Next 48 hours critical

Riley with Freddie & Freddie Jr.

To rule out any blockage in his ventricles, an echo was ordered. It showed that Riley’s ventricles are both pumping well, his valves are not leaking, and there isn’t any fluid around the heart making it difficult for it to pump. That’s all good news. The bad news is that his ventricles are still not pumping with enough oomph. As a result, his blood pressure, despite all the different types of medicines, blood products, and volume they are pushing into his body, hasn't moved into a safe range yet. It is important for his blood pressure to rise because he needs to be able to properly perfuse his brain and other vital organs.

During the echo, Riley woke up a bit—the first time I’ve seen him move any of his parts aside from his eyelids—and his whole body twitched in agony. Because of the ventilator, he couldn’t vocalize his pain, but it was so painfully obvious. We asked him a series of yes and no questions to identify where it was hurting the most. Where he was being pressed on by the echo technician hurt (no surprise there), his back hurt, and his stomach hurt. Tears dripped from the corners of his eyes. I told them that he needed a break until he had more pain medicine on board. He writhed around for several minutes before the fentanyl warmed through him and settled his battered body. Once he was settled, one of the doctors helped me feel a little better about the episode--we know Riley is still in there. He was able to answer a series of questions and for that we are so grateful.

He is about to be given a muscle relaxer (basically paralyzing him) so that his body can completely relax and not have to do any unnecessary work. “We’re going to let him relax and see where we end up,” his nurse said. Basically, they keep boosting the doses of medicine designed to boost blood pressure, but they aren’t really having any impact on raising blood pressure. The doctor explained that it becomes a point of diminishing returns.

His kidneys and liver which had begun to show signs of improving have just begun to take a turn for the worse. It's not critical yet, things are just going in the opposite direction of what we want to see. Also, his lungs are starting to sound wet. That is always a concern because one possible side effect of being on a ventilator is pneumonia. Ugh. They’ll be watching and listening closely.