I’ve got similar full-length zip Marmots.

I’d never give up the zips, especially as they keep the overall cut slim and that means I can use them on the bike without them getting caught in the chain, too.

In your case, i think I’d either add belt loops and use a belt/drawcord/whatever, or the other alternative would be to add longer tabs/more velcro around the waist, so you could pull it in tighter. Helpful if you know someone handy with a sewing machine, but could be done by hand.

@Scienceofficer: I think a better choice would have been the Boker Plus Wasabi – a friction folder that’s UK legal carry. But then I am a friction folder fan… they have most of the safety of a locking blade while not infringing the legal definition. About the same price as the CEO, and prettier too, in my eyes.

Same as DrP for me – big floor fan, hung off the wall in front of me. Plugged into an extension cord with switches which I can reach while riding.
Set to speed 1 in the winter; if it’s cold enough i’ll just use it in bursts. Up to 2 or 3 in the summer, but I’m not so likely to be on Zwift in the first place.

The only pair of Solovair I’ve had wore out far quicker than any DMs I’ve owned (I’ve used DMs at work for about 30 years now, apart from that one excursion). I bought an extra pair of soles at the same time as the shoes… which my local cobbler refused to use to resole them, as they will only fit their own. So that was a waste. Back to DMs for me.

(I didn’t notice any particular difference in widths, btw)

Which reminds me, the current pair are starting to wear the heel down… time to start checking out the sales :)

Have you set your Trainer Difficulty to 100% ?
That’s the first/best thing for making Zwift feel like real life. (Turning the TD down is equivalent to fitting a lower set of gears – you still need the same total energy to get to the top of the hill; you’ll be spinning easier but longer.)

But then downhills are odd – if you stop pedalling, then you stop moving, but the trainer leaves you spinning against air when you’re at 100% TD on a steep downhill. However, I’d rather have that (than “easier” climbs) as I’d be freewheeling in real life anyway.

I don’t know if they’ve changed this, but I found it a real problem with the pacing robots – I’d ride with the 200w one, but lose it on the downhills as I couldn’t make 200w against little/no resistance.

Also, have you calibrated your trainer?

I’ve been known to set the TD lower if I’m doing one of the mountain climb stages… after all, if I went and did one in real life, I’d probably fit lower gears to my real bike!

Miele. The cheapest (well, least expensive)/base models are 100% fine. They have an outlet store in Abingdon (stock list available on-line) with some decent discounts, too, if you don’t mind slightly scratched/dented/ex-demo.

(Our plumber recommended Beco for a cheaper machine, apparently they’re the filter-down brand of Bosch, so you get older Bosch tech and build for a fair chunk less money.)

Solid bait needs wiring down. Peanut butter/choc spread can still work if there’s enough room on the mechanism to spread it, as they can’t tug it away, and will move around to get all the angles on it… eventually, SNAP!
Traps in boxes are a good method too, as the box restricts the angles they can come to the bait at.

For some reason links where the text is modified take me to some TAG error page

Weird. It still shows the link and works correctly if you open the inspection link on the right click menu…

I know you’re sorted, but just stuck my nose in for those who like the idea but not the price (and because I didn’t pick up the thread early enough!) Try plain text:
https://www.overclockers.co.uk/scythe-scmg-5pcgh-mugen-5-pcgh-edition-cpu-cooler-hs-047-sy.html

Yep. Brick with peanut butter, paving slab backstop, little old BSA Meteor and a cheap home-brew IR night scope.
It’s basically cheating, but it doesn’t half sort them out.

I’ve got a very, very, similar cooler from Scythe on my desktop:
Scythe Mugen 5

About a third of the price, CPU sitting at 35-38′ at idle (which is about 15′ down on the stock cooler), fans at 672rpm, and I’ve never heard it over my Noctua case fans :)

Running OCCT’s Linpack CPU stress test, the CPU comes up to 72-73′ during/just after the 100% usage phase, the fans rise to (a still effectively silent) 760rpm and the temp drops back to 58-60 by the end of the 80% phase/into the next 100% (ie, it lags a bit).
I’m very happy with it.

