For over two years I have had it pretty good. I have been able to largely ignore my illness. The fact that I smoldering myeloma has meant no cancer treatments, only treatment of symptoms by giving me three units of red blood cells about every six weeks.

But the times they are a changing. I am needing more blood. My hematocrit has again fallen to 25. It will be only 4 weeks until my next transfusion. This is a significant amount of blood. And the side effect of iron buildup now needs treatment. Exjade is an iron chelating agent that is expensive. Thankfully, I have good insurance that covers almost all of the $6,700 monthly cost.

But we have decided that there has been enough progression that treatment of the disease is now needed. I will be starting on Revlimid and and dexamethasone. the cost of Revlimid is apparently about the same as Exjade. So just those two will run better than $13,000 per month!

Makes me think about health care. How much is my life worth? How much is any life worth? There are many who can not afford this treatment. What should be done about that?

We are starting with this two drug combination. It's about tradeoffs. Adding a third drug would be perhaps effective more quickly, but it would be IV and tie me to coming in for treatment every two or three days. Also side effects would likely be worse. So to balance treatment with quality of life, we will start with two.

I can't help thinking this decision will define the rest of my life. Is it the right one?