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Source: (consider it) Thread: Inquire Within: general questions
Lamb Chopped
Ship's kebab
# 5528

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I got into trouble during my stay in ICU for answering honestly about my pain on the 1 to 10 scale--I said "six" which for me means "broken bone or dislocation." They discounted it automatically to 4 (because everybody exaggerates, dontchaknow) and I got crap-all pain medicine.

Later I wised up and said 11.

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Er, this is what I've been up to (book).
Oh, that you would rend the heavens and come down!

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Leorning Cniht
Shipmate
# 17564

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I was asked the "1 to 10" question, and asked them to define their scale. I got told it was up to me to pick, and I think I said something like "that's silly. It makes no sense to define a scale like that. This isn't quite as bad as a broken arm with pointy bits jabbing me on the inside. What number do you want to call that?"

They still wouldn't choose a number for me.

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Hedgehog

Ship's Shortstop
# 14125

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As a practical matter the analog pain scale only works over time. In other words, if I just ask you once to rate your pain on a 1 to 10 scale, "6" conveys no useful info. On the other hand, if the first time you see the doctor the pain is 6 and then you get treatment and the next time you rate your pain as 4, presumably you have had a consistent pain scale in your own mind and the drop from 6 to 4 means you are getting better. If it stays at 6, presumably the treatment has been useless.

The number itself has no intrinsic meaning. It is only good as a comparison to other numbers given at other times. Which is also why the medical provider should not tell you what number to give. It is your own idea of the scale from good to bad that is important, over time.

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"We must regain the conviction that we need one another, that we have a shared responsibility for others and the world, and that being good and decent are worth it."--Pope Francis, Laudato Si'

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Leorning Cniht
Shipmate
# 17564

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quote:
Originally posted by Hedgehog:
As a practical matter the analog pain scale only works over time. In other words, if I just ask you once to rate your pain on a 1 to 10 scale, "6" conveys no useful info.

But if I tell you it's as bad as the time I broke an arm, we both have a reasonable idea about what I mean by 6 (or 4, or 8, or whatever). That's better.

As a practical matter, it seems that you want to distinguish
  • I can't think. Make it stop
  • My whole world is pain
  • I need pain meds NOW
  • It's really sore, but I can tough it out for an hour or two
  • I don't think I can sleep without painkillers
  • Just don't touch it
  • Ow

or something - and in most cases that's more important than long-term trends because there isn't going to be a long-term anything - I'm going to be home in 4 hours.

If you put a benchmark on the scale, you still get all the relative stuff. If it's getting better, my number is always going to get smaller.

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Lamb Chopped
Ship's kebab
# 5528

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quote:
Originally posted by Hedgehog:
As a practical matter the analog pain scale only works over time. In other words, if I just ask you once to rate your pain on a 1 to 10 scale, "6" conveys no useful info. On the other hand, if the first time you see the doctor the pain is 6 and then you get treatment and the next time you rate your pain as 4, presumably you have had a consistent pain scale in your own mind and the drop from 6 to 4 means you are getting better. If it stays at 6, presumably the treatment has been useless.

The number itself has no intrinsic meaning. It is only good as a comparison to other numbers given at other times. Which is also why the medical provider should not tell you what number to give. It is your own idea of the scale from good to bad that is important, over time.

This is very true, and yet half the medical people I saw treated it as an absolute--"Oh, she said six, so she doesn't need anything stronger than ibuprofen." And this right after major abdominal surgery.
[Disappointed]

Some people need some re-educating.

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Er, this is what I've been up to (book).
Oh, that you would rend the heavens and come down!

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Adam.

Like as the
# 4991

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My one comment on this question.

[ 29. November 2015, 14:06: Message edited by: Adam. ]

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Ave Crux, Spes Unica!
Preaching blog

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Curiosity killed ...

Ship's Mug
# 11770

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It is all relative. I worked through a kidney infection the only time other than when I broke am arm I have voluntarily taken myself to A&E because I was in so much pain. I currently have a colleague who has been off sick half this week and is signed off next week with a kidney infection. I probably failed to ask about being signed off. The students I worked with reckoned I was waddling like a duck, very slowly to get around.

