Paula Lazarus, who lives in California, was diagnosed with fatty liver disease in the 1990s, metabolic-associated steatohepatitis in 2003, and cirrhosis in 2019. She shares insights on fostering understanding between loved ones and patients on healthy boundaries and limits.

For my family, obviously, most people have heard “cirrhosis” — fatty liver. They don’t really maybe know what that is, and they want to make everything OK. They mean well, sometimes they say things, and then that’s really not the right thing to say to me. I know in their hearts they mean well.

Unless you’re sitting in this chair, it’s very difficult to understand. Especially for me, with all of my other health challenges, I’ve lived a life thinking, “Oh my gosh, I wish you wouldn’t have said that.”

Letting people know what you need and letting them know what your limitations are.

I think two years after my diagnosis and lifestyle change, it was my birthday. My mom called my boyfriend, “Do you think I could bring over a cupcake?” He was like, “Don’t. She will not take one bite of it.” So my mom, bless her heart, brought me over a carton of cottage cheese and blueberries. It was the most endearing thing.

So I think it’s very hard to tell people, “Don’t let me have one bite of your cake, because I’ll end up eating the whole thing.” It’s very hard to tell people that. But you have to.

And the best thing I could do for the people around me is tell them what I need and tell them what I can’t do or won’t do. Because people don’t know. And, you know, it’s your birthday. “Maybe you could just have one little bite.” Well, for me, that would be the end.

So it’s just very important, I think, to express your needs, let people understand, let people help you. That’s been a big one for me my whole life, with all my other challenges as well. Very stubborn, very independent. I don’t want people helping me. And sometimes, we have to get over ourselves and let them.