Slate: Plumber's Butt by Benefits of Quitting Smoking

medical examiner Plumber's Butt? The right and wrong way to think about heart attacks. By Darshak Sanghavi Posted Tuesday, May 8, 2007, at 12:28 PM ET Medicine brims with analogies and puns related to plumbing. Residents routinely refer to urologists as members of the "Stream Team," and cardiologists frequently say they're going to "Roto-Rooter" blocked coronary arteries. The comparison sometimes extends further: One cardiologist lobbying for better Medicare payments complained to a congressional committee, "I get paid less for a heart catheterization than a plumber gets for working on your pipes." Yet the plumbing analogy causes serious confusion regarding heart disease, and as a result, we've wasted a lot of time and money on cardiac angioplasty that does no good. Consider the recent New England Journal of Medicine study documenting the failure of this method to prevent heart attacks and save many lives, along with the U.S. Food and Drug Administration's warning that drug-coated stents occasionally can cause the heart attacks they're supposed to stop. It turns out there's a right and wrong place for the plumbing analogy. It's right for people who have heart attacks that involve a sudden, total blockage of a coronary artery. That's why procedures to unclog arteries with expandable stents and balloons ("angioplasty") save lives in emergencies and need to be used more in that setting. But the plumbing analogy fails when applied to stable, partial blockages that don't lead to sudden heart attacks. And yet doctors can't let go of the plumbing talk, and they keep unclogging partial blockages. That's why the vast majority of angioplasties are done for the wrong reasons—that is, for prevention, not acute treatment. What's the source of this confusion? Like any organ, the heart needs a source of blood flow, and like any dictator, it looks after its own needs first. Thus, the first vessels emerging from the aorta are the coronary arteries, which divide to form an intricate lattice that supplies every muscle cell of the heart. In a heart attack, sudden blockage of the coronary arteries interrupts oxygen flow, which causes acid buildup that kills heart muscle within minutes. That's why a heart attack is rightly considered a plumbing emergency, and the best option is to unclog the artery. Before angioplasty became widespread, the only emergency treatment for heart attacks was to infuse clot-busting drugs like streptokinase into a patient's whole body. This was like running concentrated Drano through a city's water supply to fix a stopped-up sink. It wasn't very effective and also caused side effects like bleeding. In 1929, a budding German crackpot named Werner Forssmann took the first tentative steps to directly unclog blocked vessels, by inserting a urinary catheter deep into his own arm. (A nurse tried to stop him, but he tied her to an operating table.) Forssmann walked up a flight of stairs and took an X-ray showing that the catheter had entered his heart—a feat that earned him the Nobel Prize. Fifty years later, on his kitchen table, Andreas Gruntzig of Zurich invented a saline-inflatable, sausage-shaped balloon that could be threaded through blocked blood vessels, and reported the first "balloon angioplasty" of a blocked coronary artery in the New England Journal of Medicine. This technique was far more effective than clot-busting drugs and successfully unclogs arteries in more than 90 percent of cases. Then, in the early 1990s, cardiologists widely began using stents, or wire-mesh tubes vaguely like Chinese fingercuffs, to prop open arteries, as studies showed they more reliably held open vessels than balloon angioplasty alone. By 1999, 85 percent of all cardiac catheterizations involved stents. In 2003 and 2004, the FDA approved Cordis's Cypher stent and Boston Scientific's Taxus stent, which gradually leach medications that prevent repeat blockage and so are about 50 percent more effective than bare-metal stents. Each generation of therapy is progressively more expensive; a bare-metal stent costs about $700, but coated stents run $2,200. Today, about 1.5 million stents are implanted yearly in the United States at a cost of $6 billion, and almost 90 percent are coated. Angioplasty works great for sudden, massive heart attacks—as one interventional cardiologist recently told the New York Times, "This adrenaline rush is why people like me go into cardiology." (Arguably the financial rush is also sweet, since the median salary for invasive cardiologists is roughly half-a-million dollars.) And there's no question that better