Three months after my initial multiple myeloma diagnosis in the spring of 2007, my oncologist at Mayo Clinic, Dr. Zeldenrust, looked me in eyes and said, “The average Stage II patient lives 43 months.”

That's less than four years. It was an accurate, honest answer at the time. I had pushed and prodded him to give me a prognosis. Like many patients, I needed some idea about how to plan for my now shortened future.

I was 51 years old. My wife, Pattie, and I were both full time realtors. We raised rescued sled dogs as a hobby, running “his and hers” dog sleds. I taught skiing. Pattie was a runner and taught fitness classes.

Now I had dozens of holes (lesions) in my bones. I could barely walk, let alone run or ski. And I was dying. What would I do with the short time I had left?

In a way, if your doctor says you have six months to live, that's easier. You take a cruise, say goodbye to friends and family, and get your will ready and affairs in order. Then you hope and pray there isn't too much pain in the end.

If you are diagnosed with an incurable, yet chronic illness like diabetes or coronary disease, you adjust your life style, take your medications, and work to live and extend your life the best you can.

But what about you and me? Here we sit in “no man's land.” We still need to try and make a living. There are tests, chemotherapy, and probably stem cell transplants in our futures. Hopefully you get better—at least for a while. Then what? Watch and wait? Hope and pray for a cure? Try to ignore the pain from those slowly healing “holes in your bones,” and pretend nothing ever happened?

Last week, I wrote a column titled “Having Multiple Myeloma Isn't Simple—It's Hard ^[1].” I promised to “help multiple myeloma patients better plan and organize their lives.” So, here we go.

A month after that fateful conversation with Dr. Zeldenrust, I found myself on a plane to Las Vegas for a long weekend getaway with Pattie.

I do some of my best thinking and planning on a plane. I'm not sure why. Maybe it's all of the possibilities and lack of media distractions. Anyway, on the way to Las Vegas, I removed a yellow legal pad from my bag and started several lists.

I broke my planning down into four parts: The big picture, short-term goals, long-term goals, and budgets. I was trying to create a comprehensive life plan. Where would we live? How much would it cost? What could we do to help make ends meet if I couldn't work?

I was trying to think outside of the box. Heck—cancer had destroyed the box! Did we need to sell our house or give it back to the bank? Should we consider re-locating to a less expensive area—or move closer to a multiple myeloma-friendly cancer center?

You need to start with a budget and work your way backward. Actually, you will most likely need more than one budget, since it will change as you plug in different projected income and expense figures.

Your decisions will ultimately be driven by what you own, how much you have been able to save, and how much your spouse or caregiver can contribute to the monthly expenses.

I was hoping to start working more with my fellow cancer patients—and working less. But could I afford it?

Since I was sitting on an airplane when I started the process, let's use an airline analogy. They tell you on the plane that if the cabin loses pressure you should put your oxygen mask on first. You can't help others if you are gasping for breath yourself! I couldn't start my new life helping other cancer patients without money and a means of support. So I started a budget, and we started to plan.

I took all of this very seriously. I started my budgeting on the flight out west. I fine-tuned things flying back. I wrote down all of my expenses on one page—monthly income on the other. Months of missed work were beginning to slow our real estate earnings. Some weeks, I couldn't help Pattie or work at all.

It soon became clear it would be difficult for me to meet my work-related and personal expenses. The expense side of the page was significantly higher than the income side—and my income was likely to keep sliding lower.

After battling a blood clot in my lungs and spending a week in the hospital a month later, I realized we couldn't afford to stay in our home. We also probably couldn't afford to live in the small town of St. Croix Falls, Wisconsin, which we loved. The high cost of real estate taxes, heat, and maintenance on our large, aging home—it was all too much. And Pattie needed a steady job with a regular paycheck.

We decided to move to Florida. Pattie found a job in the more stable health care industry. We sold our home for far less than it was worth. But we bought a home for a lot less than what we got for our home—and cut our living expenses in half!

Our new home and neighborhood isn't perfect—and we miss Wisconsin. But removing financial stress from our daily lives has been liberating! Not worrying about our finances frees me up to concentrate on taking care of myself and helping other cancer patients like I had hoped and planned.

Maybe you will need to make a major move or life style change like we did. Maybe not; fine tuning may be enough. The important thing is be proactive. Take charge, set a budget, and create a plan—then follow it.

Next week, I will discuss identifying your priorities for your life plan. Until then, feel good and keep smiling! Pat