Ralph Luciani hadn't stood on two prosthetic legs in 13 years. Then, heart surgery.
By MELIA BOWIE
Published June 15, 2003
[Times photos: Janel Schroeder-Norton]
Ralph Luciani savors hugs from his grandchildren Kyle, 6, and Nicole, 9, after his open heart surgery.
Pauline Luciani, 60, fights back tears as she watches her husband in the ICU after his open heart surgery.
Debbie Lanphear watches her father take some of his first steps on two legs in 13 years.
Dr. Raghavendra Vijayanagar, 63, performs the surgery that will give Ralph a new heart valve.
HUDSON - The surgery took more than four hours.
Now, Ralph Luciani lay in intensive care, hooked to tubes and monitors.
His face was slack. White hospital sheets clung to his upper body - but showed nothing below his thigh. At his bedside, Pauline Luciani looked on with teary eyes and willed her husband to wake up.
Slowly, he did.
Tired and weak, Ralph glanced at his family. Then down at his body. He cried out:
"My legs! My legs!"
The nurse gasped.
Pauline giggled.
Ralph lost his legs in the 1950s, when he was a little boy. For the next 48 years, he got by just fine with a wheelchair or a crutch and an artificial leg. He found a good job, wooed and won a beautiful woman, had kids, coached Little League.
During those years he not only lived with his disability, he laughed at it.
He was still laughing last month after waking from surgery. Only this operation had nothing to do with his legs.
It was his heart that was broken.
And for it to heal, Ralph would need to walk again. No wheelchair this time. No crutch.
His symptoms began in late April, the day after Pauline made stuffed peppers for dinner.
Ralph thought it was indigestion, or maybe sore muscles.
Then the 59-year-old started getting pains in his shoulder and back. Under his rib cage. He slept with heating pads but they didn't help.
Three weeks later, the Lucianis found themselves in front of Dr. Raghavendra Vijayanagar, 63, one of the state's most prominent heart surgeons and chairman of the Florida Board of Medicine.
His patient's first impression?
"I could probably pick him up he's so little," mused Ralph, who weighs 200 pounds.
Ralph was born in Ridgewood, Queens, N.Y., in 1943.
His legs "were twisted, bones missing, the ankle joint was out of place," he said. "My knee joint was up around my thigh on the (right) side."
When he was 9, the doctors wanted to amputate. His family agreed.
The first leg came off below the knee. A hip replacement followed. Two years later, his right leg was amputated above the knee.
"It was for the best," Ralph said.
His mother, Rose, died of congestive heart failure in 1952, leaving Ralph with an unsolved mystery: What had caused his deformity?
When he was 11 years old, Ralph got his first pair of artificial legs.
"I had them back when they were trunks - you know, made out of trees," he said.
"For three or four months they taught me how to walk, how to go up and down stairs, how to fall.
"I used to break legs all the time; playing with them, running with them. There was no holding me back," he grinned.
His family never tried.
"They don't treat me any different, and that I've got to be grateful for," he said. "That probably helped me. A lot of the time you don't think there's anything wrong with you until people tell you there is."
Ralph doesn't need pity.
"I feel bad for those guys who go into the service and they have their legs for 18, 20 years and then they lose them," he said.
It was never like that for him.
"They weren't functional. I couldn't run or do things like that, so I didn't miss them."
Ralph's heart had developed a leaky valve. It was stressing his heart, causing it to enlarge. Endangering his life.
"The heart can only sustain so much," said Dr. Vijayanagar, who goes by Dr. Vijay.
Pumping capacity was at 45 percent. Vijay proposed a new mechanical valve.
Pauline was worried. Things were moving so fast.
Putting it off would not make it go away, Ralph reasoned. "It's not going to get better."
Vijay would operate in two days.
Ralph and Pauline met at a club for disabled children in Manhattan in 1957. He was 14. She was 15. He relied mostly on one artificial leg and crutches then; wearing both legs hurt his back.
She used a prosthetic forearm to replace the limb she'd lost at birth.
Pauline thought he looked just like a movie star with his thick, dark hair and easy smile.
"He looked," she said, "like Elvis Presley."
Ralph still cringes when he hears the description. "Elvis!" he snorted.
"She was quick to laugh." remembered Ralph. "Maybe it was her shyness. There was just something."
They began dating. They went to Yankee Stadium, watched stock car races. They went to Pauline's, sat on the couch and followed her mother's rules: No holding hands. No kissing.
One day Ralph came over with a tattoo on his right arm in swirling green script: Ralph & Pauline.
"It was too expensive to take it off," he cracked. "That's why I had to marry her."
He went to her mother's apartment, sat on the "no kissing" couch and asked for her mother's permission.
