After heart surgery, Lotti returns to the circle

HEMPSTEAD, N.Y. -- Softball has no clock, no way to measure exactly how much time remains.

Once the first pitch smacks into the catcher's mitt, the game stops only at the whim and will of those involved. And on a brilliantly sunny spring day, with winter's brooding silence receding and lengthy lazy afternoons stretching from here to Labor Day, it's easy to feel exempt from time's onward march, as if a game might really carry on forever.

Kayleigh Lotti knows that feeling, knows how the rest of the world seems to fade away when time is tracked by counting forward in potentially infinite innings instead of backward in minutes and hours. And freed from the constraints of a clock that ticks ever closer to zero, she knows what it's like to control her own destiny. As a pitcher in a sport dominated by those who work in the circle, she is among a group that controls the course of events as much as any position in any team sport.

But more than most people, and certainly more than most 18-year-old college freshmen, Lotti knows all too well that it's just an illusion. That no matter how much raw promise or polished success any of us display, time never truly bends to our will.

Lotti is the ace for a Hofstra softball team looking to extend a tradition of success by earning the program's seventh NCAA Tournament berth in the last eight seasons. But if not for a sore shoulder that eventually led to the discovery of an undiagnosed heart condition requiring open-heart surgery before her senior year of high school, Lotti's time might have ended on the same softball field that now promises such a bright future.

With the shock of Army women's basketball coach Maggie Dixon's tragic death still fresh in many minds, Lotti offers a glimpse of at least one young life that might have been spared because of sports, one story that didn't end too soon.

A pitching sensation at St. Raphael Academy in Pawtucket, R.I., Lotti was a two-time Gatorade Rhode Island High School Player of the Year, allowing just one earned run in her final two seasons. As a top prospect, she found herself pitching in front of big-time college coaches at a national summer tournament in Colorado between her junior and senior seasons.

Only something didn't feel right in her shoulder.

"I was pitching in Colorado, and I was having arm pains," Lotti recalls. "I couldn't really pitch anymore, so we went to a walk-in clinic, and they took X-rays of my arm. And I guess when they took the X-rays, they showed my ribs, and that's how they picked up on it first."

What the X-rays revealed were notches in her ribs that, in conjunction with unusually high blood pressure, hinted at something far worse than anyone originally suspected.

"The doctor thought she had some kind of tendinitis and sent us home," Sharyn Lotti, Kayleigh's mother, says of that initial visit. "He was very concerned about her blood pressure and told us to check it out when we got home [to South Attleboro, Mass.]. He called us back later that night and said they read the X-rays and had found some notches on her ribs, which was an indication of the heart condition that she does have.

"He said, 'You really need to get to a cardiologist when you get home' -- of course, we were away for another four or five days -- and for her to stop playing softball."

After returning home to New England for more tests, doctors diagnosed the specific problem as coarctation (a narrowing) of the aorta, a defect most often detected early in childhood.

The body's largest artery, the aorta carries blood away from the heart on the first leg of a journey to numerous smaller arteries. In aortic coarctation, there is a narrowing of the aorta between the branches to arteries heading to the upper body and the branches heading to the lower body (like a traffic jam between the northbound and southbound exits on a highway interchange).

As a result, the lower body doesn't receive enough blood and calls for more from the heart. This extra pumping strains the heart and increases blood pressure in the upper body, where blood flow hasn't been affected by the narrowing farther along in the aorta. Notches on the ribs, like the ones that caught the eye of the doctor in Colorado, sometimes result from the force of the blood when it finally squeezes through the narrowed section of the aorta.

"It was complete shock," Kayleigh's mother says of the news -- what the family had thought was a sore arm was instead a potentially life-threatening heart condition. "She had no pulse in her leg, no pulse at all. [The doctors] said she would have probably died on the softball field had they not found it. You don't usually live past 21 or 22 with this condition if it isn't fixed."

Nobody will ever know whether Kayleigh's condition would have been caught in time to avoid such a tragic conclusion if not for the trip to the clinic in Colorado. One opportunity already had slipped away when doctors failed to catch the problem when they noticed her high blood pressure after an accident earlier in her youth.

