by Dr. Iain Corness
Baldilocks and the Three Hairs
Going bald is not something we men
can look forward to. Exotic ‘comb-overs’ like Donald Trump’s look a
little weird. However, the shaved head look isn’t all that smart either.
Male pattern baldness is a curse
bestowed upon men by their fathers. Yes, chaps, the way your hair
disappears depends upon the genetic disposition you inherited from your
fathers. I also fully realize that some of you will say, “My father had
a full head of hair until he was 90 and I am going bald at 50.” The
answer is genetic heritage. Did you study the postman’s genes? Or maybe
you just had a hard life.
Jokes aside, male pattern baldness
(or Androgenetic alopecia, the medical terminology) results from the
presence of circulating androgens (sex hormones) in susceptible
individuals. The end result is the baldness beginning at the crown of
your head, and it all goes on from there. Or I should say, goes off from
What actually happens, is that the
sensitive scalp follicles are progressively made smaller by
Dihydrotestosterone (the male sex hormone DHT), so the hair becomes
finer and finer and eventually falls out altogether. It is actually
normal to lose between 50 to 200 hairs every day – as you get older,
this rate increases.
Another strange fact is that the
rest of the hair on the body does the reverse with exposure to DHT. Body
hair becomes darker and coarser and more copious.
Unfortunately, our appearance is
very intimately involved with our own self esteem. None of us want to
get older (though it still beats the alternative!) and we certainly do
not wish to be reminded of this fact every time we look in the mirror.
Consequently there are many forms
of “treatment” for male pattern baldness, and the range is quite
extensive (and expensive). The simplest, but most unsatisfactory method
is straight out camouflage. This includes spray can hair sprays that
hold the hair in place and color the scalp. Unfortunately they are messy
and the dye can run in the rain.
The next form of treatment is the
covering wig. These come in many forms from quite good to downright
dreadful. Unfortunately, the cheaper acrylic hair models are very easily
detectable. Interwoven models, where the artificial hair is entwined
with natural hair looks fine for a while, but have to be re-adjusted as
the normal hair growth lifts the wig away from the scalp.
There are medications that can be
used. The one that has been around the longest is Minoxidil, usually
sold as “Regaine” and comes in 2% and 5% solutions. These have to be
rubbed into the scalp twice a day for ever thereafter. The main problem
with Minoxidil is that it takes two to three months before it stops the
hair shedding and another four to eight months before regrowth may be
apparent. On the downside, only around 50% respond and scalp irritation
from the liquid is quite common.
There is also a drug called
Finasteride, taken by mouth. This drug blocks conversion of androgen to
DHT and the results would seem to show that for most men, hair loss is
slowed or stopped and a significant proportion actually get regrowth as
well. Again it is necessary to take the medication for at least three
months before any change will be observed.
Finally, there is surgery to take
good hair from the back and side of the scalp and transplant it into the
bald areas. Again this is time consuming, and in the intermediate stages
looks most un-natural. The best is transplanting individual hairs,
rather than the punch graft tufts, but it is naturally longer and more
expensive a procedure.
There is now another procedure
called Robotic Hair replacement which my hospital has now invested in,
which is like transplants, but the replacement hair is inserted by
robot, with the donor site and the recipient site being very small as to
be almost unnoticeable. It is also almost painless and a safer method.
So that’s the good news, gentlemen.
You don’t have to go bald, but expect your wallet to get slimmer
instead. The choice is yours.
Killed by Mobile Phones?
Every man, woman and
child in Thailand has a mobile phone these days and having the mobile seems
more important when eating in a restaurant than the knives and forks
However, remember the
first mobile phones? We used to have to carry a suitcase full of batteries
and needed three months at Thor’s gym to lift the thing. Who would have
believed that one day we would be able to slip the mobile phone into our
shirt pockets, where its death dealing invisible rays would kill us.
developments always bring out the soothsayers and harbingers of doom. Forget
attacks by extremists, we are all carrying a loaded time bomb in our mobile
I read a banner
headline the other day which claimed “Hours of chatting on a mobile phone
are suspected to be slashing male fertility around the world, new research
shows.” It went on to say that “Men who use mobile phones for more than four
hours a day produce fewer and poorer quality sperm, according to results of
a study released at an American Society for Reproductive Medicine conference
in New Orleans.”
I mean this is so
serious, we should never keep mobile phones on our laps, or heaven help us,
slipped between your legs as you drive the car. Can’t you see the headlines,
“Driver’s gonads blown to bits by mobile phone while waiting at traffic
If that was not
chilling enough, Australian scientists are investigating if children are
more vulnerable than adults to the effects of radiation from mobile phones.