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Mugs - Keep the Ship afloat

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Brenda Clough
Shipmate
# 18061

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This is the article from Atlantic about how women's pain is assessed. Creeps me out.

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Hedgehog

Ship's Shortstop
# 14125

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quote:
Originally posted by Lamb Chopped:
This is very true, and yet half the medical people I saw treated it as an absolute--"Oh, she said six, so she doesn't need anything stronger than ibuprofen." And this right after major abdominal surgery.
[Disappointed]

Some people need some re-educating.

I believe you. I have seen the scale mis-used by medical people loads of times. The straight-leg-raising test is another one that gets mis-used constantly. Scary.

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"We must regain the conviction that we need one another, that we have a shared responsibility for others and the world, and that being good and decent are worth it."--Pope Francis, Laudato Si'

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Firenze

Ordinary decent pagan
# 619

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There's a lot to be said for screaming loudly and continuously.

My happiest experience of pain relief was post-hysterectomy when they left me with a morphine drip and a Gimme button.

Posts: 17302 | From: Edinburgh | Registered: Jun 2001  |  IP: Logged
Curiosity killed ...

Ship's Mug
# 11770

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Yeah right, they don't give you morphine after a Caesarean, although my health visitor pointed out it's the same operation, pretty much (this was to try and slow me down). Following that one is the only time I've fainted.

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Mugs - Keep the Ship afloat

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Lamb Chopped
Ship's kebab
# 5528

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quote:
Originally posted by Firenze:
There's a lot to be said for screaming loudly and continuously.

Heheheh--you've reminded me of a time when we took an elderly man (immigrant, no English) to emergency with enlarged prostate and a total inability to pee. He desperately needed a catheter --had about a gallon of fluid in there from what I recall--and we kept watching various nurses, residents, etc. saunter past the door very slowly with all the air of people off to take a cig break, no relief in sight.

After a couple hours of this and NO help at all, we hatched a nefarious plan. I stood at the door and signalled behind my back every time I saw a staff person walking our direction, at which point the man would give his loudest, most theatrical groan.

We had help in less than 10 minutes.

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Er, this is what I've been up to (book).
Oh, that you would rend the heavens and come down!

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basso

Ship’s Crypt Keeper
# 4228

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Oh, that hurts.

Emergency departments are not usually good at getting to people in real pain, but both times (yes!) I've landed in the local ED with urinary retention, they took care of me immediately.

That beat a gout attack on the pain scale, which beat a severely inflamed appendix. I don't play the scale-of-ten game anymore -- I just ask "compared to which of these?"

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Boogie

Boogie on down!
# 13538

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quote:
Originally posted by Firenze:

My happiest experience of pain relief was post-hysterectomy when they left me with a morphine drip and a Gimme button.

Same here - and I had the magic button for four days!

My worst pain ever was gall stones - far worse than childbirth. I couldn't move, see, speak, nothing. Each attack my friends said my face went grey-blue. I often passed out.

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Garden. Room. Walk

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Curiosity killed ...

Ship's Mug
# 11770

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Actually, you've reminded me. I got the full bladder and inability to pee after the caesarean. Collateral damage included a severely bruised urethra to go with the 20cm operation scar and blood loss (over a litre), plus minimal pain relief as I was breast feeding. That hurt. I was crying as I begged them to put the catheter back in.

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Mugs - Keep the Ship afloat

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Firenze

Ordinary decent pagan
# 619

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I think we're wandering a little far from 'How to objectively calibrate pain' into Cousin Hilda* territory.

*a distant relative whose ever favourite and recurrent topic of conversation was Her Operation.

Firenze
Heaven Host

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Jengie jon

Semper Reformanda
# 273

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Gall bladder is known to be one of the worse pains. I can remember thirty years ago a GP who was doing first aid training telling us that three pains stopped a person in their tracks
  • Angina
  • Gall Bladder
  • Cheque from a private doctor

Jengie

--------------------
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Brenda Clough
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# 18061

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I find comparatives offered by women more convincing. Childbirth -hurts-.

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Bene Gesserit
Shipmate
# 14718

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I would add trigeminal neuralgia to the top end of the pain scale, from my OH's experience of it.

