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Tandem Cycling A bicycle built for two. Want to find out more about this wonderful world of tandems? Check out this forum to talk with other tandem enthusiasts. Captains and stokers welcome!

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Old 08-28-12, 05:24 PM
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Tandem Down

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Last edited by Abram; 08-30-12 at 06:47 PM. Reason: Following mwandaw advice below...
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Old 08-28-12, 05:52 PM
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Wow. Really sorry to hear about all of that! I hope the two of you can get back on the tandem, but I understand the dilemma. I know when I'm out with my daughter that an accident can happen, but if I dwelled on that thought, we wouldn't leave the garage. I can relate to your wife's dizziness as I've been fighting "benign paroxysmal positional vertigo" the last week and a half. I'm back on the bike, but the riding hasn't exactly been comfortable. Best of luck to the two of you!
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Old 08-28-12, 06:35 PM
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Originally Posted by Abram
Three weeks ago....

...She's got a CAT scan scheduled.
Is this a CT scan of the brain? CT's are preferred for immediate assessment of the injury, but three weeks later an MRI would be much more likely to provide an explanation for your stoker's symptoms. Even if the CT is negative, that is hardly reassurance, as an MRI has the resolution to spot the more subtle problems that a CT will miss. You might want to ask why a CT rather than an MRI, and determine if there is a specific explanation, such as looking for a fracture (these show up better on CT). If there isn't a specific explanation, it would seem that an MRI would be more the standard of care than a CT.
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Old 08-28-12, 07:26 PM
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Thanks so much for your reply, Ritterview. Makes sense, we'll ask. As you say, if it's a subtle problem we're looking for, seems the MRI is the better choice. What she heard was "I'm sure it'll be fine, but I'm going to suggest a CAT scan."

Last edited by Abram; 08-28-12 at 08:06 PM. Reason: spelling
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Old 08-28-12, 07:35 PM
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That is so awful! Very sorry to hear of your misfortune! Well wishes to you and your wife for a speedy recovery!
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Old 08-28-12, 08:50 PM
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Tandem Down

Hey Abram, I hope both you and your wife are soon recovered from your crash! Thanks for reinforcing and reminding us of the need to be careful out there.
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Old 08-28-12, 09:41 PM
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You guys will be in our prayers. I hate to think that tandeming would be over but would completely understand your wife being hesitant after that. Hopefully both of you will be okay and the fear will diminish with time.

I drive about 50k a year just here in our area and it scares me to death the drivers I see eating, texting, reading,changing clothes, fighting, playing with dogs or kids, talking on phone, drinking......I have seen it all. We have some routes that we used to ride that I just will not anymore due to the way other drivers just simply drive over into the shoulder for lack of paying attention or doing one of the previous. This will not prevent an accident but I feel much safer on some of the less traveled roads. We also watch what times we ride. A group likes to ride after work and into the sun but that sun is also blinding the drivers. I love riding on the road but we recently purchased an off road tandem. We are learning and liking it so far but it is completely different. One thing is there are no cars to worry about.

Pray for a full recovery for the both of you. (and the bike ) : )
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Old 08-28-12, 10:10 PM
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First of all, the bike (and/or its components) are replaceable; both you and your wife are not. I'm glad to hear that both of you are (relatively speaking) all right.

As for the scans, micro fractures can take up to 3 weeks to manifest. MRIs are great, so long as one is a candidate: no surgical clips and/or steel pins. Not a good thing to let the magnet start moving them around in one's body. MRIs are also a good deal more expensive than the cat scans. And don't neglect your collar bone!
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Old 08-29-12, 10:18 AM
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Originally Posted by Sprout97
First of all, the bike (and/or its components) are replaceable; both you and your wife are not. I'm glad to hear that both of you are (relatively speaking) all right.
We shudder at the thought of this accident without helmets. It would have been much more serious, the difference between being relatively intact or hospitalized / killed. I had a bruise on my forehead where the helmet cracked. Wife's impact was the side of her head (much worse for concussions), with the helmet split in three places.
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Old 08-29-12, 10:20 AM
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First: I hope you and your wife heal quickly and fully.

Second: If you search, you'll find a lot of advice about not putting any details of an accident on public forums like this one. Doing so could seriously hurt your chances for getting a fair settlement for your injuries and damages.

Best wishes!
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Old 08-29-12, 01:03 PM
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Originally Posted by photogravity
Hey Abram, I hope both you and your wife are soon recovered from your crash! Thanks for reinforcing and reminding us of the need to be careful out there.
+1.
This is one of the more common safety issues we face where we ride. As we come back into town, we often have short descents where cross traffic have stop signs. We assume that the drivers are not truly looking, just going through the motions as they automatically slow down and then run the stop sign. Many a time we would be perfectly safe at 30 mph if everyone obeyed the law, but we will clamp down on the drag brake and stay under 20 mph so that we have an escape from unforeseen, but still predictable, troubles.

Edit: Sure enough, yesterday morning, while riding back into town after a forty mile ride, we had someone BACK out of their driveway into our path on a 35 mph speed limit descent. Fortunately, we were sitting on the drag brake and only going about 25 mph so we easily came to a stop, as did the motorist behind us. I see many cyclists ride down this hill at 40 mph and many motorists go faster than that.

I think some people have an internal timer that tells them when they have waited long enough and they just go when the timer dings, whether it is clear to do so or not. If we hadn't had an SUV right behind us I might have thought that this was one of those people who just don't see cyclists, but how do you not see an eight foot wide two ton red thing?

Be safe out there. The up-side of a little more speed is dwarfed by the downside of impact with, well, anything.