This should have us worried for our children, as Thailand has one of the
highest usage rates of mobile phones. Every Thai, from the age of two, or
the age of being able to speak, has one. Every child takes one to school.
Even the national way of greeting has been changed to suit the mobile phone
fad. The traditional ‘wai’ is now done by holding the mobile phone between
your palms and bringing it up to touch your nose. True, just look around
The study of 110 adults
at the Australian Center for Radiofrequency Bioeffects Research has
apparently confirmed mobile phones cause a change in brain function by
altering our alpha waves.
The center is now
investigating the effect on 40 children aged 12 to 13, and 20 people aged 55
to 75 years.
Rodney Croft, from the center, said while studies had been conducted on
adults, the effect on children had, until now, remained untested. “Although
there’s a tiny effect on healthy young adults, there is a possibility that
it could be much stronger in children or the elderly,” said the worthy
Now, Mobile phones are
hardly new technology, although the latest 4G variety seem to be able to do
everything from cleaning the house, watering the garden, tying your
shoelaces and washing the dog, as well as making and receiving telephone
calls. There have been claims that using mobile phones produces brain cancer
because people with brain cancer have used mobiles, and that is about as
stupid as claiming that shoes are the greatest killer in the western society
because 99 percent of people who died last year wore shoes.
What is not said in all
these shock, horror headlines, is that these research chappies in the
hallowed halls of academia need finance to keep going, and they are all in
competition with each other to grab a slice of the research dollar
eventually funded by you and I. The more shock, horror headers they can get,
the more likely they are to get further funding. It is the money train
Now there are groups
doing genuine research into the malaises of mankind, and the influence of
cholesterol on cardiac deaths is a classic example. The Framingham study
kicked it all off many years ago, and it has been progressively studied
since then. High cholesterol is an adverse factor as far as your cardiac
condition is concerned. Believe it. And is unaltered by mobile phone use.
Believe that one too. And get your cholesterol levels checked as well.
Beware of ‘scientific
breakthroughs’ reported in the popular press. It may just be fishing for
A bit of talk
recently in the bars about the procedure known as “Sleeve Gastrectomy”
for weight loss.
Yes, weight loss,
with the incidence of obesity increasing every year, weight loss is an
important feature today. Yes, even those delightful wispy little Thai
girls hanging on to chrome poles are larger than they used to be 10
is a surgical procedure to reduce the size of the stomach. This will
help to limit the amount of food eaten which makes the patients
successfully lose weight.
Many but not all
overweight people are able to have this surgery. Surgeons use the Body
Mass Index (BMI) as a criteria for surgery, with the normal sized people
having a BMI 18.5-24.9 kg / mē
People with a BMI
over 30 kg / mē or more are considered as overweight. But it is not yet
considered as obese. The person with the BMI 35 kg / mē or more is
considered as having severe obesity and a BMI 40 kg / mē or more is
considered morbid obesity.
The obese person
with a BMI 35 or higher is the person who benefits from the surgery. As
a result of the study it has been found that people in this group will
not lose weight despite diet, exercise or medication. That makes it very
difficult to control ailments that go along with obesity, such as
Diabetes, for example.
The benefits of
surgery to produce a smaller stomach lies from the fact that the patient
will eat less without feeling hungry and feel full faster, thereby
limiting the amount of food which in turn results in weight loss.
is similar to Gastric Banding but has surgical removal of a large
portion of the stomach along the greater curvature. The result is a
sleeve like structure making for a smaller stomach and they will eat
patients require general anesthesia for this surgery, the risk is the
same as any other surgery. Complications can occur in patients with
underlying diseases such as diabetes, hypertension, heart disease, etc.
The anesthetic doctor will assess whether or not they are suitable for
Being done by
laparoscope, after care is short (3-4 days) but if patients have
complications or need to have additional surgery, it may require a
longer stay. After the surgery, the patients are given a diet
immediately. They will receive a diet plan from the doctor and need to
consult a dietitian.
In general, they
should do as follows:
The first week
after surgery: the patients may eat liquid food such as soups,
beverages, but no sugar, (do not take carbonated drinks) water,
vegetable juice. Eat a little at a time, but often.
