Synopsis: My multiple myeloma cancer is in remission. My biggest issues are constant fatigue and a lack of energy. I will be immunocompromised for the rest of my life. These are minor inconveniences and I consider myself fortunate.

Long version: I had my one year check in with my oncologist at Stanford. A review of my monthly blood test data shows that my cancer is in remission. Unfortunately, in addition to my markers for cancer being low, my red blood cell, white blood cell, hemeoglobin and hematocrit are also below the normal range. This is not unusual for multiple myeloma pateints on chemotherapy.

What does this mean to me? The low red blood cell, hemeoglobin and hematocrit all contribute to my chronic fatigue. For me, chronic fatigue means sitting in my TV room chair for about 10 hours a day. I can do some light chores, like washing the dishes, gardening and 4,000 step (2 mile) walks, but after doing any of these things I need to take a  nap. I'm afraid my days of intense exercise in the health club are behind me.

The low white blood cell count contributes to my immunocompromised state. The oncologist tells me it will be this way forever, as the chemotherapy that suppresses the cancerous myeloma cells also suppresses the closely related white blood cells. I need to be on the chemotherapy medication for the rest of my life. This means I need to take extra precautions to avoid any infection. My body does not make sufficient antibodies to protect me if I catch the flu. They have told me if my body temperature gets even slightly elevated to 100F, I am supposed to go to Urgent Care immediately so they can pump in antibiotics. It is not only COVID that could be fatal to me - just about any infection could have the same effect. I do not avoid going to the supermarket, but I wear a mask when I do, and I must avoid crowded situations, like concerts and movie theaters for the rest of my life. It is not depressing for me - it is just something I need to be aware of.

I try to live as normal of a life as I can. To give some examples, I recently drove from my California home to Las Vegas. I didn't go into the casinos, but used the hotel as a base camp for excursions with Pat to Death Valley and Bryce National Park. We plan to do a similar trip in the future to the Grand Canyon and Zion National Park.

Pat and I along with my son's family will be flying back to Massachusetts for an extended Hahn family combination reunion/Thanksgiving celebration. Seeing family and friends is the best medicine for me.

I think this will be my last update on CaringBridge for some time. As long as I am in remission, I will remain in the condition I described earlier in this update. The oncologist says that some year the chemo drug that I am on (Revlimid) will stop working and I will relapse. No one knows when that will be. It could be one year, 5 or 10 years. I'm praying for a long period of activity before relapse, as things go downhill following the relapse. In the meantime I appreciate each day and live life to the fullest.