After my post on Vitamin D, I have continued to take a daily Vitamin D tablet after the 12 week course I was prescribed. I thought I might as well, especially over the less sunny season. Today I read an interesting article linking Vitamin D to better cycling performance. Clearly a ripe area for research.
When I have time, I want to write up some reflections on our 2 weeks cycling in Holland. In the meantime, there’s a great article in the Guardian about it. I think there are 3 key things that make a difference:
- Safe and largely separated cycle paths, which we are slowly making some progress on in London. However, even with massive political will and financial investment it would take decades to catch up.
- Strict liability laws – so if a car hits a bike, the car driver is assumed to be at fault unless they can prove otherwise. I think that would make the many motorists who overtake me too closely or try to bully their way out in front of me, think twice. As this article says, this also protects pedestrians from cyclists. The law protects the most vulnerable road user so it is not carte blanche for cyclists to be responsible. It simply enshrines what I think is basic common sense and a moral responsibility into law. I am always telling my children when we cycle on the pavement to school that they need to give priority to pedestrians.
- The above two, mean that so many more people cycle, so that motorists respect cyclists because most of them cycle too.
I am looking forward to 2 cycling experiences over half-term:
- Cycling along the Dollis Valley Greenwalk as a family. Trying to find out where you can cycle on this walking path has been an effort which I will write about another time.
- A free family lesson with a cycling instructor. Organising this has also been a saga.
My Mum said I shouldn’t mock, and I guess she was right.
A few days after my consultation, my phone rang. “Hello, this is Dr Ian Gilchrist”. I guess he could sense my confusion, so he explained that he was Dr Brain (not in those words, obviously). He told me that he’d spoken to the Consultant and they’d decided it was worth doing a couple of extra tests: an EEG and an MRI. I shouldn’t have mocked the bangy thing. Now I’m going to get some high tech tests and data. I’ve pretty much concluded that my faint was “just one of those things” and “everyone is allowed one faint”, as the Doctor in A&E said. I think my faint was probably down to lack of sleep. However, I was briefly pleased to be called back for some tests.
Then the denouement. I’m not allowed to drive until I’m cleared. I can cycle but not drive. Now with two children to taxi around, that’s not going to be easy, particularly for my wife.
I had an interesting chart over coffee after Saturday morning laps. I chatted to a guy who’s name I didn’t catch. Let’s be American and call him Jock.
Jock did track racing as a GB junior in his teens. He also rowed to a high standard at University. He’s only recently graduated, so I did point out that I was probably over twice his age, which he was far too well brought up to do anything other than politely acknowledge.
When Jock rowed they were told to measure their resting HR every morning. If it was raised by 5 they had to tell their coach and only do a half session. An elevation of 10 meant no training.
Given that, pending cardiologist visit, I’m expecting to find there is nothing wrong with me, the most likely cause of my faint seems to be lack of sleep. So I wonder if measuring HR would be an effective and simple way of guarding against a recurrence.
There was something about my consultation with the Neurologist that made me think of a carry on film. There were no Barbara Windsor like nurses. It was lying on a bed, with my eyes shut, being told to be floppy while the Registrar banged below my knee to check my reflexes. Doctors do this for real! And he called the mallet a bangy thing. He also asked if I had diarrhoea, constipation, or what might be called persistent and unwanted male floppiness. This all added to the feeling that the consultation might be some elaborate hoax.
It was all mundanely low tech. He even measured my blood pressure with a mechanical device and took notes with pen and paper.
Despite this mocking, I felt he did a thorough job. He asked lots of questions, by no means all embarrassing, listened and took lots of notes. His conclusion was that there was nothing he could find wrong with me and that I should probably see a cardiologist.
He confirmed previous opinions that I had probably fainted rather than had a seizure. The facts that I neither bit my tongue nor wet myself seem crucial here. Also, and I checked this with the Doctor who looked after me on the ground, I wasn’t clammy or sweaty.
So, its back to my GP for a cardiologist referral. The Neurologist did also say that to be absolutely safe I could stop cycling until seeing a cardiologist. However, he stressed he wasn’t recommending this and thought the risk low.
Unfortunately I typed most of this and then WordPress/my browser decided to lose it so I am now even more ranty and this will be briefer than the original version.
- Why do London drivers think its OK to park in cycle lanes. The pictures were taken on Friday morning on a short stretch of Prince Albert Road but could have been taken any morning over the past few weeks.
2. Why do a lot of drivers think its OK to hoot at a slower moving cyclist, usually going up hill. I don’t hoot at drivers slowing down for speed bumps. One of the ironies is that the road is usually too narrow to overtake a cyclist because of all the parked cars.
3. Cycling in London is so full of incidents or “near misses” as termed by the excellent Rachel Aldred.
Why did WordPress use my much more eloquent original post is another question entirely.
The one problem that my initial blood tests showed was a minor Vitamin D deficiency. So my GP prescribed vitamin D, which I found ironic as someone who has always believed in the merits of a balanced diet over supplements.
Coincidentally, I had just received some free multivitamins and my GP correctly warned me not to take them until after I had finished the prescribed course. This is because too much vitamin D can cause problems, including the removal of calcium from bones. This is strange, as one of the main problems caused by a deficiency is failure to absorb enough calcium. So vitamin D is subject to the Goldilocks theory and too much or too little are both bad. Of course, what is “just right” is subject to debate.
