Arrangements

Mom's visitation will be at Coble Ward-Smith Funeral Home on Thursday, December 16th from 6-8pm. The funeral will be at The Church of Jesus Christ of Latter-Day Saints, Leland Ward Building on Friday, December 17th at 2pm, with her burial immediately after the funeral in the cemetary behind the church. Please help us continue to celebrate her life.

Coble Ward-Smith Funeral Home
3915 Oleander Drive, Wilmington, NC 28403
910-791-4444
coblewardsmithwilmington.com

The Church of Jesus Christ of Latter-Day Saints
Leland Ward
1361 Old Fayetteville Rd NE, Leland, NC 28451
910-371-3254
lds.org
mormon.org

The Passing of an Elect Lady

This will be our final entry on Pam's Blog. She left us last night around 10:40 with her family and one very special doctor gathered around her. Oh, how she will be missed but what a legacy of friends and family she leaves behind. We love and appreciate the so very many who tended to her in her final days and who have lent their support and prayers in behalf of our family. The PamBrewFanClub became our friend and a source of great comfort. We will miss your words of encouragement and love but will monitor it for the next few days. Then, it too will be laid to rest. Thanks to all of you for what you've done for our beloved Pam and our family. - Reggie

Petition for Prayers!

Hey everybody.  Please excuse the briefness of this post.  Mom told Dad today that she wants to go home, and I don't mean Leland.  She's tired, she misses Ryan, and she's needed elsewhere.  Dad just told me he thinks she may have a couple of days.  We need you all now more than we ever have before.  Please continue to pray fervently and continuously for our family throughout the days and weeks to come.

Pam had a rough night last night. Cathy Child stayed overnight with her so I could go home to be with Taelor. Cathy said she had a lot of pain and discomfort and couldn't sleep. She is a little better today and has rested pretty well. Yesterday, more fluid was drained from her left lung. In the process her lung collapsed. It has "re-inflated" today and she is breathing comfortably. Everyday brings something new to challenge her and concern us. The anastomosis, the area where her intestines were sown together and a drain placed between, is not growing together as well as it should. It has a leak.

As if you weren't already praying in in her behalf, please pray that this will heal or grow together. It is really important that the digestive juices flow to that part of the intestine. Right now, they have begun to drain the bile from the upper part of the intestines and inject it through her feeding tube. It will be much better if this naturally occurs.

Pam has a hard fight on her hands. She needs the strength to get all these other issues she is dealing with behind her so she can start chemo-therapy. She must start that soon. It appears that we need to start praying to reach incremental goals in order to get her completely well.

We appreciate so much the prayers and concern, not to mention the assistance of those that love Pam and our family. I won't attempt to name those that have been so heaven sent but suffice it to say that we love and appreciate you for your sacrifices in assisting us. We couldn't do this without you. Please continue to pray.

Pam finally got a good nights rest. I didn't do too badly myself. Dr. Griner had her nurse remove the catheter late last night and that brought more relief as well. She was experiencing a lot of discomfort from that. It's almost 7 a.m. and she is still resting and sleeping comfortably. Well, at least as comfortably as you can in a hospital bed. I don't know of anything new for her today. Infectious diseases doctors will be keeping a close eye on her bacterial infection. One thing she does have to look forward to today is that Devan's wife (Dr. Griner's wife) is coming to give her a pedicure this morning, a little later. She should love that.

Pam is back in a room tonight after being in ICU 2 1/2 days. She is on the "step-down care" floor (2). It's been a really busy day for her. Her day included:

• Chest x-rays
• Ultrasound exam
  
• CT scan
• Insertion of a pic line for long term medication/nutrition
  
• Removal of over a liter of fluid from her right lung

She has finally begun to get some rest and has slept off and on throughout the day, when she wasn't being transported somewhere for a test, and then she slept through some of them. Let's hope that she sleeps well tonight.
We've been privileged to have two special doctors close watch over Pam. They have gone above and beyond the call of duty in her care. We have come to regard Dr. Devan Griner and Dr. Chad Burton as good friends.

Pam is recovering well after surgery on Monday. She began waking up around 8 a.m. and her ventilator was removed about an hour later. She has steadily gotten better throughout the day and sat up in a chair a couple of times. About a litre of fluid was removed from around one of her lungs this afternoon and the same procedure will be done tomorrow on the other lung. This should help with the shortness of breath she has been experiencing. Her vitals are good and she should be in a room tomorrow.

Not Such Good News

What started out looking like good news has turned bad. The surgery was performed this afternoon to bypass part of Pam's intestines to allow the backup of fluids to drain. That part went well and the draining has begun which hopefully will give her some relief from the tightness and discomfort in her abdomen, as well as shortness of breath. The bad news is that Pam has cancer coating her abdominal wall and organs. She in ICU tonight on a ventilator. Not much else to say. Hoping tomorrow brings even a hint of good news.

Yay!

