ThE CLimB.... sOmE tiMeS I'm GoNNa hAVe To LOse

Space Science and my Big Dream

Discovery preparing to lift off on 24 Feb 2011

Discovery landed safely back on Earth at Kennedy Space Centre  Florida on 9 March 2011 after a flawless mission - Credit NASA

 

I stayed up early this morning to watch the safe landing back on Earth of Discovery from its 39th and final flight to outer space. It lifted off on 24 Feb 2011 and was in space for 13 days mainly docked at the International Space Station (ISS). It transported storage space and repair materials as well as the first humanoid robot named Robotnaut2 or R2 to help enhance the operations of ISS and its research laboratory space and technical capabilities.

Discovery is one other remaining three shuttles still operational, the other two are Endeavour and Atlantis. NASA used to have five shuttles for its space program. Challenger broke up at its launching in 1986 and Columbia burst into flame at its re-entry to Earth in 2003. I only remember the names of female astronaut teacher Christa McAullief from Challenger and Kalpana Chwla a naturalised Indian female engineer from shuttle Columbia. I remember feeling very sad hearing about the astronauts' death. And so with this particular Discovery flight I prayed for their safety and will continue to do so for Endeavour in April and Atlantis in June as they fly off to space and dock with ISS and return for the last time when the world will say farewell to all  three of them as they are being retired after 30 years.

Apparently the orbital space program will be privatised leaving the US government to undertake deeper space projects which will cost billions of dollars. It seems if you have millions (in USD) to spare you may be able to go as a tourist to ISS and look at our planet Earth from out there!

I have dreamt of becoming an astronomer/space scientist and an astronaut since I read about Armstrong walking on the Moon and famously said " A small step for man and a giant step for mankind". Now what is it like to be walking in space with no gravity? How does it feel to be in that space suit? What is it like to see planet earth being suspended and orbiting  in space? I was inspired to go into pure science through reading about this space program in magazines,newspapers and radio and TV.. there was no internet then mind you. With the availability of copious materials at your fingertip now ,any curious child would be just as inspired and probably more so. Just go to the NASA website and see the information that they have there for different visitors, public, student, researchers etcetera. How I wish our children are conversant in English and able to understand what they read and be inspired to excel in science because that is the edge for any country to be ahead in this globalised world.

Man on the  Moon -1969 (NASA)

I believe children can be inspired from young to be interested in science. One needs to arrange related activities for them to be involved in. I had hoped that Malaysian schoolchildren would have taken an interest in shuttle flight program, just show them the video and what kind of things astronauts do. I saw many schoolchildren in US made time to witness the shuttle launching and look at space exhibits. They might not be astronauts but at least they can appreciate the great potential of scientific knowledge. We do not want children who ascribe everything to God and leave things as they are and are only contented to be technology users rather than technology inventors.

But I have this feeling that in Malaysia, people doing science are not that well appreciated. It is sad to see those clever children going into science and end up nowhere whereas their counterparts who are not so clever especially in maths end up doing Arts and becoming heads of civil service! It is a fact. I have come across a Medical Specialist who lamented that his academically weaker classmate became head of the Ministry he was in, earning more than him.. no wonder he left the service and has gone to Singapore, another brain drain.

Well back to my dream as you all know it remains a dream as I eventually discovered in Malaysia there was no way for you to go ahead with your ambition in space science as we just do not have the industry, the capability nor the money for that kind of program. You just have to be born in the right country I suppose. For now I can continue to dream and follow the space program development and also wonder at Hubble telescopic images as they are being transmitted to earth! And perhaps I would be among the first to know if there is a meteorite going off course and coming straight to Earth or if there is a solar flare cutting off all satellite and electronic communication on Earth.... and according to a prominent NASA scientist, there is one coming up in 2012, the last one was reported in 1889 when the effects were not really great as the world did not have satellites, mobile phones and internet then, now thinking about it is  real scary. It reminds me of the Mayan calendar which stops on 21 December 2012. Will the world end then? And there are these goons going around US reminding people that something spectacular is going to happen on 21 May 2011... I just hope the stock market would not crash on that day.

Well, people actually I am inspired today to write this posting because I want to express my admiration towards NASA and all the people who make the shuttle space program possible for the last 30 years now that they are wrapping it up. So many experimental findings in space have been applied for the betterment of our human race, satellite communication is just one of them. There are also biological research in cancer therapy and many more. It's just a terrific and brilliant human effort.

As Discovery Flight Commander Steven Lindsey on the final flight STS 133 said and I truly concur, " Guys you rock!"

Farewell Discovery.

Facts on DISCOVERY

NASA's oldest and most travelled shuttle 

1984 - (30 Aug) Inaugural flight

1990 - Carries the Hubble Space Telescope into orbit

1995 - First shuttle to be piloted by a woman ( Eileen Collins)

          Carries the first African American spacewalker (Bernard Harris) and first sitting     member             of Congress (Senator Jake Garn)       

2010  (Nov) Planned launch postponed after cracks emerge upon fuelling

2011 (Mar) Ageing shuttle due to be the first of the fleet to be retired following its final   

          Earth landing  Wednesday 9 March after 39 successful missions.

