Jennifer Radtke has endured months of medical agony but her `miracle' baby keeps her fighting on.
Walton, Richard D.
Indianapolis Star [Indianapolis, Ind] 23 July 1995: A.1.
Pneumonia.
Respiratory and kidney failure.
Three different livers - her own and two transplants.
Factor in an allergic drug reaction. It scalded - then peeled
off - her outer layer of skin.
Jennifer Radtke, her doctors say, has endured a series of
setbacks that would have killed most people. "Unbelievable fighting
spirit," offers one physician. Adds Jennifer's father: "She doesn't
say `die.' "
But in fact, there have been moments when the 21-year-old
resident of Fowler has wished for death.
Yet, each time, she has battled back - drawing courage from a
wide-eyed little girl.
From her bed in Indiana University Hospital, Jennifer whispers:
"I just want to be with my baby."
Chelsea Paige Radtke was delivered Jan. 2 at IU Hospital during
her mother's second liver transplant. Four weeks earlier during the
first transplant, doctors had opted to preserve the fetus in the
womb.
It was the IU Medical Center's first organ transplant on a
pregnant woman, and one of just a few performed in the United
States.
To prevent and treat rejection, IU physicians had pumped
Jennifer with massive amounts of drugs. Doctors feared the effect
on her fetus.
Chelsea was about three months premature. She weighed 1 pound 6
ounces and measured 13 inches long.
The infant's father, John Radtke, says her legs were as wide
around as his index finger.
Yet, far from harming Chelsea, some anti-rejection medication -
a varient of which is often given to pregnant women in early labor
- may have saved her. Steroids helped mature the Chelsea's lungs.
"We call her the miracle child," says Jennifer's older brother,
Jeff Goonen. "Because she beat all the odds, too."
That little Chelsea's mother is still alive is a tribute to the
physicians and intensive care nurses who have refused to quit on
her.
And it's a testament to her family.
For all practical purposes, Jennifer's mother, Judy Goonen, has
lived at the hospital during the past 7 1/2 months.
She lends more than moral support.
She's an extra nurse.
Goonen bathes Jennifer. She combs her hair. She helps change
her dressings. When it's necessary to move the patient, she grabs
the feet. "That's my job," she says.
At night, Goonen sleeps on a hospital cot - in a doctor's
office.
Dr. Joyce Gonin offered the lodging to the exhausted mother,
whom she befriended while caring for the desperately ill Jennifer.
Together, they've gone through one crisis after another.
The latest: a clotted artery leading to Jennifer's second donor
liver that could require a third transplant.
When she heard, Jennifer broke down. She said to Gonin: "But
I've tried to do everything I was told."
"I said, `Sweetheart, I know. This is not your fault.' "
Putting her hand over her chest, Gonin adds, "She breaks my
heart."
An athlete's zeal
Trying to do her best comes naturally to Jennifer. Her
perseverance was forged in the parks and school yards of Lafayette.
She was just eight when she started playing sports.
As an adolescent, she towered over the neighborhood boys.
"Too tall," her classmates called her.
Though many later exceeded her 5 feet 10 inches, few
competitors surpassed her drive for excellence.
Sheila Klinker, a state representative from Lafayette, coached
Jennifer in basketball and volleyball at Miami Elementary School.
She remembers that after some of the games, the gangly 11-year-old
would walk over and hug her. But there was nothing cuddly about her
play.
"She liked to win."
At Lafayette Jeff High School, Jennifer pitched for the girls
softball team. And for four straight years, she lettered in
basketball. Her position: power forward.
It was during Jennifer's senior year in 1992 that she met her
future husband. John Radtke was almost two years older, yet it was
she who asked him out.
He accepted the invitation to the Valentine's Day dance. They
started dating. That September, they were married.
The next spring, Jennifer became pregnant. Later, her blood
pressure soared. Fluids built up in her body. During one short
stretch, she gained about 40 pounds.
On Oct. 17, 1993, Jennifer gave birth to a boy, Bradley Radtke.
Eleven weeks early, he weighed just over 3 pounds.
After weeks in the hospital, Bradley came home. In early '94 he
had health problems and was taken to the hospital. On Feb. 16, at
John's mother's home in Oxford, the baby's apnea monitor sounded.
Jennifer, who was lying beside Bradley, tried CPR, but it was
too late.
Bradley was dead.
The loss devastated Jennifer. Her father, Jim Goonen, recalls a
conversation he had with her that morning at the hospital where the
body was taken.
"She was begging me to wake up a dead child," Goonen recalls.
"Make him wake up, Dad."
Later that year, the Radtkes decided to have another child.
Two lives at risk
In the summer of '94, Jennifer learned she was expecting.
Again, complications.
In the fall, she suffered two seizures. A doctor prescribed
Tegretol, a standard anti-convulsant drug.
On a cruise to the Bahamas with her husband, Jennifer suffered
a rash. She became very weak. By the time the trip ended, she was
in a wheelchair.
Jennifer was admitted to Lafayette Home Hospital, then
transferred to IU Hospital in Indianapolis. The diagnosis: liver
failure. As best IU doctors could determine, Jennifer had suffered
a terrible reaction to the Tegretol, killing her liver - and
plunging her into a coma.
Unless she received a transplant within 72 hours, she would die.
From the outset, physicians considered saving Jennifer their
priority. If they also could spare her baby, they would.
Doctors mulled inducing labor. But at just 22 weeks old, the
fetus almost certainly would not survive.
