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Each time the nurses pressed the doppler to her tummy and couldn't find a heartbeat, Yanike Sancko-Valentine braced for the worst. She was six months pregnant, gasping for air, and battling an invisible war inside her body, a disease called lupus that was trying to silence both mother and child.

When Sancko-Valentine first began feeling sharp, migrating joint pain in 2017, she thought it was her worn-out sneakers or gym fatigue. But the pain intensified.

"I was diagnosed in 2017. I started having joint pain and it would move from one joint to the next," she recalled. "Wherever the pain was, the skin would darken. It became so bad I couldn't even sit on the toilet without difficulty."

Lupus is a chronic autoimmune disease in which the body's immune system attacks its own tissues. It can affect the skin, joints, kidneys, brain and other organs. It is incurable, unpredictable, and often invisible.

After a misdiagnosis of non-specific arthritis and inconclusive tests, a referral to an internist led to an antibody blood test.

"The amount of antibodies I was supposed to produce should have been under 25. Mine was 200," she told THE STAR.

Still adjusting to her new normal, Sancko-Valentine, who was then a mother of one, was shocked to learn in 2018 that she was pregnant. She had stopped using contraceptives due to medication side effects and became pregnant soon after.

"Pregnancy made the lupus worse," she said. "I started having flares, mouth sores, swollen throat, difficulty breathing. They thought it was dengue at first, but it was lupus."

She was admitted to the May Pen Hospital when her badly swollen throat restricted her breathing. According to Sancko-Valentine, doctors administered oxygen and steroids to prevent her airway from closing.

Meanwhile, lupus began attacking her kidneys, causing severe swelling in her legs.

Doctors delivered her daughter at 35 weeks. Babies are normally born at 40 weeks. Against all odds, both survived.

"Every day I was scared. There were times they couldn't find her heartbeat, and I had to be rushed to the labour ward just to hear it."

Today, her daughter is six years old, living proof of her mother's endurance. "My two children are my motivation," she shared.

Now a manager at an inland revenue office in Clarendon, Sancko-Valentine still faces daily battles. She takes immunosuppressants and steroids, which have caused steroid-induced diabetes. She experiences hair loss, chronic fatigue, and memory fog.

"My biggest struggle is the mental fog. I have to put things right in front of me to remember where they are. When I overwork myself, that's when the flares come," she said.

A flare means lupus is actively attacking internal organs. Sancko-Valentine strategy is to pace herself and avoid stress.

Sancko-Valentine separated from her husband in 2023, and has been raising her daughters alone.

"My two girls keep me going," she said. "Even when I don't feel well, I push for them. I want to stay as healthy and flare-free as possible."

Her work environment has helped. "My staff know I'm not well sometimes, and they're supportive, especially when my legs are swollen," she said.

Still, the emotional toll is real, "I went from 156 pounds to 200. I didn't want to look in the mirror. I didn't recognise myself," she said. "You know when you're slim and you put on weight and the first thing someone says is, 'How did you get so fat?' They don't know how badly I was struggling."

With medication costing more than $700,000, assistance from the Ministry of Health and Wellness and the National Health Fund made the cost manageable.

"I've been blessed because not everyone can afford that, and I'm grateful for all the assistance I was able to receive," she said.

"There are times my body is so tired, I just have to rest. I've learned I can't overdo anything."

She now serves as the Clarendon representative for the Jamaica Civil Association and is a member of the Lupus Foundation of Jamaica.

The foundation provides professional counselling by appointment, a helpline, hospital visits by volunteers, pharmacy discount programmes, and medical expense assistance where possible.

According to Sybil McLean, communications manager for the Lupus Foundation of Jamaica, the foundation operates a resource library called the Learning Centre and supports diagnostic research and the acquisition of equipment.

"We've seen over the years how much patients appreciate knowing they're not alone," McLean said. "Many become more empowered when they have access to information, support, and community."

Valentine agrees. Her story is one of survival, physical, emotional, and spiritual. "I would rather be alive to raise my girls. That's what I tell myself, when lupus tries to win, I remind it: I have life."