access to emergency angioplasty for heart attacks would save lives. The gold standard for an acute heart attack, according to the Institute for Healthcare Improvement, is a hospital "door-to-balloon" time of less than 90 minutes. But less than one-quarter of heart-attack patients receive any angioplasty at all, according to a past president of the American Heart Association. Part of the problem is that only about 25 percent of hospitals offer emergency angioplasty, and because of arcane Medicare rules, they have a financial disincentive to transfer patients with acute heart attacks to places that do. But improving emergency access isn't the same as relying on angioplasty as the standard preventive approach for healthy people with a partial narrowing of blood vessels (which are often detected by routine stress testing or increasingly fancy heart scans). Here's the problem: Time and time again, studies repeatedly show that opening blocked arteries to prevent heart attacks in people with exercise-induced chest pain or stable blockages is, quite simply, pointless. The weight of evidence is staggering. Essentially no clinical trial shows that balloon angioplasty or stenting partially blocked coronary arteries prevents heart attacks, saves lives, or reduces the risk of other complications like strokes. The emergency plumbing model developed for sudden heart attacks has absolutely no role in prevention. Why not? Dr. Arthur Agatston, famed for creating the South Beach diet, sensibly points out that partial blockages in coronary arteries don't cause heart attacks. The trigger isn't bad plumbing—but something more akin to a land mine. People at risk of heart attacks have largely invisible cholesterol plaques throughout their arteries, which act, he says, like unpredictable "little bombs that blow up suddenly and cause a sudden and devastating blockage" in previously healthy-appearing areas. Yet doctors and patients largely ignore the data. Last year, the American Journal of Cardiology reported that 85 percent of all balloon angioplasties and stent implants are done nonurgently for stable blockages. The trial just published in the New England Journal of Medicine confirms this monumental waste. So what does help? Drugs that affect the entire coronary system—and not angioplasty or stenting—prevent heart attacks in high-risk patients. For example, Lipitor helped reduce rates from 21 percent to 13 percent in one study. But this raises another concern: Relying on widespread use of powerful drugs carries its own risks. Consider that estrogen-replacement therapy became common because of its supposed reduction of coronary "land mines." Not only did that turn out to be completely wrong—the drug actually increased heart attacks—but as the New England Journal just reported, widespread use probably bumped up breast cancer rates by about 10 percent. Thousands of women died needlessly. And so, in the end, we return to the old standbys, better diet and lifestyle. It's worth remembering that the Nurses' Health Study in 2000 determined that 82 percent of all "coronary events" were avoided by five simple behaviors: not smoking, exercising for 30 minutes daily, eating healthily, maintaining normal body weight, and drinking a small amount of alcohol. Over a lifetime, these healthy behaviors are 10 times more effective than Lipitor in lowering heart-attack risk, and infinitely more sensible than widespread angioplasty. Almost 70 years after cardiac catheterization was invented, a medical specialty called "behavioral medicine" has been created to help refocus the billions of dollars—and talented physicians—on strategies for improving diet and exercise habits. Patient incentives, such as lower insurance premiums for healthy lifestyles, may also help. And expanding insurance programs for preventive medical services, instead of simply paying for more angioplasty, might motivate doctors to spend more time on the behavioral-change counseling front. Then there are small but populationwide changes, like New York City's recent drive to eliminate trans fats, which has roughly the same cardiac benefit as treating everyone with Lipitor, without the side effects and cost. With the aid of campaigns to reduce salt intake, Australia has reduced average blood pressure by about 1 percent to 2 percent, potentially preventing 15 percent of strokes and 6 percent of heart attacks. Last year, Arkansas helped stabilize childhood obesity rates with school-based body-mass-index screening. These kinds of approaches deserve widespread adoption. Someday, maybe we'll figure that out, and the plumbing analogy will finally melt away.

