Heartbreak, Hustle, Hope + Resiliency with Sarah Michelle Boes (part 2)

Fire often looks like numbers on a dashboard—until life forces you to measure heat a different way. Sarah joins us to share how selling her exam-prep company collided with a late pregnancy diagnosis: her daughter Meadow’s tetralogy of Fallot with pulmonary atresia. The celebration turned into a sprint through cardiology consults, oxygen monitors, and an unforgettable ICU stretch that included an emergency re-opening of Meadow’s chest and a brain bleed. It’s a raw, unflinching account of what it means to make the right decision when every option is bad and time is a luxury.

We talk candidly about identity under pressure. Sarah goes back to work six weeks postpartum, learning in real time which parts of leadership bend and which must break. She pushes back on being boxed in as “just a mom,” while discovering the power of a company designed to run without a single key person. Then the story pivots: advocacy becomes a throughline. With Conquering CHD, Sarah helps reauthorize the Congenital Heart Futures Act, championing long-term research and better outcomes as more children with CHD live into adulthood. We explore emerging innovations like transcatheter valve replacements that could reduce future open-heart surgeries and change the trajectory for thousands of families.

There’s another turn—one too many founders will recognize. After 18 years of misdiagnosed symptoms, Sarah receives an OCD diagnosis and enters intensive treatment. She explains why exposure and response prevention works when talk therapy can backfire, and how her definition of success shifted from revenue milestones to sustainable presence: being a steady parent, a clear-eyed advocate, and a writer building language for hard things. She previews her memoir and children’s series, including Meadow and Her Four Leaf Clover Heart, a tender reframing of rarity and resilience for young readers.

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Transcript

Welcome And Episode Framing

SPEAKER_00 0:06

All of us reach a point in time where we are depleted and need to somehow find a way to reignite the fire within. But how do we spark that flame? Welcome to Reignite Resilience, where we will venture into the heart of the human spirit. We'll discuss the art of reigniting our passion and strategies to stoke our enthusiasm. And now here are your hosts, Natalie Davis and Pamela Cass.

SPEAKER_01 0:41

From a business sales standpoint, Sarah, I love that you how you described this partnership. You were like, I've met this company that I love and an adore. You don't typically hear that like in the brokerage sales side of businesses. Oh, no, no. It was important for you to have that personal connection with whomever, whatever entity your organization was going to take over, acquire, or merge with your brand that you had built.

A Sudden Diagnosis In Third Trimester

SPEAKER_04 1:06

Well, and the cool part is I felt like I got to have a lot of like founder-to-founder discussions with this company because the company that purchased mine, their CEO was a former founder of an LSAP brand. And then that LSAP brand, they got basically bought out by private equity. And so now he's like running the bigger conglomerate. And they have LSAT and they've got MCAT and they've got some ACT, GME, those sorts of things, but they didn't have nursing. So it was like felt like this really natural fit. And when we after we first met them, I was actually going out to California for a female entrepreneur's business retreat. And I was like, well, if we're gonna be in California, like let's just meet the dude, like let's just drive up there. And my husband was like, Yeah, absolutely, it sounds incredible. And so we got to meet and have like a human conversation in that way beyond just Zoom, and that was super helpful.

SPEAKER_02 1:53

That's awesome.

SPEAKER_01 1:54

Love that. Your daughter is born. How soon after her birth did you all receive the diagnosis?

SPEAKER_02 2:02

Yeah.

