Defining your “WHY” can take some time.  This process needs to be at the heart of why you will stick to your exercise and meal plans.  This is the reason for getting up in the morning, the drive to push you through the hard days and is your argument with yourself when you want to quit.  There are no short cuts, no magic potions or pills. No one can do it for you and no one can take your place if you’re not here.  Remember that last line, if anything else, “No can do it for me, and no one can take my place if I’m not here!” Let that be your Motto and your Why if you don’t have or until you find one.

I didn’t tell my family or children for several months about my diagnosis.  I needed to have some control of my body, my health and my weight loss.   I did not want to scare them or give them any unnecessary fear of the 10 year timeline.  So, after meeting with Angie, I decided that I would first cut down on sugar and processed foods with the goal of total elimination in 3 months. 

October, 2018, I started with my guilty pleasure, Pepsi and Dr.Pepper.  I didn’t drink as much as some, but enough to make difference in personality for the first few weeks. I mean was drinking like 3-4 sodas a day.  I began cutting it in half the first week, so only two a day and then one a day for a week.  I had some headaches and was a little tired and grumpy. Then by the third week I cut it back to one soda every other day, and by the forth week I was down to one soda every two or three days.   I was off soda by six weeks.  Yay!  I know what you’re thinking right about now, how did you eliminate sugar right as the holidays began?  Honestly, it was probably the best time to do it.  My “Why” was the strongest, I had more determination to hold to it and being with my family and gave me reasons to hold strong.

My husband Mike and I went to visit our daughter and her family in Phoenix between the Christmas and New Years break.  She had two small boys, Liam almost 2 yrs old and Ben 4 ½ months old.  We decided to go for a small hike one day at “A Mountain” in central Phoenix.  It’s less than a mile round trip and 233 ft elevation gain.  By all means, for a healthy, in shape individual this hike would be a breeze.  For a near 2 year old, he ran back and forth as struggled with every step. Mike made the hike look easy; he even carried the grandbaby and toddler at times on his shoulders like a good Papa would do.  My lungs burned, my legs were on fire.  I labored to catch my breath.  I didn’t know how I was going to make it to the top, but I knew I would make it, because I would not quit in front of my daughter, son-in-law and grandsons.    There were even a few moments I fought back tears of despair, “How could I let myself get this out of shape? Never again! Never would I be this out of shape, which I couldn’t keep up with my gradson(s).”  I did make it to the top. We took some photos and headed down the mountain.

As Mike and I got back to the car, I did get emotional. Well, more than a little. It was an angry, and I cried. I was angry with myself for being in this spot in my life: angry that I couldn’t tell my daughter of my illness, not yet.  It was still too soon.   I had been focusing on my meal plans, what I was eliminating from my diet but had not yet began to exercise.  I had a good handle on food; whole foods, fruits, veggies and lots of water.  I was almost at the 3 month mark since my diagnosis and this was another turning point for me.  I needed to start exercising.  Food modification was not enough.  With the elimination of sugar and processed foods, I was down about 25 pounds, but it didn’t make a difference in my ability to walk less than a mile up hill.  It was time for new goals with my WHY, and stating them out loud makes them real, and helps you commit.  Telling your goals to someone and then writing them down solidifies the goal and holds you accountable. I stated, “I’m going to start exercising.”

Mike looks at me understandingly, not sure how to answer.  He had to choose his words wisely at this point, he usually always does, but my timing has left him open and primed for sarcasm.  He replied, “Yes, you and the rest of the world will begin their fitness goals next week on the 1^st of January, BUT (and he had a short pause, as he looked at me and without speaking was telling me with his eyes just wait there’s more), I know you will stick with it.”

So I did.  We returned back to Logan and I did two things.  First, I called a friend Anessa, she was just getting started with schooling for becoming a personal trainer.   I informed her I was ready to start exercising and could she help me with workouts and second I went into our local Planet Fitness and joined.  This is where my fitness journey begins.

Who’s in control, You, or your doctors?  Do you blindly do as they suggest or do we do what our gut is telling us?

My first visit with my GI physician was not a good experience. It would be my first and last visit with him.  All I needed, for all intents and purposes, for my insurance, was a visit with him the GI, to get a referral to see a liver specialist, a Hepatologist.   I assumed I would meet with him, review my testing, family history and then he would refer me to someone more qualified.  But then there always seems to be those one of a kind bad apples, who think they have a “God complex” and are the only ones who can help you. Yep, this was the one who walked in the door to see me. He sat down at his computer, didn’t bother to look up at me or my husband to make any sort of eye contact or to  say hello while he looked at my chart and insurance profile.  The first words out of his mouth should have been something like, ”Tell me why you’re here, or tell me about yourself…” Nope! He said, “Well, it looks like your weight is putting a lot of stress on your liver and you’re a great candidate for gastric bypass surgery, it looks like your insurance will cover it completely, let’s talk about it. What do you think?”

