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Most of us are aware that we should do regular exercise. However, due to modern lifestyles, many of us neglect this fundamental fact. Often a lack of time is blamed, but more often than not, this is merely an excuse and an easy way out. Partaking in regular physical exercise has been proven to reduce the prevalence of type 2 diabetes, various cardiovascular diseases, and some forms of cancer. The benefits of regular exercise can be felt in both the short and long-term and require only 30 minutes of daily exertion.

Why are routines important?
Humans are naturally creatures of habit, and we do tend to adapt better to a regular routine. It is certainly applicable to exercise and helps you retain focus whilst also giving you the benefits. If you miss a day, it is always best to start again the next, but don’t be tempted to put it off “until Monday” as positive habits can be quickly broken. Decide on a realistic plan from the outset and stick to it. It should challenge you and not be too easy or too difficult, both of which can negatively impact your motivation.

The general benefits of exercise
As we touched upon at the beginning, regular exercise reduces your chances of getting some severe diseases and conditions. However, it also helps you maintain a healthy weight, develop a better physique, reduce your risk of falls and improve your recovery time from common illnesses. Exercise also helps to release mood-boosting hormones including endorphins, serotonin, dopamine and oxytocin.

How much exercise should you do?
Of course, how much exercise you do will be very much dependent on your goals. However, healthcare professionals recommend that you do at least 30 minutes of moderate-intensity exercise per day to reduce your health risk, although something is better than nothing. If you class yourself as doing no daily exercise, we would suggest speaking to your doctor before commencing any form of physical activity. Assuming, exercise will pose no risk to your health, you should build up gradually to the desired levels.

Although guidelines vary from country to country a “little but often” approach is thought to be best for most people, you should aim to do between 150 and 300 minutes moderate exercise per week. However, if you prefer more vigorous exercise, your goal should be 75 to 150 minutes per day. Try to incorporate some form of strength-building activities into your routine at least twice a week.

How can I increase the amount of exercise that currently do?
Often a rather lame excuse for not doing exercise is that people don’t know how to increase what they are currently doing. A good way is to walk or cycle to work, although this may depend on where you live. Alternatively, you could get off the BTS or MRT a stop early and walk the remaining distance or walk with your children to school. Bangkok has some beautiful parks, and these are excellent places to escape from the exhaust fumes.

Can exercise reduce your risk of Deep Vein Thrombosis?
Deep vein thrombosis (DVT) is a serious and potentially life-threatening condition resulting from a blood clot forming deep within the body, often in the legs. If the clot becomes free, it can travel to the lungs, which is known as a pulmonary embolism that is often fatal if not detected quickly. Exercise improves circulation and helps to relax the walls of blood vessels, which results in better blood flow. Blood that moves freely is less likely to become blocked, thus reducing your chances of developing a DVT.

How do people get DVT?
There are several reasons why people develop blood clots, but DVTs usually arise from poor circulation. Again, there can be a number of contributory factors, including thickening or narrowing of arteries due to age or poor general health.Exercise has been proven to improve circulation and cardiovascular health, significantly reducing your chances of developing DVT. However, even active people can get clots if they stay in one position for long periods such as on long-haul flights. Therefore, it is essential to move around periodically and do some light exercise to increase your heart rate and improve circulation.

Exercises for DVT
Maintaining a healthy exercise routine as we outlined above will help promote overall health and wellbeing and reduce your chances of developing DVT. If you lead a sedentary lifestyle in your job, such as work in an office or when you are on a long-haul flight, there are some light exercises that you can do during these times to reduce your risk. You should also avoid crossing your legs where possible as this too can have an impact on circulation. Exercises you can do while seated include:

• Leg extensions – keep your thigh on the seat, slowly raise one leg until it is parallel with the ground and lower again. Repeat with the other leg.
• Ankle pumps – keeping the heel on the ground, raise your toes toward your shin and lower. Repeat with the other foot.
• Seated march – move your legs as if walking but in a seated position for 2 minutes, increasing the speed where possible. Try to aim to complete the exercises once an hour.

Can I exercise if I have DVT?
It is possible and indeed often helpful to do some exercise if you have a DVT although you should always consult your doctor before doing this. Exercise will help to ease venous insufficiency, which is a disease that may restrict blood flow back to the heart. Aerobic activity is recommended, such as walking, swimming or dancing. Building the muscles, especially in the legs, will also help promote better blood supply, and this will reduce the chances of another clot forming or existing clots getting larger.

Most people with DVT take regular medication such as blood thinners and aspirin. Once again, you should consult your doctor about the effects of this medication on exercise.

Meat has formed a crucial part of the human diet since before pre-historic times as it was seen a vital way of attaining the levels of protein required to survive and prosper. However, we have moved on from the hunter-gatherer mentally, and an increasing number of people are adopting vegetarian or vegan diets. There are many reasons for this, such as protecting the planet, the welfare of animals, because of their religion, or perhaps more commonly, health reasons.

Of course, many people who choose to improve their diet for health reasons do so without eliminating meat. Most of us are aware that we should eat a least five portions of a combination of fruit and vegetables every day. Vegetables and fruit contain high levels of fibre and many vitamins and minerals that can’t be consumed in large enough quantities from a meat concentrated diet. Therefore, if you do wish to continue eating meat, and there is nothing wrong with this, you could consider switching to a vegetarian diet on Tuesdays and Thursdays, for example.

What are the benefits of a vegetarian diet?
In many western countries, obesity rates are often above 25%, which poses significant health risks. It is believed that this is because of the consumptionof large amounts of processed food, usually ones which contain substantial quantities of meat as well as being high in sugar and salt. Moving to a more vegetarian diet helps individuals lose weight, but perhaps more importantly, it allows them to keep the weight off.