My slow-down in riding from June to September (medication issues) followed by weeks and weeks and weeks of a cold/cough/sinus/ears is, I hope, finally at an end… my first proper Strava’d ride today since 25th Sept, and first Zwift since 6th Sept. A very gentle spin around Volcano Flats with average power about 20% down, but it’s a first step in the right direction for a good while, and I don’t want to push my body too hard when it’s only just beginning to recover.

I’m finally starting to feel better, been 2.5 months of almost non-stop coughing etc
My ears are working sometimes (they tend to be full in the mornings still, but clear somewhat through the day) and i’ve hardly coughed for the last 2 or 3 days. Starting to feel a bit more alive and interested in doing more than work, browsing and bed. Went on Zwift for a very gentle ride today – first since the end of September!
Might even get around to fixing the roof rack back on the car and getting out into the woods soon if this really is the light at the end of the tunnel :)

800mm on both bikes, though while just pedalling along, I often have my hands holding just either side of the stem or over the top of the brakes.

I went from a narrow-barred old 26″ to a 29er with 800mm bars. I haven’t felt the need to cut them down as I simply don’t think about them on the downhill so I assume their fine, but I’ve added plenty of bar tape either side of the stem, because I want my hands much closer together for the climbs.

For reference, I’m a lanky 6’4″. On my road bike I went from the 46cm (+flare) bars that came on my XL down to 40cm to get my hands lined up nicely.

A regular supply of peanuts provided in the garden, against a solid backstop. And an air rifle.

If you fancy a rocker and want to see if a bit of movement suits you, I tried a red-neck rocker plate: cut up a closed-cell foam camping sleep mat (£7 at Sports Direct), put several layers under the body of my trainer and some more under each leg (took a few goes to get the left/right balance correct as the bike isn’t centred on the trainer).
It worked really well, just a little bit of wobble, one hour max riding went up to a comfortable two hours… and it’s still there and I’ve never got around to buying a rocker plate ;)

Another 7-8 weeker here, since about the middle of October.
Started in my sinuses.
Clear there, but went to chest a bit.
And stayed there for weeks and weeks. Tiny bits of hard phlegm which take ages and horrendous levels of coughing to shift as they’re so small. Got very fed up with it, it was hard work.
Then the coughing stopped a week or so ago, and my nose started again, and my ears filled up. I’ve been living in a buzzy underwater world.
Then the coughing started back up at the weekend…

… which is the only time I’ve really actually felt ill through the whole thing.
I am thoroughly sick of it though.

@Stevet1
Not overkill at all, exactly right!
First off, get on to uklegacy.com for any questions.
Servicing and maintenance on UK cars will be much the same as any other car, given permanent 4wd will wear tyres faster.
As mentioned, don’t touch the diesels.
I had a JDM Legacy estate, so the same car effectively, but on lower suspension and with a spicy engine. I never noticed the length of it being any sort of issue, but back seat passengers appreciated the space, and the boot was very bike friendly. It was the kind of car that shrinks around you when driving, rather than feeling like a big empty box.
The mpg should be offset by the car being considerably cheaper to buy than the boring ones mentioned, all else being equal; although it may be that bit harder to shift on afterwards for the same popularity reasons.
Some of them are rusty, some aren’t, so buy on condition and enjoy :)

Mousetrap. Never ever met a set where all the different things would work, if you could even get half of them balanced in the first place.

On the other hand, if you want to recreate the magic of playing games when you were 5, buy Buckaroo. You’ll find that as adult, you can easily get all the stuff on the donkey without setting him off. Now fill all the hollow backs of the bits with blu-tac, then have a couple of pints or so of beer, and suddenly it’s a massive shock again when he jumps… just like when you were tiny :)

I buy 5 litre tubs and pour it into smaller bottles to use. Cleans/degreases pretty much everything around bikes, cars, etc – really handy stuff.

