Zack Wheeler’s outlook might be a mystery, but he says there’s no reason he can’t ‘be who I am’ in 2026

CLEARWATER, Fla. — It’s a long, scary-sounding procedure — venous thoracic outlet decompression surgery — so let’s just ask Zack Wheeler to explain what it entailed on that Tuesday in September at a St. Louis hospital.

OK, Zack, don’t spare any details.

“Basically all they do,” the Phillies ace said Tuesday, “is go in, chop the bone, get rid of that [rib] because that’s what’s causing it, get rid of the blood clot, and then open up the vein. My vein closed back, I think two different times, so they had to go back and open it. If it happened again, I think they were just going to do a stent. But so far, so good.

“And that’s really about it, honestly.”

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Oh, is that all?

Five months later, there’s a matter-of-factness with which Wheeler talks about all of this, from the onset of symptoms on the eve of an Aug. 15 start in Washington to the tension-filled days and weeks that followed.

Maybe it’s because the 35-year-old righty endured injury-related misery early in his major-league career. In the spring of 2015, he suffered a torn elbow ligament and had Tommy John surgery. Setbacks in his recovery led to a second procedure and caused him to miss two seasons.

Compared to that, Wheeler says this is “not that bad.”

“Knock on wood,” he added, tapping the side of his locker.

Wheeler remains in the long-toss phase of his comeback, playing catch from as far as 120 feet. He’s inching closer to throwing from the mound. The standard buildup will follow: bullpen sessions, facing hitters in live batting practice, more bullpen sessions, and a few starts in the minor leagues.

Although Wheeler won’t be ready in time for opening day, he and the Phillies believe he will pitch a lot of innings this season. But beneath the optimism is an underlying mystery raised the other day by none other than Bryce Harper.

“We have no idea what Wheels is going to look like,” Harper said. “We all hope that Wheels comes back and is Zack Wheeler because there’s nobody better in baseball when he’s going good. But we have no idea.”

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In classic Wheeler fashion, he insists he isn’t worried.

“I don’t think there’s any reason why I wouldn’t be who I am,” he said. “It’s not like a major surgery. I just got a rib taken out. It might sound like a crazy situation, or crazy surgery, or whatever, but mentally, I’m not really stressed about it. Physically, I’m not really stressed about it.”

Not since that Friday night in D.C., at least, when a late-night consultation by the Nationals team physicians after a five-inning start led to the next-day diagnosis of a blood clot near his right shoulder.

In detailing for the first time those few days in August, Wheeler said he felt “like a full feeling” as he went through arm exercises in the training room on Aug. 14. He chalked it up as “something wacky,” and went outside to play catch. The sensation didn’t subside.

When they work out, Phillies pitchers often wear a cuff that partially restricts blood flow to help the arm recover. As Wheeler put it, “your veins start popping up.”

“That’s literally what I felt like,” he said.

Only he wasn’t wearing the cuff.

Wheeler said he reported the issue to head athletic trainer Paul Buchheit, with whom he has developed a close relationship since both joined the Phillies in the 2019-20 offseason. He also told Buchheit about “a little bubble in my armpit” that looked like a lymph node.

Everything checked out in the training room. Wheeler said the “full feeling” went away, then returned the next day in the bullpen before his start, then went away again. He held the Nationals to two runs in five innings, threw 97 pitches, and topped out at 95.7 mph, a 1.5-mph gain over his previous start.

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But the bubble was still there.

“Paul was like, ‘Let’s just get it checked out,’” Wheeler said. “The D.C. doctors came over, and they’re like, ‘Uh, it’s not a lymph node. You need to go get that checked out tomorrow morning, first thing.’ And that was kind of what started the whole thing.”

Doctors diagnosed the blood clot. Wheeler went back to Philadelphia and underwent a venogram, a test to detect blood flow in his veins. The conclusion: The clot was caused by a vein that got compressed between Wheeler’s rib cage and collarbone.

If anything, Wheeler actually felt relieved.

“Even though like the whole blood clot thing was pretty serious, I didn’t even find it that scary,” he said. “Maybe I’m just naive to it. But I didn’t get a blood clot because of my health or anything like that. It’s just two bones were pinching together. That’s why it happened. So, that kind of eased the thoughts in my head.”

Wheeler underwent a thrombolysis on Aug. 18 at Thomas Jefferson University Hospital to remove the clot and open the vein. After taking blood thinners for five weeks, Wheeler had surgery Sept. 23 to remove the rib. The vein had closed again and a second clot was forming.

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It was “nothing out of the ordinary,” according to Wheeler, who said his St. Louis-based vascular surgeon, Robert W. Thompson, warned that the vein might not stay open until after they removed the rib.

“Just from hearing what they were saying, if it stayed open, hooray. But I don’t think they really expected it to,” Wheeler said. “The rib was still there. The clavicle is obviously still there.”

Before Wheeler left the hospital, doctors went in again to make sure the vein hadn’t closed again. It had not.

Then came the hard part: weeks of physical therapy and rehab, including a strict diet of what Wheeler described as “small amounts and healthy stuff,” not easy for an unabashed fast-food and junk-food lover. He’s unsure how much weight he lost but said it was “a good bit.”

“You can’t have fats or something like that,” said Wheeler, who rejoined the team Oct. 4 for pregame introductions before Game 1 of the division series against the Dodgers. “I lost a lot of weight doing that because I could barely eat, really.

“It was pretty painful that first week. It was rough. But since then it’s been pretty smooth sailing.”

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Wheeler spent most of the winter in Philadelphia, rehabbing under Buchheit’s supervision. There’s a history of pitchers returning from this particular form of thoracic outlet syndrome. Among the success stories: Merrill Kelly, at age 31, had surgery in September 2020, made it back by April 2021, and is still going.

So, while outsiders — and even some of his teammates — wonder if Wheeler will be Wheeler again after a procedure that he insists wasn’t as scary as it sounds, he puts in the work each day with his usual nonchalance.

“I mean, it might be a little thought, but at the same time, you can’t worry about that kind of stuff,” Wheeler said. “There’s no hesitation at all.”