RANS Xstream review: Pretty fast for a slow guy.

Built for speed and long distances, the Xstream fulfills its promise.

The RANS Xstream is a bike with a pedigree. Designed by one of recumbent cycling’s pioneers, Randy Schlitter, the Xstream was a bicycle born, I suspect, with a single purpose: To, for once and for all, bury the myth that long wheelbase (LWB) recumbents are heavy, slow, and poor climbers.

I can state with a fair degree of certainty that Mr. Schlitter achieved his objectives.

Before I get into the meat of this review, however, permit me to note a few things. Though I knew of the Xstream through reputation, and had actually taken one out for a spin at Basically Bicycles prior to purchasing mine, there were few cogent reviews of this recumbent bicycle to be found on the internet. There is one review at bentrideronline.com, and a couple of “happy new buyer” notes on the cycling fora, but thorough reviews were notably absent.

I feel somewhat justified in taking on the task, as I have been riding recumbents almost exclusively since the mid-1980s, and in fact, my first recumbent bicycle was the first one designed and produced by RANS — the RANS Stratus Model A. Though I’m no racer, I commute and tour on bikes, and have been known to complete a couple of 200k randos. I pretty much live on my bikes and I do my own wrenching. So, yes, I feel very comfortable around bikes in general, and recumbent bikes in particular.

My interest was drawn to the Xstream during the 2009 Ride Across America (RAAM). RAAM is a grueling, non-stop race beginning in southern California and grinding on, shedding the weak like Darwin on steroids, until the riders that are left reach Annapolis, MD. With many other recumbent bike riders, I watched with pleasure as the 4-man recumbent team, all riding the Xstream, crushed the competition and won their division by more than four hours, taking their steeds across the continent at an average speed exceeding 20 mph. Mr. Schlitter himself said that “The Xstream was designed for this race.”

Unsurprisingly, the RAAM win pumped sales of this bike. Oddly, though, after the initial buzz, talk about the Xstream died down considerably.  Though I was favorably impressed by my brief test ride at the time, the performance of this bike was matched by the price tag, and I never could justify the expense. And so thing sat, at least until this spring, when, with a nudge from a friend, I stumbled on a great deal from a rider who couldn’t make the Xstream work for him after his back surgery. He had only ridden the bike around the block a few times, so for all intents and purposes, it was a brand-new bike at a garage sale price. I jumped at the chance.

My Xstream sports a cool gray aluminum frame. Handlebar and stem were stock RANS. Up front is a  RANS Apex 165mm compact double (50/34) and Ultegra derailleur. A SRAM 970 chain drives a SRAM 971 cassette (11-34) through an X-9 rear derailleur. That gives a gearing range of approx. 26-118 gear inches. On the bars are SRAM X-9 twist shifters and Avid 7 Speed Dial brake levers. Wheels are Avid XM317 (559) turning on Deore hubs. Continental Sport Contact tires complete the package. Brakes are Avid 7 Single Digit linear-pull  and the cables and housings are by Alligator.

The front brake is worthy of comment as brake interference with the crankset is a chronic problem with the Xstream. The front calipers are specced with KwickStop low profile pads. These allow the calipers to run in a slightly more closed position. Using a Travel Agent instead of a noodle narrowed the profile more.

I was initially concerned with the gearing. For starters, I have never had a recumbent with less than triple chainrings, and I was worried that the slightly higher low end of the compact double would be insufficient for this slow old guy who lives in the foothills of the Berkshire mountain range. I was also concerned about the slightly higher bottom bracket than what I am used to. I’m at the short end of normal height, and the leg drop required by a high racer recumbent is thoroughly out of my league. With fingers crossed, I hoped I would adapt.

After 300 miles on the Xstream, including the omnipresent hills as well as rolling terrain and flats, and with a couple of metric centuries under my belt, I think I have a handle on this bike. It’s worthy to note that during this 300 miles, I set two personal bests, not an easy feat for a man who has been riding for 38 years.

Set-up

Getting the Xstream dialed in is not a task for the impatient. Seat angle affects longitudinal seat position, which in turn affects handlebar height and stem distance, as well as handlebar  angle…you get the idea. That, coupled with the fact that knee interference with cornering is a very real consequence of poor setup on the Xstream had me riding with bloodied left knee and allen wrench gripped tightly in the right hand for the first 50 miles or so. Interestingly, it was at about mile 100 that I finally hit the sweet spot. I popped over a friendly New England pothole, which torqued the handlebars down ever so slightly, and voilà, it all clicked into place. I tightened up the nuts a squidge and let it be.