Chronic Diseases and the Risks of Self-Medication

The government has spent a lot of money on promotion and maintenance of healthy life style for her population. Health strategists went to the extent of having an annual disease-theme country-wide campaigns on such conditions as heart diseases and diabetes. Regular media advertisements, publication of booklets and brochures costing hundreds of thousand of dollars are main approaches to get to the masses, teaching and guiding them on how to achieve good health and avoid early development of chronic so called lifestyle diseases.

I think to a certain extent the massive health campaign has been successful in educating people on the need for proper nutrition and exercises.The emphasis is however on prevention and it so comes as no surprise that those who develop such chronic diseases are left to fend for themselves to manage their condition. Whilst many come to the clinic to get screened, diagnosed and managed on a lifelong basis, others especially those without any symptoms will carry on regardless till it is too late.

Some people will talk to their friends and compare signs and symptoms and self-medicate. Some will go to the private doctor and get diagnosed and prescribed anti-hypertensive or anti-diabetic whichever is the disease. As the cost of the drugs is quite expensive especially when one is supposed to  take them every day, the patient has the tendency to be non-compliant. He/she would go to the clinic whenever he/she feels like it. For some working with the private sector, their employer would pay for the cost of the drugs but once they leave their job they would find the cost  exorbitant. Being treated by the private sector is costly as well as once you are on a long term drug you need to have your blood monitored regularly for any adverse effects on your excretory organs such as the liver and the kidneys. The laboratory tests are indeed expensive. And so these patients will tend to self-medicate.

Despite the existing drug  legislations in this country, you can get most drugs from the pharmacies without a doctor's prescription. Yes, the truth is stranger than fiction.

I come across three classic examples of self-medication. The first one is a man of 73, FK who has been taking anti-diabetic drug for the last seven years without any doctor's prescription let alone monitoring. The other one is also a man, YW aged 62 who has been taking an anti hypertensive drug for one year on his own and the third is SS a lady of 53 who has been on the same dose of an anti diabetic drug for the last five years on her own after defaulting from a private doctor's follow-up. Sometimes she takes and other times she doesn't.

FK has been having recurrent itchy skin rashes and has spent hundreds of dollars at the private skin clinic to no avail.YW came with jaundice (yellowing of skin and eyes) and some smart non-pacticing doctor told him that he had a high blood pressure and that he should take medication so he takes the same medication as his wife who I prescribed a beta blocker a year ago but was lost to my follow-up as she decided to buy the drug herself! Normally this class of anti hypertensive is not prescribed to a man! SS was on the same antidiabetic medication for a long time without being monitored. Her sugar level must have gone "yo yo" as she did not take it on a regular basis.

As expected all these three patients have deranged liver and kidney tests and their conditions are not clinically controlled. FK's skin rashes subsided once his sugar level was normalized. SS's abnormal thirst and heavy and frequent  urination, signs of uncontrolled blood sugar, also subsided the same way once the correct dose of the drug was prescribed. YW who incidentally admitted taking some herbs ("misai kucing") as well,  was observed to have high blood pressure despite his self-medication. His jaundice is a cause for concern as his blood test done a year back before he defaulted treatment had already showed evidence of liver disease. Chronic jaundice has many undesirable implications and needs to be thoroughly investigated. I proceeded to appeal to the three patients to understand that they needed regular monitoring and that the doctors are here for them.

But just how many people out there are self-medicating for their chronic diseases  without knowing the risks? Their ability to purchase scheduled drugs from errant pharmacies ( and maybe even from online agents)  is frightening. It is no wonder that there is a rising trend of cases of chronic kidney failure in Malaysia. With the advent  of  drugs such as  Angiotensin converting enzyme inhibitors (ACEI) and Angiotensin Receptor Blockers (ARB) whose prolonged use to treat high blood pressure, could affect the kidney function of some patients, it is imperative that these patients be properly monitored.

In medicine, you need to manage a patient like you would your loved ones. That is a real job-satisfaction.

Hypertension and my GA GA experience.

For almost three months I have been scratching my head wondering what has gone wrong with the treatment for high blood pressure of a patient. This is a 62 year old  female who speaks English fluently and dresses very smartly with a hijab ( head cover) and wearing long stockings. She has been my patient since 2009 and initially her blood pressure was well controlled with only one drug. In fact I complimented on her blood parameters which were excellent for someone her age. Both cholesterol and sugar level are normal.

However early this year her blood pressure has been climbing up necessitating another drug. As a doctor who have been treating many hypertensive patients, I noticed that it is better not to maximize the dose of only one drug to avoid unnecessary side effects. Instead patients seem to respond better if another class of anti-hypertensive drug is added to the regime. So that was what I did. Being overcautious I always ask patients whose drug regime I alter to return to the clinic after about two weeks or earlier should they experience some adverse effects.

