Had a slipped disk a couple of years ago, and a 456, and the answer for me was – most of the above.

Increased core strength came courtesy of the physios, made the best of my bike position by altering stem and adding ergon grips, and did invest in a thudbuster. 29er doesn’t have the latter but tends to get used on less gnarly rides.

Thoroughly depressed by this thread last night, as had a sony hdtv and a wii sitting in other room as part of family present to kids from my folks, but joined them up with a component cable today to check it all out and don’t appear to have any problems.

Arrived today in North Yorkshire.

I have a 20 inch 456 and a 19.5 inch Scandal.

Scandal has a longer Effective TT than the 456 and the difference is eminently detectable. Otherwise they are a fair match up. On that basis I suspect that you might find the 18 inch Scandal a better bet if you are coming off an 18 inch 456.

SPOTY to AP McCoy, team to golfers.

Think it should go to someone who achieves something in particular that year on the back of being pre-eminent in their sport. McCoy ticks both boxes. If BBC would stump up for the extra gong I could see a point in giving two awards, one for the one off achievement in which case Amy Williams, and one for the consistent brilliance – still AP McCoy for me.

On that basis last year would have been Button for the achievement in the year and Giggs for …… no still wouldn’t have been Giggs – how did he get SPOTY on the back of making 3 appearances that year, 2 as a substitute and once running the length of the field before remembering to put his shirt on? Now quite rightly a bookable offence IMHO. I mean he seems a nice lad, but honestly.

On an unrelated matter, I was a bit suprised to see that all 10 contenders this year profess to being lifelong Man United fans. Interestingly, so do all the contenders for the Young SPOTY and both the golfers and the cricketers have apparently made it known how grateful they were for their personal messages of congratulations from Sir Alex although the late favourites for the Team award are apparently the Manchester United Kabaddi team of Mumbai.

Today 9am and 6pm, the joys of weekend ward rounds.

As a patient, 3 years ago with a slipped disc.

Panaracer Rampage on 29er and 456,
29er switches to Kenda SB8 for the fortnight each year when the trails are dry.
Gatorskins on the Kaffenbach winter bike

Agree, she is gorgeous. Not sure my old lab would cope with the new arrival though. Would ask her but she is snoring heavily at the moment and blocking access to one of the sofas. The other sofa is firmly occupied by the cat.

1780s N Yorks farm house with a servants wing put on by the Victorians in around 1890.

The old farm buildings behind the house pre-date the main building but probably only by 10-20 years. Going to make a great workshop/office when my premium bond comes up.

There was a post here a few days ago saying trails were closed not just from snow but also quite a few branches and trees down accross trails. Still got 12-15 inches of snow alongside A170. A169 still shut ( it is the Pickering – Whitby road ). Thaw may come Friday but doubt that it will be rideable in the next couple of weeks.

Don’t know about the micro sets but my kids had a set called something like “My first Scalextric” which was very simple, very small not great quality and they got fed up with in about half an hour. Digital seems to make everything very expensive so I would agree that a basic non digital but full size set is the way to go and then look to pick up additional pieces and cars on good old ebay after xmas.

-14.5 in a frost pocket just south of Dalby. Due to remain bloody freezing until thursday and then slowly thaw over next 48 hours according to met office.

Spent last week driving our Fabia VRS round North Yorks. I agree that it isn’t great on snow and ice so Mrs Ratadog is doing the school run in the 4×4 estate. Still reckon that anything marked BMW would be worse from what my friends tell me.

North Yorkshire have got themselves some Swissbikes[/url], also known as Montague folders. Not a bad idea at all, as it means they can drop a patrol off by car without needing bike racks etc. They had them out at the Dalby World Cup XC causing them a certain amount of amusement as they rode around because they were accompanied by a chorus of “What type of bike is that?” from a whole load of bike industry representatives.

I got a Swissbike as my C2W bike ( sling it in the boot of the car and ride to meetings in town as needed ) and for a clydesdale it is a good compromise between portability and a decent bike. For my weight the fork isn’t up to much but I am going to replace that when the payment period is up and the bike is mine.

Yes, I was right up with PKRecliner for a while but got dropped off in an area of calm in the South Atlantic and then took a wrong turning at Crewe so will limp in some time this weekend.

Hoping Mrs Ratadog’s real life sailing knowledge of New Zealand waters may help in next leg

Started with a cheal Husqvana, engine shool itself to pieces and firm I bought it from claimed that I must have the wrong type of grass. Not quite clear what they meant as I was local to them and their green stuff looked mightily similar to mine – they wouldn’t elaborate. Finished up with a petrol Hayter with a metal deck – it gets serviced about once every two years and gives no trouble.

