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Final Diagnosis: ACTH-dependent Cushing’s syndrome • ectopic ACTH syndrome

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Final Diagnosis: ACTH-dependent Cushing’s syndrome • ectopic ACTH syndrome

Symptoms: Edema • general fatigue • recurrent mechanical fall

Medication: —

Clinical Procedure: —

Specialty: Critical Care Medicine • Endocrinology and Metabolic • Family Medicine • General and Internal Medicine • Nephrology • Oncology

Objective:

Unusual clinical course

Background:

Adrenocorticotropic hormone (ACTH)-dependent Cushing’s syndrome (CS) secondary to an ectopic source is an uncommon condition, accounting for 4–5% of all cases of CS. Refractory hypokalemia can be the presenting feature in patients with ectopic ACTH syndrome (EAS), and is seen in up to 80% of cases. EAS can be rapidly progressive and life-threatening without timely diagnosis and intervention.

Case Report:

We present a case of a 74-year-old White woman who first presented with hypokalemia, refractory to treatment with potassium supplementation and spironolactone. She progressively developed generalized weakness, recurrent falls, bleeding peptic ulcer disease, worsening congestive heart failure, and osteoporotic fracture. A laboratory workup showed hypokalemia, hypernatremia, and primary metabolic alkalosis with respiratory acidosis. Hormonal evaluation showed elevated ACTH, DHEA-S, 24-h urinary free cortisol, and unsuppressed cortisol following an 8 mg dexamethasone suppression test, suggestive of ACTH-dependent CS. CT chest, abdomen, and pelvis, and FDG/PET CT scan showed a 1.4 cm right lung nodule and bilateral adrenal enlargement, confirming the diagnosis of EAS, with a 1.4-cm lung nodule being the likely source of ectopic ACTH secretion. Due to the patient’s advanced age, comorbid conditions, and inability to attend to further evaluation and treatment, her family decided to pursue palliative and hospice care.

Conclusions:

This case illustrates that EAS is a challenging condition and requires a multidisciplinary approach in diagnosis and management, which can be very difficult in resource-limited areas. In addition, a delay in diagnosis and management often results in rapid deterioration of clinical status.

Read more at https://cushings.invisionzone.com/topic/56339-final-diagnosis-acth-dependent-cushing%E2%80%99s-syndrome-%E2%80%A2-ectopic-acth-syndrome/

In Memory of Judy Kennedy – December 15, 2019

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Judy died on December 15, 2019, after battling lung cancer, Atrial fibrillation, and total body weakness.  She was a great warrior for her children.

 

 

From 2008: Siblings Deal With Rare Cushing’s Diagnoses

By KALEY LYON

klyon@dailynews.net

COLBY — As a junior in high school, Justin Kennedy began getting sick and missing school on a regular basis.

He was fatigued, unable to sleep at night and gaining weight rapidly. He also was unable to focus on his school work and began experiencing memory loss.

After several doctor’s appointments, Justin was diagnosed with Cushing’s disease, a rare disorder caused by excessive cortisol levels resulting from a tumor on the pituitary gland.

At the time of Justin’s diagnosis, his younger sister, Jessica, also was showing symptoms of the endocrine disorder. Her diagnosis came at the same time.

“I think they both have had symptoms since they were little,” said their mother, Judy Kennedy.

Other symptoms include a round facial shape, flushed cheeks, excessive hair growth, skin discoloration and depression, Judy Kennedy said.

Weight fluctuation is uncontrollable. Weight is gained at a high rate, despite diet, exercise and other efforts, Jessica Kennedy said.

“The weight has a mind of its own,” she said.

The diagnosis, following many doctor’s appointments and tests, came last November. Today, Justin, 19, keeps busy with a job at McDonald’s, and Jessica, 15, is a freshman in high school taking online classes.

One of the most bothersome symptoms of the disease is the toll it takes on the sleeping schedule. Her children often are unable to sleep until early morning, Judy Kennedy said.

“When there was a chance for her to do online high school, it was such a relief,” she said. “We don’t have to worry about what time she starts her school work.”

Appetite fluctuation is another side effect. The two go through phases where they have healthy appetites, then hardly eat at all, she said.

That’s because the disease puts their bodies through various cycles, which can last for less than a day or for months at a time, Judy Kennedy said.

It’s predicted that about 15 people in a million are diagnosed with the disorder, which can make it difficult to find support and get answers, she said.

