Doctor's Review: Medicine on the Move

August 20, 2017
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Tour de Tucson

An FM gets in the saddle with pro cyclists when he signs up as a bicycle race team's medical director

One of the things I like best about being a doctor is that we're often given the privilege of seeing places and things very few others ever get to see. In my case, being a doctor has given me the opportunity to get an amazing insider's view of a sport I love.

Cycling has been a passion of mine for quite a few years now. I'm not only in love with riding and racing bicycles, I'm also in love with watching other people race their bikes. Watching elite cyclists at work fills me with the kind of awe and reverence hockey fans feel when watching the 1972 Canada-Soviet series.

If friends or family are watching any sport except cycling on TV, I can happily waltz past the tube without giving it a second glance. But if someone in my house happens to turn on the Tour de France (okay, I admit that I'm the only person in the house that would ever do this… but let's just suppose), then I'm helplessly glued to the set.

A few years back, I became good friends with the team director for a professional Canadian cycling team who approached me about becoming the team's medical director. Despite my love of cycling, I was initially hesitant to accept his offer. After all, I'm not a sports medicine physician. I'm a family doctor who mostly specializes in inner-city health (HIV, addiction medicine and the like).

However, the team assured me that what they really needed was not a sports medicine doctor (as one was usually available at the big races) but someone who was willing to take a few medically-related phone calls from these athletes when the team was on the road.

So, in exchange for responding to some weird and wonderful phone calls -- with questions ranging from which PMS medications are safe to take in case athletes are drug-tested, to how to properly apply a hydrocolloid dressing to a road rash -- I've had a chance to see my favourite sport from a perspective that most sports fans can only dream of.

I've been invited by the team to watch world-class bike races from the race caravan (the team vehicles that follow riders during their race to offer mechanical and nutritional support as well as race updates and strategic advice). I've even hung out in the team race tent where the riders warm up on stationary bikes before their races and relive the glory (or agony) of the day's events afterwards.


Physician with Benefits
But by far the best perk of the job as medical director came this past year, when I was given a chance to join some of these athletes at their winter training camp in Tucson, Arizona. From the moment I arrived at the airport, I knew this would be a holiday unlike any other.

The entire team and their race vehicles had come to pick me up. It turned out that they had been in the area, finishing that day's stage of the Valley of the Sun Stage Race (www.wmrc.org/vos/index.htm) which is held in mid February. Many elite cycling races take place over several days, each individual day within the race is known as a stage. For the benefit of my fellow plane passengers, I did my best to look casual, as though getting picked up by an entourage of pro athletes and a fully decked out set of team vehicles is a common occurrence for me. I don't think I fooled anyone.

We soon arrived at the house that I'd be sharing with the athletes for the duration of the camp. By far the most impressive rooms in the house were the garage, with about $100,000 worth of carbon-fibre bikes and the kitchen, which held enough food to feed an army.

Perhaps the only thing more shocking than the amount of food was its quality. There wasn't a sign of high-sugar or high-fat food anywhere. Considering that many of these athletes will burn upwards of 5000 calories a day while training and racing, I expected the kitchen to be filled with cookies, chocolate bars and other high-calorie junk food. I couldn't have been more wrong.

The kitchen was instead stuffed with shelf after shelf of whole-wheat pasta, brown rice, fruits and vegetables. As a physician, I couldn't help thinking how ironic it is that these athletes (who are just about the only people on earth who burn enough energy to eat junk food without worrying about obesity) eat nothing but the healthiest food. On the other hand, it often seems like my most sedentary patients have the worst eating habits.


The Little Cyclist that Could
As a full-time doctor and dad, I was obviously worried that I wasn't in shape to keep up with a bunch of professional cyclists for a whole week of training. Fortunately, the team had given plenty of thought to how to make the group rides work for everybody. The rides would start at an easy warm-up pace that was comfortable for everyone.

Eventually, we'd reach the workout destination (usually a big hill or a quiet set of roads in one of the many state parks). Once there, everyone was free to ride at their own pace. A support van was available for cyclists who found themselves getting too tired or needing mechanical support; this allowed riders to get on and off their bikes wherever and whenever they needed to.

Another big reason that I was often able to keep up was that the stronger riders allowed me to stay nicely sheltered from the wind while they did all the work. Due to wind resistance, the effort level for riders at the edges of a group (especially the leading edge) is far greater than the effort needed by those sheltered in the middle of a group. By staying in the slipstream of these other riders (a technique known as "drafting"), I was able to conserve up to 30 percent more energy than those up-front.


Rocket Fuel
Of course, my favourite part of each workout was the end of the ride "fuel stop." Most cyclists have two great passions: their bikes and their espresso. In this regard, the athletes I trained with were no exception. These folks would no more think of heading out on a ride without a shot of espresso than they would without a spare inner tube.

Sharing stories about the day's ride over a cappuccino and biscotti was definitely one of the finest moments of each day. Le Buzz (a coffee shop and cyclist hangout at the base of Mt. Lemmon) is definitely one of my favourite cafés of all time.

As for the quality of the riding itself, most cyclists would agree that Arizona ranks as one of North America's great cycling destinations. Tucson is nestled in the middle of the Catalina Mountain range. The Mt. Lemmon highway (which starts just on the outskirts of Tucson) is an epic 40-kilometre climb that will leave even the strongest of cyclists gasping for breath.

Arizona is also blessed with over 300 days of sunshine per year, which means less time cleaning rain, mud and grime off your bike and more time riding. Most of the roads have wide, well-maintained bike lanes and "Share the Road [with cyclists]" signs abound. In fact, Tucson has been given a gold designation by the League of American Bicyclists.

On my rides throughout Tucson, I couldn't help but notice all of the great things to do with kids (see page 42) and feeling more than a little guilty for leaving my family behind to face the bleak Toronto winter, while I basked in the Arizona sunshine. As soon as I got back home, I promised them all that on my next trip to Tucson, we'll all be going.

I just hope they let me bring my bike.

 

Chris Cavacuiti is a family physician at St. Michael's Hospital and Seaton House Men's Hostel in Toronto. His clinical focus is on inner-city health (HIV, addictions and care of the homeless). In his spare time, Chris enjoys cycling, triathlons, snowboarding and other outdoor activities. He trained intensively to compete in the 2006 Ironman Triathlon in Lake Placid. This was his first visit to Arizona.

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