I just got a text from Dad, I'm guessing he sent to each of us kids...
"Good news, Pam is going in for surgery now. This may be our miracle. I will call each of you. This is a good thing."
I called him the second I got it, and there was a lot going on so I couldn't get a lot of info...the doctor was prepping Dad for what is going on and Mom was trying to get situated, so I told him to just call back as soon as he can with more details...
This is what I understood from our call - Mom is going into surgery - it should take about an hour and a half. They are going to reroute part of her intestines. It seems like the j-tube was clogging everything up in her intestines. Dad acutally got to see the scan pics and he said that her intestines looked really blown up. He said there are lots of lesions around the site and it was keeping the j-tube from doing it's job. I'm sure he'll explain later when he gets the chance. He can explain it first hand and it will probably make more sense...This could be our turning point! :)

Not Much To Report

Sorry but there is not much good to report. A medication adjustment has at least reduced her anxiety, although it is still there. She has gone for several "spins" in a wheelchair today and it wears her out. Still, it occupies her mind. She watched the playoff hole of the golf tournament today and reported to me when I walked back in that "Tiger lost." A chest x-ray was done today to check her lungs. There is most likely some fluid or pneumonia present. Starting last night, we noticed some swelling in her legs and feet. Her nurse said that as strange as it sounds, it is probably related to the fluid in her lungs. She has been awake most of the day so I'm hoping that means she will sleep better tonight. At this moment, she is resting well. We're hoping that tomorrow will bring better news when all the doctors get back on their rounds. Keep praying.

No change since Friday. Still not sleeping much. Pain, nausea, anxiety. She just wants to go home.

Update: Friday evening

Dr. McNulty pulled some strings today and got the results of the paracentesis. The good news is there are no cancer cells. The bad news is he saw something "suspicious." Not sure what that means. He wants to do another on Monday and is talking to some surgeons about the possibility of more surgery (laparoscopic). He is really compassionate about her suffering and is eager to relieve it and to start chemo.
Other good news is Pam's liver function is improving and her intestines are starting to wake up. Don't let up on the prayers. Thanks to all of you for your concern, prayers, and service to our family. It is overwhelming.

Pam had a pretty good night last night. No falls and a little more sleep. This morning she was scheduled for an MRCP (MRI) but was unable to do it. I would probably have a problem with an MRI too. The most critical thing right now is the results of the paracentesis that was performed yesterday. Results most likely won't be in until Monday. So we play the waiting game. We will be in the hospital at least until then and most likely beyond.

I got a call from the hospital this morning informing me that Pam had gotten up during the night to go the the bathroom and had fallen. Fortunately, she received no serious injuries from her fall. Plans for today was for her to have an MRCP (MRI) to see what was causing the liver duct blockage but when I arrived, plans had changed. The team of doctors had decided to withdraw some of the fluid from her intestines and do a pathology report on it. If the report comes back in Pam's favor, they will then do the MRI. So, we probably won't get results until tomorrow. One other thing that has happened is that after further study of her CT scan yesterday they have determined that she has a blood clot in one of her lungs. What next?

I gave Lindsey a lot of information to post in a very brief phone call. It is very confusing to convey so let me try to clarify a few things. Here's how I understand the situation. Part of Pam's intestines are "paralyzed" or "lazy" at this point, causing an obstruction. Orders are to withhold the tube feeding and treat the lazy bowels with a medicine that's name I don't recall. Hopefully it will wake them up.
She has another problem with her liver. Her enzyme levels have been high for a while but are coming down. Meanwhile, the ducts in her liver are dilated (open) and at least one is obstructed. An MRI on Thursday should give more detail as to what that obstruction is. It could be a stone or sludge from her gall bladder or simply an inflammation. The "C" word is definitely a possibility but unlikely. The size of the obstruction appears to be about 1 mm. All of these things are most likely the cause of her nausea and pain. Her nausea, however, has been less severe and less often.
The leaking from her tube site is most likely caused by the "back pressure" in the intestines. Pam has been resting well today with a few periods of pain at the tube site, but mostly comfortable. The medications seem more effective and go to work much faster while administering them through an I/V versus the feeding tube, so her relief comes much quicker. Hope this info helps all to understand.

Not much news...

Dad called a little while ago, and there is some news, but it just leads to more questions.  There is a blockage in her intestine where the feeding tube goes in and it seems to be paralyzed for the time being, so yes, this is a problem.  There is also a blockage in her bladder, and the ducts of her liver are dilated.  All of these factors can definitely be the cause for a lot of her nausea, but Dad told me her nausea has gotten a lot better (some good news!).For now, they're are removing the tube and she's just getting her meds intravenously.  They are planning to do an MRI either tonight or tomorrow morning, so hopefully there will be getting some more definitive answers from that.  We've all been a bundle of nerves all day, and I don't know that this new news is relieving that stress for any of us, but Dad said they didn't say the "C" word when they were talking about the blockages, so hopefully that's a good thing.  She will probably be in the hospital a few more days and I hope more answers will be coming soon. We'll let you know as soon as we know.  Thanks for hanging in there with us everybody!