Resilience in the Face of Autoimmune Disease

March is Autoimmune Disease Awareness Month and Women’s History Month, a time to recognize the resilience of women whose lives are shaped by chronic illness—and the strength it takes to keep moving forward.

For American Liver Foundation (ALF) Liver Life Advocate®, Ashli Cook, that strength was tested early in adulthood. After moving to Nashville, TN in May 2016 to begin her first full‑time job, Ashli was navigating independence and long workdays when her body began sending warning signs. Fatigue, swelling, and unexplained weight gain slowly appeared – symptoms she initially dismissed as stress. However, by December, those changes had escalated into a medical emergency. Ashli shared, “My parents came to visit me around Christmas—they took one look at me and knew something was wrong. I had probably gained 80–100 pounds of fluid from swelling, and my skin and eyes started to turn yellow in mid‑October.”

Ashli was admitted to the hospital and diagnosed with liver failure caused by autoimmune hepatitis (AIH), a chronic disease in which the immune system attacks the liver, causing inflammation and damage. Suddenly, her life revolved around scans, blood work, and learning what it meant to live with a chronic, often invisible illness. Within months, she found herself in need of a lifesaving liver transplant and was placed on the transplant waitlist—an overwhelming reality for someone so young.

AIH is unpredictable, marked by flares and periods of remission. Ashli explained, “When I was pregnant with my daughter and son, my body went into remission. But once I hit the three‑month postpartum mark, that’s when my body went into a flare.” Over the years, Ashli has learned to listen closely to her body, adjusting her pace and expectations while managing medications, frequent appointments, and the emotional weight of living with uncertainty. Even in moments when her health was fragile and everything felt overwhelming, Ashli pressed forward, motivated by her role as a mother and her determination to be present for her family.

Today, Ashli continues to navigate life with AIH while raising her children and advocating for greater awareness. She uses her voice to educate others about autoimmune liver diseases, the realities that come with waiting for a transplant, and the importance of understanding that liver disease doesn’t always “look” the way people expect. Ashli shared, “Whenever someone hears about my health condition, they are immediately shocked after I explain everything I’ve been through. I’m hoping to make a decent impact on people.” Although Ashli remains on the transplant waitlist, she hopes to keep her native liver for as long as possible.

During a month dedicated to honoring women’s contributions and raising awareness for autoimmune diseases, Ashli’s story is a reminder that strength is not always loud. Sometimes, it’s found in persistence, advocacy, and the courage to share your story, so others feel less alone. To learn more about autoimmune liver disease, visit liverfoundation.org, or join Ashli in making a positive difference by becoming an ALF advocate or sharing your story, today.