Just before River turned one, she fell and bumped her cheek on the coffee table, resulting in a goose-egg. Concerned, her parents advocated for her when the swelling persisted. Unfortunately, she developed an infection, leading to sepsis and an eight day hospitalization. After tests and antibiotics, she returned home to recover, celebrating her first birthday and overcoming what her family thought was the worst. Six weeks later, the bump on her cheek grew larger, prompting further medical attention and quickly turning into more advocating. Eventually diagnosed with alveolar Rhabdomyosarcoma, River began chemotherapy promptly and responded well.

Despite a positive summer, a lymph node enlargement before high-dose radiation caused complications, leading to a three week hospitalization in fall of 2023. Although radiation was successful, further treatment quickly revealed the cancer had spread extensively. Despite ongoing efforts and various treatments, River Lou Opper passed away three and a half weeks later in November 2023. Her strong faith in Jesus brought comfort to her family, who continue to honor her memory.