That is how all of my Amazon orders arrive. Didn’t ever think about it being a problem :shrugs:

My wife had this. All sorted via the GP. Pads designed to spread toes and wider shoes didn’t help. Steroid injections didn’t help (had to do 3 rounds) but having it cut out did. Strangely things like driving and swimming were most painful for her.

Going through this process took ages but the recovery from removing the neuroma was super quick and easy.

If it were me I would go to the GP, try to get a diagnosis as it may well be something else, and go from there. IIRC she had an ultrasound to spot the neuroma. As someone else pointed out, once the neuroma is a certain size, nothing helps except snipping it out so if I found it it was reasonably large and painful I’d be looking up private Morton’s neuroma removal to save 1-2 years messing around going through all the various NHS hoops

TLDR: Ignore your Garmin and do what makes you happy.

Might be worth adding that I get better HR measurements over short/sprint intervals using a chest HRM rather than my watch. The latter can be a bit slow to react, so can miss peaks.

HR is a really poor measure of anything “anaerobic” anyway for this exact reason. If you want your Garmin to give you a pat on the back then use a powermeter and do any kind of shorter intervals a very high exertion (and get your FTP set correctly- or incorrectly if you really want an extra pat on the back ;) ). Or ride a singlespeed- amount of swearing and gurning correlates to increase in Garmin anaerobic ratings- the Garmin app seems to respond to SS gurning in my experience ;)

You need it because if you don’t use it, you essentially lose it, which is why you see so many old boys trundling around at a gentle steady pace on the flat, then slowing to a grinding crawl on every steepish climb.

It is true that physiology changes with age which is why you always see strength training encouraged with aging (your HR monitor and Garmin app won’t register it correctly but it helps in the real world). Cycling at virtually all intensity levels during is heavily aerobic and “aerobic ability” (to massively oversimplify) determines good/ bad across virtually all cycling and climbing intensities. It is quite hard to truly test anaerobic systems hard whilst cycling. Crawling up climbs with age is more likely due to aerobic ability/ weight/ habit and lack of specificity/ other health or MSK issues/ doing it deliberately to focus on aerobic gains/ etc/ etc

the villa really wasn’t geared up for anything other than warm

This was my main issue in the colder months.

When the rain hits it can be useful to have some local knowledge as some of the roads and surface run off can make things very slick compared to the hideously rough roads we are used to in the UK

Are the gowns not optional? Or are they optional in the sense you will be looked down upon if you don’t get on board?

You would hope somewhere like St. Andrews could be better than average!

^ @doris5000 posh unis do things different and like to dress up

Sorry but I am also on the side of this all sounds like par the the uni halls course. Part of the experience? Character building? Not sure, but definitely a rip off and scandalous conditions but it always has been anywhere I have seen.

I thought it would end once I was out of halls but the private accommodation was way worse. I had a 0.5m x 0.5m hole in the bathroom floor through to the kitchen in my first place which was promised to be fixed before moving in and of course never was. When you are a student with little money and everywhere else is taken, you get stuck with all kinds of sh1t.

A combination of very high demand, no incentive to actually make the conditions safe let alone great, and no better options doesn’t exactly drive up quality and reduce costs :(

In fairness to the university by the end of the first semester the other people I was stuck with had had 2 or 3 fire extinguisher fights, attracted rodents with their kitchen hygiene and thought it was funny to p1ss on each others doors when then came in after a night out… every night, so the extra investment would have been wasted with how the majority of kids away from home for the first time seem to treat places.

edit: what @ThePinkstr said

Also OP, “secure bike locations” are optimistic in any city let alone uni. If in halls, on a old rug or in a bike bag under the bed assuming a bike of value rather than a cheapy commuter.

I used interlocking loft boards on the wall of my shed to hang the bikes from, which worked really well.

That seems like a good idea. It would have solved at least one problem I had just now… getting 2440mm x 1220mm x 18mm OSB in the car :D The size I was prepared for but I completely underestimated the weight!

