by Dr. Iain Corness
Update Saturday, Nov. 18 - Nov. 24, 2017
Remember Al Whatsisname!
I have stopped worrying
about Alzheimer’s Disease. What between Google and my 13 year old daughter,
I can find anything. In the mornings when I leave home, there is Little
Miss, index finger outstretched, showing me just where I parked the car last
night and that I have forgotten my work book. And Google, the patron saint
of writers, is always there to remind me of the names I had forgotten. Now
all I have to do is get my brain hot-wired into a wireless network and I can
meet the world head on.
However, we’re not
quite there yet, so we (you and me) we have to retain as much cerebral
function as we can. And it turns out that it is not all that difficult.
We have known for some
time that if you don’t use your muscles, they waste away. By not using your
hands for physical work, the skin on your hands gets thin. However, we also
know that if you use your muscles again, the muscle tissue builds up and
becomes strong once more. If you use your hands again, the skin builds up
and becomes thicker. The message is simply that all is not lost! Recovery is
However, we were always
told that the one organ of the body that could not reverse the wasting
process was the Central Nervous System. Once it started to fail, that was
it. Dementia was just around the corner. Do not pass go, do not collect 200!
However, that view has
recently been challenged and the results are comforting, to say the least.
Experiments have been carried out that showed that by inducing stress in an
animal resulted in chemicals being released. This on its own was nothing
new, but what was new was the fact that some of these chemicals produced a
difference in the brain’s anatomy! The idea that the brain could not change
was incorrect! It could be ‘short-circuited’ resulting in a new wiring
What was even more
exciting was that if the animal was restored to its own ‘safe’ and
non-threatening environment, then the brain reverted to its pre-stressed
anatomy! It was possible to ‘re-wire’ the brain.
In turn this has led to
much research into the effects of stress and its reversal, and then on to
Alzheimer’s Disease (if I have remembered to spell it correctly)! And if it
were possible for its reversal too!
Returning to the
research, we have shown that stress can physically damage nerve cells used
in storing memory. We have also found that mindless watching of the
goggle-box also produces a decline in brain function. In fact the numbers
are more worrying than that. It has now been found that people with no
stimulating leisure activities, and who are couch potatoes instead, are
nearly four times more likely to develop dementia compared to those people
who have leisure stimuli and do not waste hours in front of the TV.
Taking that a step
further, and turning the scientific data around to be useful, it has been
found that in being the converse to the couch potato, intellectually
stimulating leisure activities had a ‘protective’ effect for the brain and
its capabilities. What is more, they have also found that if you are doing a
job you enjoy, then this was again protective, but a dull job with no
stimulus or challenge was another way to head downhill.
This does not mean that
we all have to take up chess tomorrow, because in place of intellectually
stimulating hobbies, it has been found that physical exercise itself stops
memory loss and stimulates growth of nerve cells.
factor appears to be marriage! Those who have never married have twice as
high an incidence of dementia than those who are married. So there you are,
rather than say that your wife is driving you insane, it appears that she is
driving you towards sanity instead. (I have friends who would dispute that!)
So the secret towards
staving off dementia and Al whatsisname’s disease is to have a job you
enjoy, get some exercise, watch a very limited amount of TV and settle down
with a good cook (sorry, that should have read “a good book”).
Update Saturday, Nov. 11 - Nov. 17, 2017
Thanks, Mum and Dad!
We all have much to
thank our parents for. Just letting us grow up for starters. As an
aside, if my young son continues much longer with the two year old
tantrums, he’s going to be lucky to reach his third birthday, but no
doubt his mother will shield him from paternal wrath.
is one of the ‘clues’ to your health in the future, and what you can do
to enjoy a long, lively and healthy one. This is where ‘thanks Mum and
Dad’ comes in. One problem of being an orphan is that it leaves the
person with no idea as to what ailments are going to befall them. Dad
might have legged it or ‘fled the scene’, but did he live to tell the
tale when he was 60?
With the increasing
research into genetics, we are able to map out our likely futures and
can predict such ailments as diabetes, epilepsy and other neurological
problems like Huntington’s Chorea and Alzheimer’s Disease, some cancers
such as breast, ovarian, lower bowel, prostate, skin and testicular,
heart attacks, blood pressure problems, certain blood diseases like
Sickle Cell anemia and so the list goes on.
However, you do not
need to have multi-million baht examinations done on your DNA to see
where you are headed, all you need to do is to start asking the older
family members about your inheritance. Not the money - your genetic
inheritance in the health stakes.
Have you ever
wondered why the questionnaire for life insurance asks whether any close
member of your family has ever suffered from diabetes, epilepsy and
other ailments and then also asks you to write down how old your parents
or brothers and sisters were when they died, and what they died from?
All that they, the insurance companies, are doing is finding out the
relative likelihood (or ‘risk’) of your succumbing early to an easily
identifiable disease. This does not need a postgraduate Masters degree
in rocket science. It needs a cursory application of family history.
