MOM BATTLES CANCER'S UGLY PARTNER.

Byline: Kathleen Sweeney Staff Writer

SANTA CLARITA - The lump was half the size of a jawbreaker by the time she discovered it. It was underneath her arm, and was her first indication that something was wrong.

Jeanine Gilmore was 34 when she was diagnosed with breast cancer more than two years ago. If the tumor had been left alone much longer, she wouldn't have survived. Within six months, it had spread into her spine and sternum.

Gilmore, now 37, didn't think her health could get much worse, until this summer when she developed lymphedema - a condition that doesn't allow the lymph vascular system to reabsorb and transport protein and lymph load, causing affected limbs to swell.

But unlike breast cancer, not many are aware or educated about the deadly disease that often accompanies cancer. It can affect anyone, man or woman, who has a tumor that is malignant or not. It affects those with breast, ovarian and prostate cancer.

Accompanies cancer

Local physicians are trying to educate the community about the disease that has taken a back seat to cancer. Experts say as more people survive cancer, more will face this disease.

``Once you slay the dragon of cancer, then you have to deal with this other problem that really changes your lifestyle completely,'' said Linda Jewell Husar, a neuromuscular pain relief therapist.

Husar said she is the only therapist in the Santa Clarita Valley who is trained to treat lymphedema. She uses a method called combined decongestive therapy, which removes metabolic wastes, excess water, toxins, bacteria, large protein molecules and foreign substances from the tissues as well as offering numerous other benefits.

``It's exceedingly important to treat lymphedema,'' Husar said. ``It's progressive and there is not a cure.''

If it's caught before it progresses, it can be controlled, she said. But without treatment, fungal infections may occur, as well as thickening of the skin, hardening of the limb, leakage of lymph and massive swelling, known as elephantiasis.

Arm begins to swell

Gilmore remembers reading about lymphedema while recovering from breast cancer surgery. The doctors told her not to allow nurses to poke or take blood pressure from the arm where the lymph nodes had been taken. An injury or pressure could cause the disease.

But after two years, she showed no signs of it.

``You start to feel better and you're OK,'' she said. ``You start to think maybe I can use that (vein).''

She then allowed nurses to insert an intravenous needle into her right hand because her veins had disappeared during intensive chemotherapy. Within days, her hand and arm began to swell with the fluids.

Gilmore wishes she would have had more education about breast cancer and lymphedema.

She had always given herself breast exams, closely watching for lumps although breast cancer doesn't run in her family. She didn't know to look for other symptoms, such as thickening of the skin that had the appearance of an orange peel or discharge from the breast. She experienced both, thinking she had clogged milk ducts.

``I didn't think anything of it,'' she said. ``Your body is always changing. They always say lumps, do self-examinations. I did self- examinations.''

Insurance problems

As she continued to battle with cancer and now lymphedema, more bad news would come. While her insurance company approved her claim, officials said they would only pay for treatment at Cedars-Sinai Medical Center in Los Angeles. Treatment required two hours a day, five days a week for several weeks. The drive alone was at least one hour, one way.

``I have to work,'' Gilmore said. ``I don't have the funds and means to go to Cedars-Sinai every day.''

Gilmore's insurance company refused to pay Husar because the therapist isn't considered a physical or occupational therapist or physician, she said.

Husar said doctors make referrals to her, but insurance companies won't recognize her as a care provider though she has as much, if not more, training in treating lymphedema.

Gilmore's insurance provider did not return phone calls seeking comment.

After months of battling the company, Gilmore heard late last week she may be able to get therapy at Providence Holy Cross Medical Center in Mission Hills. Although leery, she remains optimistic and surrounds herself with what she loves most in the world - children.

After getting her three boys off to school each morning, she heads to Mountain View Elementary School in Saugus, where she spends the day playing with kids as a playground supervisor.

``I surround myself with children,'' she said. ``They are just so carefree. They're kids. They're great.''

LYMPHEDEMA PRECAUTIONS

Here are a few precautions for people with or at risk for lymphedema:

--Avoid any needle pricks on the affected limb, including injections, drawing blood or receiving acupuncture treatments.

--Never allow a blood pressure reading on the affected limb.

--Avoid high-sodium foods.

--Drink plenty of water.

--Keep the skin meticulously clean and soft.

--Use hypo-allergenic products.

--Use bug repellent.

--Wear long sleeves.

--Avoid exposure to sun.

--Wear cotton gloves while ironing, using the stove or pouring hot liquids.

--Limit caffeine and alcohol.

--Wear jewelry on unaffected limb.

--Wear loose-fitting clothes.

SYMPTOMS OF BREAST CANCER

-- Breast lump or breast mass, usually painless, firm to hard and usually with irregular borders.

-- Lump or mass in the armpit.

-- A change in the size or shape of the breast.

-- Abnormal nipple discharge, which is usually bloody or clear-to-yellow or green fluid.

-- Change in the color or feel of the skin of the breast, nipple or areola. It could be dimpled, puckered or scaly, possess an ``orange peel'' or redness appearance, and accentuate veins on the breast surface.

-- Change in appearance or sensation of the nipple, including retraction, enlargement or itching.

-- Breast pain, enlargement or discomfort on one side only.

-- Any breast lump, pain, tenderness or other change in a man.

-- Symptoms of advanced disease are bone pain, weight loss, swelling of one arm and skin ulceration.

CAPTION(S):

photo, 2 boxes

Photo:

Jeanine Gilmore, who suffers from lymphedema, is happy surrounded by pictures of her family.

David R. Crane/Staff Photographer

Box: (1) LYMPHEDEMA PRECAUTIONS (see text)

SOURCE: Linda Jewell Husar, neuromuscular pain relief therapist

(2) SYMPTOMS OF BREAST CANCER (see text)

SOURCE: American Cancer Society