# A bit of a crisis after first metric century!



## the stupid one (23 Jun 2018)

Evening all.

Lovely day for a ride today. I extended a planned 50-miler to a debut 100 km, got home feeling OK, had some food and a coffee, and went to slouch in front of the telly.

About 40 minutes later I went to stand up to say goodnight to our daughter and was floored by the worst cramp of my life, so bad that I shouted for help. My wife came, grabbed my feet and pushed, while I yelped and hyperventilated. Next thing I knew, she was right over me asking if I was aware of what had just happened. I wasn’t, but I’d had a bit of an episode, something like a couple of seconds of spasm.

Mrs the stupid one has skills and equipment. My blood sugar was normal, my blood pressure was very low, my oxygen saturation left a lot to be desired. I went a bit grey and clammy, felt a bit faint, so head back on the floor and feet up while she brought me calcium tablets and milk. And other drinks. And raisins. The cramp returned, almost as bad, so wife grabbed foot and son appeared to massage my solid thigh.

Anyway, when I told her I’d taken three bottles of water with me but only consumed one of them you can imagine the kind of idiots she called me. The conclusion was that the episode was either hypocalcaemic tetany or hypoxic fit (due to the hyperventilation)*.

The takeaway message from all this is that on a warm day and an unaccustomed distance, even if you don’t feel particularly thirsty, DRINK MORE WATER. And possibly take some salts onboard.

Thank you for reading. Drink more water.


* “You don’t get hypoxic from hyperventilation, I don’t know what [caused the hypoxia].” So says Mrs the stupid one.

EDIT II: On further contemplation, Mrs tso now suggests lactic acidosis may have been implicated, largely due to the magnitude of the muscle cramp.


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## ColinJ (24 Jun 2018)

And if you don't happen to have a _Mrs the stupid one_ with equipment and skills handy, and end up feeling like that ... those symptoms are similar to what cyclists can get with a DVT/PE made more likely by dehydration! 



Velonews article said:


> What are the warning signs that should alert you to seek immediate evaluation?
> 
> *1) Shortness of breath — typically appears suddenly* and always gets worse with exertion.
> 2) Chest pain — Not only “heart attack pain,” but pain when you draw deep breaths, cough, or bend at the waist. It does not go away.
> ...


I ended up with all 7 symptoms when I had my DVT/PE but some appeared gradually over a period of a couple of weeks.


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## the stupid one (24 Jun 2018)

Thank you sir! She’s now asking me about pleuritic chest pain. There isn’t any.


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## Pat "5mph" (24 Jun 2018)

We are not used to hot weather!
I did similar a few years ago abroad: it was very hot, I drank my usual gallon of coffee in the morning, no much water during the day, went on a tiring train trip, fainted in the evening during a meal.
I don't like cycling long distances or doing strenuous exercise when it's very hot, even gardening makes me slightly dizzy if I don't take enough water.
You'll be fine tomorrow, lucky Mrs. TSO has the knowledge!


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## ColinJ (24 Jun 2018)

the stupid one said:


> Thank you sir! She’s now asking me about pleuritic chest pain. There isn’t any.


Remain vigilant though, just in case - my pain arrived later on in the process!

I had heard of DVT before I got ill but never gave it much thought. PE was something that I'd never even heard of until I developed one. 

Serena Williams has had DVT/PE twice, so it isn't something that only strikes unfit or overweight people. (I was overweight at the time, though moderately fit.)


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## Venod (24 Jun 2018)

I have a strange relationship with cramp, sometimes I can ride miles and be completely knackered but never cramp, other times a 40 mile ride will bring on the most violent cramps, I even cramp sometimes when I don't exercise, I am guilty of not drinking enough, but find it hard to drink when I am not thirsty, on an 80 mile club ride last year (at a high pace ) I cramped badly in both legs at about 70 mile it was that bad that I couldn't pedal, I told the group to carry on and I would make my own way home, I got of the bike stretched a bit got on and made a 25mph effort and caught the group up about 3 mile later, they were very surprised to see me as they moving at pace, but not as surprised as I was to catch them.


