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Posts made in May, 2010

Doctor and Former 2004 and 2008 Olympics Cyclist Explains Training for Top Cycling Events

Dr. Christine Thorburn

Dr. Christine Thorburn

As racers navigate sharp curves, race down hills  and make steep climbs mile after mile, one wonders how they find the energy after they have cycled for so long already. The answer involves more than just well developed muscles. Top cyclists use training techniques that actually change their bodies’ cells.

“Human bodies generate energy to move muscles by breaking chemical bonds that hold molecules together,” explains Dr. Christine Thorburn, a rheumatologist at the Palo Alto Medical Foundation (PAMF) who competed in women’s cycling in both the 2004 and 2008 Olympics. “As part of this process, lactic acid is created. It used to be thought that this acid was just waste and the cause of muscle fatigue and soreness. However, research has shown that the body’s cells can actually take excess lactic acid and convert that to even more energy. Training improves this ability.”

As a medical resident at Stanford University during her first Olympics and a practicing physician during her second Olympics, Dr. Thorburn understood the importance of what was happening inside her cells to the outcome of her races.

“Part of what makes Lance Armstrong such a good cyclist is that he can process lactic acid into additional energy very effectively,” Dr. Thorburn says. “When someone is not very well trained – as I am now that I am retired – lactic acid will build up during strenuous cycling and one’s leg muscles will begin to burn. Once this happens, an untrained person has to stop and rest. They cannot recover. Keep going and one may start to feel dizzy and stop thinking clearly. However, a well trained cyclist can go above his or her lactic acid threshold for several minutes at a time, recover and then do it again two or three more times during a race.”

Cyclists have to go above their lactic acid threshold when “attacking” in a race to gain an advantage over the rest of the group of riders drafting one another. At the end of an “attack,” the body has to process the excess lactic that built up during the sustained burst of energy. Some lactic acid is processed by the liver, but much of it is taken up by a portion of individual body cells called the mitochondria. The mitochondria are the cells’ engines and create additional energy as they break down and get rid of the lactic acid.

Through interval training – which involves short bursts of high intensity exercise interspersed with low intensity exercise that allows the body to recover – cyclists can increase the number of mitochondria inside their cells. With more mitochondria, the cells become even better at processing lactic acid.

In training for the Olympics, Dr. Thorburn and other U.S. cycling team members used sophisticated tools that let them scientifically measure everything from the force they applied to the bike pedals to the lactic acid levels in their blood. They then used these measures in training to maximize their ability to process lactic acid during races.

“Training is all about knowing when you are going above your lactic acid threshold and knowing how long you can sustain that effort,” Dr. Thorburn says. “In training, you can use tools to help identify when you are in that zone, but in a race you have to go by what you are feeling.”<!–<! [CDATA[

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Protecting Cyclists from Doping Pressures

 

As Stage 3 finishers of the Amgen Tour of California streamed across the finish line at the Santa Cruz Boardwalk in May this year, they were met by a small group of medical professionals and volunteers that stayed with the top five finishers until they completed an important post-race doping test. Like last year, this group included Leonard Moore, M.D., a Palo Alto Medical Foundation dermatologist and cycling enthusiast.

“Testing for performance enhancing substances does more than protect the integrity of the race,” Dr. Moore explains. “It protects the health of the athletes and that of young people who look up to them and seek to follow their example.”

The link between serious health problems and taking steroids, hormones, amphetamines and other performance enhancing chemicals have been well known for decades among cyclists. In a widely reported case, British cyclist Tom Simpson died during the 1967 Tour de France after taking amphetamines.

However, because the health problems that come from doping develop slowly over time and only very rarely touch a cyclist at the peak of performance – as in the case of Tom Simpson – the pressure to excel in a race can easily overwhelm concern for one’s long-term health.

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Sutter Health Donates Nearly $1.5 Million to 18 Community Clinics

 

Mountain View, Calif., May 5, 2010 -To help patients in need access vital medical services, Sutter Health donated $1.48 million to 18 community health clinics in dozens of communities across Northern California. These latest grants are part of the not-for-profit network’s lasting commitment to serve all patients who need health care regardless of their ability to pay.

Ravenswood Clinic in East Palo Alto is one of the nine grant recipients

Ravenswood Clinic in East Palo Alto is one of the nine grant recipients

These donations will help community clinics improve direct patient care by:

  • Purchasing and/or upgrading of vital health equipment used in direct patient care
  • Increasing of community clinic capacity to serve patients
  • Maintaining or extending hours of patient services
  • Extending access to vital specialty care services for community clinic patients
  • Launching disease prevention and/or chronic disease management programs for patients.

