From Exam Anxiety to Heart Advocacy: My Journey Through Business, Motherhood, and Legacy

I never imagined that the anxiety I felt before my nurse practitioner exam would one day spark a million-dollar business. At the time, it just felt like fear. What started as a way to cope for myself grew into something much bigger than I ever expected.

When I was preparing for my board exam, I was overwhelmed. Years of school and thousands of dollars came down to one test. Every review course I bought gave me information, but none of them helped me believe I could actually pass. The pressure felt unbearable, so I decided to create the course I needed.

That’s how Sarah Michelle NP Reviews was born. I didn’t build it with a business plan. I built it out of necessity. It wasn’t just about content; it was about confidence. I shared openly about test anxiety and the mental side of preparing for such a high-stakes exam, something no one else was really talking about at the time. That honesty struck a chord.

Within weeks, the course took off. What started through Facebook messages and Venmo turned into a real business. Within seven months, I became a millionaire. Students weren’t just signing up to pass an exam. They were signing up because they felt seen and supported. It grew into more than a test prep company. It became a community.

Two years later, while eight and a half months pregnant, I sold the company. It felt like I had climbed to the top of the mountain. I had built something from scratch, changed the way an industry talked about mental health, and set my family up for stability. I thought the next chapter would be about slowing down and becoming a mom.

Three weeks later, everything changed. We learned our daughter, Meadow, would be born with four congenital heart defects. She would need multiple open-heart surgeries in her first year of life, and more throughout her lifetime. The celebration of my exit turned into a season of survival.

Her first year was full of hospital stays, hard decisions, and moments that tested every part of me. After her second surgery, she nearly died. Sitting in the ICU, I realized the business I had just exited had given me more than financial freedom. It had given me the time and capacity to be fully present with her.

Looking back, I see it clearly. Building that business taught me how to keep going when things feel uncertain, how to trust myself, and how to fight for what matters. Those same lessons became essential as a heart mom.

After Meadow recovered, my husband and I knew we wanted to give back. We made a fifteen-million-dollar legacy gift to the hospital in her honor, funding research and innovation for kids like her. It felt like the right way to take what we had built and put it toward something bigger.

Sometimes you don’t know why you are building something until later. At first, I thought I was helping students pass exams. In reality, I was learning how to lead with compassion and resilience. The business became the foundation that carried me through my hardest season.

What started with test anxiety gave me the tools to show up when it mattered most. That’s the part I never could have planned for, and the part I’ll always be grateful for.