When singer Janice Freeman performed the song “The Story” during the live Top 12 performances on The Voice, the moving lyrics could be likened to points along the path of her personal life. Her unwritten memoir is an account of pain, perseverance and hope in the face of the multiple chronic illnesses that she manages while being a wife, mother and entertainer who stands on the threshold of her big break. As a contestant on the popular American reality TV singing competition, Freeman walked into fame through a door she opened with tenacity and talent and a strong belief that—no matter what’s going on in your life—you must pursue the things that make you feel happy and whole inside. She believes what’s most important is not to live your life in a box.

“If I’m alive, whether I’m hurting or mentally going through things, such as fighting depression, when you understand your mandate and what you’re supposed to do in this life, you’ve got to push through,” Freeman says.

When she got an opportunity to audition for the show, Freeman regarded the chance as an answer to her prayers. She’d been in search of a platform that she could use “to touch a lot of people at once,” she says. “I just thought, Maybe this is it.”

At age 32, Freeman, who is from Harrisburg, Pennsylvania, but is based in Compton, California, is no new jack to show business, and she has paid her dues. “I’ve worked from since before I was probably legally able to find work,” she says. As an adult, Freeman held down a job as a customer service representative while trying to kick-start her music career. Then lupus struck, and she ended up losing her job. She shifted gears and became a data analyst specialist supervisor.

Lupus is an autoimmune disease of, basically, four different types that’s estimated to affect 1.5 million Americans, according to the Lupus Foundation of America. The illness can range from mild to life-threatening and strikes mostly women of childbearing age, between 15 and 44.

Freeman first experienced flu-like symptoms and extreme weakness. Then her kidneys shut down. “I started first having the signs right after I had my daughter in 2007,” she says. “But it took doctors two years to finally diagnose me, in 2009.”

***

Among the battery of examinations Freeman underwent for doctors to determine whether she was suffering from lupus is the antinuclear antibody (ANA) test. Although the ANA exam is a very sensitive diagnostic test that can indicate that an individual has an autoimmune disorder, health providers usually perform additional definitive exams, such as an ANA panel, to check for antibodies to confirm a specific diagnosis.

“With those tests along with the symptoms, they were finally able to diagnose me with lupus overall,” Freeman says.

Also in 2007, doctors diagnosed Freeman with Sjogren’s syndrome, another chronic autoimmune disorder. Sjogren’s—a systemic disease that’s commonly associated with lupus and rheumatoid arthritis—interferes with the proper functioning of the body’s moisture-producing glands. For Freeman, the condition was like a giant sponge that robbed her body of water. The dryness associated with Sjogren’s made life extremely unpleasant.

The illness triggered ulcers at the root of Freeman’s teeth, causing them to break off. “I noticed that I never had enough enamel to protect my teeth and my eyes were dry all the time,” Freeman says. “My vision kept going bad and getting worse over time, so that’s how they were able to make the diagnosis for Sjogren’s syndrome.”

Four years later, a PAP smear detected abnormal cells in Freeman’s cervix, and she was diagnosed with cancer. (Lupus increases a woman’s risk of cervical cancer.) After a year of trying to treat the disease, Freeman opted for a hysterectomy. “They had to take everything,” she says.

Janice FreemanCourtesy of NBC/Tyler Golden

Like many of those who suffer from multiple chronic conditions, Freeman learned to take life one day at a time. “My first illness was kidney failure when I was 7 years old; it’s like every seven years something huge happens,” she says. “At 14, I contracted the [rare but serious] bacterial infection meningococcal meningitis. Literally, rigor mortis set in, and I almost lost my life in weeks.”

Perhaps that experience acted as a dress rehearsal to prepare Freeman for managing the current illnesses she lives with day in and day out. Living well with multiple diseases necessitated she organize a treatment plan with her doctors. In addition, she educated herself about the conditions and implemented changes to her lifestyle.

