It's eleven at night, and tears took me while I was brushing my teeth. I don't know why it was that moment that it suddenly hit me, the realization sinking deep into my bones, tingling on my skin—but right then, I felt overwhelmed with the magnitude of what tomorrow means for me.

 Tomorrow is my birthday—my thirtieth birthday.

 Seventeen years ago, I first read the phrase "average life expectancy" connected with cystic fibrosis. At the time, the life expectancy was 34. It was an enormous thing to grapple with as a new teenager; my thirties seemed so old, so far away, and yet the idea of not living past them felt claustrophobic and, at times, crippling.

 And yet here I am, on the cusp of this new decade, only a little bit worse for the wear—ready to tackle many, many more years to come.

 When I was six months old, my parents were told that I wouldn't live to turn twenty. Sometimes, the last decade of my life feels almost decadent, like a truffle center, unexpected and delicious.

 And here I am, half again as old as that original prognosis.

 I try not to think often about CF and life expectancy. I have enormous anxiety about the future, and compensate by largely pretending it doesn't exist more than two or three months out. But on birthdays, the full weight of that reality hits me a little differently—not as clutching, clawing anxiety for what I might someday lose, but as soul-deep, heart-pausing gratitude for what I've had.

 I don't know what the future will bring. My disease is still unpredictable, still progressive, still incurable. And yet, on this birthday eve, feeling the gratitude for that extra decade warm in my throat, I feel ready to face the future—thirty, thirty-four, and beyond.