Birth, First Surgery, And High-Risk Home Care

Thanksgiving Crisis And Emergency Repair

SPEAKER_04 2:02

So it was a whirlwind to say the least. I sold middle of June, like June 16, 2022. And first week of July, we found out that something was wrong with Meadow's heart, but we didn't know what. Okay. And a lot of people are really confused. They're like, Why did you find out in the third trimester? Like, what is going on? And what had happened was in my second trimester, I just really I wasn't vibing with my OB. And I remember looking at my husband one day and being like, you know what? If something goes wrong, and like we need to do an emergency C section or make a decision or whatever else, like, that is not the human I want in the room with me. Like, I don't feel like she can meet me where I'm at. I'm feeling all this anxiety. Everybody's making me feel crazy. So I'm just gonna, I'm really I'm gonna have to be brave, but I'm gonna try somewhere new. And I know that sounds crazy in my third trimester, but I'm gonna do it. Which he very graciously supported. And when I met with that new OB in my third trimester, they were like, hey, because you're new to the practice, let's just do another anatomy scan. Like it's a liability thing for us, like just double triple check. And on that anatomy scan, they were like, something looks weird with her heart. But even then, the OB was like, I'm gonna go ahead and book your next appointment here. He's like, We're gonna book one with the specialty OB, and you can go get checked out or whatever. He said, But I'm gonna book your next one here because I know you're coming back. Like it looks like a normal variant, it's not that big of a deal. And then when I was 36 weeks, we finally got her diagnosis. It's called tetrology flow of pulmonary atrecia. And what that means in layman's terms is she has the most severe type of a set of four heart defects that commonly go together. And what that meant for her and for us is that she would have heart surgery in her first week of life. She would have heart surgery again before she was a year old, and then she would go on to have five to six more open heart surgeries throughout her life. So we went from thinking we had this normal, healthy baby, and now we're like, oh my God, we just sold a business and there's not even like a breath or a moment to celebrate it, take it in, even figure out like where the money's gonna go. You know, we we started working financial advisor, and they're like, we can put money in the markets over here and do this. And I was like, do not call me, do not email me until this baby is healthy and we figure out what's going on. I have no interest in talking to anyone. So all we did in the three weeks before we found out her diagnosis was literally like put some money aside to when they donate to charity because we knew we wanted to do that, but that was it. And when Meadow was born, it's so hard to have any kind of medical expertise and almost like simultaneously be a patient at the same time. Like I know I wasn't the patient, yes, but she was basically what they told us is the moments between her first surgery and her second would likely be the most high risk period of her entire life because the first surgery was a patch to allow her to grow bigger and stronger and have the best outcomes possible for the second surgery. And what a lot of people don't really understand when I'm like, oh, it was like a patch, and they're like, Okay, like she was like good, and the in-between. No, like I brought home a baby who like at a baseline's oxygen was 70% and wore an oxygen monitor all the time. And we spoke to her cardiologist twice a day when we were at home, submitting numbers. We submitted weight, we submitted how much she ate, we submitted all of her oxygen saturations, and it was just, you know, I took a very short maternity leave because I felt all of this internal pressure. You know, her first surgery went better than we anticipated, so we got out sooner. So, you know, six weeks after Meadow was born, I attempted to go back to work and trying to integrate into a company when you're at your like least capacity that you've ever been, because I really genuinely felt like I have just never been tapped like this.

SPEAKER_03 6:13

Yeah.

SPEAKER_04 6:13

It was really hard. And I think I was kind of set up for failure from the beginning. And I think I got lumped into like a little bit of a mom box, which is like the last thing that I wanted. I'm like, I am a fierce entrepreneur, like I built this thing, I sold it. Like I've done this incredible stuff, and then to like be put in a mom box was a hard, yeah. It like makes me sweat a little bit just thinking about it. But our initial hope was that her patch would last until she was about 10 months old. And unfortunately for us, she was born in August and her patch went bad emergently at Thanksgiving. And so I happened, it was Thanksgiving, so we didn't have any other childcare. It was just us. We didn't go to any Thanksgivings that year because when you have a baby whose oxygen is 70%, a calm and cold will kill them. So we just quarantined down.

SPEAKER_00 7:04

Yeah.

SPEAKER_04 7:05

And her oxygen, which usually ran at 70, dropped to 50.

SPEAKER_02 7:09

Oh, wow.

SPEAKER_04 7:09

She was dead asleep. You know, like sometimes that would happen, like, you know, her foot would move, or like the monitor would read wrong. They dropped down to 50. And I was like, is that real? And I was like, but she's not moving, like, what's going on? And luckily, when you're doing this high-risk, like at home program, they give you a number that you can call at any time, like holiday, day, night, it doesn't matter. So I called them, I said, Hey, it just happened one time, it came right back up, but her oxygen was 50.

SPEAKER_03 7:36

Yeah.

SPEAKER_04 7:36

And her cardiologist was like, you know, just bring her in. It was like, we'll just feel better, and you'll feel better if you bring her in. And then we found out that her patch, which was really the only thing giving blood to her lungs, and it's also, I'm so glad I didn't know this when I was at home, but that patch was the size of a diamond stud earring, and it narrowed to half of that size.

