My husband, Scott and I spent Valentine’s Day 2020 sitting in an OBGYN office learning about the status of my newly discovered fibroid tumors. Three to be exact. The largest the size of a grapefruit (9 cm). The local OB was here today to tell us that these three tumors were not the reason for our infertility struggles and that medications and a tubal x-ray were next on the list of exploration into our journey to start a family. Still digesting the idea that I had unknowingly been carrying around 3 very sizeable tumors for who-knows-how-long, the OB told us that they would only remove them with an open abdominal myomectomy; essentially a c- section but tumors instead of a baby. They informed us that they would rather not remove them at this point and that we should proceed as normal with them still in place. Removal was a last option. They also suggested other naturopathic options like acupuncture. Looking back, that last sentence brings a sliver of humor.
Less than a month later, on March 2 nd 2020, I was boarding an American Airlines flight. I was returning from a weekend hiking trip to Sedona with my two best friends. My friend (Kelsey) and me waved good- bye to our Seattle bound friend just as we heard the airport TVs booming about the first COVID-19 death in the US that had occurred while we were off-grid. With a cautious wave and a quick ‘safe travels’, we boarded our respective flights for what would be our last travel in that year. I remember the flight out, looking at Kelsey, and saying “I don’t think I knew how much I needed this.” The trip had done exactly what I needed it to. Reset my mind, body, and soul. It had also left me with an unfortunate, but ridiculous story about how I accidently sat on a cactus. Maybe a little natural acupuncture I suppose.
Less than 24 hours later, prior to scheduling to call for my tubal x-ray, I did what any woman of childbearing age does before an X-Ray who is TTC. I took a pregnancy test. Positive. A miracle. 2 years, 3 tumors, and one cactus later. My first appointment with the midwives group affiliated with my OB was on day 1 of ’14 Days to Slow the Spread’. For 6 weeks I started living in this alternate reality that every single person around me was also thrust into at the same time, except I was doing it while growing a human and three tumors. On top of that, I’m a medical professional, a Doctor of Physical Therapy that specializes in 1 on 1 manual therapy. In simpler terms: I touch people all day – and every medical source and news outlet is telling me to remain 6ft apart, mask up, and keep my hands to myself. At this point, my doctors did not even know what to tell me. I was given the standard advice. Wear your mask and wash your hands.
Over the course of my pregnancy, I experienced difficulty accessing care and meeting with specialists secondary to COVID-19. Scott watched the first ultrasound from his F-150 in a parking garage via facetime. Routine check-ups were done over the phone. During my first bout of really bad pain and my first scheduled appointment with a perinatolgoist (I had to request on my own, in order to assess the tumors), I was notified that my appointment would have be rescheduled due to the doctor being called in for an emergency, and that ‘due to COVID’ I would have to wait several more weeks.
As the days passed, and the COVID death toll grew, so did my tumors, so did the pain, and so did our daughter. The largest tumor had almost doubled in size; 16 cm…a honeydew melon. After meeting with 2 different perinatal specialists, I received 2 drastically different opinions on how to proceed. One advocated for frequent ultrasounds, and the other told me, and I quote, “You think you’re in pain now? Just wait. You should just be worried about what to do with the tumors after.”
With that information and a healthy dose of anxiety, I was able to advocate for continued ultrasounds. Everything was progressing as well as it could. Even at my 24 week ultrasound. Scott was even finally able to join for a few of these.
As the next few weeks passed, my pain grew to be more intense. I also learned that masks were great at catching tears. My midwives and doctors prescribed a pelvic brace. As a physical therapist, I knew what this was for, and was hopeful they were right. Maybe it was just pelvic pain. When I started to feel less movement and notified my midwives at week 26, I was told ‘to not be concerned about movement until 28’. Being conscious of COVID (avoiding in person appointments) and gestational age, they suggested that unless I felt like I needed to, to just wait until I saw the OB at week 28.
The week of this 28 week appointment, one month after moving into our new acreage in the countryside of Boone County, we were hit by a land hurricane. The derecho blew through all 5 of our acers on August 10, 2020. Three miles east of us, a town was flattened. So there I was, in the heat of an Iowa summer and on the eve of my third trimester, we lost power for 4.5 days. Scott and I spent the afternoons cleaning up our property, assessing damage, and calling in favors to family for a generator to save our freezers. The laundry piled up, we lost the food in our fridge, and we sweat through a few miserable nights. But we were thankful for the roof over our head and the foresight of previous owners for surrounding our home with a massive, tree-lined, wind break.
