One year ago, Riley's eye was swollen shut by a brain abscess filled with puss and he had another abscess in his brain. Both were caused by a sinus infection.
"No antibiotic would work. Steroids didn't work. We didn't know what to do," said Riley's mother, Kristin Raica.
"Allergies in Houston, everybody has sinus problems. We had no idea it was that serious nor that your 18-year-old child had a brain abscess and having to crack the skull," said Kevin Holliday, Riley's father.
Riley was transferred to Memorial-Hermann for emergency brain surgery.
"They said they were gonna peel my face back, take out my eyeball, take out a piece of my skull, scrub me all down and put it all back together," said Riley.
Instead, Riley got a break. Dr. Samer Fakhri tried something new: he drained both abscesses by going through Riley's nose, avoiding brain surgery.
"This is still on the frontier of what we do in terms of endoscopic surgery that goes through the nose into the skull base," said Dr. Fakhri, University of Texas-Houston Head and Neck Surgeon.
Doctors have removed brain tumors through the nose, but emergency brain surgery isn't done through the nose.
"He went home the next day instead of staying for a few days even a week," said Dr. Fakhri.
A brain abscess like this is rare, but how can you tell if you have a sinus infection or just a cold?
Doctors said think seven days. In seven days a cold should be better, but if it's not, it could be a sinus infection. That may take antibiotics to knock out.
Now Riley has a healthy respect for sinus infections.
"I feel very lucky every time I tell my friends the story they just freak out," he said.
Warning signs that a sinus infection is heading into a danger zone: if it gets better and then rapidly gets worse, if you have unrelenting headaches, or if you get swelling around your eyes.
Christi Myers is ABC13's Healthcheck reporter