6/24/2010 After a three day drive, we arrived in Massachusetts for the committal service. I was blessed with the presence of eight cousins with spouses and friends, and Pam's sister and her husband. We were very fortunate to have the service led by the pastor from a church well-known to my family and which Pam and I have visited in the past. The words from the pastor vividly illustrated the wonderful talents and life of Pam and the nearly 44 years we were together.

The staff of the Massachusetts Veterans Cemetery in Agawam were extremely helpful and efficient in coordinating the service and interment. This is a beautiful location that Pam and I had visited several years ago. This location is near my hometown of Springfield and not far from Boston where Pam's parents are interred.

Pam's struggle with the effects of cancer is over and she is home with the Lord. May God bless all our friends who prayed for her comfort and healing which gave us the strength to understand His will.

5-26-2010 Plans have been finalized to take Pam to Massachusetts. We have a committal service scheduled for June 22nd at a cemetery in Agawam, just outside of Springfield.

As it turns out, a number of my relatives from other states will be in the vicinity because of another celebration in Maine on June 26th. That celebration involves dedication of a historical marker for one of our ancestors who served in the Revolutionary War. It will a grand opportunity to see family and friends as I drive around New England before returning home.

My immediate family and I send our love to all our friends who remembered Pam through countless cards, calls and prayers. God bless you all!

5/12/2010 We had a celebration of Pam's life on May 8th. Pam had prepared a list of 30 of her favorite hymns and anthems in planning her memorial service dominated by music. Our normal choir of 50 members was augmented by another singers who knew Pam through other church choirs and the Treasure Coast Community Singers, a group that Pam thoroughly enjoyed. A total of 111 singers sang 11 selections and the handbell choir performed 3 selections. Our soloists and instrumentalists were inspired and wonderful. All of our children and 7 of 8 grandchildren attended. Friends and family traveled from distant locations to celebrate her life. It was an uplifting experience for us.

We are making plans for Pam's final resting place in Massachusetts.

Our two years of struggle with the effects of cancer are over. Our faith in the Lord and the support of our friends kept us going. Psalm 100 says in the last verse. "For the LORD is good; his mercy is everlasting; and his truth endureth to all generations." Pam is at peace, now.

5/4/2010 The obituary will be published in the Stuart News on May 5th. Here is a link to the newspaper: http://www.legacy.com/obituaries/tcpalm. The funeral home has also published the notice at its website at www.heavencalled.com. There also is a link to a guest book and information on donations to the Music Ministry at the North Stuart Baptist Church. The music ministry involved handbells for adults and children, choirs for all ages, and special programs and provided spirit-filled joy to Pam. This was her passion and her gift to the church.

Our family has been comforted by your calls, cards, prayers and continuous support. May God bless you all.

4/29/2010

Pam passed away this afternoon, following a nearly two year battle with cancer. This past week, Hospice has been with her around the clock and they were professional and committed in caring for Pam. Although Pam was asleep all week from the effects of morphine and other drugs, she looked radiant and comfortable. She was strong to the end in her valiant battle with this insidious disease.

Peace came to Pam at about 6:00 p.m. She was surrounded by her family, two grandchildren and extended family who sang hymns, prayed, and reminisced for nearly six hours. Pam was aware of our presence and heard everything that was said.

We will have a celebration of life on May 8th at 2:00 p.m. at the North Stuart Baptist Church, 1950 NW Federal Highway, Stuart, FL 34994. Pam's sister, our family and our friends at the church are planning a service dominated by Pam's favorite hymns. Music was Pam's passion that shaped her contributions to the ministry of all the churches she ever attended.

We thank you all for your prayers for Pam's peace and comfort during this ordeal. We all have been strengthened by your continuous support.

4/29/2010

There has been no change in Pam's condition for a couple of days. She looks comfortable and in no pain. She seems to hear us when we speak to her and I even noticed a slight acknowledgment of our presence by a toe twitch. She has round the clock care by concerned nurses and frequent visits from our family.

May God bless you all for your prayers and support.

4/28/10

There has been no change in Pam's condition for more than a day. She looks to be comfortable and certainly has the full attention of the Hospice nurses. We all agree that Pam is a strong woman. At this point in time, however, there is little, if any, hope that she will wake up.

We thank you all for your prayers, cards, and calls.

4/27/10 Pam's condition rapidly deteriorated during the day yesterday. The Hospice nurse indicated this was part of of the natural process of Pam's system shutting down. Pam looked comfortable and relaxed and she responded to the family with a slight smile or glow. Pam definitely knows where she is going.

