Mucho Macho Man trainer champions the need for organ donation
Kathy Ritvo is an organ recipient herself
Written by Eric Crawford | Courier-Journal

Thoroughbred trainer Kathy Ritvo's run for the roses began only after she won a race against time.

Three years ago, Ritvo watched the Kentucky Derby from a bed in the cardiac critical care unit of Miami's Jackson Memorial Hospital.

Just before the race, she turned to her cardiologist and made what would be a bold statement for any trainer, let alone a 39-year-old mother of two awaiting a heart transplant after years of struggle with dilated cardiomyopathy, a degenerative disease that weakens the heart muscle.

“I don't know why I said it, or what made me say it,” Ritvo recalled, “but I told him, ‘When I take a horse to the Derby, you have to come.' ”

This week, Ritvo, who received a heart transplant in November 2008, is making good on that invitation: She will saddleMucho Macho Man in Kentucky Derby 137, and cardiologist Joseph Bauerlein has been asked to come.

“I'll be watching, whether it's at the race or at Gulfstream Park (in Florida),” said Bauerlein, who has been Ritvo's cardiologist since 2008. “Whatever works out best for her. … I don't want to be a distraction. She has a race to get ready for.”

But Ritvo's focus extends beyond the race itself. She also hopes media coverage of her story will boost organ donations and provide hope for others awaiting transplants.

Kathy Ritvo said she started suffering from fatigue as early as 1998, but it wasn't until 2000 that the heart problem was discovered. After that, she spent long periods in and out of hospitals, taking heavy regimens of medication.

By the time she watched Big Brown win the Derby in 2008, Ritvo was hospitalized almost full time, hooked up to machinery that administered her medication, although she occasionally was released for short periods, when she would use mobile devices to inject her medications.
'Determined to fight'

While she waited for a donor, she tried not to think of the worst, although it was difficult not to, she said.

“I lost a brother to the same disease when he was 38 years old,” she said. “And I was very determined that my mother would not have to go through losing another child. And I wanted so badly to be there for my kids. I didn't want to leave Tim with the job of raising them alone. I was preparing myself for the worst, but I was determined to fight.”

At 7 p.m. Nov. 13, 2008, as she lay in bed watching television, she got the call she had been waiting for, and within hours, she was back at the hospital.

Waking up after the six-hour transplant surgery, she felt better than she had in 10 years, she said.

Her surgeon, Dr. Si Pham, director of the Heart/Lung Transplant and Artificial Heart programs at Jackson Memorial, said, “She didn't have much longer. When the heart becomes so weak, other organs fail — the kidneys, the liver — and the weaker you are, the more difficult the recovery is. So for her, we were very lucky to get a donor.”

Today, Ritvo takes 30 pills a day, anti-rejection and other medication and vitamins. Bauerlein says the major risks are infection and her body rejecting the heart. Her immunosuppressant medication lowers the rejection risk, but raises the risk of infection.

She couldn't go anywhere near a horse barn for months after the surgery. The horses, the stables, the track still present “a potential risk,” Bauerlein said. “But I think it's acceptable, and she's managing it.”

“One amazing quality about her is that she is very positive,” he said. “She would come into the clinic before her transplant, and I would know what her echocardiogram showed — she had just very poor heart function. But just looking at her, with her attitude, it would be hard for most people to tell she was as sick as she was.”
'Not a sick person here'

Both doctors said her long-term prospects are good. The most successful transplanted hearts have lasted 20 to 22 years, with the possibility of future transplants for patients who have them.

Ritvo said her husband was hesitant about her returning to training, but after he needed her to saddle a horse for him at Gulfstream one day a couple of summers ago, she eased back into it. And “now when he sees me at the track, he sees it's good for me. I'm not a sick person here. I'm not a heart transplant patient here. I'm a trainer here.”

And she's a good one, the colt's owners say.

A native of Boston and part of a racing family, Ritvo got her training license on her 18th birthday at Suffolk Downs in Boston. Her father, Peter Petro, was a longtime thoroughbred owner before his death in 2007. Her brother Louis was a jockey before his death in 1996 (he was awaiting a heart transplant), and another brother, Nick, also is a jockey. Her brother Michael is a trainer in the northeast.

Training a division out of her husband's stable, she won 149 races — seven of them stakes — from 1990 to 1998, when her health forced her to give up full-time training. She had a filly in the 1992 Breeders' Cup Juvenile Fillies, Liberada, who finished eighth.

Ritvo has 16 horses in training now, based primarily in Florida. But she never has had a horse like Mucho Macho Man, and the owners say that the headline-grabbing nature of her health struggles shouldn't overshadow the training job she has done.

Dan Reeves, who bought the majority share of Mucho Macho Man last year, hired Tim Ritvo to train him. But when Tim took the job at Gulfstream, Reeves said he didn't think twice about handing the colt to Kathy.

“There never was a question in my mind,” he said. “She's a wonderful trainer. She's very hands-on, very old-school.”

Jim Culver of Dream Team Racing is a minority owner and the original buyer of Mucho Macho Man. He calls Ritvo's training style “maternal.”

“She just has a great feel for the horse and what he needs and wants to do,” Culver said. “And now, knowing her story, and as a guy who has a heart stint myself, you just can't help but root for her.”Neal Bira, founder of the Organ Donor Awareness Foundation and a recipient of a transplanted heart himself, said Ritvo has an important story to tell.

“I don't think you can overstate the importance of someone like Kathy, both for the message of becoming an organ donor and the message that there's hope for people awaiting transplants,” said Bira, whose organization supports donor families. “It's huge.”

Ritvo hasn't met the family of the person whose heart she received — although she would like to. She wrote a letter to the family and gave it to the hospital to be forwarded but has had no word back.

Still, she is reaching out to potential donors with her story and said she also hopes to help some who are awaiting transplants.

“If just one person sees my story and takes some hope from it, or decides to take the time to become an organ donor, then that will make whatever happens worthwhile,” Ritvo said.

Meanwhile, even Ritvo's colt has a heart-touching story.

When Mucho Macho Man was foaled — more than three weeks after his due date — in Ocala, Fla., on June 15, 2008, his heart wasn't beating. He lay lifeless on the ground, according to Carole Rio of Rose Grove Farm, while she and her husband, Jeff, and others prayed. She put her hands on the foal and rubbed him, then stopped and prayed some more.

“Then all of a sudden, this sucker just jumped up and started running,” Rio said. “He didn't just stand up, he jumped up and took off.”

If all of this seems to have a fairy-tale quality about it, Ritvo would tell you the fairy tale has already happened.

“The horse brought us here, and everything has fallen into place for us to be here,” Ritvo said. “No matter what happens Saturday, it's going to be meant to be. I am not worried. We're going to get the right post and right track and right trip. Every bit of this is a gift.”

Just over a week ago, standing outside her barn at Churchill Downs, she taped a public service ad for the Kentucky Circuit Court Clerks Trust for Life organ donation program.

She waited patiently as she was wired for sound and was asked to do multiple takes for the camera crew. It was a long way from the last months before her transplant, when the wires and tubes attached to her were keeping her alive.

“There were a lot of nights when she went to sleep that I wasn't sure she'd be waking up in the morning,” said Ritvo's husband, Tim, a former thoroughbred trainer who now is vice president of racing at Gulfstream Park in Hallandale Beach, Fla. “But she is as strong as anyone I know.”