Through this I continued to show up to work as a physical therapist. Caring for people just like me. People that were overcoming complete devastation. Whether that be from missing a roof, missing income, or missing a loved one. Nonetheless they were still showing up for themselves, so I showed up for them. Healthcare is essential.
The night before my appointment with the OB, we came home to power. That next morning, Scott and I sat in this OB’s office, one I had never met before, to discuss delivery options given the sizeable growth of my tumors. At the end of the appointment he routinely began checking for a heartbeat. I restated, just as I had moments before, about the intense pain I had been having, and the lack of movement I had noticed…citing my tumors for the probable cause. The doppler produced no sound over my abdomen. Maybe the battery was low? He called for another monitor. New doppler. Nothing. My heart sank. I knew what this meant. Scott just looked at me and held on for both of us.
Within minutes we were transferred into ultrasound. To this day, I feel for that nurse. She had no knowledge of what she was walking into. Seconds after placing the probe. There it was. Or wasn’t. Her heartbeat was gone. And so was she. Our daughter, who had no name, was gone.
Behind or masks, our tears, our cries. We just held each other. All I could mutter was, “I’m so sorry, Scott. I’m so sorry.” Over and over. The nurse cried too and allowed us to take off our soaked masks as Scott held on to keep me from falling off the table.
A quick, calm explanation from this OB on what the next steps entailed came fast and in-between waves of shock. Our world had ended as we knew it. We had time to call our parents and our doula from a separate room; detailing only that we knew we had a few hours to go home and collect our things, and that the downtown hospital would be waiting for us when we arrived. I was delivering that day.
All I could think was, ‘Go home to collect what? I don’t have any of my post-partum supplies. I don’t even have clean clothes. I haven’t had power in almost 5 days. I don’t have food in my fridge. I literally just got the hole in my roof repaired. There’s still a broken window…’
The next several hours played out in slow motion.
I called my best friend Kelsey on the way home. I don’t remember what I said but I remember the silence on the other side of the phone and hearing her brain go into overdrive on the flip side of the line.
I called my oldest sister. Who, because of COVID, I hadn’t seen the entire year. Iowa had been placed on a mandatory quarantine list making it impossible to see her.
I called my boss.
I called two other close friends. And then I just drove. All 38 minutes back to Boone.
Scott tailed along behind. We had driven separately. Thinking he was going back to work after the appointment. We thought wrong.
These were terrible phone calls. How do you explain to the most important people in your life that the only thing you’ve ever created, is no longer alive? And that you still have to go through induction, labor, and delivery.
Then how do you tell them, that because of COVID, you have to do it alone.
I’ve known for a long time that people process trauma in different ways. I see it my daily practice. Sometimes we have emotional trauma reactions, sometimes that trauma manifests physically. But, what I’m always fascinated by is what we do in those first few moments.
To put it fairly, every single person on the end of these phone calls we had just made were already under insurmountable stress in a pandemic filled 2020.
What Scott and I would need from them to survive the next few hours, days, weeks, and months, was going to be a big ask. I don’t think either party knew what was coming.
So, in this moment, Scott and I had packed a few clean clothes in a bag. I looked at my collection of masks and tried to decide which one would be easier to labor in. A very pandemic ponder. We looked at the disaster of our house and property from the derecho, and then we fell apart in our garage. I sunk back into my repeating of “I’m so sorry, Scott. I’m so sorry.” Over and over. Sweating in a heavy August heat.
On the drive to hospital, we looked at each other and decided that we needed to name her. It was time. A few months prior, when I told Scott he had to help me sort out names, he repulsively blurted out “Riley”. He let that name linger with a smirk and waited for my reaction. I asked him where that came from. He just said “I don’t know. I just like it.” So that was her name. The middle name was easy. I’ve carried around a variation of my father’s middle name, and so should Riley. Scott Louis gave way to Riley Louise.
Coming up on the exit to the hospital, I quickly came to the realization that none of my family would be able to see our baby. No one would ever get to meet Riley. COVID visitor restrictions. These rules were necessary and needed, and no doubt saved lives during this pandemic, but they never accounted for our exact situation. What if you deliver a baby that you never get to take home?
