Trainer Ritvo in Derby 3 years after transplant

LOUISVILLE, Ky. (AP) - Kathy Ritvo runs a finger over the five-inch scar in the center of her chest and leans forward. She wants you to see it. She needs you to see it.

The spot where doctors went in three years ago and took out her heart and replaced it with one given by an unknown donor is nearly imperceptible, almost remarkably so.

Yet it is there, the ridge now as familiar to the trainer of Kentucky Derby hopeful Mucho Macho Man as the faces of her two children.

It is a very tangible symbol of just how fragile life can be. The mark that gave her a second chance at life three years ago also gave her perspective on how to live it.

``It's a battle scar,'' she said. ``I'm proud of it.''

And only when she learned to love it did she learn to let go.

Horse racing can be an equally addictive and cruel business for those closest to it. Long hours. Little pay. Almost no glory. Fortunes and careers can rise and fall on a head bob here, a bad step there.

Ritvo sweated every detail for years as she and husband Tim Ritvo carved out a niche training horses in South Florida. Her family and friends learned to avoid her on race days, knowing she'd lose it when she saw one of her horses at the quarter pole. Afterward she'd spend hours breaking down every last stride trying to figure out what went wrong or what went right.

Not anymore. Oh, don't get her wrong. The 42-year-old Ritvo remains as hands-on as ever even though doctors advised her to stay away from the track at all costs following the November 2008 transplant that replaced her diseased heart with a new one.

She just doesn't pore over every detail. It took eight years battling a degenerative heart disease and a 17-hour surgery for her to realize attempts at omnipotence are futile.

``If something happens and we don't have control over it then try not to obsess over it,'' Ritvo said. ``Things are going to happen and you have to accept it.''

Oh, there were nights when she would cry and scream ``why me?''

Who could blame her? Tim Ritvo, who ceded his half of the business to his wife last winter to oversee racing at Gulfstream, Pimlico and Laurel Park, didn't get it.

``Kathy never drank, never smoked, never did a drug,'' he said. ``You see other people try to kill themselves and she never did a thing wrong.''

Genetic testing revealed Ritvo suffered from cardiomyopathy, the same disease that killed her brother Louis, a former jockey, at age 38 in 1996.

She spent months shuttling in and out of Jackson Memorial Hospital in Miami taking intravenous drugs to keep her heart pumping. There were days she felt so sluggish it was all she could do to lift her head off her pillow. There were nights when she wasn't sure she would wake up in the morning.

Ritvo spent months awaiting a transplant. When the call finally came, she didn't even pack a bag on her way out the door. She didn't plan on staying in the hospital that long.

``Once you get through that and get yourself together, you have to keep going forward,'' she said. ``It was not my time to go and I did not want to go.''

A week after the surgery, she was back home. Three years later, she's as healthy as she's ever been in her life, though there are daily reminders of how close she came to not being here at all.

Besides the scar there is the daily 30-pill regimen - a handful anti-rejection drugs at 7:30 in the morning, another handful 12 hours later, then 15 vitamins at lunch. There's the occasional cold that takes a little longer to clear up than it probably should.

That's pretty much it, though. A small list of complaints that pales in comparison to the good fortune that's come her way since she walked out of the hospital just before Thanksgiving 2 1/2 years ago.

In 2008, Ritvo watched the Kentucky Derby from a hospital bed wondering if she'd live to see another first Saturday in May.

Next weekend she'll walk in the paddock hoping to become the first female trainer to ever capture the Run for the Roses. Mucho Macho Man punched his Derby ticket with a victory in the Risen Star Stakes in February.

A late foal - he won't actually turn 3 until June 15 - Mucho Macho Man is the kind of horse Ritvo has been waiting for her entire career.

``This horse makes it easy,'' she said. ``He loves his job. It's easy for me. I wish I could take more credit.''

It's why she wakes up every morning and says a little prayer. It's why the somewhat quiet trainer has embraced the spotlight having a horse on the Derby trail provides. She's become a spokeswoman for organ donation and has yet to turn down an interview request.

A little extra attention is a small price to pay for living out a dream her family tried to steer her away from as a child.

Ritvo's voice betrays more than a hint of her New England upbringing. As a child growing up in Massachusetts she would invent ways to head to the track with her father, longtime owner Peter Petro, who told his daughter to stay home and play with dolls.

``I'd tell him I needed to go so I could see the cats,'' Ritvo said.

The moment he would turn his back, she would sneak over to another barn to hang out with the horses. She was hooked, and there was nothing her father or brothers - all of whom got into the business - could do about it.

``I have a hard head so they knew I was going to do what I want,'' she said.

Not that anybody's stopping her now.

Co-owner Dean Reeves knew he had something on his hands last fall and never considered switching trainers after Tim Ritvo left the barn last fall for an office job.

``I might have got a better trainer as a result,'' he said with a laugh. ``There just seems to be a connection that she gets. And she's doing what she loves to do and it comes natural for her.''

Ritvo blushes at the compliment, stressing she still bounces ideas off her husband each day and that Tim ``is still part of my team.''

It's a group that will likely grow as Derby day approaches. Ritvo's back story has placed the focus on her recovery, not her gender.

She's OK with that, though she believes female trainers tend to handle their horses differently than their male counterparts.

``I think women see things clearer than men,'' she said.

Even if it took a life-changing event for Ritvo to see how she needed to grow as a trainer. Mucho Macho Man went off as the favorite in the Louisiana Derby in his last start but finished third after losing a shoe.

A few years ago, she would have fixated on what she could have done differently. Instead she took the loose shoe when a gate attendant handed it to her and tossed it aside.

Life's too short to micromanage. If she ever feels like ``the small stuff'' is getting to her, Ritvo need only run a finger over thin line in her chest to get refocused.

Worrying didn't get her this far. Faith did.

``It's a great story,'' she said. ``I don't think I ever gave up because this is my life.''