If you’re old-fashioned, it’s also great for cleaning up the heads in tape players ;)

I’ve been using Oxford Rainseal overboots, on flats, for commuting. Pretty quick to put on and make sure the waterproof trousers go over the top so water runs over not into. Fit over my size 12 Dr Martens ok. They felt/feel a bit klumphy when I first put them on, but i just forget they’re there once riding. I think you’d have trouble converting them to SPD though, they’d move around too much for an exact hole to work.

SIS water bottles.

I’m going to throw the cat right in with the pigeons…

Now That’s What I Call Music 2

The original may have been a new thing, but 2 has the best tracks. i still love just about every one of them.

But then we’re always having arguments in our house as “next Saturday” is clearly in 3 days time, the next Saturday. But my OH will argue it’s 10 days off (which is clearly Saturday next week).

Being a pedantic git, I’ve spent many a happy hour winding up the most gullible girl in work with this one.

Also being a contrary git/wind-up merchant, just when she thinks she’s got the whole thing straight, I swap over the other way ;)

I’ve got small and large Ortlieb seat packs. All my tools, tube, etc live in the small one for dry/short rides. Or I can pack those bits into the large one (usually I just chuck the whole pack in there, I’m no weight weanie!), and add a jacket and some grub for longer rides. They both use the same clip, so I just choose which to put on the bike.

Small bag

Big bag

This one is good:

https://www.galibier.cc/product/zoncolan-foul-weather-cycling-gilet/

theotherjonv

In the end the error is the error; once that happens the outcome is just luck. Reducing the seriousness of the investigation or corrective action because no-one actually got killed / seriously injured misses the chance to learn the lesson.

eg: H&S policy at work for example. If you fail to maintain a roof and a slate falls off and there’s no-one there, it’ll probably be marked down as ‘oh, a slate clearly fell off, we’ll bear that in mind next time we inspect the roof’. If it narrowly misses someone, it’ll be dealt with straight away. If it hits and kills them……then the HSE are visiting and a world of pain. Same failure; what follows is pure damn luck and we shouldn’t leave things to luck.

I 100% agree.

Touch wood, I’ve never had any errors that had results as serious as this… but I’m fully aware, as are most pharmacists and I would say most other healthcare professionals, that it becomes a numbers game and a throw of the dice.

It’s not flippant: perfection really is the minimum acceptable. I keep it in my head all day every day, constantly reviewing with a small part of me what might be done better/safer. But I’m also aware it’s ultimately unobtainable.

Unfortunately (and it actually makes me a little sad), it’s clear here that someone has let that mindset slip – whether briefly or routinely – and thereby caused others to suffer. Hopefully they will be able to learn and improve.

If anyone ever wonders why the pharmacy is taking so long – “it’s only tablets” – please remember this thread and that there’s a lot more going on back there than you may see!

And our problem (and Holy Grail) in pharmacy is, as I say to all new starters, “in pharmacy, perfection is just about acceptable.” Everything needs to be 100% correct, 100% of the time. And even then, we will still get people complaining about something. I’m hoping the time I’m spending typing this helps people understand that perfection is not possible in any system that involves humans at any stage (someone has to program those computers, match the barcodes to the stock, etc) and so starting from a point of “strike ’em off!” is not helpful… it is even the opposite, as a fear of personal consequences for genuine human error leads to brushings-off and cover-ups rather than an open, learning, response.
And at the same time, I’m aware “lessons will be learned” is now perceived as a brush-off in its own right.

Here, though, there’s enough suggestion from the pictures to say that this pretty definitely exceeds that… I’m afraid sometimes the investigation does throw up poor practise or negligence.

/end thread. I feel like I’m on twitter now!

There’s a paragraph or 2 here about the pitfalls of computer checking. Seems to be the bit getting me the 403 for no reason I can see. So skip that!

@theotherjonv

he argues there seems to be a complacency or hubris in (some parts) of the medical community that means that these types of issues are just shrugged off as ‘these things happen’ rather than a desire to learn and get better.