Another crucial benefit of following a vegetarian diet some days of the week is that it improves cardiovascular health. Several studies show that those who follow a vegetarian diet in India have considerably better heart health than those who follow a mainly meat-based diet. Of the participants studied, those consuming primarily meat had higher blood pressure as well as higher levels of cholesterol. In particular, red meat is known to increase cholesterol, and although cholesterol is present in plant-based foods, it is significantly lower.

Over the last half-century, the number of people who develop cancer has increased dramatically. While some of this can be attributed to living longer and increased health checks so more occurrences are found, it should not be ignored that meat does appear to play a role. Many leading medical experts believe that following a non-meat diet can offer significant protection from some forms of cancer. However, for balance, it should be noted that more research is needed in this area before this is confirmed.

Dangers of a vegetarian diet
A vegetarian diet which is correctly managed is incredibly healthy, and there are very few arguments to counter this. However one of the problems with a vegetarian diet is that people miss out on some vital nutrients such as protein if they don’t eat the right foods. Nuts, pulses and seeds can all be high in protein, so anyone that follows a strict vegetarian diet should ensure that these foods are incorporated into their daily meals.

Although the symptoms of COVID-19 can vary slightly from person to person, some of the symptoms are far more common. These include a raised temperature, a dry and persistent cough along with loss of taste and/or smell. Other widely reported signs include fatigue, sore throat, diarrhoea and muscle aches. However, many sufferers are regarded as being asymptomatic, meaning that they don’t display any symptoms.

If you have any concerns that you may have COVID-19 or have been in close contact with someone who has the virus, you should immediately take a coronavirus test.

What is the process for a COVID-19 test?
If you are displaying symptoms or have been in close contact with someone with the virus, you should always phone the hospital first to seek their advice. However, if you wish to take a test for travel, work or insurance purposes, and you have no reason to suspect that you have the virus most hospitals offer the test on a walk-in basis. Prices start at around THB 3,500 for the COVID-19 PCR test method – the test recommended by the World Health Organisation (WHO).

When you are called for your test, you can be expected to be met by someone wearing a full hazmat suit for their protection, and they will usually be behind a Perspex screen. They will ask you to confirm your name and date of birth then they will apply a swab to each nostril and then take a swab from the back of the throat, around the tonsil area. Although you may feel some minor discomfort, you will be able to resume normal activities immediately after assuming you are not suspected of having the virus.

Results
Results are usually available after 24 hours although if there is excess demand, it may take as long as 72 hours. Most people are notified by email or SMS, although you can receive a hospital certificate, which is normally at an additional cost. A negative result will be reported as “not detected” on your medical certificate. The wording can be confusing, but this the global method from which results are reported. Should you return a positive or “inconclusive” test result, the hospital will contact you immediately and advise you of the next steps to be taken.

Do I need to self-isolate?
You should self-isolate if you suspect that you have the virus or been in contact with someone who has before taking the test. In Thailand, you will be admitted to a medical facility if you return a positive result and remain there until you produce a “not detected” result. Unlike in some countries, you will not be allowed to self-isolate at home.

COVID-19 Vaccines
In December 2020, the United Kingdom became the first country to start a mass vaccination program with several other countries following suit shortly after. There are currently (at time of writing) three vaccines that have been authorised for use in Thailand that have been authorised for use around the world which are from Oxford-AstraZeneca, Pfizer-BioNTech and Moderna. Thailand has signed an agreement with Oxford-AstraZeneca to supply 26 million doses but is in talks with the other leading producers along with manufacturers in China, Russia and India.

How is the vaccine administered?
The current vaccines are administered via an injection which requires two doses. The second dose is given between four and twelve weeks after the first. The first vaccine is thought to give around 90% of the full immunity after approximately four weeks. During this initial period, your levels of immunity will increase as the body naturally produces more antibodies. A small proportion of people have suffered more severe side effects, and anyone carrying an EpiPen should not have the vaccine.

How effective is the vaccine?
The vaccine’s effectiveness appears to vary, but the consensus is that they are over 90% effective after the second dose. However, some reports do suggest that some only offer protection to 70% of people. The vaccine has also been proven to effective against current variants or mutations of the original virus, although this cannot be guaranteed for future mutations. It is also unclear whether the vaccine will need to be given annually, if boosters will be required periodically, or if the initial two injections will be sufficient.

As the vaccine was rolled out in record time and this form of coronavirus is new, there are still some unanswered questions. Nevertheless the current vaccines have deemed safe by all the major health regulators around the world.

How much will the vaccine cost?
No definitive answer has been given about how much the vaccine will cost to patients in Thailand. However, the Pfizer vaccine is believed to cost around $19 to produce each dose, the Moderna costs between $32 and $39 while the AstraZeneca one is thought to be around $4. Previously, a hospital in Bangkok had an option to pre-book the vaccine and offered both doses to patients for THB 10,000. As the vaccine is not yet available, and the government felt that this was unethical, the hospital in question was forced to withdraw the offer.

There is no escaping the fact that both smoking and vaping carry some serious health risks. The risks associated with smoking tobacco are well known, but the long-term risks associated with electronic smoking are unknown. However, all evidence seems to suggest that they are far from a safe alternative to traditional smoking.

Is one more harmful than the other?
Initial evidence suggests that vaping is less harmful than smoking, although both potentially have dangerous side effects, smoking tobacco involves inhaling around 7,000 toxic chemicals, whereas vaping has significantly less. However, there are heavy metals, carcinogenic compounds, diacetyl, and volatile organic compounds (VOCs) amongst the chemicals inhaled. The liquid used in electronic cigarettes is dangerous if swallowed, inhaled or comes into contact with the skin. E-cigarettes also contain vast doses of nicotine which is damaging to brain development.

On the other hand, tobacco is known to cause damage to every single cell and organ in the body and is responsible for 90% of all lung cancer deaths. In the US, it is responsible for almost 500,000 deaths per year and is known to cause numerous other health conditions, including heart and respiratory diseases. People who smoke tobacco are also more at risk of having a stroke or heart attack.