Meeting community health care needs is the cornerstone of Sutter Health’s not-for-profit mission. Its care and services for the poor and underserved and benefits for the broader community totaled $667 million in 2009.

All of the community clinics for which Palo Alto Medical Foundation wrote letters of support received Sutter grants, for a total of $625,000. Comprehensive applications and details of how grant monies would be allocated were required. Most of the clinics plan to use the grant monies to increase services and clinical hours, although several will fund specialized programs. Clinic recipients and their grant amounts are:

Alameda County

Santa Clara County

San Mateo County

Santa Cruz County

Sutter Health Donates Nearly $1.5 Million to 18 Community Clinics

Nine Area Clinics Supported by PAMF Received $625,000

To help patients in need access vital medical services, Sutter Health has donated $1.48 million to 18 community health clinics in dozens of communities across Northern California. These latest grants are part of the not-for-profit network’s lasting commitment to serve all patients who need health care regardless of their ability to pay.

These donations will help community clinics improve direct patient care by:

  • Purchasing and/or upgrading of vital health equipment used in direct patient care
  • Increasing of community clinic capacity to serve patients
  • Maintaining or extending hours of patient services
  • Extending access to vital specialty care services for community clinic patients
  • Launching disease prevention and/or chronic disease management programs for patients.
  • Meeting community health care needs is the cornerstone of Sutter Health’s not-for-profit mission. Its care and services for the poor and underserved and benefits for the broader community totaled $667 million in 2009.

All of the community clinics for which Palo Alto Medical Foundation wrote letters of support received Sutter grants, for a total of $625,000. Comprehensive applications and details of how grant monies would be allocated were required. Most of the clinics plan to use the grant monies to increase services and clinical hours, although several will fund specialized programs. Clinic recipients and their grant amounts are:

Alameda County

Axis Community Health ($75,000), Pleasanton: Axis currently provides medical services for more than 10,000 eastern Alameda County. They plan to use the grant funds to provide 483 additional medical visits for residents who otherwise would not be able to access medical care. The grant will also allow them to conduct monthly audits of a variety of health outcome indicators such as lead testing, tuberculosis, tobacco education, diabetes, asthma, pediatric immunizations, and medical records.

Tri-City Health Center ($100,000), Fremont: This busy clinic serves nearly 22,000 people in the Tri-City (Fremont, Newark and Union City) area and receives nearly 80,000 clinic visits annually. TCHC will use this grant to provide basic adult dental services and free services for the area’s more than 7,000 homeless people through Project HOPE.

Santa Clara County

Ravenswood Family Health Center ($50,000),East Palo Alto:  The Ravenswood Family Health Center provides health care for more than 9,000 area residents living below the federal poverty guidelines. Asthma in children is a great concern for the cities of East Palo Alto and East Menlo Park, so Ravenswood Family Health Center will use its Sutter grant to support a pediatric asthma project.

RotaCare Free Clinic ($100,000), Mountain View: Mountain View’s RotaCare Free Clinics serves nearly 2,300 patients in Santa Clara County (Mountain View, Sunnyvale and Los Altos area) and annually receives more than 8,800 clinic visits. Funding through the Sutter Health grant will allow the Mountain View RotaCare Free Clinic to extend hours and increase access to much needed primary medical care.

San Mateo County

Santa Cruz County

  • Dientes Community Dental Care ($45,000), Santa Cruz
  • Santa Cruz Women’s Health Center (50,000), Santa Cruz
  • County of Santa Cruz, Mental Health FQHC ($30,000), Santa Cruz
  • Salud Para La Gente ($75,000), Watsonville

 

About the Palo Alto Medical Foundation and Sutter Health

The Palo Alto Medical Foundation (PAMF) for Health Care, Research and Education is a not-for-profit health care organization that is a pioneer in the multispecialty group practice of medicine. PAMF’s more than 900 affiliated physicians and 4,300 employees serve more than 655,000 patients at its medical centers and clinics in Alameda, San Mateo, Santa Clara and Santa Cruz counties. PAMF is part of the Peninsula Coastal Region of Sutter Health, one of the nation’s leading not-for-profit networks of community-based health care providers. Sutter Health’s Peninsula Coastal Region also includes Mills-Peninsula Health Services.