THREE years after the Jamaica Observer shared her desperate appeal for life-saving heart surgery, 28-year-old Jessica James is again racing against time — only now, she wants to prevent irreversible damage to her heart with another open-heart procedure that is expected to cost her US$13,000.

James, of Rock District in Falmouth, Trelawny, is seeking financial assistance to undergo an atrial septal defect (ASD) and tricuspid valve repair at the University Hospital of the West Indies (UHWI), after doctors discovered severe leakage of her tricuspid valve and a small leak in the patch that was used to repair the congenital hole in her heart during the first surgery.

The condition has left her grappling with shortness of breath, fatigue, and fluid retention while relying on medication to manage her symptoms.

The Jamaica Observer first highlighted James’ story in July 2023 when she appealed for public assistance to finance an estimated US$20,000 surgery, after doctors determined that the congenital hole in her heart was too large to be repaired using a less-invasive, catheter-based procedure. She later underwent the operation following a public fund-raising campaign.

James said she had believed the surgery had resolved the problem until a persistent fever earlier this year, which lasted approximately three months, led to her seeking further medical attention.

“I was back and forth at regular doctors because I didn’t think it was necessary to go to my cardiologist — I did the surgery [so] I’m supposed to be good,” she told the Sunday Observer.

JAMES…I wake up, my body is weak, and I feel like I’m going to pass out or I’m going to pass away

However, after she was advised by a physician to return to her cardiologist, further investigations revealed the issue with her tricuspid valve.

Her treating cardiologist and adult congenital heart disease specialist, Dr Deron Reid explained that James was born with an ASD — a hole in the wall separating the heart’s upper chambers — which allowed oxygen-rich blood to flow from the left side of the heart to the right.

The additional blood flow caused the right side of her heart to enlarge over time.

“Because the heart becomes enlarged, it stretches that right side. The valve becomes stretched, and because it becomes stretched it means that it’s not closing properly,” Reid explained to the Sunday Observer.

Although surgeons repaired the ASD during James’ first open-heart operation, Reid said her tricuspid valve was functioning well enough at the time, thus an intervention was not indicated.

However, he explained that after the hole is closed the enlarged right side of the heart does not always return to the anticipated size, particularly when an ASD is repaired later in life.

“In Jessica’s case, what happened is that the right side of the heart did not remodel or get less in size as anticipated, and the annulus actually got wider over time,” Reid said, noting that this can occur in up to 50 per cent of patients following the closure of an ASD.

A screengrab, captured on Saturday, of the ongoing GoFundMe campaign for Jessica James.

An echocardiogram conducted in March confirmed severe tricuspid regurgitation, a small ASD patch leak with left-to-right shunting, and worsening enlargement of the right ventricle compared with a previous study conducted in April 2025.

James said her health deteriorated significantly in the months leading up to that discovery.

“I could not breathe. Every second, I had to think constantly just to try and drag the air inside of my body because it just was not there,” she recalled.

She said the condition has also affected her ability to sleep and carry out everyday activities, while fluid retention caused swelling in her abdomen.

“Sometimes I have extreme palpitations. I wake up, my body is weak, and I feel like I’m going to pass out or I’m going to pass away,” James said. “I can’t really describe how it feels. I just know that it’s a very scary experience to wake up in the night when everybody else is sleeping, you’re by yourself and you don’t know what to do.”

Reid said the surgery is urgent because James is already symptomatic and dependent on furosemide, commonly known as a water tablet, to reduce the accumulation of fluid in her body.

He warned that delaying the procedure could lead to worsening symptoms of heart failure, irreversible damage to the right side of the heart, dangerous heart rhythm abnormalities and, ultimately, death.

“The risk that she faces is that she will have continued worsening symptoms of heart failure such as her shortness of breath, or retention of fluid in the abdomen as well as in the feet,” Reid said.

“She runs the risk of having irreversible damage to the right side of the heart where, despite medicines, the heart continues to fail,” the cardiologist added.

James said doctors are hoping to perform the surgery before the end of the year, amid concerns that waiting until next year could allow her condition to deteriorate further.

Documents reviewed by the Sunday Observer include a June 19, 2026 pro-forma invoice from UHWI listing her ASD and tricuspid valve repair as “urgent”. The invoice totals $280,400 for select theatre-related items including surgical clips, blood gas testing, transducers, and perioperative transesophageal echocardiography.

However, James said the invoice represents only part of the overall surgical cost. She said the US$13,000 fund-raising target also accounts for other hospital expenses, specialised surgical supplies, and costs associated with her care that are not reflected in the document.

The financial burden has been compounded by the loss of her job after Spirit Airlines ceased operations. James, who worked for a Jamaican-based company contracted by the airline, said she has struggled to secure new employment while also contending with increased medical expenses.

She said the cost of her medication has increased from approximately J$8,000 to J$21,000 monthly, though government assistance has reduced her out-of-pocket expense to approximately J$10,000.

Long-time friend and GoFundMe organiser Georgina Powell, who has known James since they attended Muschette High School together in 2012, said she was shocked to learn that James would have to undergo another operation so soon after the first.

“I was in shock — disbelief. I did not want it to be true,” Powell told the Sunday Observer.

She said the two grew closer when James was preparing for her first surgery and asked her to organise the initial fund-raising campaign.

“Without a doubt, immediately, I was like ‘Sure, anything that I can do to help,’ ” she recalled, adding that the two spoke daily in the lead-up to the operation as she offered encouragement and emotional support.

Powell said the response to the latest appeal has been considerably slower than it was in 2023, adding that the campaign has raised approximately US$1,300 so far.

Despite the urgency of James’ condition Reid said her prognosis could be encouraging if the valve is repaired in time.

“If we do a timely repair of her valve then she would be close to the normal average life expectancy,” he said.

For James, the hope is simple.

“Mi just want a likkle more time,” she said. “Just to be around people, experience stuff, just to enjoy life just a bit more.”

Those wishing to assist James may donate through her GoFundMe campaign, which can be found at: https://www.gofundme.com/f/d8j8nn-urgent-support-for-my-second-heart-surgery