Though the frame accommodates a wide range of heights and X-seams, I’m a touch shorter than average height. I found that to keep the handlebars correctly place for my north-of-normal seat position, I had to cut away a good 3 inches of stem.

The Xstream also suffers from the RANS shifting seat clamp problem, so that the seat imperceptibly slide backwards under heavy pedal pressure until, after 30 miles or so, you realize that you are stretching a bit too much to reach the pedals. This is a well-known problem with the RANS clamp, and there are various ways to fix it — the easiest being a piece of innertube situated between clamp and frame.

Surprisingly, I found that I was very comfortable with a fairly extreme reclined position on the Hoagie seat. On my other recumbents, with more standard mesh seats, a highly reclined position makes my neck very sore after 10 or so miles. It was nice to find that the intersection of aero and comfort exists.

Handling

That long wheelbase builds in a lot of suspension, so even with the fairly tight Conti tires, the Xstream runs sweetly on the chipseal and over the potholes of my riding range. Not once did I feel my teeth chattering as it has on other bikes. The LWB design also makes for very stable high-speed handling, and for the first time on a ‘bent, I really felt like I was carving the curves at 60 kph.

At the other end of the scale, like any other LWB, the Xstream is not a fan of low speeds. Keeping a line at 9 kph is dicey, though it can be done, and I didn’t really feel that I would be easily toppled until I dropped below 7 kph. I had read about people’s complaints of the Xstream’s low speed handling, but frankly, this is pretty typical for a LWB. If you want to go that slow up the hills, get a trike.

At any speed, though, the Xstream requires your attention. This is a thoroughbred you’re riding here, not your typical stable nag, and it’s not going to let you get away with sloppy handling. And there’s no chance of a low-speed sharp turn. This bike is designed for the open road, not city traffic.

The best way to handle the Xstream, I found, is with a combination of attention and relaxation. Actually, 38 Special put it better than I.

Speed

What the Xstream gives in spades, however, is speed. This bike simply leaps at the hills, begging me with its efficient power transfer to bound up them. Once I learned to respond to the Xstream’s clarion call, my concern for the lack of an extra-strength granny gear disappeared. Because, quite frankly, it won’t let me go slow up the hills, and I don’t need the lower gear inches.

This is really the first bike that I found I could appreciably accelerate up hills. It has been a unique experience for me, passing other riders like they were standing still in the middle of a climb. More often than not, in my experience, it has been the other way around, but the Xstream puts the power to the wheel very expeditiously, even when I am deeply reclined, a position traditionally weak for climbing.

The Xstream also wants its own head on the downhills. Because of the extremely aero position I can achieve, my downhill runs have increased by several kph, without me even trying. Since the bicycle feels like its running on rails, I can also corner with greater assurance, and I can lean into a curve at 57+ kph. On rolling hills this is a killer combination, allowing me to outdistance far stronger engines, because I don’t even feel the hill until I’m halfway up it, and can relatively easily maintain speed over the crests. On the flats, I’ve found that I can maintain an average speed of 30 kph comfortably. Let’s face it, that’s pretty fast for a slow guy.

The brakes work as you would expect from a pair of reasonable Avid V-brakes. They have more than sufficient stopping power, and I’ve experienced no fade on longer descents.

The Whole Package

The Xstream at the edge of the world. Next stop: Scotland.

What all of this translates into is the perfect long-distance bike. Both centuries I’ve ridden on the Xstream have been fast pleasures, in one case setting a long-distance personal best. I can hop on the bike with the intent of rolling for miles and not be dissatisfied.

At the same time, I think I understand better the more recent silence on the part of Xstream owners. The Xstream is a demanding ride. It’s not a commuter, it’s not an around-town bike, it’s not a mosey-down-the-bike-path bike. It is a get on, go fast and go far bike, which isn’t everybody’s cup of tea.  You aren’t going to get away with napping in the saddle on an Xstream, and that makes for a lively and fun ride.

Perhaps the best way I can describe it is that riding the Xstream is like riding a stallion. You have to pay attention and realize that while your steed will demand much of you, it will deliver so much more performance than any other kind of ride.

For me, the Xstream filled a perfect niche in my stable. I have the all-rounder, the tourer, the utility bike and the French country bike that carries wine and baguette to the picnic. What I needed was a bike built for eating miles on the open road, a bike that challenges me to greater performance with performance of its own. The Xstream is all that and more.

Note: There have been some design changes on the Xstream since my model came out. Nothing radical, but you can see the latest specs at the RANS website.

RANS Xstream review: Pretty fast for a slow guy.

How I protect your confidential health information.

Our security policies protect your health information.

