Chest x-ray is worse

We'd hoped to go home today if the chest x-ray showed improvement or at least no change. The cardiologist who looked at Riley this morning said he looked and sounded better and expected the x-ray to show improvement. However, the x-ray taken this morning shows that Riley's effusions have worsened, especially on his right side. They're still not at a stage where chest tubes are being considered, but we're not going home today. Instead they're increasing Riley's lasix dosage again, doubling it to 20mg twice a day. This is the same dosage Riley received before the cardiologist reduced his meds in August. If the x-ray tomorrow shows improvement, we can go home. If it's worse or there is no change, we stay. We're skeptical about getting out of the hospital on a Saturday, but we're holding out hope that things turn around.

It took several hours to reach this diagnosis after the 9:30 x-ray. The cardiologists looked at the film and assumed Riley had been lying down when it was taken, despite my protests (I was standing there with him). So they made us wait for an x-ray technician again who took us back down to radiology where we sat around some more. Eventually another technician came out and told me that the first film was fine and there was no point exposing Riley again unnecessarily. Finally radiology and cardiology spoke and we got to go back upstairs.

The chest effusions are definitely a complication from the Fontan surgery in March. It's possible that the fluid collected because his diuretics can be scaled back too aggressively, because he got sick or a combination of the two. Physically and psychologically Riley is in much better spirits today. He's drinking at a normal rate and has had a few small bites of food. Not much, but considerably more than he ate yesterday.

Last night went much more smoothly, Riley slept soundly and was not interrupted by regular coughing fits. We were awoken by the blood oxygen alarm when Riley's sats dipped into the high 80s. The nurse put Riley on an oxygen cannula and he was very upset about it. The cardiologist came by in the early morning and removed the oxygen monitor. She said that Riley probably had been dipping into the 80s all along and the monitor and oxygen were an unnecessary distraction.

Keep your fingers crossed for the x-ray tomorrow morning.