USD1.02 and Brazil at USD0.65. The Chinese pay USD0.31.
However, the people do not realize that a potential catastrophe looms. Analysts have taken samples from the North China Plains and there is a good argument to be had to say that this will dry up by 2020. This is not the only thing to be worried about. Beijing is sinking by over twenty centimeters a year - that is eight inches. This, according to geologists, is the world’s largest cone of depression (over 15,000 square miles) which is an underground crater that has been made by an insufficient water table. The second largest depression surrounds Shanghai.
Basically, the Chinese are using more than they can provide. This is why these depressions have occurred and it also explains why certain areas have dried up and you get rivers that do not actually reach the sea.
The Chinese have finally recognized the problem and have started to put up the price of water. It is feared that prices may rise by as much as fifty percent. For example, Shanghai put its prices up 25% in June and is thinking about another price increase of over 20% next year. The Chinese are obviously worried. In fact, they are teaming up with their old enemies in India to check on the speed of melt on the Himalayan glaciers. People may wonder why this is of such interest. Well, seven of the biggest rivers in the world, including the Yangtse and Ghanges are supplied by these glaciers. Put another way, they provide water for nearly three billion people. The fact is that these glaciers are melting and the Chinese and Indian governments need to know about it. Satellite imagery has shown them to have lost over twenty percent of their mass in the last forty years.
As said above, the problem is that, unlike the world economy, demand is outstripping supply. There are just too many mouths that require water. Also, this is not helped by poor infrastructure where cities like New Delhi actually lose four fifths of their drinking water due to poor pipe works, canals and sewers, etc. Until last year, the rural poor in developing countries were migrating to urban slums at such a rate that by 2007, for the first time in history, it was estimated half of the world’s population would live in towns and cities.
In China, for example, where this migration from rural to urban living was massive, 400 of the largest 670 cities were operating in serious water deficit and over-taxing the sewage treatment facilities - if these were available at all. Only one quarter of the 21 billion tons of China’s annual output of household sewage is treated. Treatment plants are being built, but will still handle only half of all city sewage, leaving rural waste water untreated.
The government has forecast an annual water shortfall of 53 trillion gallons by 2030 - more than China now consumes in a year. As already intimated, this problem is exacerbated even more due to appalling pollution thus making what should be fit for consumption totally undrinkable.
Despite what the Chinese have done about trying to limit the rise in population the demand for water is going up all the time and, as they come more into line with the western world this will just get worse. It takes about 100,000 gallons of water to produce a pick-up truck - even a cotton shirt takes a thousand gallons.
According to the US Census Bureau the world’s population is now at 6.8 billion. It is estimated to be 7 billion by July 2012. Forget industry for the moment, increased population means the demand for more water has to increase. Within the next twenty years it is expected that India will have the world’s largest population and China the second. Between the two of them it is expected they will add at least another 600 million people to their present numbers - this is two Americas. Between them they will account for more than 3 billion people. At the same time the United Nations is forecasting a total world population of over 8 million so by 2030 almost forty percent of the people on this earth will come from China and India and they all want a drink.
Water will no longer be a cheap commodity anywhere in the world but especially not China and India. The obvious thing is we need more water than we presently have. The question is, “Where from?”
Well (forgive the pun!), we can find more by drilling in new places and going deeper. Desalination is another option as is improving present infrastructure and using present stocks more efficiently.
All of this is going to take time, energy and money. People, businesses and nations will find a way to overcome these problems - the alternative does not bear thinking about. Those that are in the forefront of this change will do well.

