Make Chiangmai Mail | your Homepage | Bookmark

Chiangmai 's First English Language Newspaper

Pattaya Blatt | Pattaya Mail | Pattaya Mail TV

Update March 2018

Chiang Mai News
Classical Connections
Care for animals
Community Happenings
Doctor's Consultation
Dining Out & Recipes
Heart to Heart
Mail Bag
Mott the Dog
Daily Horoscope
About Us
Advertising Rates
Current Movies in
Chiangmai's Cinemas
Back Issues
Find out your Romantic Horoscope Now - Click Here!
Update by Natrakorn Paewsoongnern

Doctor's Consultation  by Dr. Iain Corness


Saturday, March 17, 2018 - March 23, 2018

Why the sphygmomanometer is a liar

Before we delve into this, please understand that the sphygmomanometer is merely an instrument that measures Blood Pressure (BP), but the difficulty in using a “sphyg” is that it measures something which is not stable. The other problem is that people (including doctors) take the reading as absolute, which it most definitely is not.

Many factors can influence the reading. For starters, the size and position of the blood pressure cuff can affect the accuracy of blood pressure readings. If the cuff is too small, the measurements will be falsely elevated.

As a general guideline, if your arm measures more than 33.02 cm around as its widest point, you will need a cuff in which the inflatable bag portion is at least 33 cm long. These large adult cuffs are available at most hospital and medical supply stores.

Secondly, your blood pressure may vary considerably from day to day and from moment to moment. Blood pressure also tends to be higher in the morning and lower at night. Stress, smoking, eating, exercise, cold, pain, noise, medications, and even talking can affect it, so you can see it is not a stable number you are measuring.

A single elevated reading does not mean you have high blood pressure (hypertension). Conversely, a single normal reading does not necessarily mean you do not have high blood pressure.

The average of several repeated measurements throughout the day is more accurate than a single reading.

First off, buy a blood pressure measuring device from the pharmacy. Not expensive and read the instruction manual. Now read it again. The simplest to use has a circular cuff you put one arm through. The ones in shopping centers are like that.

Record your blood pressure while you are seated in a comfortable, relaxed position. Try not to move or talk while you are measuring your blood pressure. Be aware that the blood pressure readings may be 10 to 20 mm Hg different between your right arm and your left arm. For this reason, use the same arm for every reading. Blood pressure readings also vary throughout the day. This is normal.

For electronic models, press the on/off button on the electronic monitor and wait until the ready-to-measure symbol appears next to zero in the display window. Then press the start button. The cuff will automatically inflate to approximately 180 mm Hg (unless the monitor determines that you require a higher value). It then begins to deflate automatically, and the numbers on the screen will begin to drop. When the measurement is complete, the symbol stops flashing and your blood pressure and pulse readings are displayed.

Now repeat the same procedure two more times, for a total of three readings. Wait 5 to 10 minutes between recordings. Record your systolic and diastolic pressures, the date and time. Inspect your blood pressure cuff frequently to see that the rubber tubing, bulb, valves, and cuff are in good condition. Even a small hole or crack in the tubing can lead to inaccurate results.

Generally, as long as you don’t have symptoms such as lightheadedness or faintness, the lower your blood pressure the better. If your blood pressure is usually below 90/60 mm Hg and you feel well, don’t worry. However, if your blood pressure “normally” runs high consult our health professionals.

Do not adjust your blood pressure medications based on your own home blood pressure readings without first discussing any change with your doctor.

Early detection and treatment with a combination of medication and lifestyle changes (weight loss, diet, exercise, cessation of smoking and stress reduction) may reduce the health risks associated with high blood pressure. If you are under treatment for high blood pressure, monitoring your blood pressure once a week is sufficient, though more frequent monitoring may be useful if your blood pressure is not well controlled or if your medications are being changed. Talk to your treating physician about how often you should monitor.

A large difference (greater than 20 mm Hg) between the blood pressure measurements of the right and left arms can indicate a problem. Once again, take this information to your doctor.

Saturday, March 10, 2018 - March 16, 2018

“How are you?”

I was standing in the queue at the local 7-Eleven when an attractive young lady, whom I swear I had never seen before, put her arm around me and said, “How are you?” This took me aback a little, not expecting such direct questioning from a stranger, while thinking about food rather than “fun” at that time of day. Of course, the young lady in question was not really asking about my inner health, but more about my availability. My rather embarrassed “Mai ow’s” were accepted with a smile and she sauntered off with a wave (keeping all her options open, I suspect), but over lunch I began to ponder on her words - and how was I?

Not the usual place for a truthful assessment of my physical health, but I stopped to think, what about me? Greying (I hate admitting it and it’s rather more like white, considering I once had Chinese blue-black hair); balding (I hate that even more but fortunately the bald patch doesn’t show in the mirror as I face it for shaving); face showing the ravages of time and the Aussie sunshine; getting a bit of a “tummy” (from the beer because wine’s too expensive in this country to drink socially), but overall, not bad for a man who races cars under the team [email protected] (say it quickly) and the oldest surviving male in the family ever (and you think you’ve got a lousy family history!).

