It's December 2015 as I write this, and I am enjoying my in-between time.

For me, in-between times are the months between treatments – times when I can almost forget that I have multiple myeloma.

I have been in and out of a variety of treatments since I relapsed in 2013. The good news is that all the treatments worked for a while. The bad news is that all the treatments worked only for a while, or the side effects became so awful that I pleaded to stop the treatment.

Unfortunately, my myeloma cells multiply whenever I am not receiving treatment. This is the nature of multiple myeloma for many of us. How the myeloma team knows when it’s time for me to return to treatment is the elevation of immunoglobulin A (IgA) in my blood.

Over the last year, my myeloma specialist determined that, in my case, a high IgA correlates closely with a high percentage of myeloma cells in my bone marrow. To my relief, this means no more bone marrow biopsies. Instead, I just have my blood drawn for the IgA level.

Here is the paradox of my life. Within two months of no treatment, my IgA rises to more than six times the normal level. Each month, as I await the IgA results, I check my body. Nope, I do not feel sick.

Last summer, when the IgA had reached a new high, my son asked my favorite myeloma doctor “How long before my Mom will get sick again?” “No one knows,” was the answer. The argument is that I would be much more difficult to treat if we waited for symptoms to appear.

I should be relieved because, at the time of my diagnosis, I was severely anemic, with weakness, shortness of breath, and fatigue. My bones were at a severe osteoporosis stage, and I experienced a pathological fracture of my humerus because my bones were soft. I felt ill. Now my symptoms are muted, and I have to rely on lab tests to monitor my progress. I struggle with the chronicity of this disease.

For the months of September and October, I agreed reluctantly to return to treatment. Two days a week, back to back, I received the infusions of Kyprolis ^[1] (carfilzomib) and dexamethasone ^[2] (Decadron) for three weeks plus daily Revlimid ^[3] (lenalidomide). The fourth week was treatment free. I repeated the cycle in October. I had received the same Kyprolis regimen in May and June already, but this time side effects worsened. The most troublesome were nausea, vomiting, constipation, and diarrhea.

Yet the care I received was excellent. The nurses, pharmacists, and oncologist tried a variety of strategies to minimize the symptoms. By the second month, I experienced lessening of the side effects with a combination of drugs. I also used visualization techniques during the procedure as well as acupuncture and massage before or after treatments.

The second month was difficult, but I felt safe and cared for by the professional team. Friends checked in regularly. Exercise, including participation in a local “cancer walk and talk” group, helped. Journaling worked too.

The two months passed, my IgA dropped to almost normal levels, and the treatment team supported my decision to take a break in treatment.

Similar to previous breaks in treatment, my husband and I used the time to travel. This time we toured Zion National Park in our little camper, running away from winter. We hiked a lot, exploring the majesty of nature. I focused on training for a 10k race. Mostly I enjoyed being with my best friend, my husband.

As in previous in-between times, my mind was clearer, my body stronger, and my emotional state more even, and I thoroughly enjoyed it.

In January 2016, I predict I will return to treatment. The myeloma team may try one of the new drugs. I am prepared for this return.

Over and over, I learn that I possess many skills to cope with the challenges of drug therapy. Each day I continue to be grateful for being alive.

Here is a poem that I wrote recently about my in-between times:

In-between times are when I live
Leaves glow, wind awakens
My mood lightens as I step into the outside world

During times of the poison,
My passport for the well world gets canceled,
I move into the interior world of ill
Embrace sleep, books, wine
Focused on my body, I forget to look anywhere else
Joints ache, private symptoms appear in public without my permission

In-between times, I choose to live
Gulp down life with hikes, bikes, and poetry
Laugh as much as I can
Ignore the coming threat of the next infusion
I look for signs in the clouds
Will the wide blue skies tell the answer?

They tell me that this poison is keeping me alive
And I look really good
Wide blue skies,
Is this good enough living?