This morning brought no further noticeable decline in her condition. In fact, she looked more comfortable than she did yesterday. Maybe the fact that our dog Sadie was on the bed with her was more comforting than the pain relievers.

Hospice has been a real blessing and responsive to Pam's needs. We will monitor Pam's condition and update this blog regularly.

4/25/10 Pam is now in Hospice critical care and will be receiving around the clock nursing starting tonight. I thought the nursing coverage would be for 12 hours, which is all I requested, but I learned that once a patient is assigned to critical care, 24-hour coverage is offered. Beverly will still be able to tuck Pam in at night and be here to get her up in the morning as she has done for a couple of weeks. It's a blessing that Hospice is here to help the entire family and not just the patient.

Pam has become very weak and I felt additional assistance , particularly at night, is necessary for her comfort and safety. It so happens that Pam and I know the nighttime nurse and Pam thought that was wonderful, even though we had nothing to do with this assignment. I know she will be in good hands.

God is watching over us through the continuous support and prayers of our friends.

4/24/2010 Pam has two aides from 9:00 A.M. to 8:00 P.M. Our daughter Bev, who works from 11:00 P.M. to 7:00 A.M., comes in the evening to get Pam ready for the night and stops in the morning for a couple of hours to get Pam ready for the day. Pam sleeps much of the time, but is alert when awake. The medication affects her speech and causes her to slur her words.

Pam has been comforted by the support of all our friends. She knows God is talking to her through your cards, calls and prayers. Pam is not afraid of dying and has expressed this to all our family, pastors, her business partners and nearly every one else who has visited. Pam is strong in her faith and truly an inspiration those who know her.

4/19/2010 Pam is resting comfortably after a weekend of activity. Her sister extended her visit until yesterday. Son David spent two days with us. All our family members in Florida stopped in to see Pam. The pain management seems to work, although some of the medications make her very sleepy. She has had little energy and limited mobility but she has had an active mind and good recollections with the family.

Hospice has been very accommodating and responded to our medical needs. We continue to bless all of you for your continuous support and prayers. May God bless you!

4/14/2010 On Monday, Pam visited her oncologist who basically stated that all that can be done medically has been done. There is no chemo or surgery or radiation protocol that has been effective for Pam's cancer. Her oncologist said she needs to be in hospice to control her pain and make her comfortable. We agreed and Pam was admitted to hospice on Tuesday. Pam now has an aide 4 hours per day. She spent many hours with the social worker and nurse from the hospice group and the nurse from the home health agency who assigned the aide. The whole plan is to make Pam comfortable, ease the nearly constant abdominal pain, and stabilize her weight. Her pain medication has been changed and it seems to be working. Her pain level on a scale of 1 to 10 has come down from a 7 to a 4. She has rested much of the day and we look forward to a comfortable night.

Pam's sister has been with us this week and extended her stay until Sunday. Our daughter Beverly will be here to see that Pam is set for the night before she heads to her nursing home job at 11:00 p.m. Everyone involved with this home care has been efficient and responsive to Pam's needs. We thank God for guiding us to this decision and feel comfort in the unfailing support and prayers from our friends and family. May God bless you all!

4/10/2010 -Our visit to the Mayo Clinic in Jacksonville enabled us to review all of Pam's treatments and test results. The doctor was thorough, spent a lot time with us and seemed genuinely concerned for Pam and her condition. Regardless of the source of the tumor, which apparently was the gall bladder and bile duct, the chemotherapy treatments administered over the past two years were the ones that would have prescribed if the origin had been identified in the first place. The six different chemo treatment protocols Pam received were systemic to the whole abdominal area. It seems the cancer was rejecting the treatments that science and research have shown to be effective. The conclusion is that the treatments were consistent with the information made available through the various test results. The tumors are so wide spread that any surgery or radiation is not possible, and this decision is consistent with earlier conclusions regarding surgery.The tumor is pressing against Pam's stomach which is causing her lack of appetite and feeling of fullness after a small amount of food.

The Mayo oncologist spoke briefly about some options that may be available, as follows: hormone therapy, oral chemotherapy, a feeding tube, and use of the drug avastin that starves cancer cells of oxygen. He will have discussed these options with Pam's local oncologist when we meet on Monday, April 12th. Meanwhile, Pam is struggling with pain management, lack of energy, and poor mobility.

We thank God for your prayers, concern and support.

4-6-2010 Pam had a wonderful Easter when all our children and 7 of 8 grandchildren and relatives brought food, cooked food, and ate food most of the afternoon. There were a lot of games and activities for everyone. By afternoon's end, all were sated with food and fellowship. It was a grand day.

As we prepare to go to the Mayo Clinic for Thursday's appointment, we have been truly blessed by the prayers and comforting words from our friends and family. We believe God has a treatment plan for Pam.

