Many evenings as of late find me huddled on the couch, joints aching, a low-grade fever toasting my body, and an inability to do anything but con­template an early bedtime.

I’m fine, really I am. I just saw my oncologist in early October, and his parting words were “See you in eight weeks.” My lab numbers are steady; I am on no medications.

So what’s up with my new nighttime routine? I do not have definitive an­swer, but I have a pretty good intuited guess. Call it fallout from being a member of the sandwich generation.

The term “sandwich generation” was coined in the early 1980s and really caught on in the 1990s. The phrase describes adults, usually in their 50s or 60s (and overwhelmingly fe­male), who are caught between taking care of their aging parents at one end of the spectrum and their chil­dren (teens or young adults) at the other. The resulting stress comes from being sandwiched in be­tween the older and younger generation, and tending to each, leaving little or no time or opportunity to take care of one’s own needs.

I am a member of the sandwich generation. But while my sandwich top is indeed the older generation (especially an elderly and increasingly frail aunt who lives one block away), the bottom is not my chil­dren. No, my children are doing well as they move into adulthood and parenthood.

The bottom of the sandwich is my multiple myeloma.

Let me tell you, I’d take the traditional bottom of the younger generation any day. Myeloma can out-tantrum the most terrible two-year old, out-pout the sulkiest preteen, and outlast the sullenest teenager. Car wrecks, tuition payments, and helping young adults survive the recession while they scramble for jobs are nothing compared to multiple myeloma.

Oh yeah, I’m sandwiched but good.

As the physical needs of the older generation (which also includes two aging parents living nearby as well) grow, I find those needs draining my reserves of energy. It’s not as if I have huge stores of energy to begin with; the myeloma took care of that nine years ago. When my reserves are drained and I am running on vapors is about the time the myeloma rouses itself and demands attention.

“Hey, April! Hey! Yeah, I’m talking to you. You know what I’m going to do since you drained yourself when you took your aunt shopping this morning? That’s right. I’m going to make it five times harder for you to get your energy back. How do you like them apples?”

Okay, I admit it. My myeloma has the persona of a street thug in a 1940s B movie. For good reason—my myeloma has that same thuggish narcissist worldview that it, and it alone, is worthy of my time and attention. Elderly aunt? Piffle. Cleaning the house? Small change. (Which would explain the desiccated moth on a living room windowsill.) Taking an afternoon to write a letter or mail a package? Come on, get real.

When I saw my oncologist earlier this month and he heard what I was doing on the elder front (and being well aware of my husband’s brutal work schedule), he turned to us both and said, “You two really need to take a vacation.” My husband Warren and I both said in unison, “We just took one!” My oncologist groaned softly and muttered that maybe we needed to take another one soon.

Later that same evening, I rehashed the discussion over supper. It reminded me of my oncologist’s response when I retired my law license after my tandem stem cell transplants. He said, “I would probably not have said to you that you had to retire, but I am very glad you did before it came to that.” His vacation comment resonated the same way with me. He will not demand we take a vacation yet, but at some point it may come to that.

For now, though, I am part of the sandwich generation. Pastrami on rye, ham on sourdough, vanilla ice cream on chocolate wafers: it’s all the same. I’m in the middle and the top and bottom are pressing in.

I’m not sure there are any quick fixes to this one. The needs of the older generation are real and immediate, every bit as much as the demands of my myeloma. For now, I will monitor the fevers; my personal physician is keeping an eye on me. And some of the rest can wait.

But at least I can go remove the dead moth from the windowsill.