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## ColinJ (24 Jun 2018)

Funnily enough ... I did a very hilly 100 mile ride yesterday, didn't drink enough, and started to get significant discomfort in my right calf! It probably WAS the beginnings of cramp, but of all people, I should know better than to take chances with dehydration.

On two of my forum rides, riders got severe cramp on the same steep climb! Both had to leap off their bikes and walk up the hill. I'm sure that dehydration played a part there too.


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## Cycleops (24 Jun 2018)

Another long-term result of not drinking enough water is kidney stones, even more painful than cramp!


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## ColinJ (24 Jun 2018)

Cycleops said:


> Another long-term result of not drinking enough water is kidney stones, even more painful than cramp!


I've had those too - yes, you're right!


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## Heltor Chasca (24 Jun 2018)

Similar plan to carbo-loading, you can also salt-load. 

Few days before a long or fast ride and you know the weather forecast, drink plenty of liquid, ideally with electrolytes and salts.


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## the stupid one (24 Jun 2018)

This is all good stuff - thank you for the replies.

I just ordered a load of Dioralyte from eBay.


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## Ming the Merciless (24 Jun 2018)

Yes I did 140 hilly miles yesterday. Never drank so much. Stopped at many pubs for lemonades and fill both water bottles up. Keep an eye on whether you have peed during a ride. No pee, and feeling tired, you are probably dehydrated. I carry crisps and nuts for the salt replacement. Rolled in a little after sunset.


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## Saluki (24 Jun 2018)

Ah, so Mrs TSO is actually Mrs Clever-Woman.
Well done Mrs C-W.
Drink more, she was right. I drink tons and top my bottles too. Salt tissues are very good. I have them and they do wonders for me. Those and bananas.


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## Dave 123 (24 Jun 2018)

Tonic water will help too, plenty of quinine.
The gin can still go in there too!


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## midlife (24 Jun 2018)

Not sure salt loading us a good idea, raises blood pressure and a few other side effects, plus it's not stored akin to something like glycogen The body is pretty good as sodium homeostasis, best to drink something with electrolyte as the day goes on. Dioralyte doesn't taste very nice, especially the black currant flavour. Add a bit of glucose and more flavouring and it's easier to drink.

If you had hypocalcemia you would have been Chvostek sign positive..... Blimey I've been waiting 40 years to write that, thank you Mr Ganong


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## Venod (24 Jun 2018)

the stupid one said:


> I just ordered a load of Dioralyte



I had completely forgotten about Dioralyte, I have used it in the past when competing in Mountain Marathons but never used it on the bike, I can't remember how effective it was.


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## NorthernDave (24 Jun 2018)

Drink plenty (this morning I drank 2x 800ml bottles of water with hydro tabs on a 50km ride), then had a protein shake when I got in.

Stretch after a ride too if you find yourself prone to cramp, but I've found using the hydro tabs has all but eliminated cramping.

SIS Go Hydro are my tab of choice, but High5 are good too - others will have differing opinions though.


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## midlife (24 Jun 2018)

Step back 40 years........

http://www.disraeligears.co.uk/Site/Holdsworth_-_Bike_Riders_Aids_1975_page_16.html


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## IainC (24 Jun 2018)

midlife said:


> If you had hypocalcemia you would have been Chvostek sign positive..... Blimey I've been waiting 40 years to write that, thank you Mr Ganong



Yikes, been a long time for me since I've read that one. Although the hyperventilation could cause alkalosis which gives a similar hyperexcitability. I've just had to google 'Trousers sign' which is the related phenomenon I was sure I could remember. Turns out I could only remember the not very witty student's twisting of the actual sign :-)


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## midlife (24 Jun 2018)

IainC said:


> Yikes, been a long time for me since I've read that one. Although the hyperventilation could cause alkalosis which gives a similar hyperexcitability. I've just had to google 'Trousers sign' which is the related phenomenon I was sure I could remember. Turns out I could only remember the not very witty student's twisting of the actual sign :-)



I think you have autocorrect turned on lol


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## IainC (24 Jun 2018)

midlife said:


> I think you have autocorrect turned on lol


I wish... I actually remember Trousseau sign as 'Trouser's sign'. Now if only I could remember the correct word to describe using a similar sounding word to jog one's memory of the correct word. Age is a terrible thing


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## midlife (24 Jun 2018)

IainC said:


> I wish... I actually remember Trousseau sign as 'Trouser's sign'. Now if only I could remember the correct word to describe using a similar sounding word to jog one's memory of the correct word. Age is a terrible thing



My head is full of mnemonics.....Oh Oh Oh To Touch And Fondle.........

I remember the mnemonics but not what they stand for lol


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## IainC (24 Jun 2018)

midlife said:


> My head is full of mnemonics.....Oh Oh Oh To Touch And Fondle.........
> 
> I remember the mnemonics but not what they stand for lol


Mnemonic!! That's it. Thank you . And the rest of the cranial nerve one is would likely be turned in to a family friendly but entirely unrepresentative one by the swear filter if you went any further. Although at least there are no daffodils in there. I'll stop now, honest


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## MikeG (24 Jun 2018)

the stupid one said:


> I just ordered a load of Dioralyte from eBay.



A handy alternative is to let a can of Coke or Fanta go flat, then drink that. That's an old travellers stand-by (for diarrhea in hot countries, where water is dodgy so Dioralite can make matters worse rather than better), but it works just as well for rehydration for sportsmen. Loads of sugar and some salt in both. Add salt if you need it.


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## PK99 (24 Jun 2018)

@the stupid one 

Where (which muscle) do you get the cramp?


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## the stupid one (24 Jun 2018)

Hi PK99. When cycling I nearly always get cramp in my feet. Afterwards, usually in bed, it’s my feet again and, I think, vastus medialis of the quadriceps group. Inside of my thigh, along the line where my legs touch when closed.

Both legs were affected last night, but particularly the right. I’m right handed/sided.


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## PK99 (24 Jun 2018)

the stupid one said:


> Hi PK99. When cycling I nearly always get cramp in my feet. Afterwards, usually in bed, it’s my feet again and, I think, vastus medialis of the quadriceps group.* Inside of my thigh, along the line where my legs touch when closed*.
> 
> Both legs were affected last night, but particularly the right. I’m right handed/sided.



Sartorius muscle, longest in the human body
https://en.wikipedia.org/wiki/Sartorius_muscle

It's the one that hits me every time I'm working my way back on the bike after a layoff.

Pattern for me is exactly as you describe it:

_About 40 minutes later I went to stand up to say goodnight to our daughter and was floored by the worst cramp of my life, so bad that I shouted for help_

The motion of moving from sitting to standing triggers it into spasm. Pain like no other cramp pain.

I used to find it impossible to deal with/stretch out - I eventually found that sitting on the floor, legs out in front and leaning the torso (shoulders toward and over knees) resolves the spasm and pain very effectively


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## the stupid one (25 Jun 2018)

Thank you for that piece of advice. I shall try that if there’s a next time. And it _was_ like no other cramp pain I’ve had - more severe and disabling than any I remember. I’ve experienced gastritis, biliary colic, dental abscess and various post-op pains, and this was right up there, with the bonus feature of near-instantaneous peak severity.

Ouch.


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## Lavender Rose (25 Jun 2018)

I know I don't drink enough water - desperately need to do it! I think it contributes a lot to my dodgy tight calves.


