What to Know About Telehealth for Multiple Myeloma

Patients who have multiple myeloma are at higher risk of severe illness from an infection. But combining in-person care with telehealth visits can help minimize the potential exposure to contagious diseases.

Since the COVID-19 pandemic, clinics and hospitals have taken extra precautions to protect patients from being exposed to circulating viruses. Telehealth has also become a viable option for those who prefer to manage some aspects of their multiple myeloma at home.

When to Use Telehealth for Multiple Myeloma 

Several aspects of multiple myeloma care can be effectively provided via telehealth. You and your medical team can plan when a virtual visit is appropriate.

Specialist diagnosis: The diagnosis of multiple myeloma requires examination of blood, urine, or bone marrow biopsy samples. These samples must be obtained with in-person procedures. But if you live in a region without a nearby specialist who can diagnose your condition, or if you need a second opinion during your diagnostic process, a specialty consultation can be obtained via telehealth.

Post-treatment monitoring: After treatment for multiple myeloma, such as chemotherapy, side effects and treatment efficacy need to be monitored closely. Devices are being developed that continuously measure relevant vital signs at home.

Infection surveillance: Since 2020, the COVID-19 pandemic has highlighted the dangers of infectious disease for people who are at risk. Multiple myeloma affects the immune system and has been a risk factor for severe infections since before the pandemic.

If you have multiple myeloma, your medical providers can regularly work with you to monitor signs of infection—such as fatigue, fevers, appetite changes, and more. Your providers will advise you when it’s time to seek in-person care for a more thorough evaluation and treatment of an infection. 

Disease surveillance: Your disease can cause effects such as pain, fatigue, and bone fractures. Telehealth visits can be used to follow the course of your condition so that you can discuss signs and symptoms of disease progression with your medical team and get recommendations for the next steps in your care.

You May Need to Be Seen in Person

With multiple myeloma, many situations require in-person care and cannot be managed with telemedicine. These include:

• Diagnostic testing, such as a biopsy, blood tests, or imaging tests
• Chemotherapy treatments that require in-person administration
• Testing for new signs and symptoms that could signal disease progression or complications
• Immunizations to protect yourself from certain infections

Symptoms for which you should seek urgent medical attention include:

• High fever above 101 F (or based on your healthcare provider’s guidelines)
• Lethargy or fatigue 
• Pain 
• Vomiting or diarrhea 
• Weight loss 
• Severe headaches, dizziness 
• Change in consciousness 

Many of the complications of multiple myeloma, such as infections, must be treated with intravenous (IV) antibiotics and potentially other support, such as respiratory assistance. Bone fractures, another complication of multiple myeloma, often need to be managed with in-person care, such as a cast placement or surgery. 

Benefits and Challenges 

There are several advantages to getting some of your multiple myeloma care with the assistance of telehealth. Patients who have multiple myeloma report increased satisfaction when telehealth is incorporated into their care, and you might have this experience as well if you use telehealth. 

Safety from infection exposure: Because of your susceptibility to infections, staying home for some of your medical visits can help keep you safe from exposure.

Convenience: If you have multiple medical providers who take care of different aspects of your treatment, scheduling some of them via telehealth can help prevent exhaustion for you, especially if you experience substantial fatigue due to your condition.

Challenges 

Among the challenges of using telehealth for your multiple myeloma care is the danger of potentially missing complications or delaying interventions to treat complications. Some symptoms of multiple myeloma are subtle, and progression of the disease might not be obvious.

• Blood tests can detect problems, such as anemia.
• Your healthcare provider may also notice signs like skin changes or swelling during a comprehensive physical examination in the office that cannot be easily detected with a telehealth physical examination.
• Getting the right technology to communicate with your providers and track your symptoms might not be easy for you.

These are among the reasons why it is important to combine in-person care and surveillance with telehealth in the comprehensive care plan for multiple myeloma. 

How to Prepare for a Telehealth Visit for Multiple Myeloma 

If you decide that you want to use telehealth for some of your medical care, you should discuss the idea with your primary care physician, your oncologist, and any other healthcare professionals that take part in your care.

If one or more of your healthcare providers can accommodate you with telehealth, you can consider making appointments to see them this way. You should also check with your healthcare payer to see if they will provide payment coverage for your telehealth visits.

You also need to get access to technology devices that you can use for your telehealth visits. You may be able to use your own computer or the computer of a friend or family member. A local community center or library may provide you with access and a secure, private room where you can have your visit. 

In preparation for your appointment:

• Take your medications as prescribed.
• Keep track of symptoms you have had, including fatigue, weakness, pain, bruises, swelling, or skin changes.
• Become familiar with the side effects of medications you take, and note any side effects that you have experienced.
• Get any blood tests or imaging tests that your healthcare provider has ordered for you. 

What Happens During the Visit 

You can have several different types of telehealth visits for your multiple myeloma care. You may be seen for a routine follow-up and surveillance or evaluation of a new symptom of concern.

With either of these situations, your provider will listen to your description of any symptoms you are having, ask clarifying questions, and review information from remote monitoring or other tests you have had.

You may have a modified physical examination, which can include observation of your skin and abdomen. If electronic monitoring devices are available to examine your heart rhythm, you will be asked to use these as well.

Your provider will discuss the results of your assessment and talk to you about a plan for care. The plan can include scheduling your next surveillance visit, taking pain medication, treatment for your cancer, further testing, or an in-person follow-up appointment.

A Word From Verywell

Multiple myeloma care is highly specialized. You will need close medical management coordinated by several healthcare professionals throughout the duration of your treatment for this condition. Incorporating telehealth into some of your care adds convenience and will help keep you safer from exposure to infections.