SPEAKER_03 7:55

Oh wow.

SPEAKER_04 7:56

So they're like, we gotta go in and we just gotta do the repair and try to fix it and hope for the best, even though it's earlier than everybody wanted or hoped for.

SPEAKER_02 8:06

So small.

SPEAKER_04 8:07

She was teeny teeny.

SPEAKER_02 8:08

And as a nurse, you know, have to s, you know, not be in there and leave it in other people's hands. That had to bend very hard.

SPEAKER_04 8:16

My least favorite experience.

SPEAKER_02 8:18

It's almost like that, gosh, I wish I didn't know, you know, kind of thing. But when you know everything, it's like that makes it really hard.

Complications, Open Chest, And ICU Realities

SPEAKER_04 8:25

Well, in some ways it was a gift. You know, my husband before my business was a truck driver, so he has no medical expertise. Yeah. And, you know, the the very first day that she was alive and she was born, she ended up having to be intubated. And it was related to a medication side effect, not because like her lungs were collapsing or anything like that. But even like to have the wherewithal and the understanding to explain that to him because the only person he had ever seen intubated was someone who died. Yeah. And so he was like, Oh my god, she's dying. And I'm like, no, this is just a band-aid. He's like, you know, what are you talking about? And I'm like, oh no, like I've worked in the ICU, like, this is just a band-aid. Um, so some of it was incredible and some of it was terrible. Yeah.

SPEAKER_02 9:05

Yeah. Wow.

SPEAKER_01 9:07

What was her recovery like after Thanksgiving? What was that part of the journey?

SPEAKER_04 9:11

I would say it was the worst couple of months of my life, to be honest. We spent all of her first holidays in the hospital and a routine tetralgifilo patient. So a patient that doesn't have the extra piece, which is the pulmonary atrecia where you're lacking a pulmonary valve. Usually they're in and out in a week. And her first surgery had gone way better than we anticipated. So I felt like our expectations had kind of blurred because of that. We'd read all these stories about people being in and out in a week. So I was like, okay, like this Thanksgiving will definitely by far be home by Christmas. And what complicated her care is everyone in the world knows that you do not go into a surgery on blood thinners. You absolutely do not do it. Like, if you show up to have surgery and you've taken an ibuprofen, like in the last two weeks, they're like, I get out of here. Like, we're not doing it. Meadow was on blood thinners, like injection blood thinners twice a day, every day, because of this little patch and how important it was that it didn't clot and all these things. And because it had narrowed in size, they had to make this risk versus benefit decision to leave her on her blood thinners because if that clots off entirely, then she's dead.

SPEAKER_02 10:24

Yeah.

SPEAKER_04 10:24

So we have to go into surgery on blood thinners, even though it's like the least ideal scenario possible. And as a result of that, she had a whole host of complications. But I just like to have ultra clarity. It was not anybody's fault. Like we knew what we were going into, we had a conversation about it. I was educated, I was asking lots of questions. Yes. And there was no time.

SPEAKER_01 10:46

I mean, that's just the reality, right? Yeah, you just got to do the thing. Yes.

Recovery, Pacemaker, And Stabilizing At Home

SPEAKER_04 10:50

Yeah, you just got to do the thing. And that's what she needed to be able to continue forward. But ultimately, the night of her surgery, which they call her full repair, which is like super deceiving because she still has to have more surgeries. Like they're just fixing the main defects then in the best way that they can. Her chest filled up with so much blood that her heart wasn't able to beat. And she almost crashed. And so they had to emergently reopen her chest and leave it open for seven days afterwards. Oh wow. Which is not even something I knew was a possibility or a thing. I'd never heard of that. I'd never once heard of that. But it's to give everything a little bit of space and like some decompression. But as a result, like for seven days after that second surgery, we could literally like stand over her body and watch her heartbeat from outside her body. And I mean, it was like the literal stuff of nightmares. And I feel like all of the time that we spent there over we got out finally in mid-January. We were just riding this very intense roller coaster. And you know, an ICU attending before we had ever even like had Meadow's first surgery, kind of gave us that spool of like the ICU is a roller coaster. So like you're gonna have dips, you're gonna have ups. But we really like we had no idea if Meadow was gonna go home or not. Like we just had genuinely no idea, and kind of all the lights were very dark and very dim, and there was no light at the end of a tunnel. I was like, if we survive this, I just like I don't know what she looks like after this either, because she ultimately ended up having a brain bleed as well.