Should vaping be promoted as an alternativeto smoking?
When the FDA authorised electronic cigarettes, they were used to try and wean people off tobacco rather than as a long-term alternative. Unfortunately, people appear to be equally addicted to vaping, and indeed, some teenagers are now taking up vaping as opposed to smoking. It is also thought that vaping “normalises” smoking, which may make smoking more popular again. Alternative methods should be used to quit smoking, such as patches or hypnosis.

Long-term impact of tobacco
It has been known for decades that smoking seriously damages your health. Some health issues are well known, such as the increased risk of miscarriage or children born with congenital disabilities. The increased risk of cancer is also well publicised as too are increased asthma attacks and blood clots. However, some people may be unaware of some of the other issues, including increased risk of cataracts, problems with the immune system, reduced sperm count, and an increase in general inflammation, which is now known to impact general health and well-being.

Long-term impact of vaping
As vaping and electronic cigarettes is a relatively new phenomenon, information regarding the long-term side effects is somewhat limited. The University of Iowa produced a report suggesting that vaping was safer than tobacco, but many experts now question whether that is the case. Preliminary reports suggest that vaping causes damage to the lungs and releases free radicals known to cause cancer. Like tobacco it can delay brain development in unborn children, children in their formative years, and teenagers.

Conclusion
Both smoking and vaping have been proven to cause cancer and damage the lungs, both are now regarded as bad for your health. Although vaping may be marginally better, it should still be avoided and should be treated with the same caution as tobacco.

The use of marijuana for medical purposes has been proposed by many activists and even medical professionals globally. In December 2018, the use of marijuana for medicinal and research purposes was legalised in Thailand. The legislation meant that cannabis, marijuana and kratom, a locally grown opioid, could be used for medical conditions that are recognised by a doctor.

How Many Have Applied Medical Marijuana?
Around 50,000 patients are legally allowed to use marijuana in Thailand as all users must have either a prescription or doctor’s certificate clearly stating the reasons for use. The drug is still outlawed in all other circumstances under the 1979 Narcotic Drugs Act with marijuana classed as a class-5 narcotic. Illegal possession and cultivation are punishable by up to 15 years in prison along with steep fines.

The Debate about the Benefits
Many people, including those in the medical profession, still have reservations about the benefits of marijuana which is said to offer relief from Parkinson’s, asthma and cancer amongst many other things. Most of the discussion is regarding the two main ingredients of marijuana Tetrahydrocannabinol (THC) and cannabidiol (CBD).

What is known is that both THC and CBD do affect receptors in the human brain, but the responses that they cause are significantly different. THC is the psychoactive part, and this produces the same “high” that is experienced by cannabis users. CBD is believed to show signs of promise for medical purposes with users not getting the same high but gaining pain relief and other benefits. More research is being conducted in this area.

Benefits of THC
There is medical evidence to support the idea that THC does relax the blood vessels, which is beneficial in terms of pain relief and alleviating some of the symptoms of spinal injuries and multiple sclerosis. Marijuana is known worldwide for its Sativa effects caused by the high THC content.

There is plenty of evidence of the success of THC. However, what is lacking is evidence supporting its safety and efficacy when used as the primary treatment for serious diseases like cancer. Unprocessed or raw marijuana has no supporting evidence to suggest that it is useful for treating any medical conditions.

Cultivation Laws
The Government Pharmaceutical Organisation (GPO) opened their first facility in Pathum Thani province in February this year at the cost of approximately 100 million Thai Baht. The farm covers more than 100 square metres and is fitted with aeroponic systems and is naturally heavily guarded.

All other farms which are allowed to grow hemp are in tribe-development zones in the provinces of Chiang Mai, Chiang Rai, Nan, Phetchabun, Tak and Mae Hong Son. These farms are all licensed and operate under strict regulations and subject to high levels of scrutiny. These tighter regulations have inevitably pushed up the costs of medical marijuana. The first drops of oil were issued to patients back in July after they were issued with 5ml bottles.

Drugs Policies
The partial legalisation of marijuana in Thailand is likely to have far-reaching consequences across ASEAN with strict laws in place in most countries with the death sentence still in place in Indonesia for cannabis smugglers. In Malaysia and Singapore, a yougov.com survey found that most residents believed that marijuana did possess medicinal properties, although less than half of those responding supported its legalisation. Singapore in particular still believes that cannabis should still be classed as an illicit drug.

Nowhere in ASEAN can Marijuana be sold over-the-counter or in raw form. Thailand’s moves are viewed as a way of curtailing the illegal supply of cannabis and imposing government regulation, making it harder for its illegal sale.

Few would argue that marijuana doesn’t have substantial potential worldwide, and indeed, Thailand is very optimistic about its future viewing it as a likely multitrillion-dollar industry in years to come.

We are all encouraged to lead healthier lives which are usually centred on adopting a healthy diet, doing more exercise and avoiding things such as alcohol and tobacco. Leading a healthy lifestyle has physical, mental and emotional benefits leading to improved overall wellbeing and increased self-confidence.

If you want to change your lifestyle and adopt healthy habits, it can be quite challenging, but you need to alter your mindset to embrace it. Regardless of your starting physical condition, your age or sex, everyone can feel the benefits of living a healthy life and here are just five of the benefits.

1. Controlling your weight
Both eating well and doing moderate amounts of exercise will help you to manage your weight. It is almost impossible to lose weight without adopting both strategies, and indeed, people who choose one rather than both usually fail in their objective. Carrying excessive amounts of weight is bad for the cardiovascular system. Losing weight, on the other hand, will boost your immune system and lead to higher energy levels.

