WE LOVE YOU PAMMIE SUE!

Hey all you Pammie People,

Jocelyn and I wanted to take a moment to publicly thank everyone for all that you have done. The outpouring of love and support has been unbelievable. Over time we will be able to reach out to everyone individually but felt we should at the very least post this note to say just how appreciative we are for all you have done. First and foremost, the emails, cards, phone calls, texts and hugs received immediately following our mom's passing were exactly what we needed. Your love and affection warmed our hearts and brought us much needed comfort and strength. Thank you to all that donated to mom's memorial fund as well. That money has really helped us take care of the finances required during a time like this and we cannot thank you enough.

And to those that helped with the service and celebration....wow! I think we can all agree that both were amazing and it simply would not have happened without the help of those involved. The food! Oh my goodness! Amazing! The music...perfect! And the spirit of that party was so warm and inviting...Jocelyn and I didn't want it to end. That evening and the attendance clearly demonstrated the effect that our mom has had on everyone. Jocelyn and I received hugs from old friends who haven't seen Pammie in years to friends who had only met her a few months ago. Regardless of how long each person knew our mom, the underlying theme was the same. You all loved her. She touched each of you in a special way. Pammie stood out in your minds above many others because of her sincerity, her kindness, her concern for your well being, her humor, her love for the A's, her incredible navigation skills, her knowledge of the real estate market, her positive attitude, her genuine love for you and my personal favorite....her smile. Momma's smile is so bright in my memory and I know it is in yours and I love that.


I know many want to know how Jocelyn and I are doing and I think it's safe to say that we're doing okay. We miss mom terribly though, especially in the morning. Mom was a morning person and would call us to check in and start her day. After talking to Jocelyn we confessed to each other that we both find ourselves looking at our phones during the morning...waiting for mom to call. It hurts like no other hurt to know that "mom" will never pop up on our phones again. To know that we won't hear that perky voice (at 6AM) is something that will be painful for a long time for us. But...we do our best to take comfort in the fact that mom is comfortable now. She is in a better place and God has plans for her and she is following Him. Although, it appears that she submitted some of her own requests immediately after arriving in Heaven. You see, Kelly and I have been trying to get pregnant again (I know I know...we're crazy). On the Wednesday after mom's surgery, Kelly took a pregnancy test and it was negative. Mom died on Friday and that following Sunday, Kelly took another test. And it was positive! That's right...positive! I like to think that in true Pammie fashion, she got up to Heaven and saw the deal and didn't like it, so she submitted a counter offer. And of course it was accepted. Thanks mom!

I have plans for this blog. I will get the slide show posted as soon as possible and I will add some fun things about our Pammie as time goes on so please continue to check it.

We love you all and thank you thank you thank you thank you!!!

Ryan and Jocelyn

When: Friday February 6th, 2009

Where: Community Prespretarian Church in Danville
222 W. El Pintado Road
Danville, CA 94526
(Click Here for Details)

Time: 4PM to approximately 5:00PM - 5:15PM

Immediately Following: Celeberation of Life -
Where: Sycamore Clubhouse
635 Old Orchard Drive
Danville, CA 94526
Time: Approximately 5:30PM

I hope everyone can make it. It will certainly be a very special evening.

As many of you know, our Pammie is so PROUD to be "Grammie Pammie." She loves her four grand kids, Tristan, Caden, Abby and Eddie so much! And did you know she has two more grand daughters? Most of you do, but for those that don't, her granddaughter Abby has two twin sisters, Emma and Madelyne that are already in Heaven. Well, something very special is happening today. Grammie Pammie gets to meet those two. As I type this post, my heart is so full with the knowledge that my momma is loving up on my two baby girls right now. She still gets to be "Grammie Pammie" and that makes me so happy.

For those of you just getting the news, a sequence of events yesterday morning caused mom's brain to swell and put so much pressure on it that she died. She was in her sleep when it happened and did not suffer any pain during any of this. Our plan was to carry out her wishes to be an organ donor, however, she had a small case of melanoma in 2007 and so was not a viable candidate for organ donation. At this point Jocelyn and I and few others said our goodbye's one last time today and at 12 noon the docs took her off the breathing machine and let her go peacefully. The overwhelming sense of peace and love in that room was amazing. There is no doubt that it was mom telling us that she was fine. That she was BETTER than fine and not to worry.

Interestingly enough, mom came down for Thanksgiving to my house in Mission Viejo where we talked about what she would want if she died. And momma wanted a party! "I don't want everyone standing around crying! I want good music and food and laughter." Well that is exactly what you will get momma...aka Pammie Sue...aka Grammie Pammie...aka Pamorama...aka Pammer! You will have your party.

Stay tuned for the time and date of the service. ALL and I do mean ALL are invited. That's how mom wants it. So let's do this and lets do this Pammie Style.

Thank you all for your love and support. It has been amazing. My mom loved each and every one of you and Jocelyn and I we do as well.

Mom, I love you with all my heart. I am so happy and thankful for the intense love you poured over me my entire life, for the constant "mothering" no matter how much I said I didn't need it because you knew I did, for the example you were to me, for the friend you were to me, for your sense of humor and for your generosity. You sacrificed so much for Jocelyn and me and I love you for that. You did good momma. You did real good. I can't wait to see you again. Take care of my girls for me.

Love your son,

Ryan

Good Morning Pammie Fans,

So I've been up all morning reading up on this hypothalamus dealeo. I really like this LINK so take a look if you have time. I have copied that web pages summary of what the hypothalamus is here....

" The hypothalamus is a small area at the base of the brain, weighing about 4 gm out of the 1400 gm brain weight of an adult human, yet it performs a wide range of functions that are vital for the survival of the individual. In general, the hypothalamus acts as a integrator to regulate and coordinate basic functions necessary for life, such as fluid and electrolyte balance; feeding and energy metabolism; wake-sleep cycles; thermoregulation; stress responses; and sexual behavior and reproduction. "

So the question today is, "how badly was the hypothalamus damaged?" It's clear that we all need this thing and now we just need to pray like crazy that mom's hypothalamus hasn't been affected too badly.

Stay positive, pray for my momma, your Pammie and stay tuned. I'll post some more throughout the day as I learn more from the docs.

Love

Ryan

I am asking that everyone who knows Pam take a moment tonight at 8pm to pray for her.
Please pass this information along to others. Sincerely, Marah

Hi everybody,



The good news is that mom responded well to Dr. Efron this morning. He asked her to squeeze his hand and she did a couple of times. He even asked her to show her two fingers (like a peace sign) and she did that as well. He was VERY encouraged by this one. She also squeezed Jocelyn's hand when she asked her to do so. Which of course was very exciting for her as she has been asking mom to do this from post op. day one! He too was very concerned she wasn't doing any of this yesterday and was extremely happy to finally see some activity today.

Okay...so here are the three main concerns.

1 - The Hypothalamus. The hypothalamus controls body temperature, hunger, thirst, sleep patterns, and other things. He is worried that some, if not all of these things were affected during the surgery. The hypothalamus communicates with the pituitary gland, and as I mentioned before, one of things the pituitary gland controls is bladder function which brings me to the second main concern.

2 - Pituitary Gland - This is basically the bladder control issue that I mentioned.

3 - Optic Nerve - Both of mom's optic nerves were manipulated and thus her sight is a concern. There is also a concern about mom's eye lids. The cranial nerve that controls the opening and closing of the eye (cranial nerve #3) for both eyes were touching the tumor.

Something else that Dr. Efron is concerned about but isn't part of his top 3 concerns are the fact that mom doesn't have very strong movement in the left side of her body. He's not too concerned about this because mom will be able to get her strength back with therapy and time.

There was also a loss of blood flow to mom's brain which was due to the manipulation of the tiny blood vessels that were involved in the surgery. This basically means that our Pammie suffered a stroke. The effects that this will have her long term are unkown. In fact, the long term effects of all of this are unkown. It's the unkown that is driving us nuts. We just want mom to perk up and be the Pammie we all know and love. Jocelyn has been awesome with mom. She knows that mom is a big believer in the "healing touch" and continues to tickle her arms, massage her feet and hold her hands.

Today our goal is to continue talking to her, telling her we love her and reminding her where she is and what has gone on. But it's day by day friends. Any ideas of her getting out of her anytime soon are just not realistic. So let's take it one step at a time. The first step is for mom to wake up and to get that breathing tube out.

Keep the prayers comin'.

Love

Us

Hey Team,

The ICU is really cracking down on the visiting hours today. We can't get a word out of them one way or the other re: the Cat Scan yet. Mom is doing fine. Still snoozin'.

More to come soon...

As of 7:00AM this morning, Pam is still asleep. We were all hoping to see her awake by yesterday, out of the ICU today and getting ready to go home. But this is not the case. Pammie is still not responding to voice commands like “squeeze my hand” or “wiggle your fingers” or "move your head to tell me that you hear me" or anything like that. Now... this could be that Pam was just really affected by all of that anesthesia and is still just taking her time to wake up, but at this point the docs are also concerned that she is not waking up due to some complication from the surgery. She is getting a Cat Scan now which is partly routine after a surgery like hers, but the docs are especially anxious to see if there was a blood clot or bleed after the surgery or anything else that might help explain why she's not waking up. Obviously, the hope is that they find nothing and it is indeed just Pam taking her time.

We had to get the update by way of a phone call to the ICU this morning. Visiting hours are only from 10AM to 12Am, then from 2PM to 3PM and then from 6PM to 8PM. And yesterday they really enforced those hours on us which stinks. We plan to be there by 8AM this morning though as that is when Dr. Efron will be rounding on her. The funny thing is that anybody can just walk right into the ICU. It's not locked or anything. So we'll just scoot on back there and turn on that Pammie Charm that she taught us so well and see what's up with that Cat Scan.

More to come in a few hours. Thanks for all your kind words. I plan to read your comments to mom today. These will be especially touching when she does wake up and sees how many of you have been thinking of her.

