Derek Fitzgerald: Cancer, Heart Transplant, IRONMAN

Looking at Derek Fitzgerald, you’d say he is the picture of health. In 2012, he competed in 17 endurance races, including marathons, half-marathons and triathlons, followed by an IRONMAN in 2013. But turn the clock back 10 years and the forty-year-old heart transplant recipient was in a race to save his life.

In 2003, Fitzgerald was your typical 30-year-old, focused more on his career than his health. His perspective quickly changed when doctors found a large, grapefruit-sized tumor in his stomach and, after removing it surgically, diagnosed him with non-Hodgkin’s lymphoma. Fitzgerald immediately underwent several rounds of chemotherapy. The treatment destroyed the cancer and Derek was given a second chance at life.  However, the treatment had also destroyed his heart.

In his many trips to the ER for shortness of breath and suspected pneumonia, Fitzgerald learned that he had dilated cardiomyopathy and heart failure.  His ejection fraction—the levels at which the heart pumps oxygenated blood through your body—was at 18 percent. The ejection fraction for the average healthy person is between 55 and 70 percent, according to the American Heart Association.

Fitzgerald lived six years like this under the specter of heart failure, with a persistent cough as a constant reminder of his heart condition. “I would have bouts of feeling like I was in the 12th round of a heavy-weight fight, and my arms would go limp at my sides, and I would get dizzy and light-headed and have to sit down,” he remembers. “I knew it was my heart, but I didn’t know what was really going on.”  Gradually Fitzgerald’s health worsened, and in August 2010, his cardiologist had him placed on a waiting list for a donor heart.

Selecting the right hospital weighed heavily on Fitzgerald. His cardiologist had a relationship with a local hospital, but not one to settle, Fitzgerald knew he wanted the best—so he did his research and chose Penn. “If you look at the statistics, Penn has the best program in the area,” he says. “But probably what really sealed the deal for me was the heart. Walking in and meeting Dr. Jessup and her team and seeing the facility, I felt comfortable there. I trusted that the best care they would give me would be my best chance at saving my life.”

After completing the compatibility process for the heart transplant, Dr. Jessup met with Fitzgerald and explained that the healthy organs surrounding his damaged heart were compensating well now, but that would soon change. He recalls her explaining that when that happened it would be like falling off a cliff.  “But don’t worry,” she added. “When that happens, we’ll be there to catch you.”

Fitzgerald was approaching that cliff near the end of 2010. He got very sick at Thanksgiving and was diagnosed with pneumonia in mid-December.  During a follow up visit to his cardiologist at the end of December, Derek collapsed in the exam room. Unable to get a blood pressure in either arm, his cardiologist rushed him to Penn.

Fitzgerald spent the 2010 holiday season in the hospital. His ejection fraction had dropped to 8 percent and continued falling. He was in and out of it, plagued by dizzy spells and exhaustion, and had to sit propped up with pillows so fluid didn’t fill his lungs. “I was in bad shape,” he describes matter-of-factly. Hope came on January 3rd, when Fitzgerald learned he was going to receive a new heart. His team jumped into motion immediately, and by nightfall, he was being wheeled into the O.R. for his now third chance at life.

Fitzgerald woke up surrounded by his joyous family. “The first thing I felt, the first thing that I recognized was my heartbeat,” he says. “I had been sick for so long that I had forgotten that sometimes you feel your heart pulsing through your body.”

But amid the celebration, Fitzgerald also knew that some other family was suffering from a tragic loss. He decided to put all of his energy and efforts into getting better. “I knew that I didn’t want to waste this incredible experience,” he says. Amazingly, Fitzgerald was out of the hospital within seven days, ready to work on getting his body back in shape. Penn armed him with nurses, nutritionists and physical therapists to help him with his cardiac rehabilitation. He worked with a PT on the treadmill, moving from a shuffle to a slow walk to a brisk walk to a jog. Fitzgerald kept pushing himself, until he was actually running. “At that moment, all of these memories of what it felt like to feel healthy came flooding back into my mind,” he says. “I knew that all I wanted to do was get strong enough to feel more of that.”

Fitzgerald soon set up a home gym, and eight months post-transplant, completed his first 5K. Ten months post-transplant, he ran a half-marathon with the Leukemia and Lymphoma Society’s Team in Training.  In 2012, he added a triathlon to his achievements, along with several more half-marathons, a full marathon and a half IRONMAN. Derek completed his first IRONMAN—a 2.4-mile swim, 112-mile bike ride and 26.2-mile run in 17 hours or less—this year. “At the end, you cross the finish line, and they give you a medal and they say YOU are an IRONMAN,” he describes. “It was an incredible experience.”

Fitzgerald credits his team at Penn—the doctors, the nurses, the nutritionists, and physical therapists— a team that never settled until he had been given his best chance at life and enabled him to accomplish these impressive athletic feats. “They brought me back from the brink of death,” he says. He also thanks his donor, who remains anonymous, to this day. “I wake up in the morning, I take a deep breath, and I realize that I would not be here without this person,” he says. “I have no idea who they are, but I know that this person and their family chose to save the life of someone else on the worst day of their life. And that says a lot.” Derek Fitzgerald is now training for his second IRONMAN endurance event in November in Arizona, recently celebrated 13 years of marriage and is eagerly anticipating the birth of his first child – each day a celebration of his life and promise to “live each day like my donor is watching.”

Watch a video to hear Derek tell his amazing story.