Napoli rejuvenated after dramatic surgery

MASHANTUCKET, Conn. -- "Have you ever had a bad night’s sleep?" Mike Napoli asked. "For eight years, I never had a good night’s sleep."

The Red Sox first baseman suffered from a condition known as obstructive sleep apnea, a disorder in which breathing repeatedly stops and starts while your throat muscles intermittently relax and block your airway during sleep. When the airway narrows or closes and constricts a person's breathing, it lowers the level of oxygen in the blood. The brain senses the impaired breathing and rouses the person in order to reopen the airway. Those awakenings can be so brief the person doesn’t remember them.

There were numerous nights, Napoli said, in which he woke 50 to 100 times, which left him so sleep-deprived he’d sometimes nap during batting practice just so he could play in that night’s game.

"I was always tired," he said. "There were games I came out of, people really didn’t know what happened, but it was because I was dizzy. I was sleep-deprived. I couldn’t focus or anything. It was tough."

So tough, Napoli said, that at the end of the past season he told Red Sox officials he was considering retirement, unless he underwent surgery to correct the condition.

"I was feeling, I’ve got to have surgery or I’m not going to play anymore. That’s how bad it was," he said. "I had a really bad episode one night. I would wake up, and I couldn’t breathe. I’d kind of freak out. You wouldn’t know where you were.

"I came in and I said, 'I need to see the doctor now.' I wanted the surgery yesterday."

The procedure, known as maxillomandibular advancement surgery, is typically a last resort for those afflicted with obstructive sleep apnea because of what it entails: a face-altering, three-to-four hour operation in which both the upper jaw (maxilla) and lower jaw (mandible) are moved forward, so the entire airway can be enlarged.

In November, two weeks after undergoing surgery on a toe that had troubled him most of the season, Napoli went to Massachusetts General Hospital, where the jaw surgery was performed by Dr. Leonard Kaban. Napoli had delayed the procedure a month because he needed three months from the time he stopped taking medication for avascular necrosis, a degenerative bone condition in his hips, after an MRI showed his hip was improving.

Nothing could have prepared him for what he underwent on Kaban’s operating table.

"It was a brutal process," he said. "It was probably one of the worst things I’ve ever done, to tell you the truth. They broke my upper and lower jaw and moved it forward. I spent two days in ICU [intensive care unit], and afterwards, there were 10 days of pain where I was just sitting there, I couldn’t do anything. I walked around a little bit.

"I still have some complications. I don’t have any feeling in my lips, just because they stretched out my jaw so far, all the nerves take time to get back. It’s like when you go to the dentist [and get novocaine]. You know when it gets tingly, [the feeling] is starting to come back? My upper lip is like that, but [not in] my lower lip, the front of my teeth. I can’t really feel the roof of my mouth. It could be a year, or it might not ever come back."

A harrowing story, to be sure, but one from which dreams are made of.

"I’m dreaming now," Napoli said. "The past eight years, I haven’t had a dream because I never went into REM [Rapid Eye Movement sleep, when most dreams occur), so it was always a battle playing in the game, trying to get through a game. Our game is a grind. You’re going every day.

"I know it’s going to be better for me. I wake up at 6 in the morning and start my day. I don’t remember the last time I’ve done that. I sleep eight hours."

Even the lip numbness has had an unexpected benefit: Napoli has given up dipping tobacco.

"Yeah, it’s awesome," he said. "I'm happy about that."

Napoli, who remained in Boston the entire offseason instead of returning to his Florida home, said he was given the go-ahead to begin working out about two-and-a-half weeks ago. Although unable to do his normal offseason workout routine, he insisted, "I haven’t really lost too much strength." Building up endurance is now the priority, and he expects to be ready for the start of the season.

"I started hitting. I’m throwing. I’m lifting weights. I’m running," he said. "I couldn’t clench my teeth for a certain amount of time, so I couldn’t do strenuous stuff, but I got the full go from the doctor.

"I don’t feel like I’m that far behind. I'm going down to [spring training] on the third [of February]. All the trainers are going to be down there. I'll hit outside, do all my stuff there. Everything is looking good."

There is a definite narrowing in the shape of Napoli’s face -- in part, perhaps, because of his weight loss and not just the surgery. On Saturday, his beard was neatly trimmed, and he was sporting a new tattoo on his arm. ("I’m not done yet," he said of the new ink).

Eating can be a challenge ("You don’t want to watch me chew"), but he is no longer spilling water the way he did in the first weeks after the surgery. The heavy snoring is gone, and an energy he hasn't had in years has returned.

"It’s been a good offseason," he said. "It’s been a tough offseason, but I think it was worth it."