The Big Sandy Shoot, Take 2

I return for a weekend-long rides gig.

Last year, I wrote extensively about the Big Sandy Shoot, an event held north of Wikieup, AZ by MG Shooters, Inc. I’d gone to the event at the urging of my friend Ryan, and although I did some helicopter rides, it wasn’t a terribly good gig for me. But it certainly was a fascinating experience.

A few months ago, the MG Shooters folks contacted me, asking me to come to this spring’s shoot. The rich guy with the helicopter who’d shown up last year and had given free rides had sold his helicopter. I wouldn’t have to compete with him. I checked my calendar, saw that Mike and I had the weekend free, and decided we’d try again. I didn’t expect to do many rides, but I thought it would be a nice opportunity to test out our camper in a real off-the-grid situation. We’d leave Jack the Dog and Alex the Bird at home with a house-sitter and just get away for a weekend. If I did rides, great. If not, I’d brought along a book to read and Mike could study for his helicopter check ride, which is later this week.

Getting There

The weather was bad on Thursday and Friday, with heavy rain throughout most of the day. This was good and bad. Good because the shooters would be able to use tracer rounds during the night shoots without worrying much about starting fires out in the otherwise dry desert. Bad because the shoot location is about 5 miles from pavement on the other side of the Big Sandy River. The Big Sandy River does not have a bridge at the crossing, so you have to drive across the river in whatever water is flowing. And the dirt roads often get a top layer the consistency of snot when they get wet.

Of course, I didn’t have to deal with this. I was flying in. What I had to deal with was the weather itself: clouds, rain, wind, etc. We waited until [too] late in the day to make our go decision. Mike pulled out with the camper in tow at about 5 PM and I went to the airport.

In Wickenburg, the sky was partly cloudy and the winds were no more than breezes. I’d checked the weather along the route 93 corridor where I’d be flying, all the way up to Wikieup and Kingman. It didn’t seem bad, but it certainly didn’t seem good. As any pilot who flies in remote areas can tell you, weather forecasting isn’t exactly perfect for areas where there aren’t any airports or cities. So although my destination was 60 miles from Wickenburg, I couldn’t get any solid weather information for it. I had to extrapolate based on what I was experiencing in Wickenburg and what was going on in Kingman, another 30 miles northwest of Wikieup. The radar images helped. And just looking out the window in the direction I had to fly helped.

The plan was for me to fly up there and scout out the river situation from the air. If the river was flowing too swiftly to drive across, I’d call Mike on the aviation radio he had with him and tell him. We’d set up camp at the Burro Creek campground about 30 miles south on route 93 for the night. I wasn’t sure how they’d feel about a helicopter landing down there, but was willing to find out if I had to. (Obviously, I wouldn’t land in the campground itself.)

Because a straight-line route would have put me in the mountains east of route 93, I decided to follow route 93 itself. (IFR: I follow roads.) There were two benefits for that. First, if weather closed in, I could land near a paved road where I could meet up with Mike or get a ride with someone else if I had to. Second, I could check out Burro Creek campground from the air to make sure there were potential landing zones and open camping spaces.

It was an uneventful flight. The winds were not much more than light breezes. Although there were a significant number of clouds at my altitude, none of them were near my flight path. Instead, they obscured the mountain tops on either side of the valleys I flew up. I never got within a mile or two of any of them.

I passed Burro Creek and saw that the campground was about 80% full. I also noted that they’d never painted the second bridge over the canyon there. (I’d taken a photographer from Utah to shoot the bridges from the air as the second one was being completed at least a year before.) I climbed over the mountains there and dropped down into the valley where the Big Sandy River flowed. It wasn’t flowing much at all. In some places, the riverbed was dry, in other places, there was about a foot of water flowing. It was a lot like the Hassayampa River, which flows mostly underground through Wickenburg. I overflew Wikieup, then concentrated on my GPS to locate the shoot site.

It was a good thing I had the waypoint programmed into my GPS. The shoot was quite a bit farther north and east than I remembered. It was in the foothills of the Aquarius Mountains. A line of clouds at my altitude hid the mountaintops from view. The shoot site was about 1/2 mile from the clouds. A bunch of people were set up on the flattened out ridge top with campers and shade structures.

Now, I’d been told that they’d put in two helipads since the previous year. And try as I might, I just couldn’t find them. I circled once, coming quite close to that cloud bank, then decided to land, shut down, and get directions from the ground. I used my cell phone to call Mike and leave him a message about the river conditions — I knew he was too far out for the radio — then landed on the southwest edge of the ridge.

Turns out that the helipads were nothing more than just flattened out areas on the north side of the ridge. Someone had decided that the closer helipad would make a great campsite and had set up a ton of camping gear on it. Ed, the guy who runs the place, suggested that he move, but the guy camped out there wasn’t interested in that. He tried to say that it was muddier there than anywhere else. That simply wasn’t true, although the mud leading up to that spot was terrible. So Ed and I found another place on the east side of the ridge. It was higher and dryer and although it hadn’t been cleared for helicopter use, I had no trouble landing there. Best of all, it was closer to where the shooters and spectators would be hanging out, so I was more likely to get people coming over to me.

With the helicopter settled in and the light fading quickly, my thoughts turned to Mike. Last year, he’d gotten lost on his way in from route 93. I didn’t want him getting lost in the dark. So I found someone with a truck who was willing to take me down to the main road and guide him in. That’s when I saw how muddy the road was. It was almost frightening — especially one steep hill covered in reddish brown snotty mud.