Thanks, hadn’t seen that for a while.

Ari is a thoroughly nice man to chat with and his autobiography is a cracking read.

Quack with an interest in Cardiology here.

As a quack who has to do some cardiology when on call +1 everything stoatsbrother said

Can’t believe they fix cardiac problems by actually “turning it off, then turning it back on again”!

Try googling “open heart surgery” then Brant, or alternatively contemplate your chances of being able to replace my rear mech while I ride the bike down the hill. At the very least it will make a cracking video.

OP please note that Open Heart Surgery is NOT needed for your condition.

I would encourage anyone who is worried about chest/heart symptoms to seek advice. Done it myself when I started having persistent chest pains which I felt I could no longer assume were muscular and caused by heaving a heavy toddler around. Thankfully all OK and heavy toddler it was. Mind you, I always remember that the Prof of Cardiology at one hospital where I worked died of his heart attack having allegedly been treating himself for indigestion for some time previously and despite being one of the world experts on the prediction and early diagnosis of heart attacks. If in doubt, seek advice.

Like others, I liked the house and thought that it looked like it really worked as a home. It was a great advert for the designer.

The house is only over the road from me, and if anyone would like Kathryn’s mobile number…. I wouldn’t mention her ears though…

Which presumably means that Kathryn will in due course be perusing this thread if only out of curiosity. In which light some of the posts in this thread may qualify for a tag entitled Might on balance have been better phrased.

I have joined as well. I think we need to be accepted. I may well get lost before Gibralter

Just seems odd that the labs only offer TSH, hell we can measure T4 in house if need be!

Labs can measure it but it costs money and therefore if your GP asks and doesn’t make it clear as to why they often assume that it is simply for assessing whether dose of replacement is correct and just do TSH.

From what i have researched if t3 and t4 are normal, anti tpo screen -ve and tsh<10 there is no need to treat

Entirely agree – as do the national consensus guidelines.

Thyroid disease is a doddle c/w trying to diagnose an acromegalic in a primary care setting

Not easy in a secondary care setting either but my brain is frazzled enough trying to explain relatively straightforward thyroid disease without going off into the rareities.

On the veterinary side we would usually look at T4 and TSH together as standard in dogs.

More a question of what their lab will give them I suspect. As a specialist I want all the relevant info I can get and as stated that means both TSH and T4. Not sure how reliable TSH is as a stand alone in non human animals but it does fluctuate in humans in the presence of other non thyroid problems.

some sort of interaction between female hormones and thyroxine….I guess ratadog might be able to provide more info.

Oh Dear.

OK then, pay careful attention at the back and here we go.

T4 is not only the floating reserve for the production of T3 but a significant proportion of both of them ride round within the blood piggybacking on carrier proteins including albumin ( the main blood protein ) and TBG ( Thyroid Binding Globulin – again, it does what it says on the tin ). There is therefore a significant and measurable difference between the total amount of T4 and T3 in the blood and the level of free ( that is non protein bound ) T4 and T3 in the blood and it is only the latter free hormone that has any effect. Increased Oestrogen levels produced during pregnancy and also in some cases by the taking of HRT increase the level of the TBG and therefore patients in those circumstances who are taking thyroxine may need higher doses to maintain the same level of free hormone and therefore the same effect.

However, although it used to be a bit of a problem when we could only measure the Total hormone levels and TBG and then have a bit of a guess as to what the free level might be, thankfully we now can and do measure the free thyroid hormone levels ( i.e. the active bit only). This means that although the dose of Thyroxine needed to fill up the TBG and maintain the Free T4/T3 levels at the desired value may increase with the oestrogen, in practical terms the rule is still to give a dose of Thyroxine that maintains the Free T4 level in the upper half of the normal range. The fact that the dose required to do that might have been less if the patient wasn’t pregnant or on HRT is neither here nor there.

IIRC increased testosterone makes the TBG level go down so same issue only opposite effect. Lets not go there either.

That’s it for tonight. I am off for a swift shandy and a lie down.

I suppose the only way to find out what level of levothryroxine you’re comfortable with from this point is by trial and error or is there sone other way?

Mostly trial and error. As I say, I prefer to see both T4 level and TSH level but tend to tell GPs to aim for a TSH in the bottom half of the normal range ( and therefore slightly more thyroxine rather than slightly less ).