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## dave r (25 Jun 2018)

I don't have a lot of problems with cramp when I'm on the bike, but I do sometimes have problems when I'm doing yoga, cramp in the toes is particularly unpleasant, anyway thanks people, you've reminded me I need my big water bottle this morning.


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## Blue Hills (25 Jun 2018)

Have had cramp sometimes and once in both legs at the same time mid cycle. May be my imagination but I do get the feeling that zero tabs help a lot. Did 100 miles the other day and no problem - cramp-free state could have been down to the single zero tab or the four pints of beer. Sometimes the night after a ride I do get cramp in bed. Again may be coincidence but a quick nibble of half a zero tab (not dissolved) seems to usually bring rapid relief, though I find it hard to believe that the contents of the tab can make it into my system that fast. I do like them -berry one particularly. Usually easily available for half price stocking up of course - no need at all to pay full price.


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## Alan O (25 Jun 2018)

Whenever I read threads like this, I repeat the recipe I use for very cheap exercise hydration. And against the ongoing marketing barrage of super-duper-expensive hydration tablets, I make no apology...

It's essentially the standard ORT approach but with perhaps a bit more salt, and it's just one litre of water, 6 teaspoons of sugar, half to one teaspoon of salt, zero "sports science" markup. Add some lemon juice or squash to taste.

It's easy, it's dirt cheap, and it works.


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## Blue Hills (25 Jun 2018)

Wot's ORT alan?

Doesn't the sugar cause issues with your water bottles?

I don't find zero tabs expensive to be honest and i'm a meanie. Buy them cheap, often only use half a tab.


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## the stupid one (25 Jun 2018)

Oral Rehydration Therapy.

One of the BMJ's 15 modern medical milestones in a 2007 shortlist:

*10 Oral rehydration *
_
Children in poor countries are faced with episodes of diarrhoea about three times a year. Simple, cheap and easily prepared oral rehydration therapy, which combines salt and sugar with clean water, saves millions of lives._


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## Alan O (25 Jun 2018)

Blue Hills said:


> Wot's ORT alan?
> 
> Doesn't the sugar cause issues with your water bottles?
> 
> I don't find zero tabs expensive to be honest and i'm a meanie. Buy them cheap, often only use half a tab.



ORT is Oral Rehydration Therapy, which is aimed at patients at risk of dehydration, usually from diarrhea - see https://en.wikipedia.org/wiki/Oral_rehydration_therapy

Why would there be a problem with my water bottles? I wash mine out at the end of each ride - don't you?

And however cheap tabs might seem, they're far more expensive than the ORT recipe. If you want to go for tabs, go for it, but unless you're an exceptional athlete I really don't think there's any real advantage over just being careful about salt intake and drinking enough water. H. sapiens evolved pretty well for a very long time before sciencey marketing decided it had discovered the only way to survival.


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## Blue Hills (25 Jun 2018)

Alan O said:


> Why would there be a problem with my water bottles? I wash mine out at the end of each ride - don't you?
> 
> .



No - empty them, maybe rinse. They only get washed every 1 or 2 years. I always use a clear bottle for the tabs so that I can keep an eye on any suspicious growths at the bottom. Personally not too keen on sugar in my bottles - my ride sugar boost comes from Lidl wine gums.

No I'm not an exceptional athlete  - I used to use the powders which also had a carb/energy component on tough rides and they did seem to work but these days I prefer Lidl wine guns, Lidl chocolate peanuts and raisins, my home-made energy snack and self-made espressos.


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## Alan O (25 Jun 2018)

Blue Hills said:


> No - empty them, maybe rinse. They only get washed every 1 or 2 years.


You could be at the forefront of culturing new bacteria for new antiobiotics!


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## vickster (25 Jun 2018)

Eww to not washing bottles. Mine go through the dishwasher at least once a week and usually only contain water


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## Tin Pot (25 Jun 2018)

Jesus Christ I’ve seen some over reactions in my time but this thread is starting to take the biscuit*.