SPEAKER_02 12:21

Okay.

SPEAKER_04 12:22

And they're like, okay, like she makes it through the hard stuff, like you've just got to see about the brain stuff. Like that's just something that evolves over time.

SPEAKER_02 12:29

Yeah.

SPEAKER_04 12:30

And it was just so much uncertainty to sit in. It was supposed to be like this really like cool, joyous time of like your first kiss first Christmas and like all these different things, and it just was not that for us.

SPEAKER_01 12:42

Yeah, it just looked different for you all.

SPEAKER_04 12:44

Very different. Yeah, yeah.

SPEAKER_01 12:47

Coming through the holidays, how long did you all have to go before having the next surgery? The real surgery then, right?

Turning To Advocacy And Policy Wins

SPEAKER_04 12:53

So she ultimately, so she had that repair surgery, she had a couple of miscellaneous surgeries, like she ended up having a pacemaker implanted during that stay. She had a couple of scopes and different things during that stay. But since we left in January of 2023, she has not had another surgery yet, which is really cool.

SPEAKER_02 13:12

Amazing.

SPEAKER_04 13:13

And she's doing incredibly. So I'm like, I always talk about the dark, but I'm like, she's so cool now. Like, if we could just like get to the part where she's now. But there's no set or definitive timeline on her next surgery. It's very subjective to her and kind of when her fake heart valve wears out, essentially. But we hope, fingers crossed, she'll be five or six. That's the dream and the vision. And a lot of the advocacy work that I do today really centers around there are some really cool trials out there where they're doing heart valves via heart calves. So instead of opening their chest, they're like going through their groin and like threading it up and putting the heart valve in without ever having to open them for surgery. And so we hope that her next surgery will be her last one. And then after that, they can do the alternative procedure instead, which is like so cool and so incredible.

SPEAKER_03 14:03

But my God.

SPEAKER_01 14:05

I love that. I love that. And here's the wild part, Sarah. All of this is happening simultaneous. You just recently go through a business sale and you're still. And I'm supposed to be there. Like I'm the chief nursing officer.

SPEAKER_04 14:18

Like I'm supposed to be there.

SPEAKER_01 14:20

Yes.

SPEAKER_04 14:21

Yeah. Yeah. It was.

SPEAKER_01 14:22

I mean, I know that you felt like you were in the mom box from the from the professional standpoint, but I'm assuming that there was some compassion and understanding and not a loss of momentum during that time that you were with Meadow and just being by her side for that.

SPEAKER_04 14:38

No, and I very much like that's a credit to my work wife, but also a credit to the business that we built. The momentum and everything continued even without me there. And that was really like cool for me, even to see, because I was always like, What if I wasn't here? Like, you know, everyone calls me the key woman. Like, would it survive without me? But I got a lot of compassion and a lot of grace, even from students. I was like, Oh, they're like, You do you. And then, like, you come back when you're ready, we'll be ready for you.

SPEAKER_02 15:04

But amazing.

unknown 15:05

Yeah.

SPEAKER_02 15:06

Wow.

Mental Health, OCD, And Redefining Success

SPEAKER_01 15:06

I'm always in awe at the stories where you know, you you are on this fabulous path, and in terms of from a professional standpoint, and and the world never knows that like life is lifing on on the right. Like things are also life and heart, a little detour. Yeah, absolutely. Well, you talked a little bit about the advocacy world. Tell us uh tell us about that. What does that look like now?

