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
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
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
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.
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.
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?
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.
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,
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.
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?
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.
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.
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”.
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
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
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
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
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
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
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
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
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
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
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
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
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
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
“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
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
And a couple of anonymous ones:
“I’d like a review of the bidding with all the original inflections.”
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: