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March 21st - There was a beautiful positive singularity of Pam's life this morning at 2:30am as she passed on from this dimension of the universe. She was very peaceful at the end which was comforting to see. So much support and love has been shown on this blog and I know she was able to soak up all that energy. 

Be at peace now Pam.  See Celebration of Life blog post for service details set for 3/24

Pam's middle name, Joy, is there for a reason.  To her parents her birth was sheer joy and so they gave her that name.  She has continued to share that Joy throughout her life with all she met.  Let’s keep the candle of Joy lit in her honor and pass it on to the next generation. 

-Keith Pritsker (brother)

March 19th - It's been a difficult weekend.  We've been trying to figure out where the pain is coming from but had little success.  There were some positive conversations in terms of altering the long term treatment option by including some modern technologies.  For more details, read see Randi's post from today.
March 17th - The 9th day of radiation treatment complete and the next one isn't until Monday.  The goal for this weekend is healing and working towards getting out of the ICU.  Unfortunately there is still too much swelling in the throat area to deflate the tracheotomy cuff, which would then allow air to pass the vocal cords (so no talking for at least another 24 hours).  Today was a tough day, but necessary day, on the road to recovery.  Thanks everyone for the warm wishes.  She knows you are all thinking about her.
March 16th - like I said two days ago, there are good days and bad days. Today was a great day. You're mouth is healing quickly now that there's no tube there. You're fully awake and alert now. You had another radiation treatment and although there's still quite a bit of swelling, it looks and feels better around your neck. Unfortunately the doctors could not deflate the cuff to allow you to speak but maybe tomorrow. For now we can keep playing charades. Respiratory therapist came in just now. She's here every day to check breathing.  She was completely blown away at how well she's doing. 

March 15th - tracheostomy went well today and it's great to see her face without all those tubes. It's going to take 7-10 days for the Trach to fully heal, but it's such an improvement as compared to before.  Even after that surgery she still had a radiation treatment in the evening. So it's been a very long day for everyone, especially her. Tomorrow should be fairly straightforward with a radiation treatment and a visit from her ENT to check on how well the Trach is healing. 

March 14th - there are good days and bad days. I think today was especially tough for everyone.  While it's good to see you more awake, it's tough not being able to communicate.  Without going into details, the frustration of not being able to communicate is excruciatingly painful.  Chemo and Radiation are done for today and we are praying for the best results possible.  Tomorrow the ENT doctor will perform a tracheostomy so they can finally get that breathing tube out of your mouth.  One     day    at    a    time.
March 13th - she smiled. Maybe it was the drugs, but she smiled. I'll take it. It's the most communication we've had with her in a week. Although she's not terribly comfortable, it's nice for us to get some feedback.  Radiation treatment and a quick CT scan to check blood circulation in her left foot are done for the day. 

March 10th-12th - No treatments this weekend, just some rest.  Nurses referred to it as a Sedation Vacation weekend.  Verced put on hold and we were able to make some eye contact.  Blood pressure, heart rate, and temperature all normal.  No signs of infection from all the lab reports.  She's very healthy going into week 2 of treatments.
March 9th - Finished meeting with the doctors today at 2pm. A lot of good and tough information to digest.  I'll try to put together a more comprehensive breakdown later tonight.  There is a plan forward to ease up off the sedation medication in the next day or two.  Hoping and praying for good things.

March 8th - radiation at11:30 completed, guardant blood test completed, but reiki now is Friday.
March 7th - first treatment of radiation and chemo is completed. The plan to get liquid biopsy and send to guardant health is going to have to wait one more day in order to receive the kit being shipped overnight.
March 6th - constant sedation.  mapping of tumor at radiology.  pathology sample sent to Stanford.
March 5th - heavier sedation medication given as tumor grows at disturbing rate.
March 4th - Second opinion from Stanford agrees with pathology conclusion of nasopharyngeal carcinoma.  However, there are still many unusual aspects about the report and the evidence to support nasopharyngeal carcinoma is qualitative and not quantitative.
March 3rd -  Pathology report confirms diagnosis of nasopharyngeal carcinoma.
March 2nd - Surgical biopsy performed and confirmed the presence of a cancerous tumor.
March 1st - Pam brought to ER after several weeks of major discomfort around her neck.