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Sancta Maria, Mater Dei, ora pro nobis peccatoribus

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Moo

Ship's tough old bird
# 107

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There's also the pain from damaged nerves that comes and goes like lightning. If it had ever lasted as long as five second, I would have lost consciousness.

Moo

--------------------
Kerygmania host
---------------------
See you later, alligator.

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North East Quine

Curious beastie
# 13049

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When I had my planned stillbirth, the theory was that a painful labour was better psychologically as it imprinted the reality of the stillbirth. There had apparently been cases of women who had pain free stillbirths (because no problems about taking drugs when the baby won't be affected) who went on to develop psychotic illnesses. So my birth plan stated that one aim was to make sure I was in pain. It was bearable because I fully understood the rationale and I had agreed in advance. Husband found it difficult though.

I don't know what the current thinking is, that was 16 years ago.

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Lamb Chopped
Ship's kebab
# 5528

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Wow.

I understand that there are pain scales out there that do not rely on the patient to self-assess (I think these are for unconscious or infant patients). It would be great if there was wider-spread training in reading body language, so those of us who tend to under-report* got treated more appropriately.

* according to the individual medical person's estimation, that is

[ 02. December 2015, 01:50: Message edited by: Lamb Chopped ]

--------------------
Er, this is what I've been up to (book).
Oh, that you would rend the heavens and come down!

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Jengie jon

Semper Reformanda
# 273

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I am going to be brief as I do not have details to hand and it is a while since I have dealt with a pain study.

Firstly there do exist studies that ask about wellness rather than directly about pain. Thus rather than rating the pain on a 1 to 10 scale you are asked how much the pain interferes with various life scenarios. I can see this being adjusted to when in pain scenarios. These I have seen and yes there is poor correlation with how people report overall wellbeing and how they are incapacitated by pain.

Secondly, these I have not seen but I have seen studies that must have used it. There are methods that a beginning to look at bodies physiological response to pain and to measure this.

Thirdly, why not pm To the Pain and ask her as pain (relief) is her doctoral speciality.

Jengie

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"To violate a persons ability to distinguish fact from fantasy is the epistemological equivalent of rape." Noretta Koertge

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jacobsen

seeker
# 14998

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quote:
Originally posted by Jengie jon:
Gall bladder is known to be one of the worse pains. I can remember thirty years ago a GP who was doing first aid training telling us that three pains stopped a person in their tracks
  • Angina
  • Gall Bladder
  • Cheque from a private doctor

Jengie

Arthritic spasm which left me twisted, hanging on to someone's arm to avoid keeling over, and unable to speak.

[ 02. December 2015, 11:04: Message edited by: jacobsen ]

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But God, holding a candle, looks for all who wander, all who search. - Shifra Alon
Beauty fades, dumb is forever-Judge Judy
The man who made time, made plenty.

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BroJames
Shipmate
# 9636

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I suffered first and second degree burns on my face and right arm as a mid-teenager. That's my 10. By comparison, the pain of an undisplaced sub-capital fracture of the femur felt like a four or five - though attempting to walk on it did almost cause me to pass out. That may, however, have been partly down to the shock of the initial fall which caused it. One of my children with an about-to-rupture appendix rated the pain level as 4.

I can see the 1-10 scale as a useful indicator of what level of need a person is expressing, or as a comparator for a situation that is progressing - but I feel the initial figure given must be hard to evaluate.

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Hedgehog

Ship's Shortstop
# 14125

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Before this thread gets re-named the Aches & Pains thread (hmmmm, and why don't we have one of those?), I have an odd automotive issue that has been puzzling me.

It deals with air pressure in a tire. My car has a sensor that warns me when a tire's air pressure goes too low. Now, it is a little sensitive. The tire is expected to be at 38 psi and the sensor goes off if it drops to 35 psi. But, over time, I have learned that the air loss is always the same tire (currently driver's side rear--but occasionally the tires are rotated). Also, I have noticed that the low air warning comes when the temperature drops. And the sensor is telling the truth--if I check the tire's air pressure, it is low (so the problem is not with the sensor).

Now, my mechanic did find a nail in that tire and plugged the hole, which I thought would take care of it, but a few days later the temperature dropped and the sensor came on.