It would help if you aimed to do at least 150 minutes of moderate exercise each week which could include walking at pace or swimming. Eating a calorie-controlled diet will help with weight loss, and you should always eat breakfast as this will stop you from snacking later in the day as well as helping to maintain healthy blood sugar levels. Most dieticians will tell you to eat a minimum of five portions of fruit and vegetables eat day to gain the body’s required nutrients.

2. Better moods
Leading a healthy lifestyle also leads to better moods as exercise stimulates the release of endorphins the chemicals and hormones that make you feel happier and relaxed. Eating well will increase your chances of improving your physique, which is good for self-confidence and esteem. When you carry out even moderate exercise, the short-term benefits include reduced stress and better cognitive function.

Developing healthy habits is good for your mental wellbeing and interaction with others helps to boost serotonin levels. Incorporating this with a healthy diet and an exercise regime will help to improve your moods immensely.

3. Helps fight diseases
Taking plenty of exercise and eating well has numerous health benefits, including helping to prevent heart disease and high blood pressure as well as regulating blood sugar levels. Monitoring your blood pressure and cholesterol levels will help to ensure that your blood circulates properly. It has been proven that regular exercise and a healthy diet can help to manage the following problems:

• Arthritis
• Diabetes
• Depression
• Some forms of cancer

We would always recommend that you visit your primary healthcare each year for a full medical, including taking blood and urine samples. These appointments could save your life and prevent problems from escalating. All listen to and act upon your doctor’s advice.

4. Boost energy levels
Eating too much of anything thing that would be regarded as unhealthy is likely to leave you feeling lazy and lethargic. Eating a healthy diet will help you to boost your energy levels, so try to include the following items in your diet:

• Lean meats
• Whole grains
• Fruit and vegetables
• Low-fat dairy products

Regular exercise also helps to increase muscle strength which will, in turn, boost energy levels. Moderate exercise helps transport oxygen and nutrients to all tissues around your body as well as boosting your cardiovascular system. Exercise also helps to promote healthy sleeping patterns, including falling asleep faster and going into a deeper, less interrupted sleep. Lack of sleep can be a trigger for many other problems.

5. Improves life expectancy
Eating well and doing regular exercise will increase your chances of leading a longer, healthier life. According to a study by The American Council on Exercise, walking just 30-minutes a day significantly reduces your chances of premature death. If you are new to exercise, make sure you consult your doctor first and start slowly working your way up until you can do 30-minutes walking each day.

Thailand is an extremely popular destination for expats and tourist alike with Bangkok repeatedly voted the world’s top destination according to Mastercard. Medical tourism is a rapidly expanding sector in Thailand with the country being recognised for its excellent standards of healthcare which is available at affordable prices.

Quality of Care
Thailand’s private international hospitals are famed for the quality of their levels of care. Hospitals in Bangkok and other major cities attract highly trained and professional medical practitioners who offer excellent care to all patients. With almost all world-class hospitals in the country providing healthcare that is on a par with or better their counterparts in the west, medical costs in the Kingdom will inevitably increase.

Increasing Medical Costs
Medical costs in Thailand, along with many other parts of the world, have been growing dramatically in recent years with medical inflation consistently nearing double digits. With advances in technology and new forms of treatment continually becoming available, healthcare costs are now rising at their fastest rate ever. In Southeast Asia, medical expenses are increasing at such a rate that locals are finding it challenging to meet costs without having sufficient medical insurance.

How Much Do Treatments Costs?
Costs vary from hospital to hospital, but under Thai law, their prices must be publicly available and are often available on their websites. Eye surgery, appendectomy and surgery to joints can be a significant financial burden not to mention the costs associated with coronary care and cancer treatments. These costs are far beyond the means of most Thais as well as many expats.

Why You Need Health Insurance
With medical expenses steadily rising in Thailand, any out of pocket expenses, even for relatively minor treatments can have a significant impact on your finances. Thais and those with work permits do have access to healthcare via their social security payments, but in many cases, these government hospitals do not have the equipment or expertise to offer the required levels of healthcare. To get the standards of care that you and your family need, you need a quality health insurance policy to meet these extra costs.

How Much Are Premiums Expected to Rise?
With medical inflation almost hitting double digits on an annual basis, it was inevitable that health insurance premiums would need to follow suit. Most insurers have tried to keep their annual increases to a minimum and, as such, average insurance premium are expected to rise by between five and nine per cent this year – less than the rise in medical costs. These increases are incredibly reasonable, especially when you take into account the peace of mind that insurance offers.

How Can Pacific Cross Help?
We endeavour to keep our insurance premiums to a minimum and well carefully consider all rises, absorbing many of the additional costs ourselves rather than passing them on to our clients. We have an extensive range of policies to suit your needs and your budget. Our team will be able to discuss the best options for you and your family.

As of 31 October 2019, foreigners entering Thailand on a Retirement (O-A) Visa will be required to purchase adequate health insurance, and this will form a mandatory part of the visa requirements. It is suspected, although not yet confirmed, that this will also apply to those renewing their Retirement Visa.

Basic Requirement for a Thai Retirement Visa
The requirements for an O-A visa in Thailand are quite straightforward, and it is one of the most accessible visas to obtain if you meet the requirements. Firstly, you must be 50 years old or older and have 800,000 Thai Baht in a Thai bank account, or an income of 65,000 Thai Baht per month or a combination of the two. The amount must be kept in a Thai bank for a prescribed time before, and after the application is submitted From 31 October 2019, you will need to prove that you have adequate cover.

Levels of Cover
The new rules are quite specific in terms of the amounts of cover that are required. The minimum amount needed for outpatient protection is 40,000 Thai Baht and the minimum for inpatient cover in 400,000 Thai Baht. Insurance is taken out overseas, and expat health insurance is acceptable so long as it provides the required coverage in Thailand. Local health insurance is, of course, adequate.

