Well, it was bound to happen sooner or later, but I was hoping it would be much much later. I went to the oncologist yesterday for my every-three month check up and she said that my tumor markers have been going up consistently for the past three lab reports (I get tested every three months). So she said we will likely be switching treatment. Good bye Arimidex/Anastrozole Hello Aromasin and/or Faslodex.

I've read that the tumor markers are not always reliable so the doctor is going to order a PET scan to confirm if there has been progression, but the problem is three months ago she ordered the PET and Medicaid refused to pay for it, so I got a CT scan instead. The doctor is going to push for Medicaid to pay for a PET scan but either way I will probably be switching treatment.

I think I had been a little bit in denial about the probability that I may die soon. I was hoping to be in the 3% of metastatic patients that get to live 10 years or more, in fact I'm still hopeful I'll beat the odds. But just in case I need to plan for the other alternative, right now I have a little bit of money that I could invest in a prepaid funeral service or something like that, there is also something called a "totte" trust fund which is disbursed upon death for funeral purposes.

The problem I'm having is I don't know if I want to be cremated or traditionally buried. Cremation would be easier on my daughter as she would be able to travel to Mexico with my remains and spread them in the ocean. Traditional burial would have to be here in the States, since it would be too expensive to fly my corpse to Mexico.

Traditional burial though makes it harder for my daughter. Once she graduates from Law school and passes the bar exam, she might be moving somewhere else, so if die before that and I'm buried in Orlando where we presently live, there wouldn't be anyone here to remember me.

Because of my religious beliefs (death people are death and have no consciousness) it really wouldn't matter to "me" what happens to my remains. Confusing I know.

But even before I answer the question of my burial/cremation. Before I die according to statistics and the state of medical science, I will probably deteriorate gradually rather than die suddenly and therefore another question in my mind these days is: How much medical intervention do I want at the end? I know I should file an Advanced Directive so that if I am not able to decide my daughter can make a decision based on my wishes.

But I don't know what those wishes are yet. (Maybe still in denial like I said). Right now I feel fine, quality of life is good, so I am leaning towards palliative care and hospice and fighting till the end. But what if I start suffering? What if the pain becomes uncontrollable? I wish for a peaceful death but at the same time I want to fight! Arrg I am only 54, I didn't expect to have to be making these type of decisions this early in life, but like someone says in my online support groups: "It is what it is."

I need to think about it some more, I only hope I have enough time until I can make a decision.
Sorry to be bringing these subjects right now around the Holidays, but this is my sounding board, my journal, and hopefully my inspiration.

Take care.
Aurora