To be fair, some people are like that. And the level of investigation we can realistically do, especially weeks after the incident took place, can be quite limited. So sometimes the best answer we can give is “these things happen/human error”… although we should then attempt steps to reduce the chances of it happening again.

@andylc

Also I’m somewhat surprised to see a tick not an initial.

That’s a squiggle, not a tick. They will know who makes that mark. It’s difficult to get anything neat into the tiny boxes, not to mention writing it hundreds of times a day, so for most people, most of the time, it’s squiggles… but we know whose squiggles they are!

@alansd1980

To the pharmacists here, if there is no one to do that second check should the treatment not be dispensed or is it ok for it to be given?

It has to be ok, or in some places whole days would go by where no medicine could leave the pharmacy! As I’ve said before, there’s a strong suggestion (which will probably appear in their SOPs) that if self-checking, you take a “mental break” and do something else to break your brain’s chain of assumption between the 2 steps. It can be difficult, especially if you have an impatient patient watching you walk away from their tablets, but ignoring those pressures is part of working professionally.

So i’ll split it into smaller chunks

Just typed a long reply, and got 403 forbidden when I tried to post it.

Hmmm.
It is the non-depot/immediate release version, which is easier to mix up in SALAD fashion.

But only one box signed, which immediately puts the pharmacist on a sticky wicket as, yes, there should be 2 initials there. 2 main explanations for that – either the person dispensing isn’t following the Standard Operating Procedures and the checker (may not have been be a pharmacist) isn’t pulling them up on it (which doesn’t suggest a good safety culture in the dispensary); or the pharmacist has self-checked their own work and not followed the SOPs/best practice there.

It’s hard to understand just how your own brain can fool you and make you see what you expect to see, not what is actually there… so if you do have to self-check, it’s best practise to take a “mental break” between picking/ labelling and then checking your own work… and not to do that at all, if possible. I will ask any other member of staff to look over my work (as well as double-checking myself) if an accredited checker isn’t available – it’s still better than doing it yourself. So the signature in just one box suggests that, if it was all done by the same person, they failed to separate the 2 parts of the procedure, otherwise there would be the same squiggle in each box.

(Depending on the staff mix, there is also a chance that the pharmacist wasn’t involved beyond a clinical check – and that would have been that the B12 was suitable, nothing to do with the haloperidol – but then the separation of dispensing and checking is required to be between 2 people, and the procedures and signing trail should be even more robust.)

I’m surprised anyone coming to it fresh didn’t pick that error up however (either checker or nurse). It’s neatly and clearly labelled, and for once the manufacturer’s design puts the relevant info right where you need it.

@zippykona this is looking less like one of the inevitable human errors I’ve been talking about, and more like a failure to follow procedures, which casts a different light on it. While I can picture the way/s the error may have happened in the dispensary, I’m surprised still that the nurse didn’t pick it up – I know far less about their procedures, but can’t imagine that the checks aren’t there. But going back to the Swiss Cheese model, sometimes all the holes line up. Looks like the pharmacy has reduced the number of slices (less people involved in the process, so less chances to catch the error) and/or made the holes bigger (not following SOPs) – both of which makes a mistake more likely, and harder to defend when it happens.

I’d still advocate ringing ahead to arrange a chat. And I still think that a calm approach is best! But you should now be able to make it clear that, while you’re sure they didn’t do this on purpose, you have realistic concerns as to how/why it was able to leave the dispensary. Please remember also that you may not be talking to the person who dispensed the item – they will be able to tell who was on duty the relevant day – it may have been a locum pharmacist (self-employed, they cover holidays etc around many pharmacies) who did the whole thing themselves and not actually how the dispensary normally runs. In any case, you will be asking for their insurance details.

They have a duty of candor; you should expect their response to include where they have reported the incident on to (the Health Board via DATIX in Wales, not sure about England these days)… and a simple apology should be in there somewhere.

If you are not happy with how they are responding, then your next step is with either or both of the local health authority (who you may well be talking to anyway regarding the nurse side of matters) and the General Pharmaceutical Council.

I hope this is all some help.