4/2/2010 We finally have the results of the tests of Pam's recent liver biopsy that were conducted by a lab in Arizona. The report indicated the primary tumor site is the gallbladder, while the specimen site was the liver. These tests were conducted because no definitive primary site had been established. Some of the treatment agents associated with this type of tumor have already been administered without success. We also had hoped for a DNA micro-array but the test could not be performed due to insufficient tumor present in the specimen.

The test specimens will also be evaluated by the pathology clinic at the Mayo Clinic in Jacksonville. We do hope our visit to the Mayo Clinic on April 8th will result in a thorough review and an effective treatment plan. We canceled our planned trip to the Moffitt Cancer Center G-I department in favor of the Mayo Clinic.

Pam's oncologist seemed to be in favor of the cutting-edge lab work that we just received. This was a real comfort to us.

Meanwhile, Pam is experiencing problems with appetite, energy and nearly constant pain. She has been unable to participate in the Easter music programs this week, but will make every effort to sing on Easter.

We treasure your prayers and blessings and wish you a Happy Easter.

3/22/2010- Pam struggled with constant abdominal pain, lack of appetite, lack of energy and dwindling hope for feeling better. None of her medications worked as planned, even after new pain medications were prescribed. We expect the hear the results of the last biopsy this week. Other tissue specimens will be submitted to Moffitt and the Mayo Clinic in advance of our appointments in April. These events will be a measure of progress toward seeking an alternative treatment to the chemotherapy, especially in view of the seemingly long period of time to hear about the biopsy.

Pam had a period of time todaywith no pain and awoke from a nap well refreshed. Although pain patches were prescribed today, she had not applied one before her nap. I believe Pam's outlook for relief has been refreshed.

Please bear in mind that all your prayers and support have helped us endure the effects of this cancer and give us encouragement for daily living.

March 14, 2010 This week has just flown by. Pam has been blessed with visits by friends she has had for more than 15 years. Traditionally, Pam and three friends try to meet at least annually for fun and fellowship. This year Sally and her husband Dan from the Atlanta area took time on their anniversary trip to spend two nights here. Later in the week, Ann and Bennie flew in from Dallas and New Orleans, respectively, to spend nearly three days of just "hanging out." Time was spent at the beach, at the restaurant, at the concert, and just doing nothing other than being together and having a grand time. Pam says everyone is so comfortable with each other that they just pick up where they left off, no matter how long it has been since they've been together. Of course, Pam had a wonderful experience although she is very tired. Above all, she is very happy and thankful for devoted friends from the past.

Pam has an appointment with a GI oncologist at the Moffitt Cancer Center in Tampa scheduled for April 8th. Before that date was confirmed, we arranged a visit to the Mayo Clinic in Jacksonville to seek a treatment plan for April 8th. We will sort out this scheduling dilemma this week.

Thank you for your prayers and unfailing support as we look for the next step in dealing with the cancer and its effects.

3-5-2010 Pam met with a Moffitt Cancer Center physician in the GYN clinic in a followup to her May 2009 visit. In comparing pathology reports from June 2009 and February 2010, we learned that the reports focused more on cancer cells in the bile duct in the liver than cancer cells in the ovaries. In view of all the chemotherapy treatments with no consistent measurable results, the doctor believes that a diagnosis of cancer of unknown primary is appropriate. Pam will be referred to a medical oncologist in the Moffitt GI Department for review and evaluation of GI tract adenocarcinomas and possible diagnosis of cholangiocarcinoma (bile duct cancer). We were unable to speak to any member of the medical staff in the GI Department or anyone familiar with phase I clinical trials.

The visit to Moffitt did not meet our expectations,, but we must now be more assertive and diligent in seeking test results and comparative analyses.

Your prayers and blessings have brought us comfort and hope. We remain optimistic for a treatment that will make Pam more comfortable.

2-26-2010 Pam has not received a report from the biopsy of the tumor on her liver. Tissue specimens will be analyzed by a lab for molecular structure which may lead to another form of treatment.

Meanwhile, Pam will visit Moffitt Cancer Center in Tampa next week to promote assignment to a cancer trial which features treatment with avastin. We considered treatment with avastin last year, but opted to continue with chemotherapy. Now that chemo has not been successful we will look at an alternative treatment. Avastin works by blocking blood flow to the cancer cells, but there are potentially dangerous side effects in the intestinal area. It apparently has not been used extensively for cancer of unknown primary.

Pam continues to deal with abdominal pains, and lack of energy and appetite with courage and hope. She did very well on a trip to Orlando for a visit with my brother and his wife. The opportunity to travel for fun really appealed to Pam.