Thanks all. I missed some basic common sense stuff there but have everything I need now. Thanks! :)

Very interesting. I’ll have to give that R4 thing a listen. I can’t even picture something basic like a blue square, let alone visualise family or my drive to work that should be ingrained. I can construct how things will be or should be in my mind by logic and memory- I just can’t “see” them as such…

My experience of an incident, even one with independent witnesses, was that nothing would be pursued without video. The attitude of the police and insurer basically came down to video being the only irrefutable evidence that would help take any action. Right or wrong, (good quality) video makes dealing with things afterwards so so much easier

I’ve had a reply from NHS Endocrinology that the next step is the ACTH stimulation test which is as expected.

The wait however is 3-5 months! I think they want to do it at 9am again and only have clinics twice a week so you can see how that makes a big queue as that’s 2 tests a week.

Does anyone remember how or where they had their ACTH stimulation test done?

I’ve looked privately and no-where I’ve found does it. Reading between the lines it has to be done in hospital in case of adverse reaction… but I would have thought private should be an option.

The consultant I booked to see privately has also just cancelled and will be off work for several weeks so I’m struggling to find anyone to help sooner than a few months.

Any ideas or experience from the similar journey in the early days of low cortisol much appreciated :)

If you watch again, both front wheels were level then Pidcock locked his back wheel to shorten his route, edge slightly in front and jut in to the side of Koretzky in the process. He was fully expecting contact and went full commit to edge in front by any means necessary. I’m not saying you can’t do it, but it was an all or nothing move in typical Pidcock style and it’s won him a gold medal. No-one deserves to be booed over the line

I personally think that was a naughty move from Pidcock as he knew full well he was going to go in to the side of Koretzky and gambled on coming out of the tangle best. He’s done way worse week in week out so no surprise and ultimately he was prepared to take the extra risk so comes away Olympic champion

If, say, a vegetable (let’s say beetroot for the lolz) is found to contain a wonder ingredient. At what point is it doping?

WADA definition

Typically, a substance or method will be considered for the WADA Prohibited List if the substance or method meets any two of the following three criteria:

– It has the potential to enhance or enhances sport performance

– It represents an actual or potential health risk to the athlete

– It violates the spirit of sport

^ Absolutely on the ingrained history and struggling to survive financially.

I seriously doubt Cav has a clean career

I’d disagree slightly on saying all teams have strong historical doping links. I can’t find dodgy history in VLaB staff for example. That isn’t to say they are squeaky clean but at least historically they aren’t stuffed full of rampant doping history like UAE or Astana/ Vino. It’s more of a mixed bag nowadays and most Pro Tour teams are at least making an effort whilst trying to survive

Cherry juice is clearly cancelled out by Pog’s horribly un-aero position ;) :D

edit to the above: Iban Mayo is also on the list

The amount of arse-covering in the media is interesting. Even in today’s Cycling Weekly, Ned Boulting talks about how it’s never certain whether doping is occurring or not, Pog seems lovely and is obviously a fantastic athlete, but finishes with a paragraph pointing out that Pog’s backroom is filled with the dodgiest people in cycling.

Shamelessly pulled from eslewhere:

Pogacar’s team manager and sports director.

1998 Tour of Romandie, Gianetti quit the race sighting “sickness”. He fell unconscious and was rushed to a hospital. The two doctors who treated Gianetti did several tests on him, but they suspected he had been injected PFCs. PFCs have a tremendous effect of carrying oxygen; it can carry oxygen five times the rate of hemoglobin.

2004-2011 Gianetti and Matxin were team managers of Saunier Duval team. Several riders were sanctioned for doping violations that occurred during his tenure as directeur sportif, including Riccardo Riccò and Juan José Cobo. Another rider, Piepoli, later admitted he was also part of the doping program.

Teammate of GIANETTI, Stéphane Heulot, described the situation in SDP team in 2010: “Doping is so ingrained in certain managers like Gianetti, that they can’t conceive of cycling any other way.”