Two weeks later,
the patients are able to eat a small piece of soft food, and then
convert into a regular diet. It should be eaten in small amounts. They
have to chew food thoroughly before swallowing and longer than usual. Do
not drink water with meals. The doctor will arrange the appointments for
Here is the usual
Weight gain becomes
a health problem
hypertension, osteoarthritis, back pain…
Tried to diet,
exercise and pills, but the weight does not come off.
surgery, the patient should eat three meals a day and limit unnecessary
snacks between the meals.
Weight loss is
successful or not depending on what you eat. Snacking between meals
stops weight loss and may actually cause weight gain due to the calorie
intake more than necessary.
Not chewing food
thoroughly will cause stomachache, nausea, vomiting and stomach
irritation. Chewing thoroughly is very important. You should cut the
food into small pieces before eating.
Reading food labels is essential to note that the sugar in foods is
natural or artificial sweetener. You should limit yourself to only 15
grams of sugar or less for one meal to help control calories.
(Body mass index
(BMI) is a value derived from the mass (weight) and height of an
individual. The BMI is defined as the body mass divided by the square of
the body height, and is universally expressed in units of kg/m2.)
With thanks to the
Surgery Center, Bangkok Hospital Pattaya Tel. 1719.
Influenza vaccine worthwhile?
Honestly, I do get more than a little tired of the “facts” being bandied
about on the social media on the subject of immunization. Right from the
outset let me tell you that immunization does not cause autism, and quite
frankly, even if it did (which it doesn’t) the numbers affected versus the
number of children protected makes it a no-brainer on the side of
Now let’s look at some “killer”
epidemics. We should not forget the panic with the Swine flu (also H1N1) a
few years ago. Bulletins from the WHO every day added to the hysteria.
Where WHO let itself and us down was
WHO did not tell the media that the immediate danger of viral infections has
two requirements – how easily it passes from one host to another and how
lethal is the ensuing infection.
The ‘pandemic level 6’ only referred to
the contagious nature of the virus and H1N1 is certainly highly contagious.
However, with only around 4000 deaths in the world from that 2009 Swine Flu
virus, just how lethal was it, when the seasonal flu kills 36,000 people
each year just in the US alone, and 200-300 people in Thailand? Read those
numbers again – 200-300 people from the seasonal flu in Thailand! That’s
from “nothing out of the ordinary” flu!
Right, what can you do about avoiding a
full-blown influenza infection this year? Quite simply, Flu vaccination can
keep you from getting sick from flu. Protecting yourself from flu also
protects the people around you who are more vulnerable to serious flu
illness. That’s the contagious nature again.
Flu vaccination can help protect people
who are at greater risk of getting seriously ill from flu, like older
adults, people with chronic health conditions and young children.
Flu vaccination may also make your
illness milder if you do fall ill.
Flu vaccination can reduce the risk of
more serious flu outcomes, like hospitalizations and deaths.
A recent study showed that flu vaccine
reduced children’s risk of flu-related pediatric intensive care unit (PICU)
admission by 74 percent during flu seasons from 2010-2012.
One study showed that flu vaccination
was associated with a 71 percent reduction in flu-related hospitalizations
among adults of all ages and a 77 percent reduction among adults 50 years of
age and older during the 2011-2012 flu season.
Flu vaccination is an important
preventive tool for people with chronic health conditions. Vaccination was
associated with lower rates of some cardiac events among people with heart
disease, especially among those who had had a cardiac event in the past
year. Flu vaccination also has been shown to be associated with reduced
hospitalizations among people with diabetes (79 percent) and chronic lung
disease (52 percent).
Vaccination helps protect pregnant
women and their babies for up to 6 months after they are born. One study
showed that giving flu vaccine to pregnant women was 92 percent effective in
preventing hospitalization of infants for flu.
Other studies have shown that
vaccination can reduce the risk of flu-related hospitalizations in older
adults. A study that looked at flu vaccine effectiveness over the course of
three flu seasons estimated that flu vaccination lowered the risk of
hospitalizations by 61 percent in people 50 years of age and older.
There are special vaccination
instructions for children aged 6 months through to eight years of age as
some children require two doses of influenza vaccine. Children in this age
group who are getting vaccinated for the first time, as well as some who
have been vaccinated previously, will need two doses. Your child’s health
care provider can tell you whether two doses are recommended for your child.
A complicating factor comes with the
annual make-up of the actual vaccine itself. Since the viral strains
dominant in any particular year can change, this does mean you should top up
your immune status with an annual jab.
In some quarters there is still
resistance to influenza immunization as well as the childhood vaccinations,
but to be honest, I cannot understand why. Sure, there are risks involved
with immunization, but those risks are very, very small compared to the
risks in getting the flu.