An Interview with Derek Fitzgerald: Ironman Competitor and Heart Transplant Survivor

Derek FitzgeraldAfter overcoming Non-Hodgkin’s lymphoma, heart failure, and a heart transplant, Derek decided to enter the world of endurance sports. Perhaps even more impressive is the fact that before he got sick, Derek wasn’t even active and was overweight. Since his life-saving transplant in 2011, Derek has completed over 80 endurance events, including multiple Ironman races.

THE CLYMB: How active was your lifestyle when you were diagnosed with Non-Hodgkin’s lymphoma?

Derek Fitzgerald: I was diagnosed with Non-Hodgkin’s lymphoma when I was 30 years old. After college, the time and energy I had given toward being outside and active was replaced with sitting at a desk and focusing on a career. I started putting on weight in my late 20s, so by the time I hit 30, I was a very inactive and tipped the scale at an unhealthy 200 pounds.

THE CLYMB: How long after your treatment for Non-Hodgkin’s lymphoma did you develop heart problems?

Derek Fitzgerald: My cancer treatments ended in May of 2004. Everything seemed great for a little while, but three months later I started having trouble breathing, coupled with fatigue and dizzy spells. Doctors initially thought I had pneumonia, but after several late night trips to the emergency room, a cardiologist sat by my bedside and said, “I know you’ve had a tough year, but I’m afraid I’ve got some more bad news.”

I had gained weight during my cancer treatment and was motivated to get back into shape once I was declared in remission. Unfortunately, by the time I started to work out again, my heart was so weak that any attempts at exercise would make the walls start to spin and I would end up on the floor.

Derek Fitzgerald

THE CLYMB: When did you have a heart transplant and what was the experience like?

Derek Fitzgerald: The hard part about a heart transplant is the waiting leading up to the surgery. The way the transplant waiting list works, available organs go to the most critical candidates first. So even though you’re exhausted from fighting to stay alive and you know that you’re already sick enough to die at any moment, you have to hope to get even worse before you have a chance to get better. You have to maintain hope while preparing yourself to die. I went through seven years of heart failure and was on the waiting list for the final four months. By the time I received my new heart, I was asleep for 23 hours a day and was withering away in a hospital bed.

I later found out that if my donor’s heart hadn’t become available when it did, I would have died within hours.

My donor’s heart arrived on January 3, 2011. Before the transplant, doctors told me the physical effects are the equivalent of being hit by a truck—you wake up from surgery and your chest is being held together with glue, staples and surgical wire. You have breathing tubes down your throat, drainage tubes coming out of your torso, and cables inserted into your neck that run to the heart to monitor internal pressures—it’s scary and tough, but there are some great pain medications out there. The most powerful thing I experienced coming out of my transplant was the overwhelming joy that I had been given a chance at life.

THE CLYMB: How soon after the transplant did you start to exercise? What was your routine like at first?

Derek Fitzgerald: I was using a walker to explore the hospital within 24 hours of my transplant. Unfortunately, the atrophy that had started before my transplant continued through the first few months of recovery and I dropped down to 128 pounds. I spent most of January trying to regain the muscles to lift my head from my pillow. If nobody was around to help me out of bed, I was stuck. I think it was probably a combination of boredom and bedsores that led me to wiggle my butt cheeks over the side of the bed, where I’d fall to the floor and begin dragging myself across my bedroom until I hit a vertical surface where I could pull myself to my feet. Essentially, that’s how it all started for me: sweating, panting, and cursing up a storm as I army-crawled across my bedroom floor.

Derek Fitzgerald

THE CLYMB: What made you decide to take on the world of endurance sports? And did you ever think this was going to be something you were going to pursue longterm?

Derek Fitzgerald: Before my transplant, I had never even run a 5K. I used to joke that I didn’t have the short-shorts for it and I just didn’t like being around that many people. Since my transplant, my only goal has been to keep myself in the best shape possible; to be a good custodian to my donor hero’s heart. Every day, I try to push myself a little bit further than where I was the day before. I never expected that mindset would lead me into the world of endurance sports.

THE CLYMB: How soon after your transplant did you complete your first race/endurance event?

Derek Fitzgerald: I ran the Travis Manion Foundation’s 9-11 Heroes Run 5K eight months after transplant. Seeing all the runners was intimidating at first, but it was also inspiring, especially when I saw the men and women who ran in full combat gear and gas masks. During the race, I thought back to laying in my hospital bed, not being able to breathe, not knowing if I would live another day, but there I was, outside on a gorgeous day, running and feeling amazing. When I finally crossed the finish line, I experienced a combination of feelings: I was thrilled at the sense of accomplishment, and I was filled with humble gratitude for everything I had been given that allowed me to experience that moment. My donor and I had kicked the tires and I was already curious to see what else we could do.

THE CLYMB: Since then, you have completed an impressive number of endurance events and Ironman races? Any that were particularly grueling or had special meaning for you?

Derek Fitzgerald: Every starting line I reach has a special meaning for me, but there are several that hold a special place in my heart (no pun intended). In 2013, I finished Ironman Lake Placid and became the first cancer-surviving heart transplant recipient to complete the 140.6 mile challenge. I never thought I’d be alive, let alone competing in an Ironman, so carrying my donor’s heart across that finish line will stay with me forever. In 2015, I had the chance to ride my bike across the United States while raising money and awareness for cancer research, heart health, and organ donation and transplantation. Dipping my rear wheel in the Pacific Ocean, riding through desert sunrises and over mountain ranges until my front wheel hit the Atlantic has provided countless lifelong memories.

Derek Fitzgerald

THE CLYMB: What kind of training do you do on a regular basis? And is the type/intensity of the training affected in any way by the fact you had a transplant?

Derek Fitzgerald: I train seven days a week with a combination of swimming, cycling, running, strength, flexibility and core exercises. My girlfriend and I also enjoy incorporating hiking and kayaking into the mix when we can.

I don’t think anyone expected these kinds of results, not my doctors, and certainly not me. One of the many challenges heart transplant athletes face is the fact that the nerves that were connected to our old hearts are severed during transplant. That means that when we begin to exercise, there are no mind/body cues to tell our hearts to beat faster. We have to wait for adrenaline to reach the heart to make it beat faster. Conversely, when we finish exercising, it takes longer for us to slow down the heart because there’s no connection from the brain to say the workout’s over.

Nerve regeneration is rare, never guaranteed, and if it does happen, it usually doesn’t begin to occur until at least five years after transplant. Needless to say, when my nerves started to regenerate within the first year, my doctors were shocked and could only attribute it to the amount of physical activity I was doing. Consistent exercise has helped my body and my donor’s heart work together in ways that nobody ever expected and has made my life better than I could have ever imagined. My limitations are defined only by where I was yesterday, and each new day brings the chance to beat my own personal best.

THE CLYMB: You recently completed the Ironman 70.3 Oceanside. What was the race like and how many have you completed including this one?

Derek Fitzgerald: I love destination races and seeing new landscapes in ways that even most locals don’t get to experience. Living on the East Coast, it’s such a treat to race along the Southern California coastline with the palm trees overhead. Completing Oceanside brought my total to five 140.6 races and five 70.3’s. I’m currently training for my sixth full Ironman this July in Lake Placid, NY.

THE CLYMB: Any particular challenge ahead you’d love to complete?

Derek Fitzgerald: There are several challenges I’d love to tackle: in triathlon, I’ve heard so many amazing things about Challenge Roth that it’s really high on my list, and when it comes to running, the ultimate goal has to be the Boston Marathon. I’m not where I want to be for that to happen yet, but if there’s one thing I’ve learned from my life so far, it’s that anything is possible.