We literally almost ran into Mike. He didn’t know I was in the truck, so he didn’t stop. My driver, Ron (I think), made a U-turn and tried to catch up with him. We were more than halfway back when Mike finally stopped and I switched vehicles. We followed Ron the rest of the way up, checked in at the registration area, then climbed to the ridge and parked the camper near the helicopter.

Night Shoot

We were just finishing the camper setup — which included parking its right wheels on five leveling blocks and using large stones to prevent it from rolling away — when the night shoot began.

If you’ve never been to a machine gun shoot, you’re missing a really outrageous event. These guys have the same kinds of guns the military has/had for warfare and I think they have more ammo than the military issues to its soldiers. And they’re not afraid to shoot it. At night they use tracer rounds that clearly show the path of the bullets as streaks of red or green light. The sound of fire is deafening and every once in a while, it would be punctuated by the loud boom of a reactive target (i.e., stick of dynamite) going off.

At 10 PM, the shooting stopped. By that time, Mike and I were already in the camper, getting ready for bed. It started raining lightly outside. It got quiet and we slept pretty well.

The Big Day

In the morning, the low clouds were back, but never really drifted into our area. The big camp slowly came to life as shooters woke. The local 4H club was serving breakfast and the bacon smelled excellent. After breakfast in the camper, I went out with some rags to dry the dew off my helicopter. We hung a sign that said, “Helicopter Rides $35″ on the back of the camper, which faced the rest of the camp. At 8 AM, I had my first passengers.

I flew much of the day. It wasn’t nonstop, but it wasn’t stop-and-go, either. Generally, I’d get three or four flights in between shutdowns. Then I’d get out and grab something to drink or take a pee or do something in the camper before the next few passengers showed up. Most flights had just two people on board — most of these guys were pretty “healthy” — and I made the flights a bit longer than I needed to. The later flights were a bit shorter — after all, I wanted to make money on this event — and included a view of the little waterfall in the foothills about a mile east of the camp.

Meanwhile, the shooters were shooting. They started up at about 9:30 AM and stopped at noon for lunch. Then 1:00 PM to 5:00 PM when they stopped for dinner. They kicked off the 1 PM shoot with the detonation of a pig packed with explosives. I was in the air when they did it, but my passengers and I saw the smoke out in the target area. Mike said that the car alarms for all the cars and trucks had gone off.

We used our new fuel transfer tank to refuel the helicopter. It didn’t work quite as expected. Mike got tired of cranking after about 2/3 of the fuel had been pumped and made the fatal error of stopping. The fuel drained out of the hose and we couldn’t get the damn pump primed again. So the remaining 1/3 tank (about 8 gallons) remained in the transfer tank. Later, I made a fuel run to Kingman which took about 5 minutes longer than it needed to when I parked the helicopter about 3 feet farther away from the pumps than the hose would reach and had to start up to move it. (I hate when that happens.)

The weather threatened rain to the east and west of the site most of the day. On a few flights into the mountains on the east, I got drizzled on. We saw rainbows, too. But the clouds broke up around sunset. I stopped flying at 6 PM after taking at least 40 people for rides.

We made dinner in the camper and opened a bottle of wine. Outside, everyone was preparing for the night shoot. It got dark and people started shooting off flares. They’d shoot into the air like a fireworks rocket, then explode. A red light would glide to earth at the end of a small parachute, lighting up the range. Occasionally, one would land before it went out, setting a small bush on fire. But the earth was so wet that the fire soon went out.

The night shoot began loudly. Mike and I walked down the back of the firing line, past the shooters, taking photos and videos as we went. Thank heaven for ear plugs.

The Last Day

By morning, the folks who hadn’t left the night before were packing up to leave. There was another shoot scheduled, but only the hard-core shooters seemed interested. I flew another 10 or so passengers. The waterfall was drier and harder to spot in the canyon. Between flights, Mike and I packed up the camper.

I was on the ground when one of the shooters, a man who had made a canon out of a fire extinguisher, shot a red bowling ball over the range. That thing climbed at least 300 feet, with the wind whistling through its finger holes, before crashing to earth. He’d been shooting the bowling balls all weekend, but I always seemed to miss them. Seeing it was a treat.