Lot's of Love,

Pammie's Fan Club Management

Good Evening everyone,

Mom is still sleeping. We got kicked out after visiting hours were over but the nurse promised to call us if she wakes up. If that happens I'll be sure to call but we're thinking she's going to be sleeping through the night again.

On a positive note, her urine output went down considerably in the hours we were there which is a great sign.

Mom is scheduled to have another Cat Scan tomorrow around 7am too. The docs want to confirm that everything is as it should be...meaning that there was no bleeding or clotting or anything as a result of the surgery.

Good night Pammie Fans. We love you all!

Prayers prayers prayer...!

Okay, mom still has not woken up. The docs stopped giving her the anaesthesia medication about 5 hours ago now, but given how intense the surgery was, they're not surprised that she hasn't come out of it yet.

There are two main concerns at the moment:

1 - Urine output is too high and sodium levels are too high. A common side effect of a tumor that affects the pituitary gland is diabetes incipidus which is a condition in which the kidneys are unable to conserve water. (Be sure to click on "diapetes incipidus" above for more info)
The docs do expect this to go away in several days. However, if it doesn't...if instead mom's bladder function is compromised, there is medication to cover this, which is great news. I should mention though that this would cause concern for all of the other hormones and things that the pituitary gland takes care of and whether or not those functions are compromised too.

2 - Her eye sight. Mom's optic nerves were put through quite a bit of trauma during the surgery. It is certain she will not be able to see very well or at all out of her right eye when she wakes up. Her left eye is responding a bit better to light and the docs are anticipating that mom will have fuzzy eye sight out of this eye when she wakes up. From what they're saying, I understand that the main concern is the right eye.

Both of these main issues can be permanent or temporary and the only way to tell is time. And of course...we need The Pammer to wake up!!! All in due time say the docs. And they're not going to rush it. Momma does what momma wants (trust me on this one) and if she don't wanna wake up, she ain't gonna wake up. And that's no problem mom! We are all here waiting for you when you do wake up.

So, you all have more stuff to pray about.

I'll post some more later tonight...

Well, it's that Blog time again. It is no secret that Pammie is one loved lady and as such, our phones have been blowing up with requests for updates. We are overwhelmed by everyone's love and concern and certainly appreciate all the well wishes and prayers. In an effort to keep everyone informed as quickly as possible, I have put together this blog. My goal is to update this blog a few times a day until mom is in the clear.

For those of you just checking in, let me bring you up to speed. Mom went to get some eye glasses at Lens Crafters around Thanksgiving time. She failed the peripheral vision test and was told that she may have a tumor, which proved to be correct. Mom had a Meningioma Tumor. It was benign but it was in a very dangerous spot. It was quite large and was pushing on her pituitary gland, her optic nerves, her internal carotid artery, many small blood vessels and other things that I can't quite remember right now. The docs estimated that she had been living with the tumor for about 10 years and are very surprised that she hasn't had a more severe side effect from the tumor. If she were to do nothing, the docs said she would, at some point, lose her eye sight, have possible paralysis of some kind, loss of bladder control and many many other things. They emphasised to mom that these things were basically a guarantee to happen if she did nothing. So the answer would seem to be, "no problem then. Let's take it out and all is good." Not so fast. The catch 22 is that everything I just mentioned is still very possible as a RESULT of the surgery. And that is why mom was so nervous and I can't blame her. Physically, she felt fine. It's not like she already had some loss of vision or a minor stroke or anything like that. She was feeling fine and had to go into this surgery knowing that there was a very good chance she would have some minor to major physical setbacks afterward.

And that is where we are now. Yesterday the Pammer underwent a 12 hour surgery to remove the tumor. Dr. Efron said it was one of his top 5 most difficult surgeries. The good news was that he got a lot more than he had expected but there was a lot of manipulation and trauma as a result of the surgery. As of right now, which is 2:45PM on Tuesday, mom is still on the ventilator. She is doing most of the work though as far as taking her breaths, which is good. The goal is to take the ventilator out but mom needs to cooperate for that to happen. There is a basic list of commands and reflexes she needs to respond to. She needs to lift up her head a little bit when asked, she needs to make a fist when we put our finger in her palm and she needs to be able to move her fingers and toes when asked. There are a few others they want her to do that I can't remember right now. According to Hank (mom's nurse today who is awesome), mom will have the ventilator tube in until tomorrow. He said he tried these commands with mom this morning but she wasn't quite as responsive as he would like to see. He quickly said though that he wasn't surprised that she wasn't very responsive yet, given the intensity of the surgery. A 12 hour surgery is not something you bounce back from and it's going to take good ole Pammie Sue some time.

They took her off the sedation medication about an hour ago so she should be waking up soon.

Thank you all for checking in. The updates on this blog will most likely come from myself, Jocelyn, and Marah.


Please say your prayers that when mom wakes up, she can see, she can move her arms and legs and that she is not in too much pain.

Love,

Ryan