Books In Progress And CHD Education

SPEAKER_04 16:26

Yeah, you know, I tell people a lot, like, how could I go through that experience and like almost losing my daughter and not be like permanently, like completely changed after that? And then simultaneously, like I was changed by that experience. And then when we made out of the hospital, I actually found out I had OCD and something I've had my entire life, but Meadow's diagnosis, and this is not Meadows' fault, but like Meadows diagnosis and that ultimately that first little bit of care kind of really sent me off a deep end with the OCD. And so I kind of needed to manage that, figure that out. As a result, you know, after I went through kind of an intensive outpatient program for my OCD because it was so bad, I kind of came out a different human in a way. Like I felt like I lost like so much urgency in my life. And I was kind of redefining for myself, like, what does success look like? Because you know, success was always like some sort of business metric, like we hit this amount or we sell or we do this. Well, I've done all those things. So, what is success to me and what does that feel like? And success to me was really being a present mom and doing the things that fill my cup and light me up, and advocacy work is one of those things, just like writing is one of those things. And I had this amazing opportunity to go to Washington, D.C. with a group called Conquering CHD, which I'm now the board chair of, but back then I did not know them at all. And we talked to Congresspeople on Capitol Hill all day about the Congenital Hearts Future Act, which the goal of that act is to collect better longitudinal research so we can watch these people or these children over their lifetimes living with congenital heart disease.

SPEAKER_02 18:06

Yeah.

How To Connect And Closing Reflections

SPEAKER_04 18:06

Because it was literally, it was just in 2009. I promise I'll only give like one or two statistics, but in 2009, it was the first time in history there were more adults living with congenital heart disease than children. And what that stat actually says is the first time they were living into adulthood. Wow. This is like so new in the grand scheme of things. And like 30, 40 years ago, metal surgeries didn't exist. Like they literally, there was no options for her, there was no hope for her. And now we need to collect data, we need to collect research to see like what problems are these people running into as they grow up, and how can we be more preventive or be more helpful or research new things or all those things? And so that act is an important piece of that. And we were actually able to finally get it reauthorized last year, which is really cool, kind of in like the final moments of final moments of the session. And once I had worked on that with them and kind of gotten a taste of DC, I was like, ah, I feel like I'm the perfect human for this. Like I have the medical expertise, I've got the personal story, I know how to articulate myself. Like, I am the perfect advocate. And I've already been doing this in all these different ways. Like to advocate for my own mental health when I was in nursing school, I advocated for my students and their mental health through my business. And so now, like, why not advocate for Meadow? And I think the thing that really pushed me over the edge was finding out that heart defects are the most common birth defect, but they're the very least funded. And so until we know this is a problem and we increase the awareness, then we're not going to get the funding or the research, anyways.

SPEAKER_03 19:43

Yeah.

SPEAKER_04 19:43

And so I am just shouting to anyone who will listen those two statistics very specifically, because I think they're life-changing to hear. And it like gives so much more perspective and insight into what I hope the future for me will be in those like her.

SPEAKER_02 19:58

Yeah. Because most people wouldn't, unless it touches and impacts them. No idea. They would have no I was a nurse practitioner and I had no idea. Yeah. And and so once it touches your life, then it's like, okay, now you hear this research and you're like, wow, that's and then I show them Meadow.

SPEAKER_04 20:13

And I'm like, he is a result of medicine. Like, look at this incredible three-year-old riding horses. She's at forest school. Like, this would like wouldn't have even been possible just a very short time ago.

SPEAKER_02 20:25

Yeah, that's incredible.

SPEAKER_04 20:27

I love that.

SPEAKER_01 20:28

I'm not surprised that she's Spitfire. I was like, I've been spitfire all day.

SPEAKER_04 20:32

Oh, yeah. She she is a Leo if you're into astrology at all, and she's a Leo through and through.

SPEAKER_01 20:36

There you go. Well, she's here to keep you on your toes. Oh, yes. She wants one, she wants when she wants it. That's it. Yes. Oh my gosh. Well, Sarah, you also said that you're working on a book. Oh, yes. Tell us. Just give us a little bit of a teaser. What can we look forward to?

SPEAKER_04 20:56

I should have said books. So I do have a memoir that I'm working on. And it's a book about resilience. It's a book about mental health. I mean, going 18 years misdiagnosed is a long time.

SPEAKER_02 21:09

Very long time.

