Today I began my fourth year on pomalidomide in conjunction with dexamethasone and cyclophosphamide. The good news is that nothing much has changed since my last update in March 2017. At some point the monthly blood test results will reveal that this trio of drugs is no longer working but, for now, I am grateful that all continues to go well. The side effects of the drugs regularly cause me to feel lousy for a few days each week. In the weeks ahead I am going to try changing the day of the week on which I take my regular dose of cyclophosphamide to see if I can shorten the length of time that I feel "off" each week. April will mark seven years since I was diagnosed with myeloma and amyloidosis. While my doctor reminds me that the disease is in an acute phase the daily reality feels more like a chronic condition. Given the alternatives I am very fortunate, indeed.