We ask you continue to pray for healing. May God bless you all!

2-16-2010 Pam has been very weak and simply exhausted the past few days. She was extremely upset she was unable to attend church or work with the children at their handbell practice. That is one of her loves in life.

Pam underwent a biopsy of her tumor and xray of her abdominal area today. The biopsy tissue specimens will be sent to a lab for testing to help identify exactly where the cancer started. Although all the available chemo treatments for cancer in the ovaries and GI areas have been tried with little, if any, success, we hope that something may come out of the molecular testing. The xray will let her know if there is any blockage of the digestive system and may help explain why she feels so full without eating much. She is now taking megase to help increase her need and desire to eat nutritiously.

We remain strengthened in hope and faith because of all your prayers and unfailing support. May God bless you all.

2-11-2010 This week has been unsettling. We identified two clinical trials which seemed to be looking for participants with conditions similar to those of Pam, but reaching the contact persons has been time-consuming. Pam has learned that she is not qualified for one of the trials involving molecular testing because she has had chemo treatment. That stipulation was not clearly spelled out in the criteria for participation. Pam has yet to speak to a contact for the second trial.

Meanwhile, Pam has experienced heartburn, constipation , and lack of energy and appetite each day. She overcame those conditions to practice with the handbell and sanctuary choirs. It is what she loves to do. Other church activities have been rescheduled so everything does not go on the same night and Pam will do what she can to join in.

We are not sure what the next step will be with respect to cancer treatment, but we know that your prayers will lead us. May God bless you all.

2/5/2010 Pam saw her oncologist today and he is supporting her participation in clinical trials. After some further tests, Pam will be attempting to qualify for two trials ready to start in 5 weeks. Our problem has been identifying clinical trials for Pam because she has undergone treatments utilizing all the accepted chemical protocols. We thank all our friends for sending us information on cancer of unknown primary and various success stories. Maybe Pam will be accepted into one or both of these trials.

Meanwhile, Pam has been dealing with abdominal pains, lack appetite and diminished energy. Still, she has been singing with the sanctuary choir and playing handbells. She has been steadfast in her support of the needs and feelings of others while downplaying the effects of the cancer. Pam has been strong in her faith and a source of inspiration to me.

Thank you for your continued prayers and Christian fellowship.

1-22-2010 Pam had a quality visit with her college roommate and several friends in the Florida Keys. The weather was perfect and she even had time to shop.

Pam's CT scan showed the cancer has spread with numerous nodules appearing throughout the abdominal area. It is clear that the six different chemo treatments have not been effective over the past 18 months and no other drugs are available. Pam will no longer be taking chemo treatments, but she asks for any and all information that may be available about experimental clinical trials for cancer of unknown primary.

Pam remains strong and will continue to work with the music ministry and other activities at church.

We thank you for your continued prayers which have guided us and helped Pam endure the cancer treatments. May God bless you all.

1-19-2010 Pam had a CT scan today and she will discuss the results with her doctor on Friday, the 22nd. Meanwhile, Pam is still suffering from constipation and abdominal discomfort. She learned her calcium level in her blood is elevated, which may have contributed to the constipation problem. Consequently, she was administered a treatment targeting the calcium concentration.

Pam is wearing down from the continuing medical procedures, the side effects of the chemicals, and the inability to do everything she would like to do. We are going away to the Florida Keys for two days with the expectation that a change in environment will be beneficial for the psyche.

Thank you all for your continuing prayers and support.

1-15-2010 Pam opted to forgo a chemo treatment today. She just felt like she needed a break from chemo. Her doctor appreciated her concerns about persistent constipation, lack of energy and appetite and scheduled a CT scan for January 19th. Pam's last scan was in October 2009. Even if Pam had a treatment today, she would have been scheduled for a scan in accordance with her treatment plan.

Meanwhile, Pam is planning to attend a handbell workshop tomorrow and a full schedule with church music on Sunday. The church activities really seem to help her overcome the debilitating effects of the cancer.

1-13-2009 Pam has had a rough time for the past two weeks. She has had little or no appetite while experiencing abdominal discomfort and frequent constipation. These conditions have affected her energy level, yet she has been able to sing with her choirs and lead the bell choir practices.

Pam is scheduled to meet with her oncologist this week and have a chemo treatment on Friday. Her blood work has been acceptable recently and should not affect her scheduled chemo. We continue to search for clinical trials that Pam may qualify for participation, but her diagnosis has ranged from ovarian to cancer of unknown origin. Chemo treatments targeted for many different types of cancer have not yielded marked improvement, but we hope the current treatment with Doxil will provide results.