So you had some unexpected painful cramping after riding much longer than you ever have?

Welcome to the world of overexercise.

- Stop freaking out. 
- Put down the third world drought treatments. 
- Empty out the two bottles you won’t drink next time either.

1. Build up to your next big ride over several weeks.
2. End plan.


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## Blue Hills (25 Jun 2018)

Alan O said:


> You could be at the forefront of culturing new bacteria for new antiobiotics!


Actually it's probably substantially less frequently than that. Was maybe fearful of admitting it. I do have some of that stuff for cleaning baby's bottles but the vast majority of it is still in the bottle. Will probably see me out. I'm a great believer in building up resistance by not being over fussy about such things. In case you think I'm a total slob I stress that I always shower before cycling.


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## Alan O (25 Jun 2018)

Blue Hills said:


> Will probably see me out.


One way or another :-)


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## Blue Hills (25 Jun 2018)

there are news stories on lowered resistance through excessive concern about cleaning - tried to find but couldn't. May your personal germs go with you.


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## cyberknight (25 Jun 2018)

PK99 said:


> Sartorius muscle, longest in the human body
> https://en.wikipedia.org/wiki/Sartorius_muscle
> 
> It's the one that hits me every time I'm working my way back on the bike after a layoff.
> ...


Thats the one on me cramps up when i used to get above 75 miles, started doing stretches for it more regularly and added side step squats to my strength routine and seems to be getting better.


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## vickster (25 Jun 2018)

Blue Hills said:


> there are news stories on lowered resistance through excessive concern about cleaning - tried to find but couldn't. May your personal germs go with you.


More linked to children and allergies. You're probably ok if you've got to late adulthood without a lifetime of illness. I'm not fastidious and a firm believer in the 5 second rule but I wouldn't drink from a bottle that hasn't been washed properly in a year (esp after a recent dose of acute gastroenteritis in Asia likely due to bugs in water)


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## Blue Hills (25 Jun 2018)

what's the five second rule?

If you haven't thrown up/collapsed after 5 seconds you're probably fine?

In truth my blue decathlon bottles are well over 10 years old and have maybe been properly cleaned 3 times.

Maybe time for another?

Have recently invested in some nice stainless steel ones to facilitate cleaning - primarily for touring.

Clear bottles are the thing I think - sod the flash branding.


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## vickster (25 Jun 2018)

Blue Hills said:


> what's the five second rule?
> 
> If you haven't thrown up/collapsed after 5 seconds you're probably fine?
> 
> ...


The time you have to pick up a piece of dropped food from the floor and it still be ok to eat


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## the stupid one (25 Jun 2018)

Tin Pot said:


> Jesus Christ I’ve seen some over reactions in my time but this thread is starting to take the biscuit*.
> 
> So you had some unexpected painful cramping after riding much longer than you ever have?
> 
> ...



Where to start . . .

I had entirely expected cramping after riding about 8km longer than I ever have, but I also had a short loss of awareness and significant hypotension. 
Nobody’s freaking out with the possible exception of you yourself. 
I posted because I thought it might be interesting to other cyclists, this being a cycling forum, and it seems I was right because there’s subsequently been a good discussion which has wandered along some entertaining sidetracks.
Oral rehydration therapy will work just as well here as anywhere else.

Thank you for your advice - the one about not taking the other two bottles is amusing enough to fit in with the rest of the thread - but if you don’t like a thread there’s really no need to comment, is there?


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## CXRAndy (27 Jun 2018)

you had cramp after hot long ride. common situation. just be careful when bending or straightening legs


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## Tin Pot (27 Jun 2018)

CXRAndy said:


> you had cramp after hot long ride. common situation. just be careful when bending or straightening legs


Hear, hear.


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## PK99 (27 Jun 2018)

CXRAndy said:


> you had cramp after hot long ride. common situation. just be careful when bending or straightening legs



That's unfair. Symptoms described were in the Sartorious muscle. Cramp here is painful like no other and as the muscle spans across two joints - hip and knee - is very difficult to stretch out for relief in the same way as hamstring or calf.