@scaredypants

I’d say proximity more than true SALAD

Yes, I think I’m sort of coming around that, especially if it was a depot – 2 boxes of 5 amps of the non-depots would be easier to mix up, and a lot more understandable as a SALAD.

@andylc It’ll be haloperidol/hydroxocobalamin, so they do end up near each other. Most pharmacies don’t segrate further than by dose type (tabs/caps, injections, creams, sachets, and so on) and then alphabetically – space is usually at a premium for a start, and then if you split off clinical uses you run into all sorts of problems as many drugs have more than one indication. Packaging of all sorts of drugs can be surprising similar, too, especially if it came from the same manufacturer.

The length of time that the lady was affected for strongly suggests that it was the depot version of haloperidol, however, which likely makes a lot of the above less relevant as it would probably be a single vial in a cube-ish box, rather than a pack of 5 in a fairly flat box.

I’d be interested to see the label as well, and how it’s been attached to the box. New, or poorly trained, dispensers sometimes put the label across the very information you need to read, such as name/strength/quantity/expiry date. Some packaging has a lovely space for the label to go, but no other information on that face, which makes checking the label against everything else that bit more difficult.

That it appears the nurse administering the injection also failed to pick up the error also makes me wonder about the packaging/presentation overall, and other details… the hydroxocobalamin would be watery, and a haloperidol depot oily… that perhaps should have been the final line of defense as the nurse drew up the injection.

I’m not trying to make excuses, we all make mistakes and I and most other pharmacists really do try to understand how and why. Sometimes you know immediately what went wrong (and the words “…and then I assumed that…” often appear in there if you’re being honest with yourself), but sometimes you rack your brain for hours or days and just cannot reach an understanding.

There could be many factors which would move this from the realms of a simple error into possible negligence – if it turns out from the label that a final check wasn’t done, for example; or a recorded history of regular major errors for that particular pharmacist/checker or pharmacy. Maybe they’ll have CCTV in the dispensary, and the checker was busy playing on their phone while “checking”. But it is far more likely to be an error that just slipped through the holes for no obvious reason. Either way, the insurance is extremely likely to be paying out on this one – albeit in split liability with the nurse’s.

For more info, the single largest root cause of dispensing errors is poor lighting levels in the dispensary – something employee pharmacists have pretty much zero control over. This is one factor that makes SALAD errors that bit more likely to occur.

Whatever the ins and outs of this example, hopefully I’ve given an idea of how what looks like an impossibly negligent error can/does have many factors playing into it; and that this sort of error isn’t only not impossible, it is inevitable that they happen from time to time.
I’m not impressed with the GP’s reported response, but it does appear they are not at fault here. Hopefully, the response from the pharmacy and nursing team will be much better.

I said previously it would be good to go in in a calm fashion to discuss this (and, to be fair, I extend this to all problems with companies and services in my own behaviour. I’ve never quite understood what people expect to achieve shouting and swearing at staff; I find it locks my brain up defensively and makes it far more difficult for me to find a solution).
I’d perhaps go a bit further and ring ahead to arrange a meeting, possibly ringing the head office if it’s a multiple. If it was me who’d made this error, I’d certainly appreciate the ability to address it out of hours, or arrange cover during the day, so that I could give it the full attention it deserves (while also not having loads of other work piling up while I dealt with it, making another error that bit more likely while trying to catch up…)

I’m another pharmacist, and right with Blitz. First off, I’m glad to hear your MiL is recovering.
The pharmacist will almost certainly be absolutely gutted and has a professional responsibility to follow through with an investigation… and will most likely be very keen to do so – we hate making errors, even tiny ones, but it is inevitable as no process is perfect.