Sphygmomanometer and Stethoscope - BP measuring set

This particular patient who I shall refer to as LP did not do either. Instead she claimed after taking the second drug she became dizzy and her blood pressure, according to her home electronic BP set was high (?). She immediately stopped the second drug and continued using the first drug for one month before she finally came to the clinic.

Her blood pressure was noted to be still high, needless to say and because she claimed she could not tolerate the second drug, I prescribed another class of anti-hypertensive and this time insisted that she should return to the clinic as instructed.

She returned after two weeks and her blood pressure was still high and yet she did not appear convinced with my measurement. Instead  she related how low her blood pressure was when she measured with her home BP set. She repeatedly claimed that she became dizzy when she took the extra drug. I was getting exasperated but tried my best to remain cool outwardly. Because despite the lowest dose of the additional drug prescribed, her blood pressure was still high during that consultation. I asked my nurse to use the clinic machine to measure and confirm her blood pressure, yes it was high, more than 140/90. I was at my wit's end then it dawned upon me that she might be taking something else at home that could have brought down her blood pressure more than clinically necessary.

Further friendly probing revealed that she had been taking a herbal concoction "PEGAGA" (Malay name for a plant) since early this year for her varicose vein. My! This was the first time that she admitted that she had varicose veins. This is the sort of problems facing you when you examine a woman covered from head to toe because you cannot really describe her general physical appearance to help you in your clinical examination. I asked her to show me her legs. She was hesitant despite me being a woman myself. When she at last took off her long stockings then I observed the multiple tortuous coarse veins running down the back of the knees to her calves. According to her the herb helped reduce her bilateral foot swelling on prolonged standing. You can go here http://thestar.com.my/health/story.asp?file=/2007/7/29/health/18419175&sec=health for the news report on the herb.

Pegaga ( Centella asiatica)

Well, if the plant's chemical can reduce tissue swelling due to abnormal veins ( may well be through an enzyme like prostaglandin) I surmise, for lack of any scientific evidence that it  could also interfere with or work in synergy with the drug I was prescribing to further lower her blood pressure causing her to feel faint and dizzy. It happens that she took the concoction in the afternoon whereas she saw me normally in the morning and her low blood pressure occurring usually in the  late afternoon and evening. Most likely the effect of this plant chemical is period-dependent and as the effect wears off, her high blood pressure returns!

I told LP she has to choose whether she wanted to be treated by a doctor or be on her own medication. I warned her that there was no way to monitor the effects of "agents" sold over the counter as herbal medicine as there was no proper research on them in terms of dosages and frequency of use as well as on the side effects and drug interactions. A doctor cannot possibly monitor a patient who uses other agents/drugs behind his/her back. I told her either she stop using the herb and take a clinic's medication for her varicose veins or she can continue taking the herb but see another doctor.

She decided to stop the herbal remedy and is now being monitored for the best combination of anti-hypertensive drugs for her rising blood pressure. I also advised LP not to throw away her home BP set as most likely the low blood pressure incidences would not recur with the stoppage of the herbs. So far so good and my own "ga ga " blood pressure is returning to normal now!

JCY - Am wondering about the Company

I am on the downside as far as my roller coaster ride with JCY is concerned. Today's price at 0.615 has wiped up 53.5% of my investment, a paper loss. And its recent financial quarter loss did not help matters. Looks like  I am in for a long haul on this stock. I just hope that the company doesn't fold up under this intense low demand pressure. As the company was just listed in Feb 2010, its previous performance was not generally known unless you read the prospectus prior to listing that I must admit I did not as I bought the shares in July and Aug 2010. The opening price was 1.48 which was  lower than its IPO price of 1.60 and the highest price before the precipitous fall was 1.98 I think.

JCY performance spiralling downwards

From my observation  on economy-dependent stocks, JCY stock would likely to recover  in 2012 -2013 as the Euro zone debt crisis eases triggering demand for computers in such countries. So I am supposed to bite my lip and slog along just like I did with SIME in 2008 and realised my effort by 2010. Somehow when you do this, time seems to crawl. Yet this is a form of acceptance so that I can move on with other wealth creating strategies.

So JCY can go as low as it wants to ( no more dollar averaging for me!) and I am going on the sideline and just watch and wait for the time when it turns around hopefully and then end my adventure with technology stocks. Come to think of it I am now wondering why did the company decide to list in Feb 2010 because within less than six months the stock tumbled badly. Usually when you supply materials to big manufacturers you would have got forward orders for the following year then you would have known about your receivables/risks already...... I am thinking aloud. If what I think and fear happened as it was here then we investors have to be really be on the look out for such companies and protect ourselves. Have I thought this way  in July last year I would not have dollar averaged on three blinking occasions! No surging happiness in this stock.

Such are the challenges that small investors face! Some people would do anything to get at our hard-earned money so beware.