The family, however, discovered an online support group and has enjoyed the opportunity to communicate with other families in similar situations.

“I honestly do not know where our family would be if I wouldn’t have found that support group,” Judy Kennedy said. “Even though it’s still awful, it’s better to know that other people have the same symptoms.

“There are people on the streets who have this and have no idea,” she said. “And their doctors don’t either.”

Both teenagers also are preparing for surgery. In mid-May, the family will travel to Houston, where the siblings will have the tumors removed from their pituitary glands. This is expected to resolve the hormonal imbalances, Judy Kennedy said.

“I’m looking forward to that day,” she said.

This Topic on the Message Boards


JESS AND JUDY ARE MEMBERS OF THE CUSHING’S HELP AND SUPPORT MESSAGE BOARDS.

Jess and Judy answered questions in an online Voice Chat January 17, 2008. Archives are available.

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Actress Charly Clive, Pituitary Adenoma

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Best friends Charly Clive and Ellen Robertson thought carefully about what to call the tumour that was growing in Charly’s brain.

The doctors had their own name for the golf-ball-sized growth sitting right behind Charly’s left eye — a pituitary adenoma — but the friends decided they needed something less scary. They flirted with calling it Terry Wogan (‘as in Pitui-Terry Wogan,’ says Ellen), but that didn’t seem quite right.

So Britney Spears fan Charly, then 23, suggested Britney. Bingo! Not only was she ‘iconic and fabulous’, but Britney was also one of life’s survivors. From then on, they were a threesome — Charly, Ellen and Britney the brain tumour — although Ellen is at pains to point out that this Britney was never a friend.

What a thing to have to deal with, so young. The pair, who met at school in rural Oxfordshire, are now actresses. Charly’s biggest role to date has been in the critically acclaimed 2019 Channel 4 series Pure, while Ellen starred in the Agatha Christie mini-series The Pale Horse.

But this week they appeared together in Britney, a BBC comedy based on the story of Charly’s brain tumour. The TV pilot (and yes, they are hoping for a full series) is an expansion of a sell-out stage show they performed at the Edinburgh Fringe in 2016.

The production is admittedly surreal. Viewers are led inside Charly’s brain and the show includes a scene where Charly dons an inflatable sumo-wrestler suit on the day of her diagnosis. Poetic licence? No, it really happened.

‘My dad’s mate had given him a sumo suit as a silly Christmas present and so, on Doomsday, we took photos of me in it.’

The tone was set for how these friends would deal with the biggest challenge of their lives: they would laugh through it, somehow.

As the women, now 28, point out, what was the alternative?

Charly says: ‘It was that thing of laughing at the monster so you are not scared of it. If you cry when do you stop? It was easier to make light of it.’

Their show is not really about a brain tumour. It’s a celebration of friendship. Ellen pretty much moved in with Charly’s family during this time (‘To be in place when I exploded, so she could pick up the debris,’ says Charly).

The pair live together today, finishing each other’s sentences as we speak on Zoom — and at one point both miming Charly’s brain surgery (with gruesome sound effects).

This sort of silliness rooted their friendship, which started at the age of 14 when they wrote their own plays (Finding Emo, anyone?) while at school together in Abingdon. Charly later moved to New York to study dramatic arts, and Ellen studied at Cambridge.

In 2015, Charly came home for a visit, and went to see her GP (played in the drama by Omid Djalili) about her lack of periods and a blind spot in her peripheral vision. An MRI scan showed a mass on her brain. ‘They said it had eroded the bone in my nose and was pressing on the optic nerve, and it was lucky we had caught it,’ she says. ‘The next step would have been discovering it because I’d gone blind.’

Even worse, the tumour was so close to her carotid artery that removal might kill her — and they still had no idea if it was cancerous. Into the breach stepped Ellen. ‘I saw it as my job to make her laugh, which is what I’d always done anyway,’ she says. They both talk of toppling into limbo, ‘almost like a fantasy world’, says Charly. ‘As I was going through the tests, we’d do impressions of the doctors and create our own scenarios.’

The friends talk about sitting up into the night, watching TV. There is a touching moment when Charly admits she was afraid to sleep, and Ellen knew it. ‘It’s hard when you are thinking “What if the tumour grows another inch in the night and I don’t wake up?” ’

Charly was operated on in March 2016, and Ellen remembers the anaesthetist confiding that Charly’s heart had stopped on the operating table.