I replied in shock with, “What do I think?  I ‘m not here for surgery to lose weight! I’m here to get a referral to a specialist. ”

How he dare think, that because I have great insurance, that my weight is high, that this is the reason I am here to see him for surgery.  He didn’t ask me a single question, anything about my lifestyle, if I ever had any depression, what my pregnancies may have been like, if I experienced any trauma etc.   There are so many reasons people, let alone women put on weight.  I explained to him my past 28 years, with a little we’ll say passion in my voice, “I am accountable to my weight for many reasons.   I have gained and lost weight over the past 25+ years. From 6 high risk bed rest pregnancies, and each one I was able to lose most of the weight.  I dealt with depression on and off throughout my life, being on medication that put weight on.  I have suffered with PTSD which, in itself, is self explanatory.  In short I have been on the roller coaster with my weight for over 25 years.  In high school I was very thin, an athlete, and dealt with anorexia.  I know how to exercise and lose weight.  I am here because in the last 6 months, without any changes to my diet or routine, I put on over 60 pounds, and my father who died from NASH just 5 years prior.  I started to add up some signs and symptoms and I am connecting the dots.”  Then with more emotion, dare I say, a little anger and frustration in my voice I told him, “I AM NOT HERE FOR GASTRIC BYPASS SURGERY, I WANT A REFERAL! I know how to lose the weight; I can do that on my own.”

What he did next was shocking!  He stood up from the little computer desk he sat behind and very frustrated said, “You know that in 10 years you will not be here.  You will not lose the weight without me, your liver and pancreas will fail and you will need a transplant.  If you’re lucky you’ll be put on the transplant list, but less than 30% actually receive an organ.  If you could lose the weight, you would have! If you won’t have the surgery, I won’t be your doctor!”  My husband could see that I was quickly going from frustration to anger.  He gently placed his hand on my leg as to have a quiet and silent reminder, “this isn’t worth it.”  I wanted to yell at the doctor, I wanted to swear at him, to be honest.  I took a deep breath and responded, “I do have a choice, I will not have the surgery and I will not have you for my doctor!”  He grabbed his notes and quickly stormed out of the office.  Ironically, the doors in the office were barn doors on sliders with soft close systems. He tried his hardest to slam the door, and in anticlimactic fashion the door came to a slow – gentle close.  Mike and I just laughed as I began to just cry.  With everything he said, it wasn’t the comments about my weight; I knew I could lose it.  It was the 10 year comment. 

When my dad was diagnosed, he was told he had a couple of years and should think about getting on the transplant list.  He wouldn’t even consider putting himself on the list at the time.  His philosophy was, in order for him to receive a liver, most likely a young motorcyclist would die so he could live.  He believed someone more deserving should receive the liver over him.  He didn’t want to have to be on medications the remainder of his life to maintain the new organ.  He had resigned to his diagnosis; he had lived a great life and would now live out the remainder of it spending as much of it as he could to spoil his grandkids and making memories.

So back to the gentle closing of the door; Mike and I are sitting in silence and I utter out loud, “10 years?” and tears well up in my eyes. I am thinking of my two grandsons, my future grandchildren, my children being left without a mother. My children who haven’t gotten married yet, so on and so forth.  The thoughts are racing and Mike says, “Take a deep breath we will take this one step at a time.  We will find another doctor.”   And then the door starts to slowly reopen. There’s a knock and enters a female physician. She introduces herself and asks, “May I ask what just happened in here?  I have never seen the doctor so furious.”  Mike explained what happened, I was a little emotional and needed to compose myself.  She then said, “That makes sense; No one has ever turned him down or said no to him.  I understand you do not want to follow under him.  Would you like to consider working with me?  What can I do for you?  What do you need?”  I explained what I needed, what I was looking for and we came to an agreement.  We talked for about 20 minutes, she asking me questions about my health history and needs.  She took the time to get to know me!   We agreed upon her following me with labs and scans every 30-60 days while I started a diet modification and as long as things were improving I would stay under her care.  If at any time things looked like they were plateauing or trending downwards then she would refer me to a specialist.