In light of the recent disclosures of the U.S. government engaging in massive data collection of private information about its citizens, I am sure that many people are concerned about the security of their medical information, and whether it can be accessed by the NSA or other government surveillance organizations.

The short answer, here at the Center for Alternative Medicine, is no. The health and medical information that we have is protected from government and other unauthorized access in multiple ways, which I will describe below.

Because of the location of my practice and my somewhat unique skillset,  I have  long taken a security-conscious approach to my patient’s records, an approach which informed the choices I made when we began digitizing patient data. In light of the news over the past couple of days, I have already made some modifications to the Center’s security policies which will further protect my patients’ health records.

Operating System Security

As a first step, as we began to put patient charts into digital form, I migrated all of the office’s computers to the Linux operating system. Linux is a far more secure operating system than either Windows or MacOS. In fact, because of its secure nature, Linux is the operating system that is used by the vast majority of internet data servers, many of which are under daily multiple attack.

Linux security goes far beyond firewalls and passwords. Linux is designed from the ground up to be largely immune to viruses and “trojan horse” programs. Security is built-in to the system’s design, preventing the rather massive security holes which Windows has always exhibited. Furthermore, since all of the software on my Linux systems is open, no secret back doors into the system can exist. They would be immediately spotted by the community which develops and maintains these systems.

 Backup and Online Security

The Center’s secured and encrypted local network is also protected by software which immediately informs me if unidentified devices are attempting to access it, even as that access is being denied. Furthermore, none of the computers which store patient data are accessible to any device outside of our local network.

Off-site backup is handled via encrypted VPN and the data is stored on servers outside of the U.S., in a country where data privacy laws are considerably more stringent than in the U.S. The companies operating these servers cannot be coerced by the government into releasing any information.

Email and Patient Communications

Similarly, the email server I use is located overseas in a country secure from U.S. governmental interference or access. Connection to that email server uses end-to-end data encryption, eliminating the possibility of passive data acquisition of both content and metadata.

Though I have not made a habit of it thus far, I have for years been equipped with the ability to send and receive email using PGP encryption. One of the changes I have made in the Center’s policy this week is to begin providing my public secure key to patients who wish to use PGP to protect our doctor-patient communications. This provides a second level of security.

And while I have on occasion answered patient questions via Facebook messaging, it is something I have never been entirely comfortable with, and have never initiated. One of the policy changes this week is that neither I nor my staff will communicate health information or discuss health issues with patients via Facebook messaging.

How You Can Protect Your Health Information

There are several steps which you can take to protect your health information, and they are relatively simple.

The first is to drop Gmail like a rock. It is clearly insecure, and Google has been part of the PRISM data collection system for years. There are several other systems which offer free email accounts and which are secure and will not disclose your data to the government. The one I recommend is Zoho, though there are several others.

Second, use a VPN for all of your internet activities. The end-to-end encryption of a VPN prohibits anyone from from watching your passage through the internet (and, yes, disable cookies on your browser!)

Third, use an alternative search engine. The amount of data Google collects on you — and provides to the government — is enormous. Your interests are determined by your search habits, and this information is a gold mine for those interested in your health data. There are, however, other search engines that do not collect or store your search data. At the Center, we use DuckDuckGo, a flexible and powerful search engine which also enables you to perform anonymous Google searches. Another popular privacy-oriented search engine is ixquick.

How Secure Are These Measures?

With regard to your health data, I have taken steps to protect your data far and above most other health care providers. Nobody is immune to hacker attack, and I make no claims to that, but I have done my best to ensure that your data remains secure from more than the passive data acquisition that the government appears to be engaging in, as well as typical commercial skullduggery.

Over the summer, I will continue to test and refine our security measures. But rest assured that even at this moment, your confidential health information at the Center is as protected, if not better protected than at any much larger organization.

 

How I protect your confidential health information.

5 ways to absolutely not get hired by me.

None of us really want to be here, do we?

It’s official. My office manager of 13-odd years, Teresa, is moving on. She will be missed, and I’ll write about that later. But right now, I’m in the throes of a replacement search, knee-deep in a swamp of semi-legitimate candidates. And it’s getting uglier by the minute.

If I were smart and good, I would probably get a professional, someone like my friend Bob Corlett at Staffing Advisors, to help me find a new admin. But, like an overambitious homeowner with a dull saw, I’m engaging the project by myself. The trouble is, so are the job candidates. And the results are beginning to look ugly:

This is how my search for a new office admin is going.