It should be stressed that these are the minimum levels of cover that are required, and more cover is certainly recommended as medical costs are increasing in Thailand. We would also recommend that you select a policy where the insurer will pay first rather than needing to reimburse you; otherwise, it could cause significant financial hardship at an already stressful time.

Reasons
The Thai government feels that they have been forced to act on this issue with over 100 million Thai Baht in hospital fees going unpaid by foreign patients. A large percentage of this is from the estimated 80,000 people on the O-A visa. It is accepted that the move will not eliminate the problem, but the consensus is that it will make a significant contribution in reducing future unpaid medical bills.

Who Will Be Affected?
The only people to be affected by this move will be those applying for new O-A visas as well as (it is assumed) those renewing their Retirement Visa after 31 October 2019. Those affected will be required to show documented proof that they have the insurance for the rest of their stay. Failure to do so may result in the visa being denied.

If the move proves successful, it is anticipated that the requirement will become mandatory for other types of Thai visa including Tourist Visas, Marriage Visas and other forms of long-term visa.

What Options Are Available to You?
Many local insurers do not offer health insurance coverage beyond the age of 60. However, here at Pacific Cross, we have a wide range of insurance policies that are designed to cater to your needs and your budget. We will off you friendly, helpful and advice and ensure that you have the coverage that you need.

Stroke Rates on the Rise

Stroke is the second most common cause of death globally, although, paradoxically, the problem tends to receive less attention than many other disease processes from healthcare providers. As the world population ages, the burden due to stroke is likely to increase in regions such as Asia, where an increase in risk factors such as smoking and the introduction of western dietary patterns is also occurring. Other groups, such as women, may also need attention because of their longer lifespan and increase in smoking incidence. In order to contain the problem, minimum standards concerning stroke management need to be set to provide a framework within which governments may work.

Here in Thailand an estimated 50,000 people are dying from stroke each year, according to the Royal College of Physicians which makes this health condition a leading cause of death among Thais. There are approximately 250,000 new cases of strokes are recorded in Thailand each year, with about 50,000 patients losing their lives and approximately 30% of the victims become paralyzed.

While strokes can be fatal, death can usually be prevented if victims are aware of the symptoms that precede the event and how to deal with it – which can be summarized by the acronym “FAST”.

• “F” stands for facial twitching
• “A” stands for arm weakness
• “S” stands for slurred speech
• “T” stands for timing of action taken once the other symptoms have been identified.

It has been proven that victims who receive treatment within 4.5 hours following the reporting of the stroke symptoms are less likely to suffer from long-lasting or permanent disabilities. Awareness of the symptoms could lead to timely intervention, potentially saving lives.

It has been inferred that those who regularly smoke cigarettes, have high-blood cholesterol levels and lead sedentary lifestyles face higher risks of suffering from a stroke. To minimize the risk of this disease, we suggest regular exercise, eat a lot of fruit and vegetables, refrain from smoking and limit your alcohol intake.

Air Quality Index PM 2.5

Chocking air pollution and thick smoke in Bangkok has adversely affected the health of many.

Hazardous dust particles known as PM 2.5 have exceeded the safe level around the capital, according to the Department of Pollution Control. PM 2.5 is a mixture of liquid droplets and solid particles that can include dust, soot and smoke, one of the main measures of the Air Quality Index (AQI). Public discontent has surfaced, and TV hosts are advising viewers on the types of face masks they should wear. These are serious concerns shared by the residents of the city who are battling the toxic air on a daily basis. Reasons for the persistent smog include combustion exhaust from Bangkok’s traffic-strewn roads, the burning of fields from farmers outside the city, and pollutants from factories.

The term fine particles, or particulate matter 2.5 (PM_2.5), refers to tiny particles or droplets in the air that are two and one half microns or less in width. Like inches, meters and miles, a micron is a unit of measurement for distance. There are about 25,000 microns in an inch. The widths of the larger particles in the PM_2.5 size range would be about thirty times smaller than that of a human hair.

Particles in the PM_2.5 size range are able to travel deeply into the respiratory tract, reaching the lungs. Exposure to fine particles can cause short-term health effects such as eye, nose, throat and lung irritation, coughing, sneezing, runny nose and shortness of breath. Exposure to fine particles can also affect lung function and worsen medical conditions such as asthma and heart disease. Scientific studies have linked increases in daily PM_2.5 exposure with increased respiratory and cardiovascular hospital admissions, emergency department visits and deaths. Studies also suggest that long term exposure to fine particulate matter may be associated with increased rates of chronic bronchitis, reduced lung function and increased mortality from lung cancer and heart disease. People with breathing and heart problems, children and the elderly may be particularly sensitive to PM_2.5.

Chest pain is one of the most worrying reasons to go to seek emergency treatment. While many of these people are having a heart attack, some folks may just have severe heartburn.

Often, the pain from a heart attack and a severe heartburn episode is so hard to tell apart that doctors need sophisticated tests to discover what’s going on.

To complicate things even more, heartburn and heart attacks have many of the same symptoms and happen in similar types of people, such as those who are older or overweight.

Signs more typical of heartburn include:

• You have a sharp, burning feeling just below your breastbone or ribs. The chest pain can be accompanied by an acidic taste in your mouth, regurgitation of food, or a burning in your throat.
• Pain generally doesn’t spread to your shoulders, neck, or arms, but it can.
• Pain usually comes after meals, particularly after foods or drinks that trigger reflux in you.
• Pain also comes when you lie down or exercise on a full stomach.
• Symptoms usually get better quickly after taking an antacid.
• You rarely get a cold sweat or shortness of breath along with your other symptoms.

What does heartburn feel like?

Heartburn begins when stomach acid splashes up into your esophagus, a tube that connects the back of your throat and stomach as you experience a burning feeling in your chest.

Telling your doctor about these symptoms is usually all they need to make a diagnosis of heartburn. But they may ask you to take special tests to find out how severe the problem is or to keep an eye on your treatment.