Mike and I had lunch, hooked up the camper, and prepared to leave. I took Mike on a quick flight up in the mountains before dropping him off at the landing zone. I flew home the direct route, detouring only to peek into Bagdad Mine on my way back. Total flight time for the weekend: 6.2 hours. When I later tallied up the money, I discovered that I did a little better than breaking even. (Should have made the rides a little shorter.) But it was enough to come back.

---

Copyright © 2007 Maria Langer. This feed is for personal, non-commercial use only. If you are not reading this material in your news aggregator, the site you are looking at is guilty of copyright infringement. Please contact us so we can take legal action.

Cycling: RSVP Dates for 2007

It's just getting too dangerous out there on the pavement these days isn't it? Time to head for the hills.

Mountain biking is a grass-roots sport that is only about one bake sale above your local group ride in terms of publicity and prestige, but it is an exciting sport that requires intense fitness, training, and dedication. At SFist, we understand the sport and the culture around it. We also understand what makes a good mountain bike race. To that end, we've reviewed the 2007 MTB racing season in order to provide our readers with a summary of this year's most interesting Northern California events.

So grab your bike, sharpen your elbows, and strap on a number plate for some challenging dirt action, or pack up the camp chairs, the cooler, and the kids, and head out to the races for a cheap day of fun and entertainment. Even if you aren't interested in competing, check out some of these events. You will see amazing feats of cycling prowess, discover the latest in space-age materials and designs, and probably pick up an armful of free posters, stickers, and other industry schwag.

It's time to make room for the 2007 mountain bike season on your garage wall -- and on your calendar. Image from SFist Chris.

Bookmark this page for the season, and we'll see you out there.

Festivals

Sea Otter Classic, April 12 - 15, 2007--The granddaddy of them all. The Sea Otter has everything: international cycling stars, a variety of cycling disciplines and events, games and activities for the kids, food, live entertainment, and lots and lots of industry vendors. If you've never been to the bike races before, this event should be your introduction.

Infineon Cougar Mountain Classic, July 6 - July 8, 2007 -- Sigh. This event has all the marketing, sponsors, and Cycling USA support necessary to be a huge cycling event. Unfortunately, it lacks the terrain and the trails to truly walk the walk. Until they move this event to Mt. Tam or Skeggs, this will remain a poor man's Sea Otter.

Downieville Classic Mountain Bike Festival, July 13 - July 15, 2007 -- Instead of miners, drifters, and ladies of the evening lounging on the wooden boardwalks and hitching posts of this former mining town, during race weekend, you'll find mountain bikers of every age, size, color, and ability in town looking to strike it rich on the legendary Downieville trails. But riches don't come easy. The Downieville races are the Mountain Dew commercials of the local racing calendar -- extreme to the extreme -- and it's worth every grimace, groan, and agonizing hamstring cramp. Trust us, you need to experience this race.

Bigfoot Classic, July 20 - 21, 2007 -- What's not to love about riding in Humboldt County under a Redwood canopy in a cloud of THC vapors -- eh, did we just say that out loud? Ahem. Race conditions for the Bigfoot are awesome; the courses are very challenging with an emphasis on hills. You'll get all you can handle on the bike, but don't expect the Sea Otter. There are very few bells and whistles, not much schwag, and access to race results can be problematic. The atmosphere is first class though, and there's usually a pretty good post-race feast.

One-Day Classics

Buck Ridge MTB Race, February 10, 2007 -- A decidedly grass roots affair, this race out on the shores of Hensley Lake near Madera in the Central Valley is a nice little tester. Featuring a five-mile circuit course with short climbs and short downhills on mostly singletrack, this race doesn't offer much in terms of technical challenges, but think fast.

Glory Hole MTB Race, March 3, 2007 -- Honestly, we don't know too much about this NORBA-sanctioned race other than what we found online, but we love the name.

Cool MTB Race, March 11, 2007 -- One thing you need to know about this race: be prepared. The weather is notoriously finicky and the muddy, sometimes snowy course on the Olmstead Loop is often an exercise in persistence. Despite the inclement conditions, the race is in its 15th year and has quite a following among local racing diehards. The course is a ten-mile circuit comprising mostly fire roads. Bring your booties and arm warmers!

Napa Valley Dirt Classic, April 22, 2007 -- Our all-time favorite, the Dirt Classic is a low-key affair on a top-notch course. Primarily on private land, the course is so luscious, it even attracted the attention of the mountain-biker-in chief. As a bonus, it's one of the few remaining cycling events that still includes a free t-shirt with the entrance fee.

