Despite being a lifelong Boston Celtics fan, one of my favorite coaches is former Los Angeles Lakers coach Pat Riley.

I know that sounds traitorous to most Celtics fans, es­pe­cial­ly con­sider­ing the fierceness of the teams’ rivalry in the early and mid 1980s:  Bird versus Magic, Showtime versus Blue Collar, Kareem versus The Chief, McHale versus Worthy.

With all due respect to Lebron James, Kevin Durant, and the rest of the NBA today, those were the glory days of the NBA!

As a young coach during that time, I consumed everything Pat Riley wrote and said.

My favorite work of his was a book written in 1993, “The Winner Within.” The book outlines the stages that teams and organizations go through in order to reach excellence.  It is also filled with “Riley’s Rules” – words of wisdom that he has accumulated over his playing and coaching career.

Riley claims the best piece of advice he ever received was from his father, who told him “Every now and then, somewhere, someplace, sometime, you are going to have to plant your feet, stand firm, and make a point about who you are and what you believe in.  When that time comes, Pat, you simply have to do it.”

And while, in the big picture of life, our chosen path of treatment as myeloma patients doesn’t equal who we are or what we believe in, at some point in our battle with this disease, we do have to plant our feet and stand firm in terms of what path of treatment we will choose to pursue.

Ultimately, for most of us, that choice revolves around whether or not to have a stem cell transplant.

The Myeloma Beacon has certainly served its readers well in regards to this decision.  Columnists, guest columnists, forums postings, and research articles have provided ample food for thought for anyone who has to decide whether to proceed, delay, or completely forego a stem cell transplant.

For me, an avid reader of all parts of the Myeloma Beacon, the information I have gained from this site has been invaluable. The wide range of opinions expressed has caused me to more closely examine what path I will pursue.

For me, the time has come to plant my feet and stand firm in what I choose to do.

I will proceed with the stem cell transplant in June, barring any unforeseen circumstances beyond my control that might occur between now and then.

What led me to this decision?

It certainly isn’t the research or literature.  As best I can determine, they are all over the place.  Therefore, as is typical with this disease, it very much revolves around individual circumstances, experiences, and phi­los­ophy and trust in medical treatment.

In my first column, I shared the fact that I was initially uncomfortable with the watch and wait approach, noting that it bothered me that myeloma cells were percolating in my body and we were doing nothing about it.  I wanted to be aggressive, proactive.  I wanted to “cut the head off of the snake”, so to speak.  And while I grew to accept and even appreciate watching and waiting, no one will dispute the aggressiveness of a stem cell transplant, which is more in keeping with my outlook in taking on challenges.

A prime factor in my consideration was my age and health.  Apart from the side effects of treatment that I am experiencing now, I am in excellent health.  (I am happy to report, by the way, that the side effects have di­min­ished considerably since my last column ^[1]).

At age 58, I am at the younger end of the spectrum of those diagnosed with myeloma.  While there appear to be diverse opinions on whether or when to have a stem cell transplant, all agree that it can be a physically and emotionally taxing procedure.  I choose to undertake that procedure while in good health, because I don’t know what health issues I might face two, five, or ten years from now.

Coinciding with that is the age and health of my wife, who will be my primary caregiver during this procedure. It is my understanding that a caregiver will also be physically and emotionally challenged during this pro­cess.  I am comforted in knowing that she will be providing care for me while in excellent health.

Relevant, as well, is the age of my children.  They are 22 and 18 years old.  Next month, my daughter grad­u­ates from college and my son from high school.   They will be impacted far less by the stem cell trans­plant ex­per­i­ence now than they would be in the future, when it is very possible they could be starting families of their own.

Health insurance has been an obvious factor in my decision.  As I complete my 36^th year working in edu­ca­tion, retirement is very much a possibility for me in the near term.  The fact that the out-of-pocket expenses will multiply sevenfold when I move from my employer-provided plan to the retirement system plan has been a factor I could not overlook.

The best advice I can share from my experiences in dealing with this disease is to leave no stone unturned when it comes to health insurance. I was totally unprepared (and shocked) at what I learned as I in­ves­ti­gated this.

The uncertainty that surrounds health care in the future was also something I could not overlook.

As a school superintendent, I am directly involved in negotiating our health care policy and premiums with health insurance providers for our employees.  After meeting with numerous health insurance repre­sen­ta­tives over the past six months, I am convinced that major changes in health care are on the way, especially for those of us whose monthly costs of treatments are often measured in the tens of thousands of dollars (or higher!).

It is said that the devil is in the details.  I’ll take my chances on the devil I know – our current health care system – rather than one that has yet to be fully defined, may change at the political whim of an elected official, and most likely will be quite different five years from now.

I had the opportunity to talk with three individuals who have had a stem cell transplant. One was a close friend, another an acquaintance, and the third a complete stranger who my best friend arranged to meet with me.  All three had successful results, and nothing in my conversations with them convinced me to delay or com­pletely forego the stem cell transplant.

I have an inherent trust in my medical team.  Where such trust comes from, I have no clue.  It may be due to the fact that both of my parents were nurses.  And as Mike Burns stated in a response to Paul Jakubowski’s excellent guest column ^[2], “I am not presumptuous enough to declare that, in several weeks [in my case months], I’ve learned more than my myeloma specialist has learned in X years of study and work.”

This disease, regardless of where we are in its progression, forces us to make life-altering decisions.  As I indicated earlier in this column, the stem cell decision is one of biggest decisions we have to make.  And, as many more enlightened columnists and readers than I have shared here at The Beacon, this disease is such an individual disease in terms of how we all react to treatment that we are all forced to base our de­ci­sions on our own individual experiences and circumstances, and not just on accepted protocols and reg­i­mens (as patients of other disease are often fortunate enough to be able to rely on).

I hope that, in some small way, those of you wrestling with the decision regarding a stem cell transplant have gained some food for thought through my sharing my decision making process with you.

Whatever you do, plant your feet and stand firm!