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## Alan O (27 Jun 2018)

PK99 said:


> That's unfair. Symptoms described were in the Sartorious muscle. Cramp here is painful like no other and as the muscle spans across two joints - hip and knee - is very difficult to stretch out for relief in the same way as hamstring or calf.


Very much, yes, there's cramp and there's *CRAMP*. I've had it plenty of times where a bit of stretching does the trick - painful, yes, but reasonably quick to recover. But last year I had a cramp attack (curiously, about an hour after finishing a ride) that started in both hamstrings and spread upwards. It locked my muscles in spasms such that I literally had no control over them, and the pain was excruciating. It then went through several cycles of the pain and spasms fading, but cramping up again at any attempt to move. Then suddenly it was gone, as quickly as it started.


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## Tin Pot (27 Jun 2018)

the stupid one said:


> Where to start . . .
> 
> I had entirely expected cramping after riding about 8km longer than I ever have, but I also had a short loss of awareness and significant hypotension.
> Nobody’s freaking out with the possible exception of you yourself.
> ...



I’m sorry but this thread is full of bad advice, it is only right that you should be informed of that. If you choose to take said bad advice, that’s your call, but do it for the right reasons - not because you don’t like my attitude.

The notion that a 100km ride could cause such severe dehydration, such severe electrolyte deficiency that you are put into unfathomable convulsions of pain is laughable. It would be remiss not to be derisory in response.

Either you have some other condition for which mild exercise has revealed these symptoms, or you rode harder than you can handle.

Drink more water, regardless of thirst?

Nonsense.

Oral rehydrant?



You rode too hard, end of story.

I do it too occasionally and pay a similar price.


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## ColinJ (27 Jun 2018)

Tin Pot said:


> The notion that a 100km ride could cause such severe dehydration, such severe electrolyte deficiency that you are put into unfathomable convulsions of pain is laughable. It would be remiss not to be derisory in response.


I did a 100 km ride on a hot day once. I drank 2.5 litres from the bottles on my bike, plus 2 x 0.5L of Coca Cola off the bike. I ate a sandwich, a piece of cake and a couple of bars of chocolate ...

I got home dehydrated (3 kg net weight loss, and I'm sure that most of that was fluid loss in sweat), and my face covered in so much salt that I literally scraped it off with a knife. Oh, and I suffered painful cramps too!


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## Tin Pot (27 Jun 2018)

ColinJ said:


> I did a 100 km ride on a hot day once. I drank 2.5 litres from the bottles on my bike, plus 2 x 0.5L of Coca Cola off the bike. I ate a sandwich, a piece of cake and a couple of bars of chocolate ...
> 
> I got home dehydrated (3 kg net weight loss, and I'm sure that most of that was fluid loss in sweat), and my face covered in so much salt that I literally scraped it off with a knife. Oh, and I suffered painful cramps too!



Thanks for supporting my position, though I doubt you meant to


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## ColinJ (27 Jun 2018)

Mind you, I was about 3 stone overweight and the route did involve 2,500 m of steep Yorkshire climbing ...


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## Tin Pot (27 Jun 2018)

ColinJ said:


> Mind you, I was about 3 stone overweight and the route did involve 2,500 m of steep Yorkshire climbing ...



Kerching!


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## PK99 (27 Jun 2018)

Tin Pot said:


> I’m sorry but this thread is full of bad advice, it is only right that you should be informed of that. If you choose to take said bad advice, that’s your call, but do it for the right reasons - not because you don’t like my attitude.
> 
> The notion that a 100km ride could cause such severe dehydration, such severe electrolyte deficiency that you are put into unfathomable convulsions of pain is laughable. It would be remiss not to be derisory in response.
> 
> ...




Is that Tinpot advice?


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