SPEAKER_04 21:10

And it really like it was so pivotal for me to find out how to OCD because the way you work with OCD is not traditional talk therapy that actually usually makes it worse. And so getting the resources and the tools to work with my brain and to be able to eliminate a lot of that urgency in my life, so cool. And I get to be such a better mom because of it. And I get to do the things I love better because of it too. So very much a book about mental health and also the journey in my business because I know that's interesting to people because they're like, wait, what did you do? Like two years? And I was like, I don't know what did I do? Like, let me write down. But the other books that I'm working on are children's books, and they're going to be about congenital heart disease. My first one should release next February in Heart Month.

SPEAKER_02 21:57

Nice.

SPEAKER_04 21:58

And the first book in the series is Meadow and her Four Leaf Clover Heart. Because the same odds as finding a four-leaf clover are the same odds as Meadow's defect. And so we like we try to rewrite the narrative with her all the time about her heart defect. Even at three, I think it's really important. So your heart doesn't become your identity. And like, how can we look at this in a different way and a different perspective? And so yeah, I'm really excited about that too.

SPEAKER_02 22:22

That is exciting. That's an exciting one. I love it.

SPEAKER_01 22:25

Congratulations on all. That's amazing. Thanks. Thanks.

SPEAKER_02 22:29

You're just getting started.

SPEAKER_01 22:30

Oh, I am just getting 31. I'm just getting started.

SPEAKER_02 22:34

A lot of impact to make in the world. Incredible. That's my hope. Yeah.

SPEAKER_01 22:38

I love that. I love that. Sarah, if someone wants to get in touch with you, find you, what's the best way for people to get in touch with you?

SPEAKER_04 22:47

I am everywhere. You can find me on LinkedIn. You can find me on Instagram at Sarah Michelle MP. I have a personal brand website, which is Sarah MichelleBose.com. My children's books have their own website because I open my own publishing imprint to do my children's books, which is littleclubberpress.com. And if you want to find me, you can easily find me. She's searchable, y'all. Oh yes.

SPEAKER_01 23:07

You can find me on the Google. Exactly. We'll make sure that we also put your contact information in the show notes so people can find you there as well. Is there anything else that you'd like to leave our listeners with that we haven't talked about today?

SPEAKER_04 23:19

You know, one thing that I really love about coming on podcasts and sharing my story is, you know, there are pieces of my story that are really hard to share, but I think that's important. And I think being really authentic is important because a lot of times when you are learning to manage and deal with a mental health diagnosis, you feel so isolated and alone. And every time you share about it, it brings a little levity and it makes it a little bit easier, even if nothing about the situation actually changes. And so I just want to remind people that like don't bottle all up, don't keep it all to yourself. Like the more you share about it, really truly, the easier it gets.

SPEAKER_02 23:57

Absolutely. And somebody needs to hear it.

SPEAKER_03 23:59

It's the empowerment that you get from it, from the share. The agency you get over your own life and your own story. Oh, yeah.

SPEAKER_02 24:05

Beautiful.

unknown 24:05

I love it.

SPEAKER_01 24:06

Oh my gosh. Sarah, this has been amazing. Thank you. Thank you. Thank you for sharing your personal story and Meadows' story. Thank you for sharing her story with us as well. When she gets older, she'll be able to appreciate it. But, you know, we were talking about her. Yep. Yep. And all of her greatness. So this has been fabulous. We will put your contact information in the show notes so that people can connect with you. And best of luck on the advocacy work. Thank you. I do work in the advocacy space, so I absolutely get it. It is uh one of those, what is it like a labor of love? But we know, like oh, it is.

SPEAKER_04 24:38

We're not a bureaucracy that was not prepared for that.

SPEAKER_01 24:43

I was like, oh, hello, politics. I was not prepared for that. I try not to focus on that part of it, and I try to focus on the bigger picture mission. Like, what are we trying to accomplish? Oh my gosh. Thank you, Sarah. This has been a pleasure. We will drop all of your contact information in the show notes. And then for everyone that's listening, you all know, head on over to reigniteresilience.com if you want to learn more about what's happening in our world or find us on Facebook or Instagram. Until next time, we'll talk to you soon. Thanks, everyone.

SPEAKER_00 25:10

Thank you for joining us today on the Reignite Resilience podcast. We hope you had some aha moments and learned a few new real life ideas to fuel the flames of passion. Please subscribe on your favorite streaming platform, like or download your favorite episodes, and of course, share with your friends and family. We look forward to seeing you again next time on Reignite Resilience.