Random thoughts from an anesthesiologist: if you want to age gracefully, then moisturize your hands and apply sunscreen on your face and neck. Nothing shows your age more than your hands and neck. 1/x
Anesthesiologists are generally less interested in hearing about your marijuana use than your consumption of ginkgo biloba, St. John's wort, and/or grapefruit— that's because these supplements can alter your liver's ability to metabolize the medications administered during and after surgery. 2/x
Smoking cigarettes and cigars is bad for your health and messes with your airway— big time. That said, don't quit smoking within 2 weeks of a major surgery without first consulting with your anesthesiologist— that's because phlegm production increases dramatically 2-3 weeks after you quit and that makes airway management during surgery more challenging. 3/x
I cannot stress this enough: when you ride a bike, wear a helmet. I don't care where you're going, how safe you think the streets are, or how skilled/experienced of a cyclist you are. There are very few trauma patients who are worse off than cyclists— fewer still than cyclists who weren't wearing a helmet when they got injured.
@xinit
For pedestrians the data apparently says hi-viz vests, but sadly there is no individually available tool for those at risk from the 2-ton hunks of metal around them. Making roadways more narrow works, but that requires communal infrastructure action. @DataDrivenMD
I admit my question is VERY loaded. The higher and higher, bigger and bigger of cars is basically out of control in North America, and getting worse here in the EU as well.
I believe that one of the biggest categories of injuries drivers get when they crash into other cars, buildings, or cyclists are head and neck injuries. I think it's time to introduce four-point harnesses, neck supports and driving helmets for drivers.
@xinit
Well, again, making roadways narrower would also work. In the meantime, another tool might be to reintroduce the mandatory flag-carrier ahead of the vehicle? https://en.wikipedia.org/wiki/Red_flag_traffic_laws @DataDrivenMD
@osma@DataDrivenMD The flag carriers could rock-paper-scissors at every intersection to determine vehicular priority!
I'm writing from the Netherlands where raised intersections and single-lane wide local streets are pretty normal. Making drivers feel a bit unsafe seems to make them slow down a bit.
Another design guideline which I've seen referenced for positive safety has been to reduce straight-line lanes with traffic barriers, trees, etc placed to force turns. Sorry, no link for that now. @DataDrivenMD
@DataDrivenMD policies mandating wearing a helmet discourage cycling, and by doing so are detrimental to public health. For example: more people taking the car because of such a measure. It gives a signal cycling is dangerous, whilst (at least here) it is not. (Why not wear a helmet in a car? Or walking?) This is why the Dutch cyclist union still actively opposes requiring wearing helmets. (Article in Dutch) https://www.fietsersbond.nl/de-fiets/accessoires/fietshelmen/waarom-de-fietsersbond-tegen-een-helmplicht-is
@DataDrivenMD@sheean True, but there is a subtle but important paradox at work here.
As you rightly say, while it is statistically better for overall public health for helmets not to be made mandatory, it is also statistically better for your own health to wear one once you have made the decision to cycle.
Context: I live in The Netherlands, cycle ~8,000km a year, & have had a few crashes in 11 yrs where wearing a helmet saved me from head trauma 😬
@markmccaughrean@DataDrivenMD@sheean I wear a full-face helmet when mountain biking, and have had it save my noggin at least once, not counting a number of brushes with tree branches etc. But I don’t wear a helmet while running errands around town. My rule is, if I put on special clothes for the ride, I wear a helmet; if I’m riding in street clothes, I don’t.
If I were to make one thing mandatory on bikes, it would be lights before helmets!
@DataDrivenMD@sheean@riotnrrd Sure – I’m pretty much the same: if I pootle into town on my commuter tank, I won’t wear a helmet. But an accident is always possible (& I got concussion once doing so), so it’s still a risk.
For the great majority of my riding on my road bike though, including the 12km commute to work, I wear one.
Fully with you on mandatory lights: I see so many people riding without them here in NL 😬
@DataDrivenMD@markmccaughrean@riotnrrd those lights are mandatory though! Just poorly enforced. (Mine broke down once and I had to get home late at night. Once! Guess who did get a fine for it). I would totally wear a helmet going super fast on a crazy ebike. But my bike doesn’t even have gears and a top speed I could probably reach just as well by running (for 30 seconds until I run out of breath)
@sheean@DataDrivenMD@riotnrrd Indeed – it’s an enforcement issue. I’d also go so far as to insist that people walking / running on cycle paths at night also wear lights (as should their dogs): even with lights on my bike, it’s easy to get momentarily dazzled by cars or street lamps & completely miss seeing the person running in all black 😱
@sheean@riotnrrd@DataDrivenMD@jsoref As I said, even with powerful lights on my bike, it’s easy to get blinded by a car with undipped headlights in the country & miss someone walking or riding on the bike path dressed in black without lights. Has happened to me more than once & had little to do with my speed.
