For Timothy O’Donnell, hours of denial gave way in the emergency room of a South Florida hospital late on the night of March 13, 2021, when the trauma care specialist called the resuscitation team and told it to stay close.
“I was thinking, ‘Oh, man, are you going to die right here?’” O’Donnell, a triathlon champion and one of the world’s fittest men, recalled of that terrifying day a little more than 13 months ago. “That’s where the mind-set of the athlete kicked in. Just put negativity out of the mind and focus on surviving.”
Yet, hours before, this mentality had almost cost him his life. This set off a series events that illustrated the limits of endurance sports’ tough-it-out mentality, sometimes with fatal consequences.
For roughly 20 miles on his bike and through his 11-mile run at the Miami Challenge triathlon, a 62-mile championship competition, O’Donnell had battled through severe tightness in his chest and pain shooting down his left arm as he competed against some of the top triathletes in the world.
He was able to ignore pain and kept going even when he lost count of the distance he had ridden. He had that mindset when he started the 11-mile run, even though it was difficult to breathe and felt like he was suffering from an asthma attack.
O’Donnell, 41, who is from Boulder, Colo., was making a mistake that too many seemingly healthy middle-aged men make each year, often with catastrophic consequences. He couldn’t believe that someone like him could have a heart attack. This is despite the fact that it was so frequent among fit middle-aged men and they don’t know they may be at risk.
“This is not all that uncommon a story,” said Aaron Baggish, O’Donnell’s cardiologist and the director of a clinic at Massachusetts General Hospital that provides comprehensive cardiovascular care to athletes. “You can exercise and stay healthy and reduce your risk, but no amount of exercise offers complete immunity from heart disease.”
After a year of rehabilitation and medical research, and plenty of soul-searching and long talks with his wife, the three-time Ironman world champion Mirinda Carfrae, O’Donnell is ready to compete seriously again.
He had planned to round into racing form, beginning two weeks ago with St. Anthony’s Triathlon in St. Petersburg, Fla., but a cold forced him to pull out. His comeback will now begin this weekend in Chattanooga. He will compete in the Ironman 70.3 North American Championship.
“The idea is to get back to Kona,” O’Donnell said, referring to the Ironman World Championship, which takes place in Kailua-Kona, Hawaii, in October.
Pursuing brutal tests of endurance a little more than a year after a nearly fatal cardiac event might sound reckless, and O’Donnell and Carfrae, who have two young children, had misgivings at first. They both agreed that if racing was going to cause harm to his heart health, he would quit.
“His racing career was not on our radar,” Carfrae said while nursing their 16-month-old recently. “We were trying to get him healthy so he could live a long and healthy life.”
Heart attacks like the one O’Donnell suffered occur when a piece of plaque that has built up on the inner lining of the arteries ruptures and causes a blockage, keeping blood from flowing properly to the heart.
After his, O’Donnell learned he had a genetic predisposition to heart disease, specifically plaque building up on the walls of his arteries, a condition difficult for doctors to detect.
Doctors used a common procedure to repair O’Donnell’s left anterior descending artery with a stent — a mesh coil that expands the artery — then continued to treat him with medication, all of which has made a return to racing safer than it might appear, Baggish, his doctor, said.
During O’Donnell’s race, his body was working so hard to pump blood that he was able to force blood through the clot. He was 11th overall in 2:44 minutes 56 seconds but could not stand afterward. He called his primary physician from the recovery area to report the tightness in his chest, and the pain in his arm that he felt during the race. He was advised by the doctor to take aspirin to stop the clotting. Then he should go to the emergency room. There, a trauma specialist called for the resuscitation team.
“At that point in the hospital, I finally got it,” he said. “Like, wow, it is actually happening.”
A week after the heart attack, O’Donnell got on a treadmill for a stress test and was soon cleared for light aerobic training.
Once O’Donnell, Carfrae and his doctors were comfortable with his general fitness, they began to discuss racing again, including which medications he might be able to stop taking because they could inhibit his performance.
The mental challenges were more difficult, especially for someone with an analytical bent, like O’Donnell, who graduated from the United States Naval Academy with a degree in naval architecture and marine engineering. He was told by doctors that his heart attack would occur regardless of whether he was participating at a triathlon. However, O’Donnell still grieves for the loss of his family.
Carfrae too has had her ups and downs. Early in O’Donnell’s recovery, as Carfrae went down for a nap with the children, he told her he was going to get on the treadmill. Two hours later, she woke up to the sound of the treadmill running and the television blasting. She thought that there was no way O’Donnell could still be training and that he must have collapsed. She ran to the door, fearing for her life. He had begun the exercise later than he planned.
They participated in a triathlon for couples that was short in length. He was heading into the water, and she thought, Should he be there?
“I had a horrible race,” Carfrae said. “I was so emotionally drained.”
They find comfort in the science, the words and the math that tells them that his chances of having another heart attack have fallen significantly since the primary cause has been identified.
“Tim is more likely to hurt himself in a bad bike crash than another coronary event,” Baggish said.
However, this does not necessarily mean that he will not experience another heart attack. No matter what O’Donnell looks like on the outside, he has heart disease. He saved his life by being so fit after he ignored the symptoms. He won’t do that again, but former Navy officers do not often live their lives in Bubble Wrap, and he knows the only alternative is to accept the uncertainties.
“There’s always variables you can’t control,” he said.
Source: NY Times