I've got my first hematologist appointment next week, and I intend to ask whether the MGUS may have any impacts on any of the other medical issues I've got going on, or whether any of those issues or their actual/potential treatments might have ramifications for the MGUS.

At this point, I've got a multi-page table tracking my various medical issues: upcoming appointments, notes/questions for the appointments, past appointments, outcomes from past appointments, drugs, side effects of the drugs, actions I've taken to manage the side effects of the drugs, non-traditional stuff I've tried, etc. Really, it's a journal in table format. Because I've given up entirely on being able to hold it all in my head.

The medical community operates in silos -- not their fault, it's just how it is. But the human body/mind is not made up of silos -- it's an integrated whole. Expecting my excellent but overworked PCP to coordinate all that effectively is just absurd. So these days, when I see each physician (let's see -- at the moment, it's seven of them plus, of course, my pharmacist), I try to encourage them to think about the consequences of each diagnosis/treatment on all the other diagnoses/treatments.

I'm 72, I'm living a quite engaged life, and I am not my diagnoses. Since I want to hold onto that as long as possible, doing my best to help my medical providers operate as a team has become one of my priorities. Because it's really hard for them to do that if the patient isn't actively helping.

I recently asked my migraine neurologist to take a quick look at several possible insomnia drugs I planned to discuss with my PCP, and she flagged one that she routinely uses off-label with success as a migraine preventive. You never know what can pop when you try to be somewhat holistic about things.