We will make another check of my CEA levels at next Monday's chemo, but I am not scheduled for the CT scan until Tuesday, 5/7. I won't have a formal diagnosis until after the CT scan. However, the likelihood that this is a false alarm is rather low. More to the point, even if the new metastasis somehow is not happening right now, it will soon enough. There has been an awful inevitability about this since we learned the outcomes of the January surgery.

I'm power-cycling through a number of difficult reactions. The sons of Mars nip at my heels. This is expressing itself in part as a much higher priority on sorting through the material here in the house before I become so ill I would not be up to the task. Hence yesterday evening's plunge into the Basement of Terror, which resulted among other things in the uncovering of my eighth grade English teacher's year-end farewell note to me. This read, in part, "If you were thirty years older or I were thirty years younger..." Which both very amusing and more than a tad odd.

Also, here's the text of an email I sent my primary care doctor yesterday:

I had a very unfavorably high CEA reading last week. I have a CT on 5/7, and I'm seeing [my medical oncologist] on 5/8, but it would be thoroughly unsurprising if I were presenting with a new round of liver mets. Given that surgery is no longer an option due to the fragility of my liver, this may be the beginning of my end game. If not right now, almost surely sometime within the next year or sooner.

A question I'd been wondering about was the progress of late stage liver failure. As I understand my most likely current prognosis, that is likely to be my cause of death. Is there delerium, dementia or cognitive failure associated with that process? I'm wondering if I should make some plans around mental incapacity.

Can we discuss this process? Or is there a liver specialist I should discuss this with?

The number of horrors which I have to parse as a part of my everyday life just keeps mounting.