MALMSTROM AIR FORCE BASE, Mont. -- Every day at the Malmstrom Air Force Base Fitness Center, more than 20 Airmen nervously - or confidently - make their way into the fitness assessment cell to complete a physical fitness assessment. Although some are adequately prepared for the assessment, for others, their future in the Air Force is dependent on this test.

On Sept. 10, Lt. Col. James Tanner, 341st Medical Operations Squadron chief of physical therapy, was one of those 20 Airmen.

After 67 pushups, 68 sit-ups and 8 minutes and 53 seconds, he aced the maximum fitness test requirements for males ages 30 and under for the thirteenth year in a row, despite the fact that he no longer falls into the "under 30" category.

Since 1990 when he commissioned into the Army through Reserve Officer Training Corps, Tanner made a promise to himself that he would get a perfect score on every single fitness assessment of his military career. For an athlete who competed in track and field and cross-country in college, and later on the Olympic Pentathlon Athletic Team as a U.S. Armed Forces member in both the Army and Air Force, earning an "excellent" on the fitness test was always a breeze until 2011.

"All of a sudden I started getting chronically sick," said Tanner. "This continued into 2012; I would be sick, take antibiotics, then get sick two weeks later. I just knew something wasn't right and my endurance was going down a lot faster than the age calculation charts say they should. I thought it was just age but I noticed I couldn't do my normal three-hour bike rides. I kept hitting a wall and couldn't recover."

A chance visit to his doctor ended in Tanner receiving a specific antibiotic that his liver reacted to negatively.

"They did some tests on me and in September 2012 I was diagnosed with potentially terminal hepatitis - my liver was failing," Tanner said.

Just three months after being diagnosed with the virus, he had no choice but to go through a six-month treatment of chemotherapy.

"It was pretty brutal and beat me up to a point where I could barely walk up a flight of stairs without passing out," he admitted. "At the peak [of chemotherapy] I was spending 20 hours a day in bed. It was the most hideous thing I've ever experienced."

Due to blood transfusions he was required to undergo as a child, Tanner was exposed to the virus at a very young age. According to www.webmd.com, before 1992, people could get hepatitis C through blood transfusions and organ transplants because donated blood was not screened for the virus at that time. The incubation time for symptoms to appear ranges in two weeks to six months.

Tanner has been living with the virus for multiple decades, but due to his health and level of fitness, he wasn't symptomatic.

"You start to look at your own mortality and start thinking 'maybe this won't be successful,'" he said. "I [thought] I may be looking at [complete] liver failure within five years. Me being in a medical career field, I can't look at the research and [grasp] the longer you have the virus the less successful the treatment is."

But Tanner kept pushing on. Even in his darkest days during chemotherapy, he hopped on his stationary bicycle even if it was just to go through the motions.

"I would have to get injections once a week," he said. "It was such a weird cycle because I would recover, start to feel halfway alive, then suddenly I had to get another dose."

Mentally and physically drained, Tanner finally finished chemotherapy in June 2013.

"Obviously I had to start at square one with my fitness," Tanner said. "I was able to gradually progress back into a regular training routine, which I have to admit was very difficult. I wanted to sit on the couch; I wanted to stay in bed, but I had to force myself to get out there and do it."

With his knowledge and vast experience in physical therapy, Tanner was accustomed to managing injuries.

"I've had three ankle surgeries, but I've always been able to come back from them and still maintain a 100 on my fitness test," Tanner said. "Those were minor injuries, but those injuries taught me how to cross train as opposed to running all the time. I've been able to adopt the 'don't make excuses, just do it,' when it comes to fitness."

Just three months after finishing treatment, after finally getting into a routine of working out five to six days a week, Tanner was again scheduled to take his physical fitness assessment.

"It felt wonderful to get a perfect score again," he said. "I honestly didn't think I was going to be able to get back to where I was [in fitness], but I was consistent with my training. Some people train hard, but they don't train smart. Today, I plan seven days a week of workouts and I usually hit five to six of them. I'll spin, run, swim and lift weights. I only run three days a week, but I make those miles count. Today not everything is the same, but I'm grateful."

Grateful, resilient and an example of living the saying, "the struggle is part of the story," Tanner continues to educate and inspire people every day with a wide range of physical fitness and health.

"I see people every day who don't take care of themselves," he said. "My biggest thing [I tell patients] is you have one body. Bad things still happen but I know that being in shape pretty much saved my life.

"Everyone has excuses, but it's important to take health and fitness seriously because you only have one life to live," he added. "I know a missileer who would work out when he was on alert even though he couldn't take a shower. But he still did it. He did what he could do. It's just about being creative and figuring out what you can do with what you have. Anything is possible and it's worth it because hard work always pays off."