When to call for help

If you have pain in your chest that’s not going away and you’re not sure whether it’s heartburn or a heart attack, call an ambulance.

 

Also, call an ambulance if you have symptoms that are more typical of a heart attack or angina (severe chest pain from heart problems).

 

If you have any pain that lasts for more than a few minutes or any warning signs of a heart attack, get medical help immediately. Also get emergency help if you’re confused at all about whether your symptoms are from heartburn or a heart attack.

The government set an April 4, 2019 deadline for all private hospitals, regardless of size, to submit the data or face penalties under the 1999 Prices of Goods and Services Act.

According to the Act, those that refuse to supply information to the regulator violate Section 18 and are subject to up to three months in jail, a fine of up to 5,000 baht or both. Let’s see how the regulator reacts to those who non-comply, as it will be an interesting read when the results are known.

The interesting point in this exercise is that doctors in private hospitals while prescribing medicines never complete a prescription document that could be taken to a local pharmacy to have filled.  All medicines are provided from the hospitals own pharmacy, so controlling prices will be a real challenge for the government unless that door is closed!  The Ministry says prices are between 30-300% above production costs which is alarming and the Commerce Ministry has found that more than half of private hospitals overcharge for medicines and medical services.

How many times have you visited a doctor and came out with 4 or 5 different medicines – do you question, why? Do you have these same medicines at home, so why take them? All these unnecessary costs simply add to premium increases that occur each year.

While a number of hospitals have purchased robotic surgical tools, are these tools the most appropriate for the surgery being performed?  Or is this just another way to add to the complexities of pricing that some hospitals claim?  We are not sure that you will get the right answer as quotas and utilization of equipment are present in the hospitals each of us visit. These hospitals also want a return on their investment as fast as possible. Also there have been claims by some private hospitals that medical costs in Thailand are hugely cheaper than in the United States of America.  If

this is the excuse used to justify excessive pricing, then we are all being fooled, as the US is at the extreme end of medical treatment charging stupidity!

Is there a fine line between a moderate or social drinker and an alcoholic? How much alcohol is too much? Some theories suggest that alcoholism has nothing to do with the amount people drink. A leading psychiatrist says, “Some people who drink just a little can become addicted, whilst others who drink a lot, are not”.

There are two main criteria for alcoholism diagnosis, tolerance and withdrawal. Tolerance applies to someone who keeps requiring an increased amount of alcohol, and withdrawal symptoms are both physical and psychological, occurring when the use of alcohol ceases. Physical withdrawal conditions include headaches, dizziness, nausea, sweating and a fast heart rate. Psychological conditions include anxiety, irritation, fatigue, insomnia and poor memory and concentration. Scientists worldwide continually debate what is a safe amount of alcohol. Alcohol itself usually does not kill, but hard drinkers and those addicted to it run serious risks of succumbing to alcohol related illnesses. Worryingly, despite the health risks associated with it, global consumption of alcohol has been predicted to rise during the next decade.

Psychologically, alcohol dependence can result in poor functioning at work, hallucinations, aggression and loss of control, which in turn can lead to relationship problems, divorce and debt. Therapies for alcohol abuse can be carried out on an inpatient or outpatient basis, depending upon the severity. Mostly it begins with cutting down alcohol followed by treatments for alcohol related complications and dealing with withdrawal symptoms. For those who are addicted and want to seriously quit, the most important thing for them is maintaining their determination to change. Like many other psychological illnesses, many do not realize or accept that they are sick, and do not want to seek medical help. Treatment for alcohol abuse can actually start at home by simply reducing the amount people drink. If that fails, it could mean they are addicted, and need to visit a doctor to seek immediate professional help.

They are probably the most difficult cancer patients to treat – around 150,000 men worldwide every year whose cancer is aggressive enough to defy standard hormonal therapy, though has not yet spread to the point where it can be seen on scans. These patients enter a tense period which can often end too quickly with the cancer spreading to their bones and other organs, causing great pain.

Researchers have recently found from independent clinical trials that two different drugs help these patients, giving them two more years before the cancer progresses through the body, meaning they have additional time before pain and other symptoms spread, causing the need for chemotherapy and other treatments.

Prostate cancer is the second most common cancer in men worldwide. The patients in recent studies were men who had already received treatment for prostate cancer, such as surgery and radiation, but had not responded to standard treatment to block testosterone from binding to and entering cancer cells. In the studies, two thirds of the men took androgen receptor inhibitors, while a third took a placebo. They all continued to receive androgen-deprivation therapy. The studies are considered to be scientifically important as they lead to clinical improvement and initial indications show that the drugs may extend patients’ survival, though researchers will have to monitor the patients for longer to know for certain. Both drugs are apparently safe, with relatively few side effects, though some experts have warned enthusiasm about the new drugs should be tempered by other changes occurring on the subject of prostate cancer.

Information sourced from LIFE, The Bangkok Post

In recent years strokes have become more common among people under 60 years of age. Elderly people, working age adults and even teenagers can be threatened by strokes depending upon a range of factors.

Types of strokes include Embolic strokes that occur when blood clots form, possibly in the heart or elsewhere, travel in the blood, clogging the small blood vessels in the brain.

• Cerebral thrombosis occurs when blood clots form inside a blood vessel within the brain that has been narrowed by the buildup of fatty substances.
• Hemorrhagic strokes occur when weakened blood vessels rupture and bleed in the brain. The blood accumulates and puts pressure on the surrounding brain tissues, causing damage.

Time is the key to stroke treatments. If symptoms occur, patients should be in the care of specialists as soon as possible. If reached in time, modern technology can greatly improve the chances of survival and even complete recovery.