The thing is that the pattern is that it has to be a change in temperature from warm-ish to cold-ish. It does not have to get down to freezing, but it does need to get within 5 to 10 degrees of freezing (Fahrenheit--I haven't calculated it on the Celsius scale). The thing is, if the temperature stays cold and I put air in, then it will stay inflated. If it stays warm, it will stay inflated--it is only when the temperature dips from warm to cold that I get air loss.

So why is this happening--even after a possibly leak was plugged? Remember, it only happens to one tire, so it must be something special with this particular tire and not a oddity of tire design in general.

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"We must regain the conviction that we need one another, that we have a shared responsibility for others and the world, and that being good and decent are worth it."--Pope Francis, Laudato Si'

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L'organist
Shipmate
# 17338

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Hedgehog

There are two possible causes for the loss of pressure:

1. When outside temperature drops the temperature inside the tyre will also fall (takes a little time) and the lower the temperature the lower the pressure. For example, if a tyre pressure is 29psi at 20 Celsius, when the temperature falls to 0 Celsius (32 Fahrenheit) the pressure will fall to 26psi. However, this doesn't explain why it is only the one tyre which is affected on your car - I assume you are checking the pressures on the other tyres?

2. So it is likely to be something else that is causing the loss of pressure in that particular tyre. I'd plump for there being an inadequate seal around the valve: that would explain why there is the pressure drop even when you change the tyre.

So, off to your local tyre clinic and ask them to check the seal at the valve of your inner tube.

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Rara temporum felicitate ubi sentire quae velis et quae sentias dicere licet

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lilBuddha
Shipmate
# 14333

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Inner tube? If the car is new enough to have pressure sensors, it will not likely have inner tubes.*
Though you point about the valve is likely spot on.
Hedgehog, pressure sensor valves are easily damaged. It may well be that the cold causes just enough contraction to slowly release air.
It is also possible, but less likely IMO, that the wheel itself is slightly bent.


*Even where legal, it is not recommended to install inner tubes in tyres designed to function without them.

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I put on my rockin' shoes in the morning
Hallellou, hallellou

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Boogie

Boogie on down!
# 13538

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quote:
Originally posted by Hedgehog:
Before this thread gets re-named the Aches & Pains thread (hmmmm, and why don't we have one of those?)

Your wish is my command, dear Hedgehog.

[Smile]

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Garden. Room. Walk

Posts: 13030 | From: Boogie Wonderland | Registered: Mar 2008  |  IP: Logged
Hedgehog

Ship's Shortstop
# 14125

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L'organist, I first thought it would be your first suggestion, too. But subsequent investigation proved it was only the one tire. An inadequate seal around the valve seems more likely.

lilBuddha I was wondering whether cold could cause enough contraction to do it, but I lacked sufficient scientific background to have any confidence. Thanks for the confirmation. It is times like this that I miss my father. He knew all sorts of scientific stuff like that and would have figured out the problem in jig time.

I can't begin to tell you how disappointed I was that plugging the hole where the nail was failed to solve the problem.

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"We must regain the conviction that we need one another, that we have a shared responsibility for others and the world, and that being good and decent are worth it."--Pope Francis, Laudato Si'

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North East Quine

Curious beastie
# 13049

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Today I heard a high pitched repeated sound and went outside thinking it might be my next door neighbours smoke detector. Once outside I realised it was a bird, but I couldn't see it properly.

What bird makes a teen, teen sound not dissimilar to a smoke detector bleeping, loud enough for somebody indoors to hear it? Although I couldn't see it properly, it was either a small or medium size bird, no bigger than a blackbird, but possibly quite a bit smaller.

Posts: 6414 | From: North East Scotland | Registered: Oct 2007  |  IP: Logged
Drifting Star

Drifting against the wind
# 12799

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Could it have been a Great Tit? You can play their call here.

There are birds that mimic sounds they have heard. Starlings do this quite commonly, and blackbirds have been known to as well.

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The soul is dyed the color of its thoughts. Heraclitus

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Moo

Ship's tough old bird
# 107

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quote:
Originally posted by Drifting Star
There are birds that mimic sounds they have heard. Starlings do this quite commonly, and blackbirds have been known to as well.

Also mockingbirds.