If either of your
parents had diabetes, your elder brother has diabetes, your younger
brother has diabetes and your cousin has diabetes, what are the odds on
your getting (or already having) diabetes? Again this is not rocket
science. The answer is pretty damn high! And yet, I see families like
this, where the individual members are totally surprised and amazed when
they fall ill, go to hospital, and diabetes is diagnosed.
It does not really
take very much time over a family lunch to begin to enquire about one’s
forebears. After five minutes it will be obvious if there is some kind
of common medical thread running through your family. That thread may
not necessarily be life threatening, but could be something like
arthritis for example.
Look at it this way
- your future is being displayed by your family’s past. This could be
considered frightening, when your father, his brother and your
grandfather all died very early from heart attacks. Or, this could be
considered as life saving, if it pushes you towards looking at you own
cardiac health and overcoming an apparently disastrous medical history.
This is an
advantage that you get provided you are not an orphan. You know what to
look for before it becomes a problem. Going back to the family with
diabetes, what should the younger members do? Well, if it were me, I
would be having my blood sugar checked at least once a year from the age
of 20. Any time I had reason to visit the doctor in between, I would
also ask to have the level checked. We are talking about a very
inexpensive test that could literally save you millions of baht in the
future, as well as giving you a better quality of life, and a longer
Ask around the
dinner table today and plan to check your medical future tomorrow. It’s
called a ‘Check-up’!
Update Saturday, Nov. 4 - Nov. 10, 2017
Medical treatment costs
I was asked by one of
the Chambers of Commerce for guidance on how individuals and families may
secure the best possible medical treatment (and insurance cover) at a
sensible and affordable cost.
Having been involved in
health care for more years than I wish to remember, and having worked in the
UK, Europe, Australia and Thailand, I believe I am qualified to comment on
However, this is a
vexed question. Just what do people consider to be “sensible and affordable”
costs? What is affordable for some people, may not be as affordable for
others. A comparison can be drawn between private international school fees
and “ordinary” private Thai school fees. Everything is relative, surely?
And then there is the
question of insurance cover. I have always adhered to the dictum that
medical insurance is a contract between the patient and the insurance
company. It is not a contract between the insurance company and the
healthcare provider, even though some private hospitals (mine included) do
assist the patient with the transaction. However, I do not believe I am
qualified to comment on medical insurance cover, I leave that to the
individual, but I do counsel that one should always work through a reputable
agent. I realize that a small saving on premiums may be available by
purchasing direct from the insurance company, but in the event of a
difference in opinion (for say is the ailment a pre-existing condition or
otherwise) who will go to bat for you? The insurance company most certainly
will not fight itself. That’s why you should have an agent as your
representative! I believe that is actually very important.
Back to the Chamber’s
question regarding “best possible medical treatment at a sensible and
affordable cost.” If we then look at “cost” as the parameter, is this the
correct yardstick? I’m sorry, but in this, as most things in life, you get
what you pay for. The CEO’s Mercedes is better than your Toyota. Sorry, that
is just one of the inequalities of life.
If we were to lower
prices (and let’s face it, profit margins) there are very well understood
end results. Cut-price medical treatment results in simply:
Long Waiting lists
(pick any two)!
My experience tells me
that this cut-price scenario does not represent the “best possible medical
treatment.” I would rather have my gall bladder removed by today’s
(relatively expensive) ‘key-hole’ surgery than by yesterday’s old (cheap)
open abdomen surgery. I would rather have my brain visualized with
(expensive) Magnetic Resonance Imaging (MRI) than yesterday’s (cheap) simple
X-Ray. Unfortunately, technology costs money.
I’m sorry to harp on
this, but the CEO’s Mercedes is still better than your Toyota. If you want
the best, you have to be ready to pay for it.
So is it a case of open
slather in the private hospitals? Simple answer, it is not. There were 1,002
public hospitals, and 316 private hospitals registered with the Ministry of
Public Health in 2010. There are obviously more by now. Costs will move
according to prevailing free market forces. Like any business venture it is
possible to price one’s self out of the market. The other 315 private
hospitals will keep the 316th within
the constraints of the market place. And if that is not enough, other
surrounding countries such as India and Singapore are actively trying to
attract patients from Thailand, using the “price” parameter.
hospital fees, on a world scale, are very inexpensive. This is the reason
that Medical Tourism to Thailand is continuing to grow. With procedure costs
in Thailand between 30-50 percent of similar procedure fees in Australia or
America, for example, Thailand is not considered to be expensive.
Returning to the
question of how individuals and families may secure the “best possible
medical treatment (and insurance cover) at a sensible and affordable cost,”
there are some guidelines. Patients are medical consumers. Like all
consumers you should shop around. Get more than one opinion both for the
diagnosis and necessary treatment, and for the costs. Do not be afraid of
hurting the doctor’s feelings. Second (and third) opinions are part of
medical life, and a healthy part, I believe.