But when doctors suggested that Freeman stay on regimens to treat lupus and cervical cancer at the same time, she said no. “I wasn’t on chemo long because I had to make a decision,” Freeman says. “I couldn’t undergo both treatments together.”

Fortunately, the therapy quickly brought Freeman’s cancer into remission. Today, she still undergoes treatment for lupus with intravenous infusions of Benlysta (belimumab) once each month and takes Plaquenil (hydroxychloroquine) to relieve the symptoms caused by Sjogren’s syndrome.

When lupus flares, also called flare-ups, occur, Freeman can experience draining fatigue, pain from fibromyalgia, skin problems (rashes and sores) or urinary tract issues. Medications help with pain management, but Freeman also relies on more holistic ways to stay healthy. She makes resting a priority and tries to find complementary approaches that might work for her. “For the last six months, I’ve been doing research on essential oils, different salts and a lot of baths and overhauled my eating habits,” she says.

***

Freeman cut gluten, dairy and red meat from her diet and upped her intake of greens, such as spinach and kale; she also drinks alkaline water. “As you grow and you learn, you find out what your body can and can’t take,” she says.

In the midst of juggling therapies, side effects from prescription meds and financial struggles, Freeman says she constantly thought about her goals while competing on a show viewed by millions. “I just wanted to be able to capitalize off this platform, walk away from this, live comfortably and do the things that I’ve been wanting to do since I was little, namely share my music and have it be successful in all the ways that matter,” she says.

“I want to be able to inspire people because my heart’s desire is for people to have hope,” she adds. “So many people don’t live up to their potential. I want suicides to decrease and for people to choose life.”

The message is one that Freeman works hard to impress on her daughter, Hannah, age 11, whose father, Freeman’s first husband, died of cancer. “There’s been times where I wanted to give up, and I know why God gave her to me,” Freeman says. “She’s taught me so many things, and for her to see me fight again, for her to see that in spite of what her mom goes through, she still stands tall and she’s always pushing, for her to see that nothing—from what color she is to being a woman—can stop her, that there’s nothing that she can’t accomplish. That means the world to me.”

Janice FreemanCourtesy of NBC/Trae Patton

As The Voice neared the close of its 2017 season, Freeman’s elimination from the competition shocked many fans. But even when her stint on the show came to an end, she continued to thank God for her blessings.

An emotional Freeman posted a video online in which she reveals that her coach on the program, Miley Cyrus, helped her and her family find a new home just before she was scheduled to go on tour. “One thing is for sure, the bond she and I cultivated still holds strong to this day,” she says. “Miley more than exceeded her statement, ‘I will do anything for you.’”

And so chronic illnesses be damned; they don’t define her. “I’m so overwhelmed,” Freeman says. “I need y’all to understand that it is time to go into 2018 believing God is for real.”

Management Tactics

How to build a comprehensive plan to supervise your care

The leading causes of death and disability in the United States are chronic diseases. One in four Americans have several such conditions, according to the Centers for Disease Control and Prevention.

The high rate of chronic illnesses has several underlying causes: the rapidly growing population of older adults, the increasing life expectancy associated with advances in public health and clinical medicine, and the high prevalence of some risk factors, such as tobacco use and physical inactivity.

With each additional chronic condition, an individual’s risk of dying prematurely, being hospitalized and even receiving conflicting advice from health care providers increases. People with multiple chronic conditions are also at greater risk of seeing a decline in their day-to-day functioning.

To manage these diseases, individuals must assemble a team of health care professionals who communicate regularly with patients and one another and whom they authorize to share medical information. Those living with chronic illness should schedule all their doctors’ appointments on one day if possible. If you are newly diagnosed with several diseases, ask doctors for referrals to other professionals they know and trust who specialize in specific conditions.

Experts advise folks suffering from diverse illnesses to educate themselves about their conditions so they fully understand what each disease entails. Another tip for handling chronic diseases is simply to be honest about your condition with family, friends and, if appropriate, employers who truly value you.