My parents, after the numbing phone call from the OB’s office, cleared their schedules and were there in the parking lot when we arrived at the hospital. So was Kelsey. So was my sister who lived in town. They were all there, masked up, to see us one last time, to hug me, to hug Scott, to hug Riley. My sister had also purchased most of Target and bagged it in the back of her van. A mother herself and realizing how unprepared I would be for every minute moving forward, she came armed with every piece of labor, delivery, and post-partum need I could possibly dream of.
The hospital had re-instated Doula privileges a month prior, and so our Doula (Melissa) met us at the doorway. My Dad dropped me and the bags off at the front door.
After arriving to our room, and settling into my gown, Melissa looked at me and started to run down what the next few hours would look like. I don’t remember a lot after this point, but I know that of all the things Melissa told me could or would happen, she said “You also don’t have to do anything of these things. You always have the option to do nothing.”
I knew that wasn’t the healthy or safe option. But it was the first time all day that anyone told me I had a choice. That I had power. That I could make a decision. I don’t know why that mattered so much, but it did. With that sentence and that sentence alone, I’m here to tell you that no woman should ever deliver without a Doula.
In the middle of induction medications and beginning contractions, I had my COVID test. The sooner it came back, the sooner I could take my mask off. *I’m also here to tell you that if I can tolerate a COVID test while having contractions, you, too, can tolerate a nasal swab from the comfort of your non-laboring self. It took four hours for a negative result; at this point I could remove my mask but Scott had to keep his on.
Scott took my hand once the meds were started and never let go. He didn’t let go for almost 3 weeks; long after the contractions would end. With every contraction I gave him a tiny squeeze to let him know what I was feeling. In-between those contractions and through the night, nurses came in to ask details I had no answers for. They were planning her funeral. Where was it going to be? What town? The name of the funeral home? Do you have a plot? Would you like to cremate? …On and on.
I couldn’t do it. I looked at Scott and told him he had to handle it. I left him alone with some of the hardest decisions. Secondary to COVID visitor restrictions, you couldn’t conference with family across the hall or in a waiting room. So, I heard Scott making multiple phone calls to both sets of parents. All while I just rode the waves of contractions and kept squeezing his hand.
12 hours, after laboring through the night, they decided to ramp up the medications, and thus the contractions. There would be no gradual ascent, it would come hard and fast. With the guidance of my Doula, I opted to take pain medication for the first time and then an epidural a few hours after that.
In less than an hour after the epidural, I knew something was happening. I called my nurse in. She lifted up my covers and started crying. She looked at me with coming down her face and said, “We feel it too. Just one more push and she’s here.”
27 weeks, 5 days.
8.15.2020
12:02 PM.1 lb. 8.3 oz. 15 ¼” long.
Riley Louise Radke’s earthly body entered this world.
She has her father’s hair. And face. My fingers. His lips. My legs.
She made me a mother. She made Scott a father.
I held her on my chest and Scott held me, and we cried. There it was again, the words “I’m so sorry.” It was all I had left in me. A feeling of complete failure and despair.
At 12:02, on August 15th , 2020 I simultaneously felt every piece of my heart fill and then break into pieces that no one would ever be able to repair.
A hurricane of the heart and land, in the heartland.
Then I watched on as Scott met the human I had been carrying around for nearly 6 months. I’d felt her kicks and rolls and flips. He hadn’t. He curled her fingers around his. He carried her around and starred at her endlessly. He kept apologizing for holding her so long.
I just shook my head and cried more. I had months. He had hours.
Via facetime, our families watched a blessing from the hospital pastor.
Later in evening we were notified that the family down the hall had also had a stillborn delivery, 17 week twins. That given the circumstances, the hospital was bending the rules. Our parents could come in to see her. A weird feeling to comprehend. I had prepared myself to live with knowing that my parents would never meet my daughter. This was a true gift. Rules, in this situation, were meant to be broken. In addition to this, we found out that one of our friends had broken another rule for us. The hospital was going to allow a photographer in the hospital for the first time since COVID lockdown. We would have pictures to keep with us forever.
The photographer came before I had a chance to get out of bed and shower, but, I’ll never regret her presence and her kindness of donating her time and her talents. It was also comforting to know that she was going next door to see the twins.