So, in the interests of humankind, my sanity, and to bolster the increasingly faint possibility of actually hiring somebody before the next equinox, I am going to share with you, dear candidate, the errors that your predecessors have made that have guaranteed them a place in my personal Hall of Amazing Ineptitude, or in other words, the Would Not Hire Ever file.

 

1. If you make an appointment for an interview, SHOW UP FOR IT.

No, seriously. Wednesday night I scheduled two candidates to interview. Neither of them showed up. Neither of them called.

If I wanted to interview myself, I’d at least get a Mountain Dew and a bag of pork rinds.

 2. Don’t wear yoga pants to your interview.

So long as it isn’t loaded with enough metal to give the TSA the fantods, I really don’t care about your body. I do, however, care about what my patients would think about being greeted by someone in the universal I-didn’t-get-out-of-bed-in-time-to-get-dressed outfit. How would you feel if you came to the interview and I was wearing my bike shorts? Ewww.

A job interview is not a booty call.

3. For the love of all that’s holy, please clean up your email address.

When I am emailing a candidate to schedule a job interview, and I have to send the email to sweaty_pole_dancer@yahoo.com, I’m not going to do it. I’m just not. You could have the best resume in the world, have all the right experience, be willing to sign a 10-year contract and work for $8/hour with no days off, and I’m still not going to do it.

4. And while you’re at it, clean up your social media.

You can bet that the first thing I’m going to do if I may hire you is google the heck out of your name. If 37 of the 40 pictures you’re tagged in have someone holding a handle of marshmallow-flavored vodka, I’m not going to call, because of the very poor judgement such pictures indicate. Marshmallow-flavored? Really?

“I am a responsible, reliable, hard-working employee. And sometimes sober.”

 5. Do not tell me your chiropractor horror stories.

I don’t know even why I have to say this, but it’s happened. More than once. If you’re being interviewed by a chiropractor (me), it is generally regarded as Bad Form to tell me how you, or your nephew, or your Aunt Myrtle had their head almost ripped off by a chiropractor who – gasp! – ADJUSTED THEIR NECK! OMIGOD THE HORROR!

Odds are, I probably adjusted someone’s neck less than an hour before seeing you, and that was probably the umpteenth time I had done a neck adjustment that day. It’s not dangerous. In fact, it is quite beneficial for many people.

No, this is not how chiropractic adjustments are done.

If you follow these relatively simple guidelines, I can guarantee your chances of getting hired by me will go up exponentially. Of course, then you have to deal with the whole working-with-Dr.-Jenkins-issue. But that part is easy. Just ask Teresa.

 

5 ways to absolutely not get hired by me.

5 Reasons You Can't Trust Nutrition Research

Both medical and nutritional research cannot always be trusted, but for different reasons.

If I had a nickel for every time a patient had told me that they  cannot have certain foods, because of an article they saw or their MD told them, I would be a rich man.

A case in point is salt. For years, I have been telling my patients with high blood pressure that salt is the least of their concerns, particularly when they have been scared off of it from their MD. I’ve had patients eating foods that were terrible for their hearts, because their cardiologist had put them on a salt-free diet, and as a result, worsening their condition instead of improving it.

Just last week, “new” research has been reported on which now shows that salt is not an important risk factor for high blood pressure.

The fact of the matter is that physicians such as myself who specialize in nutrition have known for years that only a very small part of the population with high blood pressure is sensitive to dietary salt. That research was done a long time ago.

But the news really never caught on with the popular press, and it clearly didn’t reach the ears of most medical doctors, who have been pressing the no-salt diet for years.

As I read the news online last week, I noted in the comments that several other readers were saying that the research on nutrition is so flighty that they no longer trust any of it, and will just eat whatever they want to.

As I have noted before, much of the mainstream medical research cannot be trusted. The majority of it has been tainted by big money from the pharmaceutical industry which has the money to hire its own research organizations and produce “scientific research” that, unsurprisingly, perfectly supports drug marketing plans.

Nutritional research becomes similarly warped, although on a smaller scale and for slightly different reasons.

One of the key problems with nutritional research is funding. Unlike drugs, which have a phenomenal return on investment, herbs and nutrients cannot be patented. So nobody is likely to get rich from, say, a paper which demonstrates that Vitamin C effectively combats the common cold. The return on investment on non-patentable health solutions is pretty low, so research investors are few and far between.

Nonetheless, the research is influenced by greed in a different way. While it is hard to find the money to prove a nutritional intervention is positively therapeutic, there is a tremendous amount of money available for research which will demonstrate that certain nutritional interventions are useless and/or dangerous.

And there is also a tremendous amount of political pressure which can be brought to bear on nutritional therapies, if they are thought to be a threat to pharmaceuticals.