Doctors also thought about terminating the pregnancy. But there
was no proof it had caused the liver failure. Moreover, some
thought it highly possible the stress of the transplant would cause
Jennifer to miscarry anyway.
But, if she didn't, her family agreed, surgeons would just
leave the fetus alone.
Recalls John Radtke: "They said the safest place for Chelsea
was inside Jennifer."
Because the fetus was still in the lower abdomen, notes IU
transplant surgeon Dr. Mark Pescovitz, "It was not in our way."
The operation lasted more than 10 hours.
A few days later, Jennifer was walking with assistance.
But in the next few weeks, she turned jaundiced - a sign of
organ rejection.
While there was scant medical literature about the subject to
guide them, IU physicians now suspected Jennifer's pregnancy was
somehow contributing to the rejection of her new liver.
Doctors eyed a second transplant, only this time they were
determined to induce labor or to take the child by Caesarean
section. Even under normal circumstances, a 26-week-old fetus would
have just a 50 percent chance of surviving.
But at least it was a chance.
Jennifer consented to the procedure.
A liver became available at the first of the year. Dr. Ronald
Filo, the IU Medical Center's director of organ transplantation,
made the transplant incision.
It was a curving cut all the way across the upper abdomen above
the belly button.
The incision exposed the uterus for Dr. Alan Golichowski, the
Medical Center's director of high-risk obstetrics.
Though the uterus was a little smaller than he expected,
Golichowski was able to cut into it and extract the baby.
Filo not only had never done a C-section before, he had never
seen one. His eyes grew large as the newborn emerged. "She was just
so tiny. Yet all the parts were there."
The transplant team let out a cheer.
As Filo proceeded with the liver operation, Chelsea was
transported to intensive care. Jennifer's family got a glimpse of
her.
Jim Goonen says he had seen bigger Barbie dolls. Red as could
be and nothing but bones, recalls Judy Goonen. Still, there was a
spirit to this wiggling infant, her grandmother says. "We knew she
was going to make it."
Physicians said they expected Chelsea to be on a respirator for
a month.
Three days later, she was breathing on her own.
Recalls John Radtke: "These doctors were like, `Who is this
kid?' "
It was a tearful moment when Jennifer first saw her daughter.
Staff brought the newborn to her. Mom reached into the incubator
and touched her.
"She's beautiful," Jennifer said.
But while Chelsea thrived, her mother faltered.
All the drugs she had taken to prevent organ rejection had left
her extremely vulnerable to infections.
First, cytomegalovirus caused internal bleeding.
Only days after the transplant, doctors operated again, this
time to remove most of her colon.
Then, just as Jennifer was starting to recover from the viral
infection, she developed a form of pneumonia that commonly afflicts
AIDS patients.
Doctors were performing a life-and-death balancing act: To
treat Jennifer's infections, they would back off on her
anti-rejection drugs. Then, at the first sign of rejection, they
would up the dose again.
Further complicating matters, doctors were severely limited in
the drugs they could use to treat her infections.
Even before the second transplant, Jennifer had demonstrated a
bizarre reaction to certain antibiotics. Watery blisters formed
over most of her body. It was the equivalent of second-degree burns.
For some reason, her immune system produced white blood cells
in an allergic response to the medications.
The cells then invaded the outer layer of skin - and basically
devoured it.
In one of these episodes, Jennifer shed 90 percent of her outer
skin.
The pain sometimes got so bad that Jennifer said she wanted to
die, her mother recalls.
"I'd tell her, `I don't know if this is the time or not,' "
Judy Goonen says, her voice cracking. "And I said, `The doctors
aren't quittin'. And as long as they're not quitting, there's hope."
Finding a reason to live
Still, it has been a struggle.
Says Jennifer's mother: "She's been to that edge so many times."
Twice, Jennifer has made it as far as a rehabilitation
hospital. Twice, she has suffered setbacks and had to return to IU.
The last time, she developed a blood infection that plunged her
kidneys into failure. She required bedside dialysis to filter her
blood.
Since then, tests revealed the clot in her hepatic artery.
Because that is one of the vessels that supplies blood to the
liver, part of the organ has died.
While the clot has interrupted the blood flow, it has not
stopped it, Filo stresses.
Still, he estimates there is a 50-50 chance that Jennifer
someday will require a third transplant.
Filo confesses he doesn't know how many comebacks Jennifer has
left in her.
"How many times can she do this? The human body can only stand
so much."
Clearly, Jennifer has wondered the same thing.
Right after Chelsea's birth, she was reluctant to bond with her
baby. Thinking she might not be around to raise her, Jennifer kept
an emotional distance.
Now, there's physical distance because Chelsea is growing
healthy and strong at home with her father in Fowler.
But a bond of love is drawing mother and baby together.
Chelsea needs her mother. And Jennifer has needed a reason to
fight on - a fact that doctors have seized on to pull her through
her lowest moments.
"I'd use the baby . . ." says Filo, pausing to dab tears from
his eyes, "to keep her going."
Filo would remind Jennifer how much her daughter needs her
love, and she'd sob.
Then, "she'd dig down deeper inside."
Now, says Jennifer's father: "She wants her baby."
Her parents believe that if they can just get Jennifer home and
build up her strength, she would consent to one more transplant,
should one be necessary.
Says her mother: "I really think she's got a life ahead of her."
And one alongside her, too - a wide-eyed little miracle named
Chelsea.
