After much mucking around the best solution I could find was to disconnect the iPhone from the usb cable, start the windows Device Manager and un-install the Apple iPhone driver from the Portable Devices section of the devices.  Make sure you check the delete driver checkbox.  Finally, re-connect your iPhone and the driver should re-install allowing you to see your device in Windows Explorer again.

No images on device

So now I can see my phone in Vista – but when I browse to the device the internal storage folders are empty.  There are tons of images in the “Camera Roll” when looking at the phone.  After much more muckery – I found one image that was saved from the interwebs rather than taken with the phones’ camera.  Once I deleted this image, and reconnected the phone all the images showed up no problem.