One set of parents made it down that night, and the other in the morning. Riley stayed in our room that night. All of the natural mothering instincts kicked in that first night. I kept waking to realizing that I was no longer pregnant. A recurring nightmare that carried on for several months. One nurse caught me mid-nightmare. She was kind of enough to bring me Riley to hold. Even if it was just for the weight in my arms. I suppose there is purpose in that practice.
We stayed one more night, two total. We had two nights with her. The next morning we watched them roll her out of the room for the last time. Another feeling I don’t yet have words for.
Left with the three large tumors, my milk coming in, and broken hearts, we made our away back to Boone. On the way there the funeral home called to suggest we order Riley’s urn off Amazon because they don’t carry her size in stock at the funeral home. Another purchase I hope to never make again.
Pulling into our driveway, packages had piled up our door. Because headed into my third trimester I had started to order essentials; like my breast pump. That and a diaper bag were waiting for us when we arrived.
Opening the door, and leading to more tears, we realized that my best friend had let herself in and cleaned our entire house. Top to bottom. And with the help of people I likely still have yet to thank, our fridge had been stocked and the freezer filled.
With my hand in Scott’s, he held on through recurrent nightmares, severe anxiety attacks, and deafening moments of silence.
When I did let go of his hand, we spent our days outside cleaning up our property from the derecho. A chainsaw and an axe all the sudden proved to be very therapeutic energy outlets. Destruction turned constructive to the crazy we had been climbing through.
In a mess of tele-med visits and local OB appointments over the next several weeks, I was able to secure an appointment at University of Iowa in October to discuss confusing bloodwork results and my tumors that had left me looking >20 weeks pregnant even after delivery.
Scott and I both returned to work up until the point that U of I agreed that my tumors need to be removed ASAP. On 10/27/2020 I was scheduled to deliver for a second time; this time an open abdominal myomectomy (essentially a long, vertical incision like a c-section). Again, due to COVID, I had to remain COVID negative in order for them to perform the surgery. Two weeks prior to surgery, Riley’s funeral was planned. Like most people in 2020, we had to navigate COVID positive/exposed family and attendance to her funeral, all while respecting the fact that a negative COVID test was crucial to my tumor removal. Just one more hurdle surrounded by decisions that only Scott and I felt the weight of.
The silver lining of Riley’s funeral being that 2/3 of my sisters were able to attend. One of which I hadn’t seen in nearly a year due to COVID travel restrictions.
Two weeks later, after another negative COVID test. I had my myomectomy. I woke up to Scott informing me that not only did they remove three tumors, but five. There were five. He was only able to stay for a few hours due to visitor restrictions. So I spent my first night alone since Riley’s birth in another hospital bed.
In the weeks following, after requesting my bloodwork be re-analyzed at U of I, I had a time sensitive test performed to detect for a rare clotting disorder. The test I needed re-done had to be tested 12 weeks apart. The results are back. And was positive. Triple positive to be exact; the trifecta of three antibodies that cause very thick-clotting blood. (Single is bad, double is pretty bad, and triple is worst case scenario.) The only way you know you have it is if you have a stroke, a DVT, a pulmonary embolism, or a stillbirth in the 2nd or 3rd Trimester.
And in my case, I only know this autoimmune disorder existed because I had spent the last 6 years treating a patient with the exact same diagnosis.
It's a clotting auto immune disorder called antiphospholipid antibody syndrome: APS. Essentially, my blood attacks itself and clots randomly without cause.
I may never know if this was the cause of Riley’s stillbirth. But what I do know is that based on the preliminary lab results we had going into my surgery, my doctors started me on blood thinners. Blood thinners that I never would have been on had I not been suspected APS+. Now, confirmed Triple Positive APS.
I may never know the reason behind of Riley’s short life, but she may have saved mine.
Now, looking up from the bottom a heartbreak and the brunt end of a land hurricane, we are processing not only the grief of Riley’s absence but the loss of grieving as well. Any other year we would have melted into hugs and shared tears and tough conversations in the grips of loved ones and strangers. There would have been more meeting thru the mourning.
So, to the family that planned, prepared, and used every COVID precaution but ended up with heavy hearts, empty arms, and broken hearts…alone. I see you.
Riley’s story is your story, too. You are not alone.
IN HONOR AND CELEBRATION OF RILEY, DONATIONS CAN BE MADE HERE. ON BEHALF OF THE RADKE FAMILY, THANK YOU FOR YOUR GIFT.