 She was listening to me, taking my feelings and fears into consideration, I felt as though we had a provider to help me. Now I needed someone in the holistic realm to help and I knew exactly who I wanted to help me.  I asked Mike to drive us directly to my friend Angie’s home.  Angie has been a friend for over 25 years, a nurse, a holistic healer, worked with oils, herbs and more.  She was the first person I spoke to about my diagnosis.   

For years the weight would come and go and now I had my WHY for needing and wanting it to stay off.  My weight was the trigger to get me into the doctor’s office for my diagnosis.  My WHY would be my motivation to overcome this disease! This time it would be the last time I lost the weight, improved my health in the process and to prove I would be around longer than 10 years.  So how do you find your WHY?

Chapter 1

“We need to talk.”  This phrase has so many meanings.  It can invoke positive excitement of anticipation; it can be lead to curiosity and suspense, or harbor even fear.  Hearing this phrase on the phone from my physician immediately brought me back to memories of hearing the exact same words from my dad.  So many times he would call me on the phone and say, “Hi Sarah, We Need to Talk.”  Most of the time it was good, but one of was the last time he uttered those words to me, I’ll never forget them.

My family and I were visiting my parents in early October 2013.  They lived in Kanosh, a small town in the center of Utah.  We knew my father’s health was declining fast and we were trying to spend as much time with my parents as possibly.  We drove from American Fork to Kanosh, about 100 miles to help my father harvest his small, but plentiful garden.  In the middle of the day, he uttered those words, “Sarah and Mike, We need to Talk.”  We had my brother entertain our kids with the 4 wheelers and we went inside for a conversation.  I knew this would be serious.  I knew that just the day prior he had a paracentesis done; a procedure to drain excess fluid buildup in his abdomen. This is a complication to advanced NASH.  He had been averaging every 5-6 days between procedures, but now needed it done twice a week. He informed me that the fluid buildup was continuing to increase each time he went in and this time there was a complication.  This was the reason for our talk.  He felt prompted to get his affairs in order. Today quickly turned from a happy visit to “This is what I need you to take care of.  You and Mike are to take care of your Mother. “and so forth. He knew didn’t have much time left, and he didn’t. 

When I received the call from my physician and he asked if I could come back to the office, his exact words were,  “Sarah, we need to talk, and I feel this would be better in person and not over the phone.”  I knew what he was going to say.  I knew deep down inside what my labs were. I am my father’s daughter and this was just confirming my suspicions that I had his disease, and I agreed to meet later that day.

Frankly, when we met, I think he was more in shock than I was.  I was already prepared for it.  I went to him for the validation of the lab work confirming my symptoms.  He was the one who originally was in disbelief that I could have a Liver disease at 45, after all, he thought it was just all chalked up to obesity symptoms; so why look any further?  He looked right at me, dead serious and said, “Your liver panel is higher than I have ever seen before, especially for someone so young.  We need to run more test. Get an ultrasound…” and I interrupted him.  I told him, “Thank you for confirming my suspicions, but if it’s all good with you, I just prefer to get a referral to a Liver specialist.  My Dad waited too long to see a specialist and I’m not going to make that mistake. “We talked a little longer and found out I had “proper channels to go through for my insurance.  I would need to see a GI, Gastroenterologists.  So I went through the process of getting set up.

Losing my Dad to this disease was hard. Losing the grandfather to my children was even harder.   From the time my dad was diagnosed to the time he passed away was 22 months.  He was told he needed to lose weight or he was pre-diabetic.  It wasn’t until he had ruptured veins in his esophagus, that they realized, or they looked further into all of his health conditions.   I knew I was going to fight this disease with everything I had in me.  I was going to fight it for my dad, as if he was along side, telling me, “If I knew sooner, I would have fought!”  It was too late for him, but not for me.   I was an athlete in High School. I knew the basic fundamentals of exercise and healthy eating.  I had done the Yo-yo weight loss with pregnancy, battled with depression and PTSD.  Now it was time to fight for my life, fight for my kids and grandkids. 

Now to see the GI and get his opinion…Yeah, this does not go well!

Have you ever had one of those years where you thought you were doing everything right? Your job was going well, your home life was good, you thought your eating habits were good…Everything was good… Right?

Then one evening, after many nights of inability to sleep you begin to add up all the random, but “could they be connected symptoms?” you’ve been having.  You suddenly begin a mental list of the unexplained weight gain, fatigue, brain fog, restless sleep and so on. Yep, that was me, back in October of 2018.  I finally connected all of the dots and it hit me, it hit me like someone just slammed the front door. I have the symptoms of early NASH.