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

TOMORROW IS ANOTHER DAY

A week or so ago I went to two events arranged by the 200 Club which, loosely speaking, is a group of people who, in a variety of happy ways, are raising funds for two exceptional forward-looking organizations helping animals: Lanna Dog Rescue and Mae Taeng Elephant Park, (for the hospital there).
The first event was at the lovely garden of one of the supporters, Mary, and on the Sunday in question many people converged on the stalls and stands selling lots of attractive goods, enjoying food from Arco’baleno Restaurant, coffee and wines and generally having a great time – all in a good cause.
The second outing was to Mae Taeng where we were able to see the progress made in the buildings which will become the elephant hospital and rehabilitation centre and a refuge for the new offspring which are very vulnerable in their early weeks and months.
By January the 200 club hope to have raised enough cash to finance the equipment needed at the hospital. The building so far and the running costs will be met by the sales of the beautiful t-shirts, table cloths, wine carriers, paintings and so on produced from the amazing elephant paintings. The main organizers of the group, John and Sally, are energetic forward-looking people and the re-use of those adjectives is deliberate, not my laziness. The point is they are looking to the future, optimistic about helping these two centres which help man’s best friend and those odd, willful and often ill-treated beasts of burden – to coin two apt clichés in one sentence.
They and hundreds of other people in Chiang Mai do a great deal to help people and animals. It’s done in myriad ways, often quietly (not a particular characteristic of the two people mentioned!!), often by amateurs, sometimes involving professionals. Usually involving no cost to the charities involved – as was the case with the lamented Hillside 4 Rooftop Party.
Money sometimes trickles in, sometimes it comes in bigger amounts, often from abroad or from government or ‘official’ sources. It would, of course, be wonderful if there were no need for such help, but the rich world seems unwilling or unable to spread its wealth to those in need. So it’s up to you and me and these active people to look to the future.
It’s sadly true that many people never think of ‘tomorrow’ (list your unfavourite politicians in the margin) and live in far from splendid isolation, rooted, inactive and clinging to the past. I had one friend in particular who was the embodiment of such an attitude, which, I am a sorry to say, seems a peculiarly English characteristic, possibly shared with other ‘colonial’ powers, in search of times remembered.
Such people just about cope with the present, treading warily as though on ice. But the future? There seems almost a sense of dread there, a selfish disregard for those who will inherit our mistakes and abuse of the planet. The present may be of little concern, but the future is approached in the manner of someone entering an operating theatre. The person referred to above had that attitude in spades and would, given an acquiescent listener, catalogue a personal history which seemed to stop in early maturity. Nostalgia carried to obscene limits.
Personally I’d sooner cherish the past, but think of the future, recalling the wonderful opening sentence to The Go Between, ‘The past is a different country: they do things differently there’. It seems more useful, if that is not too feeble a word, to enjoy the present and assess what is best done for the coming years in modest optimism. Which is where we came in. By ‘doing’ so that things actually get done, people act rather than ruminate and progress is made.
The two people I have mentioned and the hundreds like them seem intent on helping Chiang Mai become a ‘better’ place, with some of the inequalities and injustices ironed out and some – at least – of its potential being realized. Their credo is an echo of Scarlett’s, ‘Tomorrow is another day’.
You can contact the dog rescue centre on www.lannadog .net and find out more about the elephant hospital on www. maetangelephantcamp.com