"She broke her leg, and it was a very bad break," Sharyn says. "Her blood pressure was elevated, and they kept us there about three days because of that, but they felt it was more from the trauma of the whole thing, that she was very nervous from the whole thing. She actually went on medication for about a week, and we were back and forth to the doctor. And it went back down to a normal range, so we were all done with that. I now know that I probably should have asked for more tests."

Second chance in hand, surgery was scheduled for early September 2004 in Boston. Perhaps the only one who wasn't overly concerned was Kayleigh, who was shielded from the seriousness of the situation by her parents.

"They didn't tell me at first that I was going to have heart surgery," she recalls. "When I was in Colorado, they didn't tell me anything about heart problems. They just said I couldn't run around a lot. I didn't really know, I wasn't really paying attention. And then when we got back, they were like, 'We have to take you to the heart doctor.'

"But the whole time, even up until surgery, I wasn't really nervous because it was just something I had to get done. I just didn't think it was going to be a big deal. The only time I got nervous was right before going in for surgery. They had a nun come over and you have to say a prayer and stuff, and I was like, 'Oh my God,' and my dad made me cry. So everyone started worrying like 20 minutes before I was going in, so that was the only time I was nervous."

The seven-hour surgery was a success. Doctors were even able to perform the procedure in such a way as to help her eventual return to the sport by protecting the range of motion on her right (throwing) side.

"It was right before my senior year, and I hadn't committed to a school yet," Lotti says. "My biggest fear was no college was going to want me if I had to have a major heart surgery."

But Hofstra never backed off recruiting Lotti, offering constant support and assurances that they still wanted her as part of the softball family.

"We have a philosophy here, and we stay to our philosophy," says Hofstra coach Bill Edwards, who was in Colorado to watch Lotti pitch that summer. "We have the best interests of our student-athletes in mind all the time, whether they've committed here, are in the process of being recruited or have played here for four years.

"Our philosophy with Kayleigh was one of total support, not only from the university but from us individually. And we just needed to make sure she was OK. It was all about her and her family. Families need support, and they need to know they have our support -- and all of those things we sometimes lose in a process that is recruiting more than personal situations."

Cleared by her cardiologist and having passed a physical (her blood pressure is monitored on a regular basis to guard against a return problem, a potential development known as recoarctation), Lotti was once again free to play softball. And she wasted little time in showing a flair for the dramatic, throwing a no-hitter against Temple on Feb. 18 at a tournament in Florida in her first college start.

The rest of the season has been the kind of up-and-down journey common to freshmen, with Lotti earning a 14-6 record with a 2.29 ERA entering this weekend's games against Delaware (she also missed a few starts with a shoulder injury).

"Here she is pitching against Michigan, when a year before she was pitching against some high school where she could throw it over the plate and strike out 21 hitters in a row -- which she's done -- and not worry about anything but throwing it hard," Edwards says, referring to a 5-3 loss in late February in which Lotti allowed six hits and four earned runs in six innings. "Now all of a sudden, she has to be perfect and precise against the defending national champion."

But giving up an RBI double to Michigan's Becky Marx or dropping a conference game against Drexel aren't the end of the world for someone who has seen much worse.

"You go in and you feel bad for yourself, you know, you're like, 'Why does this have to happen to me. I've worked out my whole life, I've tried hard.'" Lotti says. "But then, when they walk you around the hospital, and you see all these younger children going through things 10 times worse than what you have, like cancer, you just can't feel bad for yourself anymore. These children are going through that, and you feel bad for them.

"That was the worst experience, seeing those little kids."

Standing outside the stadium under the warm spring sun, as teammates and parents fire up hot dogs in a postgame barbecue to celebrate a win on Senior Day, Lotti's memories of those children offer a moment of reflection for a young woman now wise enough beyond her years to enjoy the opportunity to act her age and just be a college freshman.

"It's amazing," her mother says of seeing the daughter she watched over in a hospital bed, still unconscious after open-heart surgery, now back on the softball field. "And I think the thing I realize is you feel bad for yourself and your family going through this, but there were so many kids so much worse off than Kayleigh. And she was so lucky to have this chance.

"I will worry forever. I watch her out there, and I think of everything. But I'm just very happy that we are able to watch her."

Graham Hays is a regular contributor to ESPN.com's softball coverage. E-mail him at Graham.Hays@espn3.com.