In August I wrote a column titled "Reflections ^[1]." In that column, I dealt with the question of what the worst part about having multiple myeloma was.

Personally and professionally, I am now going through a far more reflective stage in my life than I was then.

In six weeks, I will retire from my position as a school superintendent. After 37 and a half years in education, there are plenty of memories to reflect on. Because of the fact that multiple myeloma has such a huge impact on my life, reflecting on issues associated with living with multiple myeloma is something I have also done a lot of lately.

This state of reflection was initially caused when I read a recent issue of Time magazine. The cover story of that issue was titled "What if I just decide to do nothing? Breast cancer's new frontier."

The story describes how doctors are rethinking breast cancer treatment, particularly calling into question the "cookie cutter," one-size-fits-all approach to treating the disease. After reading the story, I couldn't help but reflect on the basic question of the story - What if I had just decided to do nothing when I was first diagnosed with multiple myeloma?

I don't think I need a medical professional's opinion to say that the lesions on my hip, spine, and femur would have become problematic and impacted me in a way that was avoided by starting treatment when I did. In addition, my myeloma markers would have skyrocketed and other more serious symptoms associated with the disease would have manifested themselves.

Perhaps the question of not doing anything is even more relevant now that I am on maintenance therapy. I have read of others who have chosen to forego maintenance therapy after achieving a level of remission, whether remission was achieved through induction therapy or an autologous stem cell transplant.

As I battle sudden, unexpected, volcanic bouts of diarrhea three days a week and bronchitis that seems to linger for months on end (all side effects from the Revlimid ^[2] (lenalidomide) maintenance program I am on), doing nothing at this time sounds very attractive.

Reflective discussions and Monday morning quarterbacking on treatment are common for those of us afflicted with this disease, and there is no shortage of columns or articles (both personal and professional) espousing what should or should not be done.

There are many other questions or issues I have reflected on lately, one being the words or terms used to describe multiple myeloma.

I cringe when people use the word “terminal” to describe multiple myeloma. I associate the word terminal with imminent death.  Newly developed treatments in recent years have lengthened the prognosis and, in many cases, have allowed multiple myeloma patients to live near-normal lives for years.

By the same token, I also question the use of the word “chronic” to describe multiple myeloma, a word that seems to be used more commonly now.  The use of that word seems to minimize the seriousness of the disease.

I’m sure that one could say this is nothing more than a question of semantics, but I prefer “incurable but treatable,” a phrase that best describes the true nature of our disease.

I also have tried to understand anecdotal evidence that disputes the scientific facts about multiple myeloma.

Multiple myeloma is rare. According to the National Cancer Institute, myeloma represents 1.6 percent of all new cancer cases in the U.S.  You have a 1 in 143 (0.7 percent) lifetime risk of getting the disease.

And yet, I know six people who have multiple myeloma.  I am not talking about casual acquaintances. These are individuals I know well – parents of former players, a Canadian fishing trip partner, a neighbor who lives a block away, a very close work associate of my wife.  I know more people who have multiple myeloma than who have any other type of cancer.

One of the things I continue to reflect on is the heterogeneous nature of multiple myeloma.  Most diseases and their treatments may be similar, and my limited knowledge of physiology and the human body probably con­trib­utes to my inability to comprehend this. Using an autologous stem cell transplant to illustrate my point, I could very easily describe my stem cell transplant to be as close to a near-death experience as I would ever want to be. And yet there are others who have described their stem cell transplant experience, amazingly, as restful.

One of my New Year’s resolutions was to take better care of myself:  to exercise, eat right, and rest when fatigued. My doctor and his staff have preached the importance of this approach since my initial diagnosis, especially emphasizing it since my stem cell transplant in June of 2014. In retirement, I will have no excuse for failing as miserably as I have in these important tasks of living with multiple myeloma.

I have always told my staff and my teams that self-reflection is a valuable tool in improving personally, pro­fessionally, and spiritually. We owe it to ourselves as people with multiple myeloma to use reflection to help us deal with the reality of living with this disease and to hopefully improve our condition while doing so.