Moved to step-down unit

Riley was just moved to 7 North, the ICU step-down unit. Nurse-patient ratio is more like 4-to-1 than 1-to-1. Fortunately we are in a nice two-bed room with a beautiful view of the skyline. We've been in 7 North three other times and were always in the noisy four-bed room so this is a happy development. The nurse practitioner is currently removing one of Riley's chest tubes. He'll keep the Tenkoff drain, the left pigtail drain and the other two chest tubes until they run dry.

Grampy was with Riley overnight and he did well. At one point he became agitated because he wanted juice but they were keeping his fluid intake low. He turned grey and that escalated his lactate levels, but those came back down when he settled down. He has some congestion in his chest and you can hear it when he breathes. But the x-ray looks fine and he just needs to clear it out. The nurse showed us how to tap on his back and chest area to help him free it up - he just needs a good cough.

Riley's been sleeping most of the morning since we arrived. He had a little morphine and was also given something before they pulled his chest tube. When he starts coming around he'll be able to eat and drink as much as he can handle which should improve his spirits. Doctors will be keeping an eye out for chylothorax now that's he's had some fats. This is the leakage of lymphatic fluid due to a tear in the thoracic duct, usually from surgery (or as the surgeons say, a byproduct of "dissection"). Riley had this after the Glenn, requiring him to be on a fat-free diet for six weeks until the duct healed. In 2004, Riley was still nursing, and that made things very difficult. Hopefully it will be easier this time around now that Riley has much more variety in his diet.

Suzanne and I got to sleep at home last night for the first time in several days, and I even got out this morning for a refreshing bike ride. Riley's birthday is on Sunday and we're going to have a small celebration.