The Lemurian, April 28, 2007-- Racing in the Lemurian requires a unique mentality. Through either reputation or personal experience, competitors are fully aware that they're signing up for two to three to four hours of pain, sometimes very intense pain. There is no avoiding it, no matter how fast or slow they go, them hills is gonna hurt. The harder they push, the more it's gonna hurt. Throw in some chainsuck, a sprinkling of flats, a highlight reel of spectacular wipeouts, and some shit-eatin' grins, and you've got a pretty good portrait of the Lemurian experience.

Howell Mountain Challenge, August 12, 2007 -- The summer bookend to spring's Napa Valley Dirt Classic, this race uses a 10-mile circuit made up of sections from the Dirt Classic course. With smaller fields and hotter temperatures than its spring cousin, this NORBA race is a great low-stress, late-season tester. Pre-rides are not allowed, but if you get there early enough on race day, you can get a crack at the course.

Racing Series

TBF MTB Challenge series, February 3 - March 18, 2007 -- TBF Racing, based out of Sacramento, organizes several different race series in the greater Sacto area. Their MTB Challenge races skirt Folsom Lake and many riders consider these races the kickoff to the northern California MTB racing season. The fields are small (150-200 riders), but the events are well organized.

CCCX Mountain Bike Race Series, February 11 - June 30, 2007 -- If schlepping out to Sacto doesn't sound good, consider a drive down to the Monterrey peninsula to partake in the annual CCCX race series. This nine-race series tackles circuit courses in Salinas and Fort Ord, and offers a great warmup for the Sea Otter Classic. You can ride all nine events or cherrypick just a couple. Either way, this series offers a low-stress way to work on your racing techniques and learn the local terrain, which should give you an extra advantage when you tackle those 200-racer Sea Otter fields.

Prarie City Race Series, April 4 - June 27, 2007 -- The Prarie City series, also set in the Sacto area, is the epitome of grass roots cycling. Weeks and weeks of races for kids, teams -- even week night racing. And at $25 for the first race and only $10 for each subsequent race, it really is mountain bike racing for everyone.

Corral Hollow Downhill (CHDH) Series, April 20 - September 9, 2007 -- This is the first year for the three-race CHDH Series, which has been a one-day, one-race event for the last five years. Formerly the Groovy Gravity Games run by Team Wrong Way, the event was reincarnated last year as the CHDH and is now run by rideSFO. And if mind-jamming downhill action isn't enough to get you out to the Carnegie State Vehicular Recreation Areas, how's this sound, "Apple Wood Smoked Tri-tip Sandwich"? That's what we thought.

Endurance Events

Boggs II, March 31, 2007 -- Formerly known as Boggs for Africa, this NORBA-sanctioned 8-hour solo and team relay scares up the dust of the Boggs State Demonstration Forest, a wonderful outdoor playground for cyclists and a great setting for MTB racing. Organizers have set a racer limit of 200, so the fields will be relatively small, but the race is for a good cause. Money raised by racers in lieu of entrance fees goes to benefit the Sonoma County Bicycle Coalition and the Sonoma County Trails Council.

24 Hours of Laguna Seca, June 2/3, 2007 -- An excellent entry-level endurance event, the 24LS is all about pace. And by pace, we mean speed. Race organizers 24 Hours of Adrenalin are known for courses that favor fast times over technical challenges and the Laguna Seca tracks are hard-packed earthen adrenaline. If you can stomach the hefty entrance fees and convince a big group of friends to camp out with you, this is a great event. Watch out for that early morning breeze off the ocean though, it's bitter. In case you miss this race, they're reprising the event in September.

Other Competitions and Events

Brews, Bikes, Bucks, February 11, 2007 -- A fundraising event to support the organization Trips for Kids, this is a chance to rub elbows with the pioneers of mountain biking. Gary Fisher, Joe Breeze, Tom Ritchey. Otis Guy, and Charles Kelly are among the dirt legends who regularly attend this event and regale guests with tales of the sport's early days. Some cool prizes and good beer too.

Amgen Tour of California, February 18 - February 25, 2007-- Our own little taste of Europe, the Tour of California brings the world's greatest road cyclists and their teams to the Bay Area for four days of intense racing. The 1.9-mile prologue time trial from the Ferry Building to Coit Tower is a City spectacle not to be missed.

buy viagra buy soma buy soma buy viagra