Lisa Papapa was diagnosed with multiple sclerosis in August, lost her job as an Aloha Airlines flight attendant last month and today will look for a new career — mostly for the medical benefits to cover the $1,049 monthly cost of her MS medication.

"I've never felt so not in control of my life," said Papapa, 39, whose 19-year dream job as an Aloha flight attendant died on March 31 when the company ended its passenger operations.

Like most of the 1,900 other former Aloha employees, Papapa has begun starting over even as she grieves the loss of the job she loved and the co-workers she came to know as family.

For former Aloha employees like Papapa who are dealing with serious medical issues, the search for a new job carries even more urgency because they rely on health coverage to pay for costly medications, doctor visits, lab tests and treatment.

Former flight attendant Rod Nakabayashi has lost 10 percent of his kidney function as a result of diabetes and needs kidney and pancreas transplants. He undergoes dialysis three times a week at the Rehabilitation Hospital for the Pacific.

Nakabayashi estimates that each session costs $1,500.

He has no idea how he'll pay for them without Aloha's health plan.

"Everything's still so fresh," said Nakabayashi, 49. "We're working with a social worker. But we're still trying to figure everything out."

Meanwhile, as they worry about their health, Nakabayashi and Papapa also face the same money and housing issues as their former colleagues.

Nakabayashi and his wife, Mercy, for instance, will rent out their three-bedroom, 2 1/2-bath home in 'Ewa Beach because they can't afford the $1,980 monthly mortgage payment without Rod's Aloha paycheck.

They'll move in with Mercy's family into a two-story, six-bedroom, four-bath house in Salt Lake already crowded with eight people.

"There's my brother, my brother's wife, his three kids, my sister-in-law's mother and father," Mercy said. "And my mom lives in that house, too. Then you're going to add Rod and me and my dog. We like our privacy. But we have no choice."

JOB FAIR OFFERS HOPE

Relief may come today for some Aloha employees at a job fair organized for them by the city and First Hawaiian Bank at the Blaisdell Center Exhibition Hall.

Papapa will be there, as will her friend, Gail Garcia, another former Aloha flight attendant. Garcia also needs a job that comes with medical coverage, especially for her youngest daughter, Liberty, 8, who was hospitalized as an infant with a pulmonary virus and currently suffers from asthma.

Garcia, 46, is finding it hard to muster enthusiasm about switching careers after 20 years as a flight attendant — and dreads the emotions that will come when she sees her former colleagues at the job fair.

"It's hard," Garcia said. "You try to heal and then you go to (the unemployment office) and you see them again. It's part of the process, I guess. But it's like a funeral that never ends."

Papapa is torn over whether to disclose her illness to the 190 organizations and businesses today that will try to lure former Aloha workers in one of the tightest job markets in the country. She wants to be forthcoming. But she doesn't want to hurt her chances of getting hired.

"That's my big concern," she said.

Mike Nauyokas, a mediator and one of Hawai'i's leading employment and labor lawyers, said Papapa and other job seekers have no reason to fear.

"They don't have to talk to future employers about any of that," Nauyokas said. "Their medical records and background are protected by HIPA (the Health Insurance Portability and Accountability Act of 1996.) It's a federal statute that protects the confidentiality of medical records."

Even part-time jobs will come with health coverage for people with serious illnesses and injuries.

"Under the Hawai'i Pre-paid Health Care Act, after they work 20 hours a week or more for four consecutive weeks the new employer is obligated to provide the new employee with health insurance at the earliest possible date after those four consecutive weeks," Nauyokas said. "There's no exception for pre-existing conditions."

INSURANCE OPTIONS

Former Aloha workers who don't find new jobs can get health coverage — at a high cost — under COBRA, the Consolidated Omnibus Budget Reconciliational Act.

"It's a federal statute that requires employers with 20 or more employees, which would include Aloha Airlines, to provide notice to employees that they're eligible for continued coverage of their existing health insurance if a qualifying event occurs," Nauyokas said. "The qualifying event here would be the layoff of Aloha employees and the cut-off of their health insurance."

Although former Aloha employees can get health coverage under COBRA, they'll have to pay the entire amount, which can be more than $1,000 for a monthly family plan — plus administrative costs of about 1 percent.

"If they can't afford it, they can apply for Quest, the health insurance subsidized by the state for people that can't afford health insurance," Nauyokas said. "You don't want to be without health insurance."

Especially people like Papapa. Papapa went to Kuakini Medical Center's emergency room in May suffering from severe dehydration. In August, following CAT scans and MRIs, doctors diagnosed the white spots on her brain as relapsing remitting multiple sclerosis.

"There is no cure," she said.

She soon experienced anxiety attacks, growing numbness in her left leg and the fear that her disease could degenerate into paralysis and blindness.

Papapa and her husband, Clayton, also worried about their three kids — ages 14, 11 and 7.

"We wondered if we should tell the children, how we should tell them," she said.

Papapa cut back to working part-time for Aloha in December to keep up with lab and doctor appointments.

The couple's middle child, sixth-grader Cori, dived into her mother's healthcare, injecting Papapa three times a week with a drug called Rebif.

"Mommy cries," Cori said this week, as she demonstrated the process of injecting her mother in their home in Hawai'i Kai. "She puts her head in the pillow and tries not to scream. But she does scream."

"It burns for some reason," Papapa said. "It's really painful."

When Aloha Airlines closed, Papapa worried about meeting expenses, so she asked her doctors if she could stop taking Rebif, which costs $5,246 a month.

The medication had been fully covered through the combination of health coverage provided by Aloha and Clayton's job. Without the Aloha health coverage, Clayton's health plan only pays 80 percent of Lisa's medications, forcing the Papapas to pay $1,049 a month.

At first, Papapa's doctors told her she couldn't quit Rebif.

Then they discovered the drug had caused liver damage, which also has the peculiar side effect of making Papapa feel she has something wedged between her toes. So it's likely that she will have to take some other MS medication after her liver improves.

Then on Sunday, Papapa woke up blind for about 10 minutes.

"It was so scary," she said. "Not knowing what to expect is so scary."

Today, she also won't know what to expect at the Aloha Airlines job fair.

But before she can even start looking for a new career, Papapa first has to undergo another liver test this morning.

"What else am I going to do?" she asked. "I could stay up for days just worrying."