Last edited by B. Carfree; 08-31-12 at 05:19 PM.
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Old 08-29-12, 01:15 PM
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Sorry to learn of your accident Abram. Best wishes to you and your wife with your recovery.
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Old 08-29-12, 10:33 PM
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Sounds like the driver will be liable.
Get the best medical care possible.
After such an impact would not trust the frame to be perfect. Suggest driver's insurance pay for a daVinci replacement.
Been there, done that.
Stay positive and heal quickly.
Pedal on!
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Old 08-30-12, 10:13 AM
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I pray that you both recover completely and are able to come back to this wonderful sport.

You story reminds we that we have a similar section that we ride and have talked about going slower on it because the possibility of a car pulling out of a side street. The other day we (I) was concentrating on setting a Strava segment record (and we did), beloved stoker patted me on the butt at around 36 mph and I did not heed her concern. We did not have any issues and did set the record but after reading your account I decided with full affirmation from my stoker that in the future we will take that section much slower.

We rode a motorcycle for several years on the road and came to the realization that car drivers do not see cyclists (motor or bicycle) and you need to ride VERY defensively. if there is a car at an intersection you have to figure that they will probably pull out in front of you. We have learned to try to make eye contact with the driver and even wave at them to get their attention.

On the motorcycle we added extra head and taillights to help people to see us. On the tandem we have a bright strobe front and rear light. It is apparent to us that people do see us better than before we installed the lights.
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Old 08-30-12, 10:47 AM
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Originally Posted by DubT
I pray that you both recover completely and are able to come back to this wonderful sport.

You story reminds we that we have a similar section that we ride and have talked about going slower on it because the possibility of a car pulling out of a side street. The other day we (I) was concentrating on setting a Strava segment record (and we did), beloved stoker patted me on the butt at around 36 mph and I did not heed her concern. We did not have any issues and did set the record but after reading your account I decided with full affirmation from my stoker that in the future we will take that section much slower.

We rode a motorcycle for several years on the road and came to the realization that car drivers do not see cyclists (motor or bicycle) and you need to ride VERY defensively. if there is a car at an intersection you have to figure that they will probably pull out in front of you. We have learned to try to make eye contact with the driver and even wave at them to get their attention.

On the motorcycle we added extra head and taillights to help people to see us. On the tandem we have a bright strobe front and rear light. It is apparent to us that people do see us better than before we installed the lights.
We also use bright daytime running lights front and back and believe strongly that they help.

I do not like strobes for three reasons:

1) I feel that some drivers fixate on them and will tend to drive toward them. This may result in police cruisers being hit when on the highway shoulders.

2) I believe it is more difficult for other road users to judge the distance to a strobe than to a steady light.

3) They are very annoying to other users. When being approached by a bike with a front strobe I find it difficult to concentrate on the road in front of me.

Strobes do get noticed even more than steady lights so perhaps the best solution is a steady light with a way to toggle it to strobe for a short period nearing an intersection or to alert a specific driver.
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Old 08-30-12, 09:00 PM
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Originally Posted by Ritterview
Is this a CT scan of the brain? CT's are preferred for immediate assessment of the injury, but three weeks later an MRI would be much more likely to provide an explanation for your stoker's symptoms. Even if the CT is negative, that is hardly reassurance, as an MRI has the resolution to spot the more subtle problems that a CT will miss. You might want to ask why a CT rather than an MRI, and determine if there is a specific explanation, such as looking for a fracture (these show up better on CT). If there isn't a specific explanation, it would seem that an MRI would be more the standard of care than a CT.
Well, it's certainly debatable whether any imaging 3 weeks after a concussion will give information that helps get the OP's stoker better faster than the body's own healing mechanisms will. See "Concussion" https://www.nejm.org/doi/full/10.1056/NEJMcp064645 -- should be available free to non-subscribers. The Medscape article focuses on the decision about when (or whether) a concussed athlete should be allowed back on the field (or ice), which is a different question from "Why am I still not feeling right?"

Modern medicine (including my little corner of it) is much, much better at taking ever more sophisticated pictures of disease than it is at actually doing something beneficial to improve it. As the pictures get finer, they see things that we really don't know what role they play, if any, in the illness and even less about what, if anything, ought to be done about them. This can lead to dangerous and harmful meddling that, absent the fancy pictures, would never be considered. And if the MRI shows subtle abnormalites that get called "brain damage" that the CT didn't see, how does that help the patient recover faster? Be careful what you wish for.

To say someone isn't meeting the standard of care -- them's fightin' words, since that allegation is the foundation of every medical malpractice suit. It's a legal concept that can only be determined locally taking into account all the medical facts, not via remote control over the Internet. I do hope that Ritterview hasn't planted the seed of mistrust in the OP's mind about the bona fides of his wife's doctor.... since this is the sort of thing that makes concussed patients take longer to get better.

Let's save our criticism for the jerk motorist who ran the stop sign, shall we?
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Old 08-30-12, 10:03 PM
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Con1, you conflate diagnosis and treatment. Whatever the imaging reveals will not necessarily be treatable. BUt three weeks on there is little doubt that an MRI is more diagnostic and definitive than the CT, and without 0.5 rems exposure. I owned that ordering physician may have a specific reason for ordering a CT, but if not, an MRI is the better test to diagnose persistent symptoms. Okay, not the 'Standard of Care' with caps, but the preferred imaging very likely.

Diagnosis of concussion: the role of imaging now and in the future.
Magnetic resonance imaging is more commonly used as a secondary test for the investigation of persistent symptoms.
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