So what can I do about all these? I tried the black paint Grecian 2000 route years ago and you go a strange brown which turns into orange after three weeks. This look fools nobody but yourself, unless you began life with strange orange hair. The balding? This has been creeping on for the past twenty plus years too. In the beginning I tried the rubbing “Regaine” lotion into the scalp twice a day as recommended by the manufacturers. All I got was a red scaly scalp and the hair shedding continued. I console myself with the knowledge that it shows male hormonal activity, so at least I’m not turning into a girl, as seems to happen with a fair percentage of “lady boys” round here.

The face? The mirror of the soul? The mirror has no soul. Admit it, you’ve all stood in front of the mirror and gently pulled your cheeks back to see what you looked like fifteen years ago, haven’t you? I could fix that with some timely cosmetic surgery, but it does mean you have to remain out of the public eye for at least three weeks while the bruising fades. This option remains high on my 2020 list (but it was also on the 2010 and 2015 lists as well).

The tummy? Now that’s something I do have to deal with. There has been a slow and inexorable weight gain over the past three years and the time to stop it is now. Well, during 2018 at least. This means a simple adjustment to the dietary intake - less fats, more vegetables, less Brit food and more Asian cuisine - and a simple decrease in the alcohol intake - less beer and more soda water. I could even be tempted to step up my physical activity with some gymnasium work, but I know with my lifestyle and my innate dislike of lycra leotards that it is unlikely to happen. Perhaps I’ll put that in the 2022 list.

So what about me, and my New Year’s health resolutions? An acceptance of the inevitable looms high on the list, followed by some sensible dietary and social habits and life looks pretty good for 2018.

However, it might also be a good idea to check the inner workings with one of the hospital’s check-up packages. Having had check-ups before, I can look at any trends that are showing. Could even be a life saver.

And how are you? Time to grab a check-up package?

Update Saturday, March 3, 2018 - March 9, 2018

When was your ‘Use-By’ date?

My dear old Mum who lived to be 94, didn’t enjoy her final years on the planet with failing eyesight (Macular degeneration) and increasing deafness and painful joints and the need to use a Zimmer frame. She used to say, “What am I doing here? I’ve passed my use-by date.” However, despite the limitations in her lifestyle, it still beat the alternative!

Some people ask me where I get the ideas for these weekly medical mutterings from the mount. The answer is simple - generally from you folk yourselves. Many of you will pop in and ask me a medical question, which may stimulate my imagination and away we go from there. This week’s is one of those.

One of these questions related to the expiry or “Use-By” date that you see on tablets, capsules, suspensions, etc. These expiry dates are worked out by the manufacturers of the magic medications and relates to how long they keep their biological activity at good therapeutic levels.

However, like 60 km/h speed limits where 59 km/h is “safe” and 61 km/h is “dangerous” - a totally ludicrous concept, the same exists for the expiry date on medications and even the family loaf of bread. If it says use before 19th of August it does not mean that on the 20th of August the medication changes into chalk. In today’s non-risk taking world, the manufacturers are covering their posteriors. They have to imagine that you are going to maltreat their medications and the expiry date really represents the “worst case” scenario.

Let me assure you that on the 20th of August, that medication is still good. In fact, many of the charity organizations go around the doctors’ surgeries in the western world, collecting “out of date” drugs to be used in the developing world. In Vietnam a few years ago the pharmacies used to sell medications with the expiry date cut off the foil wrappings. You can guess where they came from!

Another reason for short expiry times could be that the shorter it keeps, the more has to be manufactured and bought. But of course the large drug companies wouldn’t think that way, would they. That’s just a thought from old cynical brains like mine!

So how should you store your prescription medicines? Well the first thing is to look at the box and it generally tells you the ideal storage place and temperature, but if it doesn’t then you won’t go far wrong with storing it in the door of the household refrigerator. This is particularly so for liquids, suspensions, eye drops and the like; however, with opened bottles, there is always a very short expiry on them, generally around 30 days from the date of opening. Do not be tempted to extend this time. It is not worth it.

For individually wrapped tablets in blister packs or foil, then a cool dark cupboard is fine, but for capsules, it is even more important to keep them cool. Again the door of the fridge is a good place.

There is one other important consideration regarding keeping medications at home - children. You must keep drugs away from all children. Many medications are brightly colored, suspensions are sweet and children are attracted by them. Always keep medications out of the reach of children!

With the household bread – look for mould and discard!

So that is the expiry date story, not exciting, but mainly simple common sense.

HEADLINES [click on headline to view story]

Why the sphygmomanometer is a liar

“How are you?”

When was your ‘Use-By’ date?



Chiangmai Mail Publishing Co. Ltd.
189/22 Moo 5, T. Sansai Noi, A. Sansai, Chiang Mai 50210
Tel. 053 852 557, Fax. 053 014 195
Editor: 087 184 8508
E-mail: [email protected]
Administration: [email protected]
Website & Newsletter Advertising: [email protected]

Copyright © 2004 Chiangmai Mail. All rights reserved.
This material may not be published, broadcast, rewritten, or redistributed.