Dear ANN SILBERMAN,

I love my insurance company. I have no complaints about them. They have approved every test, every treatment, and every single thing I've wanted to do about my cancer, even when it isn't a normal treatment, like liver resection. I have not gotten any big bills or any surprises. Referrals and authorizations happen within a day or two and birds sing and bees buzz when they are around. I highly recommend them to anybody who has a terminal illness.

But, they keep sending me these letters.

Dear ANN SILBERMAN,

Keeping track of healthcare needs can be challenging for all of us. We are here to help. If you are due for care, please schedule a visit with your doctor. You are due for:

Colorectal Screening: Rates of colon cancer are decreasing because screening can find pre-cancer and treat it before cancer ever develops.

Cervical Cancer Screening: It's time! The American Cancer Society recommends a PAP test every 1-3 years based on your medical history. Please make an appointment with your PCP or OB/GYN for your Pap test.

Sincerely,

Your Health Care Team

I get these letters every other month or so, and I throw them in the round file, ignored.

Maybe you don't know this, but once you have cancer that has metastasized to another organ, you don't really need screenings to go looking for cancer anymore. You've already found a sufficient amount.

Based on my medical history, I've kind of moved past screening mode and gone straight into treatment mode. I have regular CTs of my insides, which will show anything going on, so taking a few cells off my cervix in a cancer hunt seems pretty old school at this point.

Yes, one of the beauties of Stage IV breast cancer is you never have to have a screening colonoscopy. Honestly, that's one of the first things I thought when I found out my cancer had metastasized. "I guess I won't have to do the 50 year old colonoscopy thing now, thank God."

That's how badly I don't want a camera up my butt.

As far as keeping track of healthcare needs, I think I am managing just fine, thank you very much. Last week alone I had an appointment at Nuclear for a MUGA, then two days later at my oncologist's office for a Zometa drip, and then yesterday I had one at Radiology for a chest/abdomen/pelvic CT. That, my friends, is three appointments in one week, none of which I missed or was even late for.

That doesn't even include several phone conversations trying to reach the infectious disease guy, which were unsuccessful. I am, apparently, only allowed to speak to him through his very unpleasant secretary. I am going to have to find a different doctor to treat C-diff, maybe get a referral to a GI doc. Which, will happen fast with my insurance, and who will not be allowed to put a tube up my butt.

In any event, I am the Queen of keeping track of my healthcare needs, and don't need a letter to help me with the challenge.

Next week is my down week; one appointment only. I see my oncologist on Wednesday.

But, it's a biggie - I get the results of Friday's CT.

For the first time, I don't want to hear what it says, good or bad.

Maybe once in a while my healthcare needs include denial.

.