Having said that, what we have here is known as a SALAD error – Sound Alike, Look Alike, Drug – sound alike in this case.
I’ve been a community pharmacist for coming up on 30 years; when I started there were faded old stickers on the shelves trying to point out and prevent this sort of error so it’s been a problem forever, basically. As I’m certain that literally thousands of highly qualified and highly motivated pharmacists have been trying hard to reduce and ultimately prevent this sort of error without great success for at least those 30 years, it has become clear to me that this is not a problem that can be sorted completely within the dispensary. The EU’s Falsified Medicines Directive might have helped as it required a scanned match between the product and the prescription, but only about a third of manufacturers were on-board, it was very time consuming to implement, and was dropped in the UK following Brexit anyway. Although when I say “required”, it was possible to skip past the warnings anyway ( Alert fatigue ), so although it was another slice of swiss cheese, with small holes, holes are still there (the extra time it took of course made missing the alerts more likely as you’re having to do more with each script in the same time).

I’ve rattled on probably more than I intended to, but hopefully it’s helped you see that we do (most of us) take errors very very seriously.

I believe Blitz is mistaken on the error rate leaving pharmacy – the research I was studying a few years back gave a rate of 1 in 10,000. In fact I knew a pharmacist who was making a job out of presenting to other industries how pharmacy gets the error rate so low. But a busy pharmacy will be doing over 10,000 items per month, so are likely to have at least one error per month… luckily, most are far less serious than the one here.

It’s essential that you do approach the pharmacy. If you don’t tell them, they’re just that bit more likely to make the same mistake again! But hopefully I’ve explained enough that you won’t feel it necessary to go in shouting (we completely understand why you might, but it doesn’t help us deal with it well straight off… again, we are human!) – a calm approach explaining what you believe has happened and the consequences, with a request for their insurer’s details and a further request to be kept up-to-date with the results of their investigation should give you what you need. If you could take the original box with the label on it, it would help them a lot as it should have the initials of the dispenser and checker on it, which helps us see who did what. If you want to keep it as evidence, then the pharmacy will probably want to take a photo. Don’t panic if they ask to keep the box themselves though – this is normal and we keep it with the details of the investigation. However, with the district nurse involved as well here, it may not be appropriate.

Finally, on the results of that investigation… as the dispensing happened some weeks ago, it’s unlikely that anyone involved will remember it especially. It may be they find stock is muddled on the shelf; that they were very short staffed or massively busy that day (although a very quiet day can lead to more mistakes as you switch off a bit!!); or something similar… but at the end of the day, this is a SALAD error and it’s known to be both the most common and hardest to catch (cause/effect issues there). Please don’t feel that if it comes back as having no particular identifiable reason for occuring (beyond SALAD) that it’s a cover up or whitewash; we really do wish we could say why we sent out nine thousand, nine hundred and ninety nine correct items that month … and one wrong one.

I used to buy HH ski jackets for the winter, but I’ve been feeling the cold more as I get older; last year I bought a Jack Wolfskin Troposphere jacket… comfy, very warm, half decent pockets in the right place, pit zips for when it’s too warm, generally near perfect to me – I’d like the internal pocket to be zipped under the storm flap rather than right inside, so you could get to it without unzipping the main zip – but that’s nit-picking a bit.

Bad news and good news, it seems to be discontinued but the ones still around are heavily discounted (and it was worth the full price to me) if you can find your size. Here’s a couple to get you started:
https://www.wiggle.co.uk/jack-wolfskin-troposphere-waterproof-jacket
https://www.outdoorgear.co.uk/Jack-Wolfskin-Jack-Wolfskin-Troposphere-Jacket-sku41184100.asp

@richardkennerley

WW2 style gas mask and a 6ft tape worm amongst other stuff

WW2 gas mask filters being another place you’ll find asbestos… I wouldn’t recommend trying it on

Install a Drimaster instead. Job jobbed for the entire house :)
Not only is it much cheaper to run than either sort of dehumidifier (tho you can add a heater which ups the consumption a bit), it’ll save a noticeable amount on your heating bills, too, even though it seems like you’re constantly adding cold air as it’s much easier/cheaper to heat dry air than damp. Also, helps if anyone suffers allergies as it’s constantly adding filtered air (ok, not the best filters ever, but far better than not).

https://www.nuaire.co.uk/product-list-page/drimaster-eco-range