I sense a kind of opportunity or challenge for Panko. Given that her health issues and other obligations are making it hard to stream specific content (games) she could use this to her advantage. At the very least they would offer both content for us and an outlet for her energies. I consider these to be what she could do to keep herself up and running while at the same time giving herself a challenge:
1. Yapping. We all enjoy a good zatsudan, and it forms the raw basis of any chuuba's repertoire. Without it there is nothing, so much is known. What Panko could do alongside normal zatsu is to borrow an idea from Remi - thematic zatsu. Remi is a hardcore weeb and uses this to her advantage, it's something she knows much about and what she enjoys talking about. Panko could use the same approach, simply choosing a topic she knows a lot or a bit about and using it as a vehicle to express her opinions and thoughts on the subject. These could be about whatever she finds interesting - fashion, current memes, old memes, anime, cartoons, movies, a specific subculture or oddity, or anything she has some knowledge about or interest in. These would also serve as a bonding experience since we would get to know her better if she leans into her own interests. This would naturally be quite welcome and is the point.
2. Thematic and RP streams as done by Lumi and Uruka. Both of these girls have put out great streams while roleplaying as this or that and I think Panko could try the same. This would constitute the challenge bit since she has never done anything like this. It obviously doesn't have to be GFE, nor do Lumi and Uruka do those. While the ride might be bumpy at first and the girl herself might not have the faintest idea on how to do these or what exactly to RP as that one's on her. She needs to figure it out.
3. Singing. No elaborate explanation necessary. She is a singer and has a lot to offer in this regard, so she could incorporate more karaoke into her content.
4. Reaction streams with a caveat. Reaction streams are dangerous because they can utterly consume a chuuba and leave behind a hollow husk, but there is a variation that I think nullifies this - watchalongs. Specifically old movie watchalongs and by implication watchalongs of longer stuff, not clips or shorts or similar. Hell, it can even be a critique kind of deal. There should be enough copyright free music videos out there we could watch together, and Panko could give her opinions on the song and the vid. By utilizing polls this could also engage the audience. This Pippa tactic of old movies in particular would also work from a timezone POV, since the two stream at very different times. Watching movies together is a nice communal activity that avoids the pitfalls of reaction slop while having a comfy appeal bordering on GFE.
These are some of the admittedly simple things I thought Pankocchi could do for us while simultaneously grappling with her private issues. There's nothing new under the sun so there's no point in trying to shy away from utilizing these. Vtubing lives and dies with the talent, so even if these ideas have all been done before and will continue to be done they haven't been done by Panko, and that's the important distinction. This presents both an opportunity for her and a challenge. Something to work towards, something to struggle with. Theoretically it would strengthen her appeal and skill and open up new doors in terms of content and ability.
There is also another power to learn. A difficult and forbidden art of ASMR. It is something to consider, and she could do much with it. Perhaps even going the avantgarde route, the cursed route. One of my favorite memories is when a long time ago Pippa tried ASMR and while having sound issues we all tried to help her, which frustrated her and made her start cursing us and calling us fucking mongoloids while maintaining her whisper and a dreamlike atmosphere. I forgor the name of the stream, it was way back, but the point is this is what I'd consider "avantgarde" in this context. Panko could go for the off kilter feel, for the odd but soothing, or teasing, or cursed. ASMR is not simply ecchi, it can be anything. Experimentation leads to both success and disaster, but a good disaster is often a legendary stream.
In any case, Panko has achieved a lot and has grown a lot across the years in every capacity and has become a force in her own right. While her health and obligations are now roadblocks on her way there is no need for her to succumb to depression, sadness or other menhera tendencies. If one way is blocked another is open, and I offered a few here. They might not be what she wants to do, they might not be what she has planned to do or set out to do, and they might not even be appealing or "on brand" for her and the way she sees herself. But they are available routes, and they also offer a new path for growth. Imagine is she became proficient in ASMR, or RP, or found that she likes bullshitting us about topics she barely understands with absolute certainty that she is right. These would all be good content and would be great new additions to her toolbox.