This summer, for the first time in the 40 years that we have lived in New York City, my wife and I have arranged to spend weekends in “the country.”

While we knew many people who regularly went with their children to a cottage in the Catskills or the Berkshires, three to four hours away, I always marveled at the weekenders’ organizational skills. How did they compress work and household management into five days? When did they do the laundry and the grocery shop­ping? Where did they get the emotional skills necessary to gather their children in the car and join the traffic lines on Fridays? How did they manage two house­holds?

We somewhat smugly told our friends that Manhattan was such a fine place to play on the weekends. Muse­ums, parks, and bicycle paths are plentiful, as are concerts and plays, indoors and outdoors. Long Island ocean beaches are a train ride away for riding the waves and listening to them crash against the shore. And great hiking is available in the Hudson Highlands, a 90-minute drive from the City. And anyway, how can you live in a place that doesn’t have a 24-hour grocery store across the street, an adjacent pharmacy, dry clean­ers, and restaurants too numerous to mention?

However, this year we decided to join the country weekenders, in large part because of the stage of my mul­tiple myeloma. This, of course, requires abandoning our smug attitude toward country weekenders, but friends have been forgiving (perhaps because of the myeloma diagnosis).

The impact of the multiple myeloma on our routine has been enormous.

First of all, I have to be at the medical center frequently.

The current stage of my myeloma treatments involves weekly (or often twice weekly) visits to the medical center: my Pomalyst ^[1] (pomalidomide) treatment has required weekly blood tests to ensure that my white and red blood cell counts don’t drop too low.

In addition, I spend four hours each month at the medical center receiving an intravenous gamma globulin infusion. Add to that another monthly visit with the medical team.

On top of that, I may start Kyprolis ^[2] (carfilzomib) later this summer, which entails two intravenous infusions a week.

All these medical visits preclude planning for any lengthy vacation, so weekends are all that is available.

Second, the side effects of some of the treatments have required that we cut back a lot on our former Man­hat­tan summer activities.

After my stem cell transplant last year, I can no longer bicycle at all because I never quite recovered my bal­ance and my hands have been too delicate to hold the handlebars for any length of time. I dream of our old bicycle rides, and perhaps on some cool quiet morning, I will try a short ride.

Any walk or museum visit longer than an hour has to be broken up by frequent rests because of neuropathy in my feet. The thought of hiking beyond a mile or two is really intimidating, for I am one of the relatively rare patients who suffers renewed neuropathy from Pomalyst.

Finally, and probably most importantly, I’ve been spending four to five hours swimming in a pool every week, so my wife thought that lake swimming would be a great treat for me. I know she is right. While I have loved the rhythm I have established swimming in the pool, swimming in a clean, fresh-water lake (particularly one like ours, that prohibits motorboats), is indeed a great pleasure. My family annually vacationed on a small lake near Mackinaw Island in Michigan, so I learned in child­hood the pleasures of lake water swim­ming.

Thus, going with the flow, we have joined the hordes and arranged a weekend rental 70 miles north of here. The cottage and lake are located in rural New York City water supply country, adjacent to a 14,000 acre New York State park, just east of the Hudson River.

We take the train to a small, nearby town where we rent a car and drive over to the lake.

We just spent our first weekend there, swimming, canoe­ing, and getting acclimatized to the rustling of leaves, open windows, and chirping birds.

Rural living will require some adjustment in our orientation and a whole new way of organizing our daily lives, but hopefully we will find this new experience rejuvenating.

As many other columnists have observed in their Beacon articles, the diagnosis of active multiple myeloma changes almost every aspect of your life.

I’ve spent a great deal of time trying to learn the basic biology of the disease and treatments. I live with a constant awareness of my mortality and have attempted to get my personal and financial affairs and pos­ses­sions in some sort of reasonable order.

The rhythm of the week is disrupted by my dex days, and I have had to learn how to avoid “roid rage” and other mood swings induced by the medications.

I have learned to slow down. I have had to learn how not to fight too hard against the waves of exhaustion that mysteriously hit me some days: I have become a master of the 20-minute nap, sometimes twice a day. I have learned to let a crowded subway train pass by and wait till there is a train that comes into the station where there is a reasonable chance that I can get a seat. I have learned that there is no need to rush across an intersection just as the “Don’t Walk” sign is flashing its last warning sign. I thank drivers for yielding to the unsteady person (me) in the crosswalk. I have become an afficionado of nature in Central Park, which I almost always cross on my way to or from the medical center.

And now I have become one of those country weekenders, who, feeling a bit guilty at my disloyalty to the city, travels to the country for greenery, clean air, and lake swimming.

I hope to have some country tales to add to the Manhattan tales I’ve been writing about these last two years.

Happy Fourth of July weekend to everyone, and to those readers who are patients, here's to understanding the new rhythms and phases of our myeloma-infused lives!