• Stroke symptoms include weakness of the arms, numb limbs, and an unsteady walk. Difficult speech can also occur, with the inability to complete a sentence, along with a drooping appearance in the face, usually with a severe headache.
• Recognised stroke risks are high blood pressure, diabetes, smoking, carotid artery stenosis and atrial fibrillation or other heart diseases. Try to avoid excessive alcohol intake, partake of regular physical activity and encourage weight control.

Stroke treatment. If a major clot is confirmed material will be injected into the bloodstream to pinpoint its location, after which it may be removed by minimally invasive surgical treatment. Due to the fragile nature of tiny blood vessels, all procedures must be performed by expert teams of radiologists and neurosurgeons.

Strokes can happen to anyone and may reoccur. Follow a healthy lifestyle, study your family history and consider an annual checkup. For those affected by stroke activity, try to bear in mind early rehabilitation leads to faster brain and muscle function recovery. It can also prevent various complications, such as muscle weakness, respiratory tract infection and thrombosis.

Information source : Bangkok Neuroscience Centre

Anyone can have a fall, but older people are more vulnerable and likely to fall. Falls are a common cause of injury. If you have a fall, it’s important to keep calm. If you’re not hurt and you feel strong enough to get up, don’t get up quickly. If you’re hurt or unable to get up, try to get someone’s attention and always keep a mobile phone in your pocket so you can call for help.

Older people are also more likely to suffer a fall because they may have balance problems and muscle weakness, poor vision or a long-term health condition, such as heart disease, dementia or low blood pressure, which can lead to dizziness and a brief loss of consciousness.

Falls are more likely to happen if floors are wet, the lighting in the room is dim, rugs or carpets are not properly secured, or if you are reaching for storage areas, going down stairs or rushing to get to the toilet.

There are ways you can reduce your risk of having a fall, including making simple changes to your home, for example removing clutter, trailing wires and frayed carpet, mopping up spillages and using non-slip mats and rugs. Also consider doing exercises to improve your strength and balance. Finally, it is also worth mentioning that avoiding alcohol or reducing the amount you drink can reduce your risk of having a fall…and remember to watch your step when walking outdoors at all times.

They are probably the most difficult cancer patients to treat – around 150,000 men worldwide every year whose cancer is aggressive enough to defy standard hormonal therapy, though has not yet spread to the point where it can be seen on scans. These patients enter a tense period which can often end too quickly with the cancer spreading to their bones and other organs, causing great pain.
Researchers have recently found from independent clinical trials that two different drugs help these patients, giving them two more years before the cancer progresses through the body, meaning they have additional time before pain and other symptoms spread, causing the need for chemotherapy and other treatments.
Prostate cancer is the second most common cancer in men worldwide. The patients in recent studies were men who had already received treatment for prostate cancer, such as surgery and radiation, but had not responded to standard treatment to block testosterone from binding to and entering cancer cells. In the studies, two thirds of the men took androgen receptor inhibitors, while a third took a placebo. They all continued to receive androgen-deprivation therapy. The studies are considered to be scientifically important as they lead to clinical improvement and initial indications show that the drugs may extend patients’ survival, though researchers will have to monitor the patients for longer to know for certain. Both drugs are apparently safe, with relatively few side effects, though some experts have warned enthusiasm about the new drugs should be tempered by other changes occurring on the subject of prostate cancer.

Despite many reports and theories to the contrary, there is inconclusive evidence that using talcum powder can cause cancer. In its natural form, some talc may contain asbestos, which is known to cause cancer. However, modern domestic talcum powder does not contain asbestos.

Asbestos free talc, such as that found in modern talcum powder has been suggested to increase the risk of ovarian cancer in women who apply talcum powder regularly. Several studies in women have looked at the possible link between talcum powder and ovarian cancer, with mixed findings. Some studies report a slightly increased risk, while others have found no increase. In addition, there is no evidence to suggest that talcum powder increases the risk of other types of cancer. Due to this inconclusive research evidence, talcum powder is classified by the International Agency for Research on Cancer (IARC) as possibly carcinogenic (cancer causing) to humans when applied to certain areas. When inhaled, talc that contains asbestos can cause cancer. As asbestos is not an ingredient in modern consumer talc products, exposure risk is mainly for employees in industries who may have long term exposure to natural talc fibers. Occupational exposure studies can be complicated by the fact that talc in its natural form may contain varying amounts of asbestos and other minerals. The best advice is to tread with care, and be sure to know exactly what you are buying and using before you do so. Carefully read safety advice as stated on the product packaging, and avoid applying talcum powder to facial areas, rubbing it into the skin or inhaling it.

Cotton buds could soon be banned to cut plastic pollution. They’re small, but are actually one of the most serious sources of marine pollution because so many people flush them down the toilet. They’re small enough to be eaten by birds and sea life, too, so they’re pretty harmful. Recently, a whale died in southern Thailand after swallowing more than 80 plastic bags, with rescuers failing to nurse the mammal back to health.

The convenience of using a white bud in your ears to remove wax and other debris has worked well. They’re bad for the environment though, so it’s probably a good time to learn how to live without them. Cotton buds aren’t really that good for cleaning out your ears as in fact they may even push wax in further. You don’t actually need to remove earwax, as it serves an important purpose, trapping dirt and dust, and preventing it from traveling further into the ear. You only need to remove wax if it’s blocking your ears. Simply drop two or three drops of olive oil into your ears twice a day for a few days. This will loosen your earwax and help it ease itself out. Earwax softener uses much the same technique as olive oil, and you can buy special earwax softening solution from most pharmacies. Again, you’ll apply a few drops in your ears and notice earwax fall out over the course of a few days.

Use a warm, damp cloth for the outer parts of your ears, which you really should keep clean. Run it around the curves of your ear without trying to poke around inside. The outer bits of the ear are all other people can see, so those are the areas that need cleaning. Also beware, as tweezers, needles, and any other small, pointed things you have should not go in the ear, as they may cause damage.