They married on May 2, 1964, and moved to the Bronx. Ralph worked as an inspector for Litton Industries, a defense company that made guided missile systems. Pauline was an accountant. They had two kids, Debbie, now 34, and Ralph III, now 30.
In 1978, the family left New York.
"The cold weather ...," said Ralph. "I had a back problem. Lots of double amputees do because you're supporting all your weight with your back."
Pauline swallowed a chuckle.
"I remember this one time you were walking on the crutches in the snow and you slipped. You almost fell down the sewer!"
Pauline's chuckle gave way to a belly laugh. Ralph rolled his eyes.
They moved to Port Richey.
At first it was so quiet, Ralph couldn't sleep. The kids cured him of that. There were sleepovers and recitals. For 13 years Ralph coached Little League in Hudson.
Debbie and Ralph grew up but didn't go far. Ralph and his wife live in Tampa. Debbie and her husband bought the house next door to her parents. Her two kids visit Ralph and Pauline almost every day. Now there are more sleepovers and after-school visits.
"Our home is not a showplace," said Pauline, excusing the wheelchair tracks on the bedroom carpet and the black cocker spaniel mix rampaging through the rooms.
Ralph had artificial legs, but he didn't like to wear them. Together, they weighed close to 16 pounds.
He could not walk straight in them. They hurt his back.
He preferred to get around on one prosthesis and crutches. In fact, the last time he had worn the legs together was 13 years earlier when Debbie got married.
"I promised her I'd walk her down the aisle," he said.
Inside the Lucianis' living room is a framed photograph of the ceremony: Debbie in her white gown, beaming as she navigates the aisle. A cane in one hand and pride in his eyes, Ralph towers beside her.
He is six feet tall.
On a family vacation to Disney World, Ralph decided to use a wheelchair to get around.
They left the artificial leg in the hotel room.
"I didn't want the maid to get scared," Pauline said. So she put it in the closet.
And forgot it.
No one missed it until they reached Tampa. Pauline called the hotel.
"She couldn't get anybody to believe her," he laughed. "You know what day it was?"
April 1.
Six a.m approached. So did a nurse. It was time to say goodbye.
Ralph struggled to stay awake.
He was at Regional Medical Center Bayonet Point. His family was there. Pauline was breaking down. There in the hallway with Debbie watching.
They began wheeling him away but Pauline was not ready to let go.
"I love you. I love you. I love you!" she cried.
Inside the operating room, Dr. Vijay and one of his partners, Dr. Ira Siegman, worked on Ralph.
Siegman sliced through skin. Then came the buzz of an electric hand saw. With a metal retractor, Siegman cranked open the rib cage 4 inches, exposing Ralph's heart.
"We're going to stop the heart completely, drain it of all the blood," Siegman explained.
On the table, Ralph's heart deflated like a balloon, blood and air seeping out. Its rapid beating slowed, stuttered, stopped.
Dr. Vijay nimbly sewed in the new valve. For 63 minutes, a machine kept Ralph alive.
There was a problem.
The surgery was a success, but Ralph could not lift more than five pounds without damaging his sternum, which had just been wired back together.
Before, his arms supported all 200 pounds. Now he had no way to move his body.
He could not maneuver from the bed to the bathroom. The doctors insisted he exercise his heart. Arm movement was out. That left just one option.
Ralph would have to walk. He set a goal of Father's Day.
The Lucianis picked a nursing home 6 miles from home, and for the next three weeks Ralph did physical therapy, strengthening his stumps.
Near the end of his rehabilitation, Ralph made a promise to Pauline:
"I'm going to take you dancing."
On Tuesday, he was fitted for new legs. On Friday, Debbie and Pauline drove him to Tampa to try them on.
They were ushered into a narrow room furnished with a pair of parallel bars.
Ralph took his new legs for a spin. Holding the bars for support he stood, then let go, swaying for a moment before finding his balance.
"How do I look?" he asked, taking a few steps. "How's my gait?"
"You look real good," answered Pauline, grinning.
Growing bolder, Ralph slowly paced back and forth on the legs: "There's a spring to my step!"
With each tweak and adjustment by prosthetist Greg Bauer, he stood a little taller. His confidence growing, Ralph loosened his grip on the bars. He walked backward, mimicking a truck in reverse:
"Beep, beep, beep."
He turned in a circle, shimmied his hips from side to side - smiling as Pauline held her breath.
"Ralph! Ralph!" she called, motioning for him to take it easy.
"Look, I'm downhill skiing," he teased.
He would still have to get used to the legs. Maybe another week of therapy to improve his walk. But Ralph would keep his promise. He would take Pauline dancing. He had one condition:
