One Step at a Time

On July 10, Chronic Disease Day, we recognize the millions of Americans living with long-term health conditions that affect every aspect of daily life. For American Liver Foundation (ALF) patient advocate, Randy Ramey, that reality became all too familiar when a series of health challenges – including liver disease, diabetes, heart disease, and kidney failure – changed his life almost overnight.

In July 2023, Randy was diagnosed with pneumonia. At the time, swelling in his ankles was believed to be related to his heart. After cardiac issues were ruled out, doctors began looking elsewhere and ultimately discovered the true cause: advanced liver disease. Looking back, Randy sees the signs had been there for some time. “I had questioned intermittent swelling in my ankles during the prior year,” he recalled. “In hindsight, those were the beginning signs of liver failure.”

Just three short months later, Randy received the devastating diagnosis of stage 4 liver cirrhosis. His decline was swift. He went from working full time to sleeping 16 to 18 hours a day. Some days, he couldn’t get out of bed. As his physical health deteriorated, so did his emotional well-being. “I went from healthy to unable to function within months.” Within a year of his diagnosis, Randy was told he would need a lifesaving liver transplant and was added to the transplant waiting list.

As specialists continued evaluating him for a transplant, they uncovered additional health complications. Randy was diagnosed with metabolic dysfunction-associated steatohepatitis (MASH) and severe heart blockages that required immediate attention. In total, he underwent a double bypass surgery, liver transplant, and later, a kidney transplant. Despite each setback, Randy was determined to continue moving forward ‘one step at a time’. “I’ve always been a ‘one step at a time’ kind of guy, and that became my motto throughout this journey.” Today, Randy is one-year post-transplant and focused on rebuilding his life. “I feel like I'm 90% back to the person I was before transplant” he said.

Randy’s journey has fueled a passion for raising awareness about chronic disease, the connection between liver disease and coexisting conditions such as obesity, heart disease, and diabetes, and the critical importance of early detection. “I don’t think people fully understand how important the liver is to daily life,” Randy said. “We tend to think of the heart as the most important organ, but the liver is right up there. Knowledge is power, and catching liver disease earlier could help prevent more people from reaching the point of needing a transplant.”

Managing liver disease alongside other chronic, coexisting conditions can feel overwhelming. This Chronic Disease Day, Randy hopes others living with chronic illnesses understand they are not alone. Whether you're newly diagnosed, awaiting a transplant, recovering after transplant, or caring for a loved one, support is available. Through support groups, patient education resources, and transformative programs like the ALF Living Donor Network™, ALF helps patients and families find the information, connections, and hope they need to move forward – one step at a time. Learn more and see how you can get involved at liverfoundation.org.