After a heart attack mid-race, the triathlon champion returns to the starting line

For Timothy O’Donnell, hours of denial gave way to a South Florida hospital emergency room on the night of March 13, 2021, when the trauma specialist called the resuscitation team and told him to stay close.

“I was thinking, ‘Oh man, are you going to die right here?’” O’Donnell, a triathlon champion and one of the fittest men in the world, recalled that terrifying day just over 13 months ago. “That’s where the athlete mindset comes into play. Just put the negativity out of your mind and focus on surviving.”

And yet, hours before, that mentality had nearly cost him his life. He unleashed a series of events that illustrate the limits of the endurance mentality that pervades endurance sports, sometimes with deadly consequences.

For about 20 miles on his bike and during his 11-mile race in the Miami Challenge Triathlon, a 62-mile championship race, O’Donnell had battled severe chest tightness and pain shooting down his left arm while I was competing against some of the best triathletes in the world.

The attitude that made him so good at ignoring pain kept him going when he lost track of how far he’d come and got off the bike a lap early. That mindset was present as he tackled the 11-mile race, the final segment, even though he was gasping for breath and feeling like he was having an asthma attack.

O’Donnell, 41, who is from Boulder, Colo., was making a mistake that many seemingly healthy middle-aged men make every year, often with catastrophic consequences. He just couldn’t accept that someone like him could be having a heart attack, let alone one called the widowmaker because of its severity and its frequency among unsuspecting middle-aged men who are fit and have no idea that they could be at risk.

“This is not such an unusual story,” said Aaron Baggish, an O’Donnell cardiologist and director of a clinic at Massachusetts General Hospital that provides comprehensive cardiovascular care to athletes. “You can exercise and stay healthy and lower your risk, but no amount of exercise offers complete immunity against heart disease.”

After a year of rehabilitation and medical research, and much soul searching and long talks with his wife, three-time Ironman World Champion Mirinda Carfrae, O’Donnell is ready to compete seriously again.

He had planned to get into racing shape, starting two weeks ago with the St. Anthony Triathlon in St. Petersburg, Florida, but a cold forced him to withdraw. Now his comeback will begin in earnest this weekend in Chattanooga, Tenn., at the Ironman 70.3 North American Championship, followed by the full Ironman continental championship in June in Des Moines.

“The idea is to go back to Kona,” O’Donnell said, referring to the Ironman World Championships, which take place in Kailua-Kona, Hawaii, in October.

Undertaking brutal endurance tests just over a year after a near-fatal cardiac event may sound reckless, and O’Donnell and Carfrae, who have two young children, were hesitant at first. They agreed that if there was any chance that continuing to race would harm his heart health, he would resign.

“His career as a pilot was not on our radar,” Carfrae said while breastfeeding her 16-month-old son recently. “We were trying to keep 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, preventing blood from flowing properly to the heart.

After hers, O’Donnell learned that she had a genetic predisposition to heart disease, specifically plaque buildup on the walls of her arteries, a condition that is 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 have made his return to racing safer. from what it looks like, Baggish, his doctor said.

During O’Donnell’s run, his body was working so hard to pump blood that he was able to force blood through the clot. He finished 11th, in 2 hours 44 minutes 56 seconds, but couldn’t get back on his feet afterwards. He called his primary care doctor from the recovery area and told him about the tightness in his chest and the pain that shot through his arm during the run. The doctor told him to take an aspirin to stop the clotting and to go to the emergency room, where he saw the trauma specialist call the resuscitation team.

“At that moment in the hospital, I finally got it,” he said. “Like, wow, it’s actually happening.”

A week after the heart attack, O’Donnell hopped 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 overall fitness, they began talking about racing again, including medications he might 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. Doctors told him this heart attack was going to happen regardless of whether he competed in a triathlon or not, but he still thinks about how his wife and children almost lost him.

Carfrae has also had his moments. Early in O’Donnell’s recovery, when Carfrae went to nap with the kids, he told her he was going to get on the treadmill. He woke up two hours later to hear the TV blaring and the treadmill still running. She thought that there was no way O’Donnell could still be training and that he must have broken down. She stormed into the room fearing the worst. It turned out that she had started training later than planned.

This year they participated in a short course triathlon for couples in Florida. She watched him go into the water and thought: Should he be out there?

“I had a horrible race,” Carfrae said. “I was so emotionally drained.”

They take comfort in the science, the words of their doctors, and the math that says the chances of you having another heart attack have been substantially reduced because the main potential cause of one has been fixed.

“Tim is more likely to be injured in a serious bicycle accident than in another coronary event,” Baggish said.

That doesn’t mean you absolutely won’t have another heart attack. No matter what O’Donnell looks like on the outside, he has heart disease. Being absurdly fit probably saved his life after he ignored the symptoms. He won’t do that again, but former Navy officers don’t often live their lives in Bubble Wrap, and he knows the only alternative is to accept the uncertainties.

“There are always variables that you can’t control,” he said.

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