Are multivitamin supplements that contain several vitamins and minerals essential for good health? Vitamin A, C, and D, plus calcium, iron, and magnesium among numerous others, are taken in a once a day dose, a simple way to get the vitamins and minerals you need from a small tablet or pill.

But multivitamins and their efficacy remain controversial. While supplements may help if you’re deficient in a specific nutrient, at the end of the day, your diet is most important.

Before supplements, humans had only foods to rely on for the vitamins their bodies needed to function. Vitamin A, for example, can be found in milk, eggs, liver, and green vegetables. Vitamin C can be found in oranges or dark leafy greens. Cheese, milk, yogurt, fortified tofu, and broccoli are all high in calcium. A well-balanced diet should, in theory, provide us with all the vitamins and minerals we need. Only when you’re sorely lacking a vitamin and aren’t eating a reasonably healthy diet, do you need supplements.

If you’re considering taking supplements, consult your doctor before choosing a multivitamin plan. Many find that supplements have little or no effect at all. That being said, it’s probably a better idea to focus on consuming a well-balanced diet, complete with protein, whole wheats, and plenty of green leafy vegetables, than to turn to expensive pills.

What happens to your body when you don’t eat enough salt?
Reducing salt intake is important for maintaining a healthy blood pressure level, however overdoing it could harm your heart.
Many otherwise healthy adults are at great risk for heart disease and stroke because of high blood pressure, also known as hypertension. While many people consume more salt than they should, increasing their risk, not everyone should switch to a low-salt diet.

While lowering salt intake is the key to keeping those with high blood pressure in check, cutting out too much salt could put them at greater risk of cardiovascular disease.

Some people’s bodies are more sensitive to the effects of salt than others. However, consuming too much salt leads to fluid retention and high blood pressure. Those who are sodium sensitive or who have a history of heart problems or hypertension in their family, may want to reduce the amount of salt, but also need to make sure they’re consuming the right amount.

Once you go below 2,300 milligrams of sodium per day, there are no benefits to the heart, but instead there is potential for harm.
A single teaspoon of table salt, which is a blend of sodium and chloride, has 2,325 milligrams of sodium. Sodium and chloride are two electrolytes that help maintain fluid balance, nerve impulses, and help the body absorb glucose, amino acids, and water, ultimately regulating the body’s blood pressure.

The relationship between salt intake and health requires an approach that recommends salt in moderation, particularly focused on those with hypertension.

Five signs that show you need to drink more water
1 – Light-headedness
Are you having trouble concentrating? Studies have linked dehydration with high anxiety and fatigue, grumpiness and trouble completing tasks, grogginess and confusion. Dehydration can also increase driver errors, putting you at risk on the road
2 – Constipation
Constipation can be a sign of more chronic dehydration. Drinking plenty of water is the best way to treat the problem.
3 – Poor exercise performance
A good run outdoors when it’s hot is a great way to get extra sweaty! However if you sweat too much and don’t replace it with fluids, you’re at risk of heat cramps, and worse, heat exhaustion, weakness and dizziness. To prevent heat emergencies, pre-hydrate 20 to 30 minutes prior to exercise with 15 to 20oz of water, and when it’s hot, sip every 20 minutes during exercise.
4 – Urinary problems
When there’s not enough water running through your body, your kidneys won’t produce much urine. Drink water immediately to resolve the problem.
5 – Headaches
Even mild dehydration can bring on persistent head pain. Dehydration decreases the fluid levels around your spinal cord and brain, which may affect the pressure in your brain. Again, drink water to alleviate the problem.

How to spot signs of stress in your children
Young people, like adults, experience stress, which can come from a variety of sources. These are all fairly normal parts of growing up, but because children now have less down time and expectations are so high, these ordinary problems can become magnified and less easy for them to deal with.
How to spot the signs that something might be wrong in your children

1 – They want to skip school
It’s no surprise to hear your child doesn’t want to go to school sometimes, but if it becomes more frequent be aware that perhaps there’s an underlying reason why they want to stay at home. So many things can cause stress at school – exams, schoolwork, socially fitting in and at worst, bullying.

2. – Their grades are slipping
Another tell-tale sign of stress is how their grades are. If they used to be getting As and Bs and they start getting Cs and Ds, ask yourself why. Children can also feel huge pressure from their parents and teachers during exam time.​

3 – Their eating habits have changed
As with adults a big indicator of stress is how you relate to food. It can go two ways, a child can overeat, where they use food as a comfort, or they can eat too little or even lose interest in eating altogether.

4 – They say they feel physically ill
Understand that ‘feeling sick’ may be caused by stress. Stress can appear as physical symptoms, such as headaches and tummy aches. If this happens more frequently or increases in certain situations, like before an exam, the child may be experiencing stress. They may also show their stress in physical behaviour, such as being more jumpy and less able to settle down.

5. They don’t sleep through the night
Children who are suffering from stress often experience poor sleep. Modern technology may be playing a big part in this. Your child may be taking their phone or iPad to bed with them and it may be stopping them from sleeping. As wonderful as modern technology is, it needs to be monitored.”

6. They have a negative outlook
Does your child appear sad and unhappy? Look at their behaviour and perhaps they’re misbehaving to get your attention – but not even on a conscious level.
You should know the behaviour in your child normally to recognise any changes. It’s often not what’s being said that’s important, but what’s not being said.

If you feel something is wrong, the first port of call would be to speak to your GP. Sometimes a child may be reluctant to go to the doctor, but initially you can go on your child’s behalf.
Hi, and welcome to the first edition of Health Matters, from Pacific Cross Health Insurance PCL.
We are providing a range of informative articles to give you an insight into important health related matters that are particularly relevant in the modern times we live in.
We hope you save money, enjoy a healthy lifestyle and of course, are adequately insured in times of need. Please read on, and remember, your health and that of your family, matters.

Tom Thomson, Chief Executive Officer
Pacific Cross Health Insurance PCL