2011-2014 Gianetti then formed the ‘Geox-TMC’ team: Juan José Cobo won the 2011 Vuelta a España, but in July 2019 he was stripped of this title after being found guilty of doping with EPO. Following this, in July 2014 Dennis Menchov lost his tdf results from 2009, 2010 and 2012 when he was also banned for 2 years for doping.

2014-2016 Gianetti and Matxin were then managers of Lampre-Merida team: In 2014 Diego Ullissi received a suspension for a doping violation. L-M was involved in the Mantova doping investigation by CONI, and 3 riders were implicated, including a 2 year ban for Alessandro Ballan. Michele Scarponi received his second doping suspension whilst at L-M, managed by Gianetti and Matxin. Lampre-Merida got a new sponsor in 2017 and became Team UAE.

History tells us all the top guys are doping but I’m not prepared to throw them all under the bus anymore without any whispers or evidence of it beyond XYZ performance is not normal.

History tells us the guys looking after Pogacar have been part of some of the worst doping scandals in recent years. Menchov, Cobo, Ballan, Scaponi and the king of them all Riccò (remember the CERA and outrageous blood transfusions).

He says he put out career best power numbers but this was directly at the finish. He’d not looked at power files etc. Just what was on the computer and made his own interpretation. He may have done for the 45+minutes of the climb due to the way it was ridden whereas normally climbs go steady then stop starty for the leaders as they try and find a weakness. That was full on from the bottom. I don’t agree Vin was faster than ever but he was clearly at his current limit.

Vingegaard put down the all time second best climbing performance, as confirmed after the ride. Pogacar rode with no hands casually taking a bidon while Vingegaard was going full gas, before disappearing in to the sunset with 5km left (the best all time climbing performance).

Vingegaard is just as superhuman, especially considering his build up to the race, but Pogacar could at least pretend that riding off from the worlds best is at least a little difficult :) The ease he has pulled away from the front of GT stages this year is incredible

@slowoldman @tomlevell sure you can make excuses for the rest of the field but they are no mugs and they haven’t turned up making no effort at all

Pog effortlessly riding away from the entire field at will, two GTs in a row is superhuman. The Giro didn’t slow him down at all which is incredible too.

As much as Vins relative performance isn’t too surprising, he still put out career best power numbers up la planche des belles filles whilst Pog was casually riding no handed taking a swig from a bottle, before riding off in to the sunset. Previous crash or not, Vin was flying faster than ever and Pog makes it all look ridiculously easy.

As a casual fan I’d love to see him repeat the same feat at La Vuelta :)

Two Grand Tours made to look like child’s play! For all the talk of Le Tour having a weak field, lets not forget he made previous Grand Tour winners look like amateurs.

Who wants to start the grey zone and undetectable shopping list to get a STW member in yellow next year? :) Sand worm hemoglobin anyone?

I was thinking today about the key things which have led me to potentially getting my long term issues potentially understood and I think they are good tips for anyone trying to solve mystery health issues:

1) Having the NHS app

Actually seeing what has been investigated, GP notes and dates of visits made a huge difference from “I think I’ve been to the GP 2 or 3 times saying the same thing” to “sh1t I’ve been saying the same thing for 4 years and nothing has been done- time for action”.

2) The power of personal connections

Not so much who I know, but the influence of people who know other people. A podiatrist helping me with nerve issues put me on to a particularly good physio put me on to a sports consultant who knew a neuro OT who recommended cortisol testing among other blood tests

3) Chance

The big one was having a massive MTB crash which kick started a lot of investigations after my long term symptoms got suddenly worse. I’d prefer not to have had 7 months of severe concussion symptoms but it has forced a big health overall and MOT

4) Knowledgeable clinicians who are prepared to dig a bit deeper

Finding the right person on the concussion side has been huge (sports consultant for his signposting to local services and concussion physio in particular).