Moo

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Kerygmania host
---------------------
See you later, alligator.

Posts: 20365 | From: Alleghany Mountains of Virginia | Registered: May 2001  |  IP: Logged
Penny S
Shipmate
# 14768

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quote:
Originally posted by Moo:
quote:
Originally posted by Drifting Star
There are birds that mimic sounds they have heard. Starlings do this quite commonly, and blackbirds have been known to as well.

Also mockingbirds.

Moo

Not usually in Scotland...
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Lothlorien
Ship's Grandma
# 4927

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Lyrebirds are well known mimics, but I doubt it was one of those in your neck of the woods.

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Jengie jon

Semper Reformanda
# 273

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Having recently caught starlings in Sheffield imitating high powered electric train lines (yes I do wonder where they got the idea), my money would have been on them.

Jengie

--------------------
"To violate a persons ability to distinguish fact from fantasy is the epistemological equivalent of rape." Noretta Koertge

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North East Quine

Curious beastie
# 13049

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Thanks for the link, Drifting Star. It wasn't a great tit. We have both starlings and blackbirds here, so it may have been one of those imitating something it has heard. It sounded like an alarm with a single repeated note.
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Tree Bee

Ship's tiller girl
# 4033

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The alarm call of some birds is markedly different from their song. The blackbird has a strident repeated note for example which is nothing like their usual call. It's fast though, unlike a smoke alarm.
Doesn't help I'm afraid!

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— Woody Guthrie
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Lamb Chopped
Ship's kebab
# 5528

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quote:
Originally posted by North East Quine:

What bird makes a teen, teen sound not dissimilar to a smoke detector bleeping, loud enough for somebody indoors to hear it?

A bird in the chimney.

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Er, this is what I've been up to (book).
Oh, that you would rend the heavens and come down!

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Penny S
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This has occurred to me while reading "Box of Delights", where I have mentioned it, but I'm putting it here as well, in case anyone has any idea about the matter.
When I was young, in the 50s, we listened to Children's Hour on the BBC Home Service, on which were many exciting drama serials. "Jennings"; historical stories of Alfred (I have a letter with the words of the theme song!) and "Willikin of the Weald"; "The Eagle of the Ninth" (I can still sing "The Girl I Left at Clusium" - and all the versions since have THE WRONG TUNE); and "The Midnight Folk".

And also a story of the genre of children going on a magical journey for some reason and meeting interesting characters before they get home, the name of which I cannot recall. I thought it was "Where the Rainbow Ends", an edition of which I have downloaded, but even with missing pages (because I, cheapskate, only signed up free) I can see it isn't it. That book, though of the genre, is a piece of imperialist, classist, fairyish soppiness - in my opinion. I cannot remember having come across it in any guise before. In the play version with music by Roger Quilter, it may come across differently. It certainly has echoes of the same sort of thing as Kay's encounters with Abner Brown: orphaned juveniles with obnoxious adults over them, all made well with powerful magical friends. But it isn't the one I remember, and have seen as a book.

The one I have seen, though also starring St George (the one out of the mummers' plays, rather than whoever he really was) had among the dramatis personae Mercury as the tutelary entity of his planet - planetary visits were in this particular Odyssey, as well as hilly lands and hollow lands. I think he may have been the enabler of the magical travel, as would be his right. What else went on I have no memory of, but I would like to revisit it.

Does anyone else remember it? I don't remember it as being soppy.

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Curiosity killed ...

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Two thoughts for the book, both of which are going to be totally random guesses as I wasn't around to hear Children's Hour: the one I suspect it might be as that episode is ringing a faint bell is something from The House at Arden or Harding's Luck or very possibly The Enchanted Castle by E E Nesbit or possibly Puck of Pook's Hill and/or Rewards and Fairies, both by Kipling.

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Fineline
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I would also like to ask a question. Is the chatroom no longer working at all, or does it work with some computers and not with others?
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Penny S
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quote:
Originally posted by Curiosity killed ...:
Two thoughts for the book, both of which are going to be totally random guesses as I wasn't around to hear Children's Hour: the one I suspect it might be as that episode is ringing a faint bell is something from The House at Arden or Harding's Luck or very possibly The Enchanted Castle by E E Nesbit or possibly Puck of Pook's Hill and/or Rewards and Fairies, both by Kipling.