Let's Go To The Movies:  by Mark Gernpy

Now playing in Chiang Mai
The Final Destination 4:
US, Horror/ Thriller – Officially inaugurates the new digital 3D cinema system here at Major Cineplex.  After a teen’s premonition of a deadly race-car crash helps save the lives of some of his peers, Death sets out to collect those who evaded his plans.
Note that the price of regular seats has been raised from 120 baht to 200 baht for the added dimension.  But I have to tell you the movie is only one dimension in terms of story and character.  Nevertheless, you sort of get your money’s worth with this one, should you enjoy watching deaths: It contains 11 death scenes, the most of any film in the series.  They brag about it!  Rated R in the US for strong violent/ gruesome accidents, language, and a scene of sexuality; “18+” in Thailand.
Far be it from me to discourage you if you truly slaver over this sort of thing, but I thought it truly repulsive and offensive.  You have various human organs flying at you right through the cinema, and yes your reflexes make you actually duck!
I found it interesting to note where the Thai subtitles appear in 3D – they appear to be floating in the air about five rows ahead of you in the cinema, which means that sometimes they’re actually behind an image on the screen.  The glasses use nice solid plastic frames, not the like the cardboard ones they used last time.
Technically, the 3D, and the digital sound and image, work just fine, though you can’t really appreciate the digital clarity of the image in 3D as the glasses and the visual process seem to muddy the image up a bit.  When you see a non-3D digital movie, you are struck at once with the clarity and super-sharpness of the image.
Gamer:
US, Action/ Sci-Fi/ Thriller – By the writers and directors of the two recent Crank movies, this continues their quest for bigger explosions, and action which is even more “non-stop.”  Set in a near future when gaming and entertainment have evolved into a terrifying new hybrid, allowing millions to act out their most savage fantasies online in front of a global audience, using real prisoners as avatars with whom they fight to the death.  Rated R in the US for frenetic sequences of strong brutal violence throughout, sexual content, nudity, and language; “18+” in Thailand.
Inglourious Basterds
: US/ Germany, Action/ War – Quentin Tarantino’s exceptionally bloody tale of Jewish-American troops on the hunt for Nazi scalps in World War II France, with an amazing Christoph Waltz giving a truly fine performance.  A must-see movie, though I’m uncomfortable that I’m recommending a film that carries violence to such extremes.  But the filmmaking skill is mind-blowing.  Never have I felt studied control over all the aspects of movie making.  A milestone in film.
Rated R in the US for strong graphic violence, language, and brief sexuality; “18+” in Thailand.  Generally favorable reviews.
The Elephant King:
US/ Thai, Drama/ Romance – Well done farang in Thailand story, filmed for the most part in Chiang Mai.  Two American brothers – one domineering, the other introspective – binge on drink, drugs, and women in our fair city.  The mother (Ellen Burstyn) dispatches the younger son Oliver off to Chiang Mai to do everything he can to lure his reckless, older brother Jake back home to the U.S. to face pending fraud charges.  Oliver finds the intoxication of Chiang Mai hard to resist, and as he falls deeply in love for the first time, his brother Jake slips deeper into despair, and the seams of their relationship begin to come undone.  Rated R in the US for sexual content, drug use, language, and some violence; 18+ in Thailand. Mixed or average reviews.  Vista only (previously played at Airport Plaza in January).  In English with Thai subtitles, despite what the Vista website may say.
G.I. Joe: The Rise of Cobra:
US, Action/ Adventure/ Sci-Fi/ Thriller – Another action-adventure film based on toys, very much like Transformers: Nonsensical mayhem, and very loud, but stylish.  Generally negative reviews, but very popular.
My Ex / Fan Kao:
Thai Horror/ Romance – Unaccountably bloody, dreadful, and confusing, even for a Thai flick.  An actor with a bad boy reputation is haunted by one of his ex-girlfriends.
Buppha Rahtree 3.2: Rahtree’s Revenge
: Thai, Horror/ Romance – An exceptionally bloody and confusing horror flick, continuing the romantic-horror story of the revengeful ghost of Buppha. Rated “18+” in Thailand.
Trail of the Panda:
China, Family – A Disney live-action film about a panda cub that is separated from its mother and subsequently rescued by an orphaned boy.  The story is sweet and the film is charming.  At Airport Plaza only.
Scheduled for September 9 (Wed)
Phobia 2 / Haa Phrang:
Thai, Horror – A five-part horror anthology by some of Thaialnd’s best-known directors of horror films.


Bridge in Paradise : by Neil Robinson

Here are some of my favourite bridge quotes, starting with a comment made by Jan Janitschke, when his partner put down dummy:
“Where’s the hand you held during the auction?”

From Victor Mollo (writing in the character of Rueful Rabbit):

“Bridge is a great comfort in your old age. It also helps you get there faster.”

Now, a few from Alfred Sheinwold:

“It’s not enough to win the tricks that belong to you. Try also for some that belong to the opponents.”
“One advantage of bad bidding is that you get practice at playing atrocious contracts.”
“The real test of a bridge player isn’t in keeping out of trouble, but in escaping once he’s in.”

And a similar thought from Alan Sontag:

“It is not the handling of difficult hands that makes a winning player. There aren’t enough of them. It is the ability to avoid messing up the easy ones.”

Now a few from Edgar Kaplan:

“Zia Mahmood gave himself some very good advice when he said ‘Stop’. But he paid no attention.”
“If you are a good enough player, you can get away with making mistakes because nobody will believe it.”
“It is well-known that in third seat, you must have 13 cards to open the bidding.”

And a couple of anonymous ones:

“I’d like a review of the bidding with all the original inflections.”
“South: Alert
East: Yes?
South: I’m requested to further misdescribe my hand.”

Or, you can take this advice from Alfred Sheinwold:

“A player who can’t defend accurately should try to be declarer.”

Of course, if you want to be declarer, you have to bid. Consider this from Jon Baldursson of Iceland:

“Don’t be a pleasant opponent—bid”

And finally from Hugh Kelsey a useful thought in no trump:

“If you bid a stop at no trump, then you don’t need to actually have one.”
The Bridge Club of Chiang Mai welcomes new players. For information on the Club go to the web site at www.bridgeclubchiangmai.com or contact Chris Hedges at:  [email protected] If you have bridge questions, or to send me your interesting hands, please contact me at: [email protected]