Seven months ago, after hav­ing smol­der­ing myeloma for 10 years, I crossed over into the ‘active’ dis­ease category. Thankfully, there was no dramatic myeloma defining event, just a painful bone mar­row biopsy that showed 60 per­cent plasma cells. How long I have been at 60 per­cent, I have no idea, which makes the de­ci­sion to proceed with treat­ment a dif­fi­cult one for me.

Back in March, when Covid-19 was start­ing to grip my region, my doctor agreed that it would be prudent to hold off on treat­ment, as Seattle was in the midst of trying to prevent a surge of the virus. I happily complied and have been hanging out ever since. My num­bers have not been changing at all, so I thought that I could stay in this sort of sus­pended animation for quite some time.

But not so. I most recently ‘saw’ my doctor via a video­con­fer­ence call. He was masked and in an exam room; I was tucked in a corner of my bathroom, for privacy (plus the light and wifi are good in there). During that call, he said that they have man­aged to prevent the surge and they under­stand more about treating the virus. He added he has had one patient with smol­der­ing myeloma catch Covid-19 and not re­quire any treat­ment. So, ac­cord­ing to him, Covid-19 is under con­trol, and he advised I begin treat­ment.

I came away from that appoint­ment bewildered. It’s all good and well that the med­i­cal com­munity feels like they have a handle on Covid-19; I’m grateful for that. But for me, the patient, it’s still a very clear and present danger.

I have not been into a store since early March. My only in-person appoint­ments have been with the physical therapist, the lab, a PET scan, and a quick check at the dentist. My friends don’t come into my house. My hus­band-and-wife housekeeping team, which used to come every two weeks to do the big stuff, moved away in April after everyone dismissed them. I haven’t had any of my usual sup­port­ive care such as massage and acupuncture. I don’t have safe access to a pool or the gym. I don’t share a house­hold with my part­ner, so I haven’t been within six feet of him either. It’s just me and my teenage son, who only sees his friends for masked and socially distant outings outdoors, which are far and few be­tween.

Beginning treat­ment is a launch headlong into a scary un­known. While I’m not a con­trol freak, I am someone who likes to have some semblance of con­trol of the things that I can. I always imagined that when I would need to begin treat­ment, I would con­tinue to in­cor­po­rate integrative ther­a­pies to maximize my wellness and well-being as my body reacts to the myeloma med­i­ca­tions and my spirit is dampened by stress, pain, and un­cer­tainty. This pan­dem­ic takes those things off the table, and I’m left with a very lim­ited arsenal of things I can do to help myself have an optimal re­sponse to treat­ment.

Now this may sound like I’m whining, but I don’t agree. I have seen stud­ies showing that can­cer patients who have good social sup­port, use integrative ther­a­pies, and have pos­i­tive attitudes have better out­comes during treat­ment. The constitution of my attitude would be a lot stronger and more pos­i­tive if I wasn’t stuck in my home feeling guilty for putting my teenager through the terror of his only living parent hav­ing an incurable can­cer, and him hav­ing to give up his ac­tiv­i­ties to shield me from Covid-19. I would feel more in charge if I wasn’t in such a confined situation, wary of venturing out for wellness care, separated from my loved ones.

My stress level would be lower if the world wasn’t collectively grieving, if our country wasn’t in the midst of a contentious election, and if the 13th anniversary of my hus­band’s passing wasn’t looming. This, to me, does not seem like a good time to begin treat­ment.

But what are my op­tions?

I could refuse to start treat­ment, which makes me a liability and also puts me in danger of bad things hap­pen­ing (think compression fractures and kidney dis­ease). Do I get a sec­ond bone mar­row biopsy? If I do, what hap­pens if it comes back with less than 60 per­cent plasma cells? Do I get a sec­ond opinion? Do I just bravely begin treat­ment, and hope for the best (after all, most people are masked right now so maybe it’s not such a bad time to begin treat­ment after all?).

I don’t think any amount of meditation, yoga, or even prayer will help me figure this out. I guess for now I have to be ok with feeling dazed and confused.

May we all go from strength to strength.