No, unfortunately, neither Nesbit nor Kipling. My brains would have filed them correctly, and anyway, I have all the Kiplings. Politically, I'm pretty sure that, although not quite as empire based as the Rainbow one, it would not have fitted Nesbit's view of the world at all. And it wasn't as grounded in real history as Kipling.

But thanks - and you may start a hare with someone else.

[ 05. December 2015, 17:47: Message edited by: Penny S ]

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Tubbs

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Please would someone here help Baptist Trainfan out:

quote:
Can anyone help me? In the past, I have been able to display Google books on my computer (or, at least, sections of them).

Now, if I try to do this, I get the headings and can click on the contents list, but the bit of the page where the text should be displayed is blank.

I am not registered for Google Play - is this the root of my problem? My browser is the most recent version of IE.

Tubbs

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"It's better to keep your mouth shut and be thought a fool than open it up and remove all doubt" - Dennis Thatcher. My blog. Decide for yourself which I am

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Sipech
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I'm in need of a new iron. Can UK shipmates recommend makes/models or advise which ones are best to avoid?

Almost all my ironing is for shirts and hankies and is in use for a couple of hours a week.

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Penny S
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I've got one from Lidl (or possibly Aldi). This was because it had the option of using cordless, which means I can use it left handed - I iron ambidextrously. I have had no problems with it, possible because I iron as seldom as I can get away with. Tefal used to do one like this, but stopped.
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Cottontail

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quote:
Originally posted by Lamb Chopped:
quote:
Originally posted by North East Quine:

What bird makes a teen, teen sound not dissimilar to a smoke detector bleeping, loud enough for somebody indoors to hear it?

A bird in the chimney.
This is true. We had a crow stuck in the chimney once, and it sounded not unlike a smoke alarm chirping when the battery runs down.

I'll tell you that story sometime. *shudders*

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"I don't think you ought to read so much theology," said Lord Peter. "It has a brutalizing influence."

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Ariel
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quote:
Originally posted by Curiosity killed ...:
[QB] Two thoughts for the book, both of which are going to be totally random guesses as I wasn't around to hear Children's Hour: the one I suspect it might be as that episode is ringing a faint bell is something from The House at Arden or Harding's Luck or very possibly The Enchanted Castle by E E Nesbit or possibly Puck of Pook's Hill and/or Rewards and Fairies, both by Kipling.

Definitely not "The Enchanted Castle" or "Puck of Pook's Hill" and unlikely to be "Rewards and Fairies". I couldn't guess what else it might be, sorry - the inclusion of Mercury doesn't ring any bells.
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Penny S
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I do agree on that - and I suspect that it was a one off by the author, as I would have read the others if there were any, which would have made it more memorable.

Curiously, I have just started rereading "Red Moon and Black Mountain" by Joy Chant (which I suspect I may not read fully this time before donating it to Oxfam). It is again of the genre of children going on a magical adventure, the version where they are snatched into another world/universe rather than travelling around this one, and it appears that this has been organised by a deity who, though with another name, has the characteristics of Mercury/Hermes. (The travel agent and tricking characteristics.) It isn't this, though. Only written in 1970 when I was well out of college, and away from Folkestone Library, in which were many treasures, now dumped.

I think I have grown out of books in which somebody gets dragged willy-nilly out of the here and now to be the Chosen One somewhere else.

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Celtic Knotweed
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quote:
Originally posted by Sipech:
I'm in need of a new iron. Can UK shipmates recommend makes/models or advise which ones are best to avoid?

Almost all my ironing is for shirts and hankies and is in use for a couple of hours a week.

Mine's a Russell Hobbs one. Bought a slightly cheaper version after the last one was recalled by them for safety reasons (I took the refund instead of the replacement option).

I didn't have any problems with the old one, or the new one so far, and that's a total of 3 or 4 years. I iron most things, because until recently everything was drying on rails, so needed to get rid of the lines across the middle. Now we have a washing line, but it hasn't been drying weather...

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My little sister is riding 100k round London at night to raise money for cancer research donations here if you feel so inclined.

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