The problem with getting the dose right for any individual patient is that by the time you get diagnosed your blood levels have changed and we don’t know what normal for you is, we only know what the normal range for the population is. You could therefore have a value within the normal range that was still on the low side compared to the level that your body is used to. Hence, aim for the top half of the T4 range – and therefore the bottom half of the TSH range – and most people will be right or slightly over replaced – which won’t do them any harm.

Most people with straightforward underactive thyroid will be fine managed by their GP, for those that don’t settle rapidly or have problems then you can always ask to consult your friendly local endocrinologist 🙂

Don’t know if STW would consider me the right kind of specialist but I am an endocrinologist.

If GPs ask for a thyroid function test they tend to get the TSH (Thyroid Stimulating Hormone, produced by the Pituitary, does what it says on the tin) rather than the T3 and T4 levels which are the thyroid enzymes actually produced by the thyroid. The gland produces mostly T4, the work is mostly done by T3 and there is a mechanism in the blood which converts T4 to T3 as needed. That mechanism very occasionally doesn’t work but I can only recall 3 people in 20 odd years where that was so. Therefore T4 or levothyroxine effectively acts as a floating reserve and for the most part that is what is used for replacement letting the body sort out the T3 level for itself.

T4/T3 levels basically control the tick over rate of all the body’s systems so with a low level everything slows up and your body adapts to that level of hormone and activity. You tend to start on a low dose of replacement and work up every few weeks because to do otherwise is the medical equivalent of putting 5000 revs on the clock and dropping the clutch – might work, might be very expensive. By and large, most people get to the correct replacement dose of Thyroxine over 6 months or so and then need another 2-4 months for their bodies to adapt back to the level that the rest of us consider normal.

Body only cares that the level of T4 and T3 is right, doesn’t care if you make it for yourself or get it as a tablet from Boots. Most people do feel better however if they are slightly over replaced ( T4 in the upper half of the normal range and TSH, which goes down as T4 goes up, in the bottom half of the normal range ) and once that is sorted symptoms tend to drift away. Dose needed can change over time as often thyroid is still producing some hormone for itself for quite a while.

The only real controversy I’m aware of are whether or not to treat “sublinical hypothyroidism” ie raised TSH with normal T3/T4. There is more of a consensus to treat earlier to get TSH normal even if T4 normal.

Shouldn’t be controversial. Guidlines say treat anyone with TSH raised above upper limit of normal who also have positive anti thyroid antibodies and treat even in the absence of antibodies if the TSH is greater than 10.

It’s fairly straightforward apart from that

Yes – but as stated above, overactive thyroids are a whole different ball game.

Email in profile CG if you have any more questions.

Now built three sets, for the fun of it and also to have what I wanted at a decent price. Find it very therapeutic.

I have one on a non DH bike and it keeps the mud/cowshit off my glasses/eyes and as my lack of cool was established age about 7 and according to another thread I am rapidly approaching the age when a troll thinks I will be too old to ride, the ugliness doesn't bother me.

(And yes I will say diabetics, I'm entitled)

You are indeed, and I would have bedecked my original comment with emoticons if I could have been bothered/been sure of not using the wrong one.

Your sister probably doesn't see this as being the problem you do etc

Also a very fair point – like missingfrontallobe I also see lots of patients who choose to run their diabetes in a way that they feel causes them least hassle in the short to medium term. If its an informed decision then I may not agree but that's their right and mine

I can honestly say one thing – diabetes is sh!t

Yep.

in type I diabetes patients with type I diabetes

At least you didn't say "diabetics"

I don't have diabetes, but I am a diabetes doctor.

I would back up what has been said, particularly the pointers to the Tayside website and Diabetes UK as well as the usefulness of Diabetes Specialist Nurses although I suspect that your partner's sister is aware of most of this.

We were an early adopter of the DAFNE patient education course for Type 1 diabetes which as some of you will be aware is all about getting patients to self manage. Newer insulins do have different characteristics which may be helpful and different ways of delivering insulin particularly pens and pumps have become available over the last 20 years as have newer agents for Type 2, but they are all tools for the job rather than being some form of instant or magical solution by themselves.

There are a number of reasons why patients' blood sugar levels can start to fluctuate more and they become more prone to low blood sugar events or hypos but if your sister has seen a specialist then he or she should be well aware of those reasons and have checked them out.

Finally, I agree that diagnosis by mountain bike forum is not appropriate and although you yourself can get background knowledge and hopefully a better understanding from the pointers provided, only specialists who are directly involved with your sister's care can properly advise her.

