Mientkiewicz's wife, Jodi, underwent emergency heart surgery to implant a pacemaker earlier this week. He stayed in Pittsburgh to be with her and was placed on the bereavement list on Monday while the team flew to St. Louis.
The Pirates reinstated Mientkiewicz from the bereavement list and optioned outfielder Steve Pearce to Triple-A Indianapolis prior to Friday night's game against the Brewers.
Jodi's situation is still very serious, and doctors won't know if the viral infection has gone away for six weeks.
Mientkiewicz will communicate with his wife through text messages before the team returns home for a series with the Cubs that begins on Monday.
"She's still in a lot of pain, I'm not saying she's fine," Mientkiewicz said. "She's a warrior. She's a trooper."
Jodi, 35, first noticed a problem while in Montana, but attributed her chest pains and shortness of breath to the high altitudes there. When she returned to Pittsburgh, she still didn't feel right, prompting a visit with a cardiologist last Friday.
"The next thing I know, I get a phone call saying you're going to have to come in here," Mientkiewicz said.
They found a viral infection in a dangerous part of her heart. Jodi's resting heart rate had fallen to 32 beats per minute. A normal resting heart rate is between 60 to 100 beats per minute.
"The only thing they told her before I got there was, 'You'll see your son graduate high school,'" Mientkiewicz said, referring to their son, Steel, who turns 3 in October. "That really floored her."
She had surgery less than 72 hours later to correct a problem she's apparently had her whole life. As a high school gymnast and track athlete, she dealt with fatigue and even blackouts. The condition can't be treated with antibiotics, and doctors won't know if the virus has gone away for six weeks.
"They haven't had too many cases of this," Mientkiewicz said. "It's been kind of tough to figure out what it is."
Mientkiewicz bought her a La-Z-Boy recliner on Thursday to ease the pain. He didn't want to leave her side, but Jodi "kicked me out of the house," Mientkiewicz said. She even made the plane reservations. She said that him leaving will bring normalcy back to their lives, but it still doesn't feel right.
"With all the surgeries I've had and all the times she's been by my side, I feel kind of weird that I'm not next to her," Mientkiewicz said.
That proactive attitude doesn't surprise those who know Jodi well.
"That's what I told people, I said, 'She's going to be the one that makes him come here, not him,'" Pirates manager John Russell said. "She's doing better. It's good to have him back. It's a trying time. It affected us a lot. I know everyone out there, myself included, are happy to see him back."
The Mientkiewicz home resembles a floral shop. From the Pirates and the city of Pittsburgh to people he hasn't heard from in 10 years to strangers on the street, he's very thankful for the good wishes.
"I've been a wreck," Mientkiewicz said. "Everybody in here has done something to help get me through this. It hasn't gone unnoticed. I can't say enough about Pirates fans and the city of Pittsburgh. It means a lot."
Closer Matt Capps, due to come off the disabled list on Saturday, shared Friday's flight with Mientkiewicz.
"I walked into the airport, and right there at the ticket desk, he was standing there with a big smile on his face," Capps said. "He seems in good spirits, the same old Dougie. If you didn't know anything had happened, you wouldn't have known by the way he was acting. It was very encouraging to see."
Nick Zaccardi is an associate reporter for MLB.com. This story was not subject to the approval of Major League Baseball or its clubs.