Tatyana McFadden is widely considered the fastest female wheelchair racer of all time — but her road to success has been far from easy.

The 17-time Paralympic medalist has 23 World Major Marathon wins, has broken five track-and-field world records and is competing in her sixth Paralympic Games in Tokyo this week, representing the United States. Those accomplishments are particularly remarkable given her upbringing: The 32-year-old started with virtually nothing.

As a result, from a young age, she leaned into the one thing she could control: her attitude. “I’ve always had a determined mindset,” McFadden tells CNBC Make It.

Born in St. Petersburg, Russia, with spina bifida, a condition that left her paralyzed from the waist down, McFadden was turned over to a local orphanage by her parents. Doctors doubted she’d live more than a few days. Instead, she spent the first six years of her life in Russia’s “Orphanage No. 13” without a wheelchair or medical care.

At age 6, she was adopted by Debbie McFadden, the commissioner of disabilities for the U.S. Department of Health and Human Services. Living in Baltimore, McFadden took up sports to help strengthen her muscles, and fell in love with wheelchair racing. At age 15, she made her Paralympic debut at the 2004 Summer Paralympic Games in Athens, Greece — winning two medals, a silver and a bronze.

But the obstacles didn’t end there.

At 16, McFadden was barred from competing on her high school track team alongside non-wheelchair students. She sued the school, and won. At 27, after winning six medals at the 2016 Summer Paralympics in Rio de Janeiro, blood clots almost derailed her career. She attributes her recovery — and continued dedication to her sport — to the same resilience that pushed her to survive in that Russian orphanage.

Or, as McFadden says more simply: “I like challenges.”