Mrs Ratadog had a frozen shoulder which proved immune to painkillers and physio. At medical school the teaching was that frozen shoulder was an inflammatory process where the tissue in the joint became inflamed and stuck together and then after a year or so magically healed. Doesn't really hang true as most things that become damaged scar and adhesions are usually permanent.

Did some research and came across Trigger Point Therapy. Seehere. Book available from Amazon etc. Essentially says that frozen shoulder and some other muscular conditions are caused by tears/malfunctions in the muscle which can be self or partner treated by massaging specific trigger points.

Approached it with a fair amount of scepticism and a dollop of desperation but it seemed to make a significant difference both in the case of the missus and in the case of a work colleague with the same problem.

You need to get a diagnosis because there are other causes of shoulder pain as outlined above, but if it is a frozen shoulder it may be worth an investment in the book.

As an aside, I now find the knowledge gained from wider reading on the subject useful in dealing with knackered muscles after riding which is a double plus.

Only annoying thing is that despite this branch of knowledge being developed by the medical profession with good evidence to support it and being used by certain pain clinics, it seems to be unfashionable in mainstream medicine and not widely known.

+1 for brass.

Wheelpro book gives figures but IIRC difference in weight between brass and alloy for the average wheel is only equivalent to the weight of a couple of nipples. Certainly the advice given was stick to brass.

looking for the clinical med hand book, but just want to check that it's this one.

Looks right to me. Used by medical students and consultants everywhere. In my day, dreadful phrase, you messed around with anatomy, physiology etc. for the first two years and all the textbooks you bought for clinical medicine were two years out of date when you saw a patient. Now they tend to throw them in at the deep end and the Clinical Handbooks are excellent.

+1 for the Littmann cardiology and also for the book vouchers/book tokens as allows some flexibility. The one universal thing about medical textbooks is they don't come cheap, albeit most medical students these days seem to find their laptop and broadband connection the essential they cannot do without. Agree that Otoscopes etc. are not necessary.

30 years ago our prof of anatomy put one of his own books on the essential list. It was never referred to again at any time in the ensuing 6 years. Never liked the man.

Main thing about surviving medical school is having an absolute determination to succeed. Sounds like your friend has that bit sorted and I wish her well.

Cut slots in a piece of 22mm copper pipe and flare the ends.

Unless you have a short length of 22mm copper lying about, I'd either by a 1m steel tube or get the proper tool.

+1 for both comments.

The copper tube method works fine and when I tried to buy the proper tool the internet bike shop emailed me back to tell me not to waste my money if I had an appropriate length of copper available. Owing to just jhhaving the kitchen redone I did have such a thing. Mind you the kitchen cost me best part of £8k so it was hardly a cheap solution. If I'd had to buy the tube I'd have gone for one of the other two solutions depending on availability.

viral marketing ad for the computing game mentioned at the end

Still entertaining

currently wearing merrell chameleons to ride.

+1 and good for the get off and push bits as well

I don't commute by bike but see roe deer on early morning rides round the NY Moors fairly regularly. If I understand correctly Roe deer detect movement ( and obviously scent). Certainly, a coasting bicycle coming from downwind tends to get careful consideration rather than fear, at least until you are close enough for them to either get a scent or work out that whilst you aren't strictly moving you are getting a lot bigger. At which point they tend to light the blue touch paper and leave at speed. Foxes on the other hand tend to see you from a distance away and nonchalantly fade into the trees.

Just bought a Nikon coolpix L22 from Amazon and been using it this week on holiday. Between 63 and 69ukp depending on your preference for colour of body. Runs on AA batteries, alkaline or rechargeable. Will need SD card and case if you don't have one already. 12.1megapixel if you must – I have had it set on 8Mp and as a slightly sophisticated point and shoot it is a bargain at the price.

Bought a 1.8tsi 4×4 a year ago and it came through winter in rural North Yorks with no problems. Didn't go for the Scout as couldn't justify the extra clearance and price but the 4×4 has a slightly higher clearance than the standard estate anyway. Compares favourably with the Subaru Legacy it replaced.

Another vote for suspension.

Started out with my Scandal 29er on a steel rigid Surly fork, got my wrists shaken to bits on anything remotely rough and it wasn't doing much for my slipped disc either so, as I couldn't afford a Reba, I switched to an RST M29 which has been fine.

Intense Prototype
Intense Uzzi SLX
Intense M1
Intense Tazer HT
Intense Tazer FS
Intense Sniper
Intense Tracer VP
Intense SS
Intense Fenix

I think I see a pattern here

in frames I have a Tomac Buckshot, Marin Palisades Trail (90 vintage) and an old Saracen

No, sorry, as you were.