Not but not least in the financial parade are the people which can make money directly by distorting the research. This is the group I am the most familiar with, so they get to be number one in our list:

1. The media: Not getting it right on a daily basis.

It is a poorly-kept secret that, prior to becoming a physician, I was a journalist. In fact, I was a science and technical journalist. My background in the sciences gave me the ability to explain complex technical topics in easily-accessible ways to non-geeks. So I’m familiar with the ways in which reporters, editors and publishers will, both consciously and unconsciously, bend their coverage to suit their needs.

The major problem with the reporting of nutritional research is that the findings of any study are sensationalized to increase the page hits. A relatively minor study of salt and hypertension, for example, becomes the health section’s page 1 news — and then, for the next 25 years, both diet and medical recommendations are misdirected.

Another problem with nutritional research reporting stems from the reporter’s inability to understand the science itself, or unfamiliarity with the field. It can be difficult to explain scientific-y stuff to a general audience, and to do so well, you must thoroughly understand the science yourself. Too few reporters have more than a basic grasp of the life sciences, much less a basic understanding of nutritional physiology, and fundamentally important data in a study gets flattened, misreported or simply ignored because of the reporter’s ignorance.

Finally, there are a few reporters who have been reported to consciously misconstrue the results of studies on alternative medicine in general.

New York Times health and medicine reporter Gina Kolata is a case in point. The author of hundreds of articles for the Times, Kolata has been uncovered by The Nation and others as using her articles to press her own agenda — a profitable one, at that. On one occasion, Kolata published an article which strongly hyped a couple of cancer drugs (an article which turned out to be erroneous, to boot) and within hours was floating a book proposal based on buzz generated by her own hype. While this is an ingenious feedback loop for a reporter hungry for a book contract, it is hardly impartial reporting.

Imagine how nutritional research is reported by a writer with the reputation of Kolata, with one hand on the keyboard and the other reaching for the pocket of the pharmacuetical company. It won’t be the unbiased story that many would imagine it to be.

2. Oops, we used the wrong vitamin.

For some reason I’ve never been able to fathom, the world of mainstream medicine has always been very faddish about vitamins and minerals. One vitamin or another is always “hot” with MDs. When I started practice a couple of decades ago, Vitamin C was the one being recommended by every MD and his brother. I suspect this was based largely on the later work of Linus Pauling, who already had accredited status with the mainstream medical community for his groundbreaking work in molecular biology.

Vitamin C has since cooled considerably since its days as the go-to vitamin for almost everything. Today, that role is fulfilled by Vitamin D. which is currently being touted by the medical community as a second-class cure-all for everything from fatigue to fibromyalgia to heart disease to depression to joint pain (it remains a second-class cure because in mainstream medicine, nothing is better than a pharmaceutical, natch).

Interestingly enough, 10 years ago, before D got big, it was being maligned on many fronts as being a near-useless nutrient which was only being touted by quacks as a remedy for fatigue and fibromyalgia and depression…you get the idea.

Many of these studies suffered from one very significant, very undisclosed flaw: The researchers were using the wrong form of Vitamin D.

The legal definition of Vitamin D includes 2 forms: Vitamin D2 and Vitamin D3. Both are equally useful in preventing rickets in children, which is what all Vitamin D was once thought to be good for. However, when it comes to its effects on the cardiovascular, immune and other systems, the D3 form is much more potent than D2, which often has little to no effect at all in these systems.

However, researchers investigating Vitamin D often neglected to note the difference. Thus, studies would report that Vitamin D was ineffective at treating a certain disorder — when actually, it was the ineffectual form of Vitamin D that was being used.

A variation on the “wrong vitamin” error is the “lousy vitamin” error. As most people know, there is a great deal of variability among vitamin products. Much of that variability results from how the vitamin is packaged in the tablet — particularly how well that tablet survives the gastrointestinal tract to dissolve at the right time. Many vitamins just are not digested well, and I have seen on x-rays, vitamin tablets residing unmolested in the large intestine, waiting to be moved out of the body without having given up the slightest amount of the nutrient they were supposed to disseminate. “Pharmaceutical-grade” nutrients tend to be no better in this regard than what you may pick up over the counter at a chain pharmacy store.

So if you are testing the efficacy of a certain nutrient, and not monitoring whether that nutrient is actually getting into the patient’s bloodstream, your results are going to reflect more the failure of the nutrient packaging than of the nutrient itself. It has happened more often than you would like to believe.

Coming up in Part II: Dodgy Dosages and Dietary Dilutions.

5 Reasons You Can't Trust Nutrition Research