Over the past four years, the 63-year-old singer has undergone open heart surgery and recovered from a brain injury after a bicycle accident.

Amy Grant is feeling good – and grateful – after dealing with two serious health issues in the past four years.

The Grammy-winning singer, 63, who underwent open heart surgery in 2020, then maintained a brain injury in a bicycle accident in 2022, says the incidents “changed the way I look at life.”

Grant, who works with the American Heart Association on a new campaign for heart health, says that before discovering she had problems with her own heart, “I always saw myself living to be ninety. My great-grandmother lived to be 94 years old. She had a sharp mind,” she said. “Realizing that something could happen that you never saw coming, and that it could be over… everything became more precious.”

Related: Amy Grant says she feels ‘fantastic’ 8 months after open heart surgery to correct rare disease

THE “Baby baby” the singer only learned about her heart problem because the doctor was caring for her husband, the singer Vince Gil67, who was suffering from shortness of breath, suggested she also get tested. She joked: “After I told Vince the ‘good’ news: ‘You’re just fat and out of shape’ – and Vince said, ‘Tell me something I don’t know!’ – the doctor looked at me and said: ‘I want to see you.'”

Tests revealed she had a rare heart defect known as PAPVR (partial abnormal pulmonary venous return) in which some blood vessels in the lungs attach to the wrong place in the heart. This condition means the heart has to work harder and can cause difficulty breathing, lung infections, swelling of the heart chambers, or other serious heart problems.

Up until then, Grant knew her heart rate would be elevated if she exercised and thought she just needed to build up her endurance. “I just learned to cope because that’s what women do,” she says. “I was one of those women who said, ‘I’m fine. I’m doing well. I’m the Energizer Bunny,’ and then I’d be dead. And I’m not ready to die.”

Cardiovascular diseases are the leading cause of death among women, according to the AHAcausing one in three deaths among women each year.

Following his open heart surgery in June 2020, Grant says he renewed his commitment to staying fit by starting regular swimming. “I was probably in the best shape I had been in a long time, maybe 20 years,” Grant says.

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And then, in July 2022, while cycling in Nashville, she hit a pothole. Despite wearing a helmet, she suffered a brain injury that left her with lingering memory problems for months.

“I would just say, ‘What if I never come back to the end?’ Because my treatment was so slow, I could be in the room with people, but I had no feedback,” she says.

Related: Amy Grant says she had to relearn how to sing and still has ‘short-term memory problems’ after bike accident

But over time, Grant’s memory improved and she says, “Now I feel in full control of all my abilities.” She adds: “I write everything down on a calendar. But whatever my memory problems are, I think they’re age-appropriate. I’m about to turn 64. So I just say to myself: “I’m just on time.”

Since her health problems, her perspective has changed, she says. “I’m finding a different balance between music and family and just trying to be a lot more involved, as much as my adult children allow,” she says. Grant has three children from her first marriage to musician Gary Chapman, with one daughter, Corrina Grant Gill, 23 years old, which she shares with Gill. Gill also has a daughter Jennifer Gill, from his first marriage.

“It made us all look at each other with a kind of appreciation,” said Grant, who begins his annual Christmas concert series with Gill in Nashville at the end of this month, the fourteenth year the couple has undertaken this residency vacation. “I think maybe being together was a little bit on autopilot, and that’s not the case anymore.”