Having multiple myeloma ^[1] isn't simple – It's hard! Not only do you have cancer, but you also have a dizzying array of treatment options available to you. Additionally, it doesn’t just affect your health–it can affect just about all aspects of your life.

First, you and your caregiver need to decide where to go for treatment. Do you travel across state lines to a large, regional or national cancer center that specializes in treating myeloma? Or do you pick a medical center closer to home?

What about insurance? Cost may ultimately determine where and how often you are treated. Are you sacrificing quality of care for financial considerations?

How do you know which therapy option to choose? Do you start induction therapy and then proceed immediately to transplant? Or do you wait and watch and delay your transplant until later.

How long do you take bisphosphonates like Aredia ^[4] (pamidronate) and Zometa ^[5] (zoledronic acid)? If your myeloma is stable, do you reduce the frequency of your bisphosphonate treatments, or discontinue them all together?

How do you plan for the future? Median life expectancies of people with multiple myeloma are heading in the right direction. Good news, I know! But it can make it difficult to budget and plan.

Multiple myeloma is close to being considered a chronic disease. Living a long time with a serious illness presents its own set of challenges.

Currently, once approved for Social Security Disability, multiple myeloma patients often continue to receive disability payments until they die. But as myeloma patients live longer, will that policy change? What then?

It isn’t easy holding down a job when you need to take time off regularly for tests, to see doctors, and to receive treatment—or if you are in constant pain.

Pain management can be difficult for the majority of multiple myeloma patients with bone involvement. Working can be difficult or downright unsafe for those taking high doses of prescription pain medications.

Here is another unfortunate reality: Long term survivors soon learn that family, friends, and acquaintances lose interest and are less available to provide help and support as time goes on. When a person is first diagnosed, friends and family often make earnest offers to help with housework, transportation, or cooking. But as the real life drama subsides and everyone settles into a routine, that help can start to dry up—whether you continue to need help or not.

Let’s stop here. I’m sure we could easily come up with a number of additional challenges. It is easy to identify the challenges and disappointments presented to those living with multiple myeloma. It is more difficult to begin to resolve and solve them.

That is where I hope to help—even if just a little. For the next few weeks, I will be writing a series of articles for my column specifically designed to help multiple myeloma patients better plan and organize their lives—and maybe even help solve a specific problem or two.

Until then, feel good and keep smiling! Pat