I recently had lunch with a group of fellow multiple myeloma patients, during which we touched on the problems we patients have had with memory and cognitive issues.

We all agreed that the treat­ments we have received seem to have affected our states of mind.

For me, that was particularly true after my stem cell trans­plant in January 2010. I was dealing with many aspects of "chemo brain" at the time. These problems included short-term memory loss, slower thinking, and trouble concentrating. Sometimes I would walk into a room to get something and com­pletely forget why I was there. I also was having problems finding words and people’s names. I was weary and had trouble keeping up with the "normal" people in my life, which did not help me to stay mentally sharp.

Since then, I received treat­ment with Revlimid (lena­lido­mide) and dexa­meth­a­sone (Decadron). I pre­vi­ously had one treat­ment holiday for over three years, and to my delight I once again am off any myeloma treat­ments (since September 2016).

Compared to the time around my stem cell trans­plant, I feel very much better now. My energy levels are much higher than before so that I can stay busy with my family (especially my three grandchildren, who are toddlers now), work, and hobbies. Babysitting toddlers does take mental energy and con­cen­tra­tion because they have to be watched a lot of the time.

What has particularly im­proved for me is that I have more mental strength to deal with my myeloma. I am fortunate that my myeloma has become a chronic con­di­tion for me. After I got past the five-year survival mark, I realized that I had been fortunate and should try to live my life to the fullest now.

As far as cognitive issues go, I still have a few problems, but try to work around those.

I still stumble over words sometimes, and can’t speak quickly enough since I am searching for the right language to use. However, I don’t really blame myself any more for not finding a word to convey a specific meaning. My mother, sisters, and I have been playing Scrabble online since 2006, com­plet­ing what now probably amounts to hundreds of the word games. I think that these games help with my focus and mental sharpness.

Another activity I practice that helps me with mental sharpness is writing, where I need to go over words and phrases to try to convey meanings. I have been writing this column since 2012, when I already was over two years into my myeloma journey, and that has been a huge help to me. Inter­acting with the folks who comment has been great too, since it makes me try to think from their point of view as well as my own.

To help with short-term memory loss, I have an agenda calendar notebook where I keep track of all my appoint­ments, meetings, and other important in­­for­ma­tion during the year and refer to it daily so that I don’t forget something.

At my choir, we have to memorize two songs per season to sing them "off book" (we just finished up another choir season and had to memorize "Loch Lomond" and "Distant Land"). That is a challenge, as adults can struggle to memorize things compared to younger folks, and I am no exception to that. However, I really believe it helps me to stay sharper.

And more broadly speaking, I think my choral singing is helpful in getting me to focus on details in the music such as timing, dynamics, pitch, and generally staying together with the conductor and the rest of the choir. As far as I am concerned, all of this can only have a positive impact on my brain.

On a lighter note, even a simple task of remembering where I have parked my vehicle in a large parking lot is improving for me now. At times a few years ago, I could get really confused about where I had parked, and I would walk around literally in large circles looking for it.

Maybe it was cognitive problems that caused me to overshop sometimes too. I am not sure how to define that, but when I look at the number of projects I have collected for my fiber arts hobbies, I just wonder what I was thinking. I obviously overestimated the amount of time I have to work on my hobbies.

Of course, the big question is what my state of mind would be if I had not had all of those treat­ments for multiple myeloma.

Although I can never know that for sure, and even though I am feeling much better now, I wonder if I have lost some of my cognitive abilities due to the treat­ments I received. At the same time, I also realize that I am nine years older now than I was when I was first diagnosed, and that some of my issues may also be related to the natural aging process.

Be that as it may, I’ve decided to make the best with what I’ve got and live life to the fullest.

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The quotation for this month is from Roger Walsh (1946 - ), a Australian professor of psychiatry, philosophy, and anthropology at the University of California, Irvine, who said: "Keeping a [journal] need not be a major chore - just a few minutes of notes each day can be valuable. Writing crystallizes insights, fools the defense of forgetfulness, and builds a collection of ideas and reflections that can spur further insights even years later."