If not for a neuro-OT who has previously worked in a military head injury clinic, I would have never had the endocrine side investigated. I have been saying the same things to a load of different people for years but this wonderful person in particular had the previous experience and knowledge to ask more questions and dig a little deeper

5) Linked to the first point, but one of the main things has been persistence and taking a lot more ownership of health. It has felt like a second job at times but hopefully the hard work will pay off in the future

All good fun and continuous learning and I’m sure that is set to continue!

Thanks @Jordan that gives some reassurance that things can be somewhat normal, but as others have already pointed out, a lot of trial and error potentially ahead.

First step is to know a bit more about exactly what is going on and go from there

Thanks @Rio That is all really helpful information.

One of the things I had not appreciated before your post and the ones above, was how rare adrenal insufficiency is. With that context it does help make it easier to understand the perspective of the clinicians I’ve come in to contact with.

I do like the ironic humour of a gastro professor eating his hat too :D

I think continuous cortisol monitoring does exist, but it is a short term testing device that isn’t much fun to live with (tube under skin and bulky monitor strapped to body) rather than the glucose monitoring type things (I may have misunderstood some of that from the pituitary affected ladies my wife works with).

I will give the book a look too, thanks!

@fizik that is all really helpful, thank you!

I have found that it is when there is some sort of bug lingering around schools etc that I get really hit with the extreme “body shutdown”, D+V, etc.

As above, I also lost 20kg several years ago but was managing to function in patches in that time. It is my most recent crash at speed directly to my face which seems to have sent things really over the edge. It was a sports consultant who ordered the cortisol tests as part of a pituitary gland investigation linked directly to the head injury. But as in my other post I’ve hit a wall where it seems only an endocrinologist can take things further.

In hindsight, the really horrible crash to my face could actually be one of the best things to have happened (if I ignore the whole not being able to work or function at all for 7 months :) ).

Thanks everyone, I really appreciate you sharing experiences and the extra tips!

The extra blood tests have been a frustration. The NICE guidelines for next steps, treatment etc seem quite straight forward (and are readily available online) but the extra bloods have been refused by my GP despite me asking twice. Even getting the 9am Cortisol repeated took 2 weeks for a nurse appointment to be available.

I don’t want my endocrinology appointment to be another delay of bloods and no action followed by waiting for yet another appointment to review.

@Steve_B I agree on the private route. I actually booked an appointment last night for 10 days time. GP estimated an urgent endocrinology referral is currently taken 3-5 months!

I brought up adrenal crisis, especially since I had very similar sounding symptoms in the past few weeks, and the response was “your body will tell you when you need to go to hospital”. Such awful advice!

Looking back I have had a lot of warning signs. I also lost 20kg around 3 years ago and am now around 15kg under that previous weight. I’ve had several times when I’ve been working away and have been too unwell to return home. But in that time I have also had extended patches where I could ride 10 hours a week and got my fitness to an all time best (4.5W/kg FTP for example). It has been a very up and down journey of exhaustion and being frequently really quite unwell!

If you guys don’t mind, I would be keen to hear how the diagnosis to treatment went and if anything was learned along the way? I fully appreciate these are all different cases and causes to come to a similar end point.

I am mainly wondering things like, from picking up the rough problem were you able to start the treatment quite quickly or did the root cause need to be identified first? I don’t want to get too internet doctor on this and rely on hearsay from situations which may not apply to me, but I am curious if help and change might be soon after getting to the endocrinologist or if I should brace myself for the next lengthy spell of letting the various required steps of the health system play out

Thanks @shoko it is encouraging to hear you have found a way to get riding again

Definitely read up on the recommendations on the Addisons Self Help Group re exercise – I used to bail out on long ride and needed to recover and limp to the finish. Using the guidelines as a starting point has made a world of difference.

It is an amazing time and we are really lucky to have so much information and connection to others anywhere in the world.

Kind of ironically, my wife has actually started working with a pituitary damage charity on the stress reduction and managing daily stresses side of things. They seem to be learning more from each other than they have had help from the formal route as it doesn’t seem too common.