At the time, I put down my vitamin D deficiency to my brown skin and didn’t think much more about it. I then learnt about new draft scientific advice to the UK Government to the effect that many more people in the UK probably need vitamin D supplementation than was previously thought. This is still draft advice and therefore not yet reflected in the official advice. The official
One of the main sources of Vitamin D is that it is made in the body under exposure to summer sunlight. Another application of Goldilocks, in that you need enough sun to make enough vitamin D but not so much that you burn. I did wonder if my deficiency might be caused by not cycling since my accident, and therefore reduced time in the sun. However, vitamin D is stored in the body for months, so this probably is not the cause, though it might have reduced slightly.
I look forward to the final scientific advice, as the whole area of vitamin D seems quite poorly understood. Beyond regulating Calcium, there seem to be a range of possible problems from having too little. These include, from the articles mentioned above:
- musculoskeletal health, including rickets in children, and osteomalacia in adults which can cause the person’s bones to become weak and painful, and hamper mobility
- heart disease,
- type 1 diabetes,
- multiple sclerosis.
On the other hand, too much can result in:
- excess calcium which can be deposited in and damage the kidneys.
- calcium being removed from bones, which can soften and weaken them.
- weight loss,
- poor appetite.
- anomalies in heart rhythms and mental confusion
The NHS recommends the following supplementation – 10 micrograms per day for adults falling into the groups where they do recommend it. They also set the upper limit at 25mg. On the other hand, the livestrong article I referenced sets the upper limit at 100mg, citing the University of Rochester Medical Center. So, what is too much is open to debate. My prescription is for 500mg per week (i.e. about 70mg per day) and this is a deliberately high dose to top up my level for 12 weeks.
The other important number is the level that is actually measured and which resulted in my diagnosis. The Guardian ran an earlier article on what this should be and it seems to say that below 30nmol/litre is bad, 50nmol/litre is probably about right but some think it should go up to 100nmol/litre. So I had to ask what my level was and it was actually measured at 39nmol/litre so it doesn’t seem that bad. However, given all the uncertainties, I am left wondering whether there might be some link to my accident. I will certainly keep on eating oily fish, though I will have to eat more to increase my levels.
What more can be said. The Dutch care enough about cyclists to sign a diversion when a cycle path is blocked. Before we had seen it, someone having a meal in a restaurant had come over to us and told us the way round the blocked bridge. It was pretty obvious that we could have just cycled down the road to the next bridge across the canal. However, the diversion allowed us to do this through a combination of segregated path as in the photo and quiet back road rather than along the main road.
Heel erg bedankt!
Fietspad is Dutch for “cycle path”. However, after 4 days cycling in the Netherlands, I realise that as the Inuit are said to have 20 words for snow, and we English have at least as many for water falling from the sky so “cycle path” fails to do justice to ” fietspad”. Fietspad is more than a splash of paint with less power than a yellow line. Fietspad are physical paths on which you can cycle safely and are also a culture in which motorists respect cyclists so that a splash of paint means so much more than in the UK. Road planners also clearly think in terms of the journey a cyclist might want to make rather than the British approach of where might I put a cycle lane without inconveniencing other road users.
The worst sort of Dutch cycle lane is an unseparated line at the side of the road. However, the behaviour of motorists is clearly that they do not cross the line if there is a cyclist in the lane. Even if that means slowing down behind a cyclist, or stopping for an oncoming cyclist. So , not only do you feel safe, but you also feel your children can cycle safely.
Moreover, many roads, even relatively minor roads, have separated cycle paths at the side of them. Sometimes there is one on each side of the road. Other times, there is one lane with a dotted line, separating cyclists in opposite directions, just like a proper road.
We are in a very touristy area. So it may be unrepresentative. But there are also cycle only paths through the forest. We had lunch at a pancake house that you have to pedal or walk to. And everything is so well signed and maintained. Some of our paths have been gravelly or unsurfaced but I don’t recall a pothole.
Everything is so well linked. We took a few paths today that crossed more major roads. So, of course there was a cyclist crossing with a request button at the right height. And you are taken safely around roundabouts, rather than deposited on the inside of a left turning lorry as is the custom on the so called Super Highways.
You do have to be very careful of motorists when a cycle path crosses a road. Rather than accelerate to avoid being slowed down by a cyclist, the Dutch generally stop to let you cross. This can cause embarrassment to the Englishman waiting for his family to catch up. So my advice is not to stop too close to the edge, always sloped, never a curve.
A day of constant rain means that we haven’t yet been pedalling.
Rain doesn’t stop the Dutch cycling though. It seems as normal to cycle of get in the car. There was a mother and her two daughters ahead of me at the supermarket checkout. All smartly dressed. I was surprised to see them cycling home. Not a helmet in sight. And among the many cyclists, I only recall one drop handlebar bike and 2 helmets all day. Everywhere has bike stands, one with an integrated track pump. And bikes are not necessarily locked up and have panniers left on them.
Cyclists in Holland seem like normal people rather than members of a Lycra clad tribe. And there are bike lanes everywhere, separated where is space, at the side of the road where not: and then cars are clearly meant to stop if there are cars coming both ways and a bike as there wouldn’t be enough room otherwise.
Driving on a rural road, alongside a separated bike lane, we even noticed that the bike lane had a smoother tarmac than the road. Some contrast to the broken glass and dog shit that carpet London’s rare bike lanes.
If only it would stop raining …