There is a lot you have to adjust to when you are living with metastatic cancer because it will be with you the rest of your life. The one thing I just can't get used to is that regardless of what plans you may have or any commitments to which you've agreed, without much notice, your body can say, "No.” You become overwhelmed by a feeling of exhaustion, and you can't move. Literally.

It's such an awful feeling because your mind is ready to go, excited about the plan, but your body forces you to lie down. At that moment, you realize you are not going anywhere. You are stranded. For me, those feelings aren’t fleeting: They can last anywhere from 24 to 48 hours.

I was supposed to fly to Cleveland today for my dad's birthday. I was so looking forward to celebrating with him, and I know he was eagerly anticipating our time together. But then it happened. I am glued to my bed. I had to call Dad to say I physically cannot make it. I can't blame it on the flu or a migraine. It's the same with dinner plans, parties, concerts, all the fun stuff you look forward to, and up until the day before, you are certain will be fine. Then, you're not. I hate it.

I would love to share an article written by the late oncologist Jeffrey M. Piehler, who battled prostate cancer. He lived with metastatic cancer an unusually long time, 12 years, which puts Dr. Piehler and me in the same boat.

He was addressing a group of colleagues and had so many articulate insights into living through the pain and discomfort of disease, while, at the same time, preparing himself to die. This is the portion that resonated most with me:

"People often ask me how I cope with my disease. In truth, that’s one of those secret of life questions that defies a single answer, and perhaps even a coherent one. To some extent that is because, as I intimated, I can be a moving target. Although the inevitability of my disease has never been in doubt, thanks to you it’s progression has been variable, as have been the emotional resources needed to live with it.

But if I did have to give the most succinct answer to that question, I’d say the key is to maximize the times when you can condense your life down to the moment of your next breath. Savor that moment, and everything that surrounds you, with all your senses. Give up both past and future with equal determination."

My takeaway? Live in the now. The past will make you nostalgic then deeply sad. The future will take you to a place of thinking about family experiences you will miss. Hard to do, for sure, but it’s wise advice for us all.