CLEVELAND -- It has been 20 days since Terry Francona underwent a procedure called a cardiac ablation geared to eliminate an accelerating heartbeat. The man who is nicknamed Tito after his ballplaying father, looks good and says he feels good.
But the 58-year-old Indians manager told MLB.com over the weekend at Progressive Field -- where his club swept the Blue Jays -- that he's still feeling the effects of what turned out to be a nine-hour procedure.
Francona is taking a medication known as a beta blocker, which slows the heart rate and lowers blood pressure. That medication, though, also causes fatigue.
"The beta blockers really make you groggy," Francona said. "But I get it. Hopefully, nothing happens in the next few weeks and they'll let me come off the beta blockers, 'cause, man, I'm tired. And everybody who has this procedure says the same thing."
Prior to the All-Star Game, Francona endured a number of periods of lightheatedness that were, at times, debilitating. He wore a heart monitor to the ballpark, but the condition wasn't revealed until he was placed in the Cleveland Clinic and had what Francona called "an event," during which his heart sped up uncontrollably.
Until then, doctors weren't sure what the problem was. They then prescribed the procedure in which a catheter is run through a blood vessel to the heart, electrically shocking it back into regular rhythm. That at least gave Francona some clarity. Giants manager Bruce Bochy also underwent the same procedure this past April.
"It became more black and white, which helped me a lot," Francona said. "It's amazing how many people have had it. It sounds like Boch and I had something very similar."
The two veteran managers talked about their shared experience when the Indians were in San Francisco last week to face the Giants.
"I was teasing him," Francona said. "I said, 'Man, we're the pictures of health. How could that happen to us?'"
Bochy, 62, has had three heart episodes in two years, including two stents inserted to open clogged arteries and a cardioversion to halt an irregular heartbeat. The ablation was the latest.
Francona hasn't had any other heart problems, but he's undergone dozens of surgeries, in the end artificially replacing both hips and one knee. It was after one of those surgeries in 2002 that Francona had a dangerous staph infection and blood clots in both lungs. The clots, called pulmonary embolisms, can be life threatening.
"That was a fiasco," Francona said.
At the time, doctors placed a filter in Francona's inferior vena cava -- a large vein that carries deoxygenated blood from the lower body to the heart. The goal was to block blood clots from traveling to his lungs. He's used blood thinners ever since, and he will have to for the rest of his life.
That turned the July 6 ablation into a dangerously lengthy procedure.
"It was hard because I'm all clotted up from that thing that happened 15 years ago," Francona said. "They had to get a specialist who got through there without killing me. So it was a long procedure, nine hours."
Ordinarily, an ablation ranges from two to four hours.
"I know. Just the fact that you're under an anesthetic for that long kind of beats you up," Francona said. "I think I was in the hospital for three or four days. But I'm not sure. I lost track of one day because I was out the whole day."
Having taken his Indians to the final pitch of Game 7 last November before losing the World Series to the Cubs, Francona was slated to manage the American League in the All-Star Game for the third time, this time in Miami on July 11. He managed the AL in 2005 and '08 the years after winning the World Series with the Red Sox.
But Francona knew that wasn't to be. He left the hospital on July 8, missing Cleveland's final series before the break. Indians bench coach Brad Mills took over for him and led the AL to a 2-1 win on a 10th-inning homer by Robinson Cano.
"I just felt like to go was sending the wrong message. If I was missing work here, this is my priority here," Francona said. "And when they said Millsy could do the game, I was thrilled. I was glad because I took those days and tried to build up some strength. Then we went to the West Coast and that was a hard trip for me. I mean, I was beat. So I'm glad I waited a few days."
Even now, Francona knows he isn't over the hump. Ablations are tricky procedures and sometimes must be repeated to get the desired effect -- to keep the heart from rolling out of control without notice.
"It's been a couple of weeks," Francona said. "I think they want to go like six to eight weeks to make sure, but so far, so good."
In the meantime, Francona will just keep managing, which is what he wants. There's another AL Central title and pennant to be won. And like the Royals, who lost to the Giants on the final pitch of Game 7 of the 2014 World Series, Tito knows there's still work to be done.
The Royals came back and beat the Mets in the 2015 World Series. Why not the Indians this year?
That's another part of the conversation Francona had with Bochy. Despite health concerns, both men want to continue managing.
"Boch and I talked about that, too. If I wasn't doing baseball, I don't know what I'd do. I would be a mess," Francona said, echoing Bochy. "As long as I'm healthy enough where I don't feel like I'm short-changing an organization, I don't want to do something else.
"I still feel competitive. I like trying to figure things out. I love baseball. But if there comes a time where I feel like I'm short-changing, then I would certainly step back and try to look at it a little bit."
Not now. Not yet.