On Facebook he describes himself as a "wounded warrior … very wounded." Schofield Barracks soldier Brendan Marrocco, the first service member to survive losing all four limbs in the Iraq War, received a double arm transplant Dec. 18, doctors revealed Monday.
Those new arms "already move a little," he tweeted a month after the operation.
Marrocco, a 26-year-old New Yorker with the 2nd Battalion, 27th Infantry "Wolfhounds," was injured by a roadside bomb in 2009. The transplant was done at Johns Hopkins Hospital in Baltimore, his father said Monday.
Alex Marrocco said his son does not want to talk with reporters until a news conference today at the hospital, but the younger Marrocco has repeatedly mentioned the transplant on Twitter and posted photos.
"Ohh yeah today has been one month since my surgery and they already move a little," Sgt. Brendan Marrocco tweeted Jan. 18.
Responding to a tweet from NASCAR driver Brad Keselowski, he wrote: "dude I can’t tell you how exciting this is for me. I feel like I finally get to start over."
The infantryman also received bone marrow from the same dead donor who supplied his new arms. That novel approach is aimed at helping his body accept the new limbs with minimal medication to prevent rejection.
The Hawaii soldier’s odyssey through the loss of four limbs and recovery of two began early on Easter Sunday, April 12, 2009, when he and other Schofield soldiers were returning to Forward Operating Base Summerall, 130 miles north of Baghdad.
An explosive projectile slammed through Marrocco’s big mine-resistant, ambush-protected vehicle, known as an MRAP.
The projectile pierced the driver’s-side door where Marrocco, then a private, was sitting.
His injuries included the loss of his arms and legs, a severed left carotid artery, a broken nose and left eye socket, the loss of eight teeth, severe lacerations and burns on his face and neck.
Another Schofield soldier, Spc. Michael J. Anaya, 23, was killed.
Maj. Jayson Aydelotte, the trauma surgeon who treated Marrocco at Camp Speicher, recalled in a 2010 New York TImes story that Marrocco wasn’t bleeding from the carotid injury because he had precious little blood left.
"Any one of his injuries was life-threatening," Aydelotte told the Times. "It’s incredible."
And yet, seven months later, on Nov. 19, 2009, the irrepressible soldier was in a blue wheelchair at Schofield, front and center for the redeployment ceremony of the 3rd "Bronco" Brigade after it returned from a year in northern Iraq.
The military sponsors operations like the ones received by Marrocco to improve quality of life. About 300 have lost arms or hands in Iraq or Afghanistan.
"He was the first quad amputee to survive," and there have been four others since, Alex Marrocco said.
The Marroccos want to thank the donor’s family for "making a selfless decision … making a difference in Brendan’s life," the father said.
The soldier has made many public appearances. During a July 4 visit last year to the Sept. 11 Memorial with other disabled soldiers, he said he had no regrets about his military service.
"I wouldn’t change it in any way," he said. "I feel great. I’m still the same person."
The 13-hour operation was led by Dr. W.P. Andrew Lee, plastic surgery chief at Johns Hopkins. Marrocco’s was the seventh double hand or double arm transplant conducted in the United States.
Lee led three of those earlier operations when he worked at the University of Pittsburgh, including the only above-elbow transplant that had been done at the time, in 2010.
Marrocco’s "was the most complicated one" so far, Lee said in an interview Monday. It will take more than a year to know how fully Marrocco will be able to use the new arms.
"The maximum speed is an inch a month for nerve regeneration," he explained. "We’re easily looking at a couple years" until the full extent of recovery is known.
While at Pittsburgh, Lee pioneered the immune-suppression approach used for Marrocco. The surgeon led hand transplant operations on five patients, giving them marrow from their donors in addition to the new limbs. All five recipients have done well, and four have been able to take just one anti-rejection drug instead of combination treatments most transplant patients receive.
Minimizing anti-rejection drugs is important because they have side effects and raise the risk of cancer over the long term. Those risks have limited the willingness of surgeons and patients to do more hand, arm and even face transplants.
Lee has received funding for his work from AFIRM, the Armed Forces Institute of Regenerative Medicine, a cooperative research network of top hospitals and universities around the country which the government formed about five years ago. With government money, he and several other plastic surgeons around the country are preparing to do more face transplants.
Marrocco expects to spend three to four months at Hopkins, then return to a military hospital to continue physical therapy, his father said. Before the operation, he had been fitted with prosthetic legs and had learned to walk on his own.
He had been living with his older brother in a specially equipped home on New York’s Staten Island that had been built with the help of several charities. Shortly after moving in, he said it was "a relief to not have to rely on other people so much."
The home was heavily damaged by superstorm Sandy last fall.
Despite being in a lot of pain for some time after the operation, Marrocco showed a sense of humor, his father said. He had a hoarse voice from the tube that was in his throat during the long surgery and decided he sounded like Al Pacino. He soon started doing movie lines.
"He was making the nurses laugh," Alex Marrocco said.
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The Associated Press and Star-Advertiser reporter William Cole contributed to this report.