I also have a child with a rare disability so really digging around for extra information is old news to us :)

Thanks @andylc

Sounds like you need an accurate and definitive diagnosis first??

Absolutely, and given the long wait for an endocrinology appointment I am keen to get as much out of the contact time as possible which is my main reason for these questions.

As above, I am barely functioning, have 2x 9am cortisol blood tests which appear very low (at least against the scales I can find on the NHS site and elsewhere) and it seems like the solution could be very simple (and cheap) but the process is potentially long. Anything I can do to be extra prepared I will take :)

Thanks @Steve_B

I have seen the links and general information.

I would love an equivalent of the Freestyle Libre that diabetics can use to be able to monitor Cortisol levels. But yep information on a higher level of fitness is very challenging – I like your “NHS-sit-at-a-desk-all-day” definition. Added to which if you stay fit and eat well you will have a classic invisible illness. 

I am keen to not repeat my NHS head injury experiences where I was told many times by various doctors that there isn’t anything you can do except rest and “normalise lifestyle to reduce fatigue”. After 5 months of poor vision, constant dizziness, incredibly poor mood and generally inability to much at all ticking every concussion symptom, I finally tracked down a sports consultant and concussion physio who changed things completely by just giving a sh1t and digging a little deeper.

treatment will probably be a lifetime daily dose of Hydrocortisone

I am finding myself often unable to stay awake past 10am and it feels like my entire body shuts down like I have no say in the matter. I might often be very conscious lying down but nothing in my body will work. If I try to push through I have had a few events of going in to an uncontrollable fever (sweats and feel freezing), HR goes nuts, stomach goes nuts…. which on the back of 2 cortisol tests coming back very low seems like it could be very avoidable with a £1.20 tablet which is frustrating!

Does anyone know why Gee didn’t race?

I’d be interested to know more about this one too. The comment “Gee was not allowed to race” in commentary is an unusual one given he did full runs

Yep loops really aren’t important with the Aeroe rack. It’s very secure

The Aeroe are definitely heavy and sturdy. They would be an easy choice if you want a bulletproof bag where you can be confident everything will be dry in any conditions.

I haven’t used mine much if anyone is looking for an Aeroe rack and bag.

I more tended to strap on a lightweight backpack to have some flexibility when I got to the other end of my trip. The Aeroe racks are really secure holding such a variety of stuff that I wouldn’t worry about the exact bag too much- its the rack itself that is the special bit IMO

Well that’s a new one on me!

Happy to share a code too if anyone wants to sign up to Octopus and get £50.

If either your or your partner’s ‘adjusted net income’ is over £50,000 a year, you may have to pay the High Income Child Benefit Charge.

Your adjusted net income is your total taxable income before any personal allowances and less things like Gift Aid. Your total taxable income includes interest from savings and dividends.

If you have to pay the charge, you can still get the other advantages of Child Benefit like National Insurance credits.

Answered my own question with the excellent.gov pages.
https://www.gov.uk/government/organisations/hm-revenue-customs/contact/child-benefit

So takeaway is apply for child benefit as a self employed person even if you end up having to pay it all back. As a family this allows me to earn whatever I earn and my wife maintains full state pension entitlement until the child is 12, even if she does not earn and contribute towards her state pension.

You can check your national insurance record here:

https://www.gov.uk/check-national-insurance-record

This will tell you how many years of contributions you have paid – you need 35 for the full state pension which you can only draw down once you get to 67 (or whatever they change it to).

I did this a while ago before realising a state pension wasn’t the full story, but thanks.

If anyone is as much of a pension numpty as me then I urge you to follow this link :) It is very easy to miss years of state pension contributions (no income until ~23 y/o owing to studying for me for example).

first step I would do is see if your partner can get national insurance “years” whilst looking after your son. I don’t know how the system works for your scenario, but I would hope there’s a way she can be entitled to the full allocation even if she’s not working due to being a full time carer. If you achieve that, your retirement income as a household is £20k.

Thankfully the government websites have improved massively in recent years so I was able to find this out. Being in receipt of child benefit or being registered as a carer (in receipt of carer’s allowance) are two routes to full state pension entitlement for the affected years.

Navigating the system is the tricky bit because if you ever thought “why bother for registering for child benefit- we don’t need benefits” then you miss out on knock on provisions like state pension cover if not working.

The only thing I’m not sure about is if paying back child benefit payments when earning over the threshold removes the entitlement to state pension. This isn’t a frequent worry but would be good to know for peace of mind.

Thanks @theotherjonv

2/ Your specific circumstances make it harder. Personal question but will your son outlive you and so you need to provide for that, or do you need to make his life as full as possible while you can – in which case prioritise what’s important

That is a really hard question and a really good one. The answer is unknown. He has a condition only identified about 30 years ago so the oldest people with the condition are only around 30.

I spend all my time planning for things that never happen so the lack of pension is out of character for me. But the point of enjoying now and not feeling cheated by the tottering to the shop for some Werthers stage of retirement also resonates as I’m already feeling a lot of opportunities have passed me by (that is also a big part of caring for someone with significant disabilities- realising life and things you can do as a family are changed significantly).

And lastly – as others have said, do it now. Find a good IFA by recommendation who will listen to your needs and help you plan against them, not generic advice (although see last comment coming). Even if the half your age is scary, don’t use it as an excuse to put off until you can afford it. If you can only put a bit in now, and then ramp it up as circumstances change, still way better given you have 30+ years of compounding interest to go than doing nothing now.

Regardless of the specifics and the fluffing around on my part, getting started is the key thing.

The reason for posting here is I am quite confident of better advice than most IFA, or at least a better spread of opinions and experiences. Thanks to everyone for the thoughts and help as I feel in a better position to actually get stuck in to this now

OT, but I would say that you may be paying 2x hourly rate Poly, but the end salary is probably comparable when you take in all the things nickjb mentions. The unpaid hours can be significant when you are your own accountant, IT, HR, logistics, marketing, etc, etc) and it does annoy me when people think all self employed people are making a killing for doing the same job and “doing sneaky tax stuff” as you put it :)

In my case I’ve made a niche in my area of Engineering that isn’t really an existing job, basically acting as consultant using my knowledge and skills. That isn’t a great business model but it does allow for flexibility around family needs and does allow me to do the work I love. That is the trade off vs other ways I could be financially better off but probably more miserable.

employee’s money is taken off them for the pension before they even see it.

One of the many advantages. When you are employed, you pretty much have everything taken care for you and your finances are far simpler. If you don’t have enough money you try to find a better paying job or negotiate a raise and the percentages of outgoings and future planning stay quite constant. If you want more money it is pretty much a case of find a higher salary.

When you are self employed you often don’t have the luxury of upping rates or just switching to a different group of clients who will pay more. There isn’t the easy option of “just higher salary”. It is usually work more and find more hours to charge for. I do agree that there are probably a lot of business basics people miss out on, but being self employed (in the sole trader sense) means having to be an expert in so many areas. As I said, I’m aware what I do is a bad business model but the life benefits have me in that position :) I’m just trying to make it all work as best I can

Does anyone know how to find information about past employer pension contributions?

My wife will have paid in when working in the NHS and I will have paid a small amount when employed. Neither of us have any clue about what or where we paid. We contacted the employers and they said they didn’t know either.

I used my pension for the years I went over to make the best use of this.

@clubby do you mean that any money you earned over the basic rate of income tax (£50,270) you would put in a pension to make sure you only pay basic rate income tax?

I guess this makes sense for things like keeping child benefit eligibility (under £50,000 earnings) but making your income appear lower has the disadvantage for things like terms when applying for mortgages. Being self employed is a real juggling act that most people never have to think about!

@nickjb the 3 pots is a good way to think about priorities for self employed but my worry is you still potentially end up with so little in a pension pot you kind of think “why did I bother”. Maybe not when older and anything extra is a bonus. That balance of needs before retirement and after is tough.