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Trainer Kathy Ritvo is every bit as macho as her Preakness horse

Trainer Kathy Ritvo, all 5 feet of her, stands on her toes in the Preakness barn at Pimlico Race Course and reaches up to the massive horse known as Mucho Macho Man.

"You need a hug," she says, stretching her arms to encircle his face.

Mucho Macho Man puts his ears back and gives her a look. Ritvo, dressed in jeans and Kentucky Derby jacket, shakes her long blond hair and laughs.

"I say, 'You need a hug.' And he says, 'Scram,'" she said. "But isn't he a handsome horse?"

Mucho Macho Man is a very handsome horse, indeed. He stands about 17 hands high (5 feet, 7 inches) from the ground to the top of his shoulders. He's a bay, a light chocolate shade of brown, with a white blaze down the middle of his face. And he has long, strong legs that look like they're covered in knee-high black velvet nylons.

On the outside, Mucho Macho Man and his trainer are a study in contrasts: one, a big, strong horse with a fine, shiny, short brown coat; the other a small woman with long blond hair and the everyday clothes of a working trainer.

But on the inside, their hearts are strong.

Mucho Macho Man, now a month away from turning 3, was born lifeless in a field, then suddenly opened his eyes and sprang into a life that eventually saw him become the third-place finisher in this year's Kentucky Derby. Ritvo, 42, was dying for most of her life, she said, until she received a heart transplant in November 2008.

When she opened her eyes after her operation, she, too, jumped into her life.

"From the moment I opened my eyes, I felt fantastic," she said. "He's Mucho Macho Man and I'm Macho Woman. Now look where we are."

It wasn't like that before the transplant. Then "she was very, very sick," recalls her husband, Tim, who was the primary trainer in the couple's business until six months ago when he became director of East Coast racing for MI Developments and she took the lead trainer role.

"I knew her at 16, when we were growing up at the racetrack," Tim Ritvo said. "Then she got sick and was on the brink of death. It was sad for the kids, for all of us, to watch her. It was such a roller-coaster ride. The one who is sick suffers the most, but those around her suffered, too — worrying, trying to go and do the everyday things for the kids, having to put on this front that everything is OK. You have to do that, even when you're not sure what the outcome is going to be. All of it without knowing if everything is going to work out."

There were nights when Kathy Ritvo's children pulled her hair back into a ponytail and lovingly bathed her face as she coughed through the night without stopping. And other nights when Tim Ritvo went to bed not knowing whether his wife would wake in the morning.

They had discovered she had cardiomyopathy, a severe deterioration of the heart muscle, when she was pregnant with their third child, a child she could not have, in 2001. It was a blow. Her father had died from heart problems, and a brother, Louis, died in 1996, because of complications from the same disorder from which she suffered.

"I think about Louis every day," Ritvo said. "Why was I blessed and he got so sick he couldn't have a new heart?"

She doesn't know the answer to that question, but she is trying to make her own survival count for more. Ritvo has become the spokeswoman for the Kentucky Organ Donor Association, encouraging people to help others by donating their organs and/or those of their loved ones.

"I do think I'm having an impact," Ritvo said. "I've gotten emails and calls from people saying I'm helping them. Donating a heart is such an unselfish gift, a very special gift. When someone can do this, they've told me it makes them feel better because it means another person isn't going to be without their family."

Going through what she has, Ritvo said, it wouldn't be normal to not change at least a little.

"I appreciate everything I have every day," she said. "And I think going through this kind of health issue makes you tougher. If you don't have that will, you're not going to make it. There were so many, 'I'm sorry for me' days. I'm not the bravest person. But after I woke up, every day is a great day. I'd say the only thing I do differently is have more fun."

And much of the fun comes at the racetrack, a place she probably shouldn't be. Her doctors told her it would be better if she didn't go to the stables. She is not supposed to get sick. She is not supposed to breathe dust or be around mold or bacteria — all things very possibly present in a stable area. She is also supposed to take her pills, 15 of them in the morning and another 15 in the evening.

Though nothing could deter her from the track, she takes her medication like clockwork. When Mucho Macho Man goes out for his 7:30 work here in the morning, she takes her meds and at night her cellphone buzzes to remind her.

"I knew eventually she'd go back to training," Tim Ritvo said. "It's the only thing she always loved. About a year and a half after the operation she was doing very well and I think she was getting a little bored. I had to go away, I think we had two horses running at two different tracks on the same day and she saddled one of the horses for me. The horse won and she started doing more and more. When I got this job, I told her she didn't have to keep training, that we'd be fine. But she told me, 'No. I really feel like I'm not sick when I'm at the track. I'm not a heart transplant patient there. I'm just another trainer doing my job.'"

Late this afternoon, Ritvo will saddle Mucho Macho Man for the Preakness, give him a hug and then go to the stands to be with her husband and daughter. All of them, of course, will be rooting for their horse. But Tim Ritvo said his family looks at life and racing a little differently these days.

"The prestige and honor of running in one of these Triple Crown races is there," he said. "But you realize you do your job really, really well, which Kathy does. You prepare the horse the best you can and put him in the gate. Win or lose, you can be happy with that. It's not life and death. What the doctors did, putting the heart in her chest, is life and death."

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