@markmccaughrean@DataDrivenMD@sheean@riotnrrd I haven't had to do a daily commute in the dark in a couple years, but I think I'm more settled in the Netherlands to be able to yell "ZET JE LIICHT AAN, OMA!" when I see an all-black omafiets thundering towards me, the wrong way on the fietspad.
@markmccaughrean@DataDrivenMD@sheean
Anecdotal reports about patients in a trauma unit is a highly selective subset of people who have already been hit. Not being hit is the best way to avoid injury, but drivers give you less room if you wear a helmet, making it more likely that you will be hit.
Chris Boardman (cycling data and statistics uber nerd) doesn't wear a helmet.
@DataDrivenMD@sheean@ely_peddler Much less of an issue here in NL, where the ubiquitous cycle paths are often well-separated from cars. Plus broadly speaking, most car drivers here are also cyclists, so behave respectfully.
None of my crashes have involved cars: black ice at night, dog not on lead running across me, rogue skateboard (!), hit & run by a moped, not clipping out at a junction etc. Helmet was very welcome every time.
@DataDrivenMD@sheean@ely_peddler Only crash I had without a helmet was pootling with my young son who was trying out new bike. I got too close, he swerved, I crashed: full face plant & concussion. Always possible.
Unless wearing a helmet actively makes riding more dangerous (& perhaps in the psychotically testosterone-driven angry UK it does), it has to be the safer choice to wear one if you’re going to cycle in the first place (see first toot 🙂)
@markmccaughrean@DataDrivenMD@sheean
The real problem with the OP is that telling people cycling without a helmet is dangerous doesn't encourage them to wear a helmet, it just discourages them from cycling at all and that increases their chance of dying prematurely from heart disease, diabetes etc caused by a less active lifestyle.
Cycling is better for your health, with or without a helmet, than not cycling.
@sheean@DataDrivenMD@ely_peddler Fully agreed – we’re both on Team Cycle here & my >90,000+ km in the last 11 years have been vital to my health 🙂👍
But equally I wouldn’t dream of riding my road bike without wearing a helmet because once you do choose to cycle, cycling with a helmet is better for your health than cycling without one 😜
@markmccaughrean@DataDrivenMD@sheean@ely_peddler
There's research, replicated-ish, that suggests drivers will pass you closer if you wear a helmet, and other research, not replicated AFAIK that shows that wearing a helmet will increase the wearer's risk-taking. No implication that these effects cause enough extra crashes to offset per-crash safety benefits, but technically, it suggests yes, helmets cause extra crashes.
@dr2chase@DataDrivenMD@sheean@ely_peddler I've seen those studies mentioned before, but have never dug into them deeply enough to know where they were conducted. It's possible you might get different outcomes in countries like NL & DK that are bike-friendly & where most drivers are also cyclists, compared to the US & UK, where there seems to be an endless war by drivers on cyclists, with perhaps cyclists becoming more aggressive in return out of self defence.
@DataDrivenMD@jsoref@ely_peddler@sheean@dr2chase Interesting piece. That said, the data are from the UK riding on roads & the article even cites NL as having a much better approach to separating bikes & cars. And apropos that, none of my potentially dangerous crashes involved cars: they were all on bike paths. So for me at least, even in NL, wearing a helmet makes sense most of the time when cycling.
@markmccaughrean@DataDrivenMD@ely_peddler@sheean@dr2chase I'm not absolutely opposed to helmets. I'll wear them when riding trails or long distances, but when I'm traveling in the city and the most likely problem is a multi ton vehicle operated by what should be described as an inattentive sociopath, the helmet won't protect me but might result in them giving me even less space–seeing me as less human when they bother to look.
@DataDrivenMD Before he became a PI/MM attorney, dad was a claims manager for an insurance company. Over dinner he'd tell us lovely tales about how Volkswagens were opening up like tin cans in accidents back then, and what it was like searching for bits of brains. Yikes! Wear a helmet, people!
For no reason in particular, despite owning over 2 dozen cars over the years, none was a Volkswagen.
@lazarus7@DataDrivenMD I don't own one at the moment. Modern cars come with 3-point restraints and airbags. Cars when he told us that stuff often didn't even have seat belts. There was a cadre who swore they'd never even wear ones on motorcycles.
Want to hear about the cyclist drag racing one night when a drunk in a camper cut him and his buddy off to make a left turn in front of them? The winning rider had no helmet. The indentation went clear to the other side of the camper. Not healthful.
@stevesplace@DataDrivenMD also … in your example of death you sent to me, it doesn’t sound like a foam hat would have saved that poor individual from the drunk wielding a weaponized chunk of steel and plastic.
@stevesplace@DataDrivenMD A friend of my son’s came of his bike & split his helmet. Looked at it for a couple of minutes before saying, “ that could’ve been my head”.
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