‘He wasn’t the most tactful person we’ve ever met. He said “Oh my God, guys, she died”.’ Charly makes a jazz hands gesture. ‘And guess who is alive again?’ Even at that darkest moment, there were flashes of humour. Ellen laughs at the memory of the surgeon in his scrubs, with wellies on. ‘They had blood on them. I was transfixed. I wanted to ask “Is that Charly’s . . . brain blood?” ’

In the stage version of the show, the anaesthetist gets two full scenes. ‘He’s the heartthrob of the piece,’ says Charly. ‘A sexy rugger bloke who is crap at talking to people.’

The days that followed the surgery were hideous — and yet they, too, have been mined for comedy. Charly’s face was bandaged, ‘as if I’d had a Beverly Hills facelift’, and she was warned that she could not sneeze. ‘If I did, bits of my brain would come out my nose,’ she says.

Ellen read her extracts from Harry Potter but ‘made them smutty’, which confused the already confused Charly further. ‘I was drug-addled and not myself, and in the most bizarre pain, concentrated in my face’.

‘That week after the surgery was the worst part of all,’ says Ellen, suddenly serious. ‘She was behaving oddly and there was this unacknowledged fear: was this Charly for ever?’ Oh, the relief when the old Charly eventually re-emerged — albeit a more fragile, often tearful version.

It was Ellen who persuaded Charly to take their stage show about her illness public — and it went on to win much critical acclaim. ‘I wanted Charly to see it as something other than just this rubbish chapter that needed to be forgotten about,’ says Ellen.

For her part, Charly credits her best friend as her saviour: ‘I don’t know how I would have got through it all without Ellen.’

The good news is that Britney was not cancerous, although surgery did not obliterate her entirely. ‘She’s still there, but tiny — just a sludge. I’ve been told that she won’t grow though. If I ever do get another brain tumour, it won’t be Britney.’

Off they go again, imagining what is happening now inside Charly’s brain. ‘Britney is still in there, trying on outfits for a comeback tour, but it won’t happen,’ says Charly. Ellen nods. ‘It’s over,’ she says. ‘But she’s just left a pair of shoes behind.’

Britney is available to watch on BBC Three and BBC iPlayer

Adapted from https://www.dailymail.co.uk/femail/article-10264203/I-laughed-brain-tumour-Id-never-stop-crying-Actress-Charly-Clive.html

Sushmita Sen’s battle with Addison’s disease

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It was in 2014 when the actress left her fans shocked when she revealed that she was diagnosed with Addison’s disease. Talking about her condition, Sushmita said that the years she battled Addison’s disease “were pretty traumatising”. After fighting for 4 long years with the chronic condition, the actress healed and emerged stronger by exercising daily.

Addison’s disease is a disorder in which the adrenal glands don’t produce enough hormones. The gland present just above the kidneys starts producing too little cortisol and too little aldosterone. The condition can affect people of all age groups and sexes. The symptoms of the disease develop slowly but can be life-threatening if not treated on time. Extreme fatigue, weight loss, darkening skin, low blood pressure, salt craving are some of the signs of Addison’s disease. Treatment of the condition involves taking hormones to make up for the missing ones. The disease is caused when the adrenal glands are damaged, affecting the production of cortisol and aldosterone hormones.

Post recovery, the 46-year-old actress shared that meditating with nunchaku helped to fight the disease and helped in the healing process. “I healed in time, my adrenal glands woke up, no more steroids, no withdrawals and no auto-immune condition as of 2019,” she had shared. Even after that, Sushmita kept on with her extensive workout to stay fit and healthy. From time to time the actress shares a glimpse of her workout routine which includes yoga, meditation, callisthenics and bodyweight workout.

Adapted from https://timesofindia.indiatimes.com/life-style/health-fitness/health-news/sushmita-sens-battle-with-addisons-disease-and-the-workout-that-helped-her-emerge-stronger/photostory/87988141.cms

In Memory of Kathryn McBride ‘Bridie’ Miller ~ May 1, 2007

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in-memory

From the Message Boards at http://cushings.invisionzone.com/index.php?showtopic=21816

“My name is Caroline and I dont post often but have met a few of you guys and read the board regularly, it has definitely been a godsend to cushies everywhere. The reason I am writing tonight is I have just received devastating information about a dear friend of mine, and a woman some of you may have met during testing. Her name is Kathryn Miller and she is a patient of Dr. Ludlam, that is how she and I met. She was diagnosed with cushings late last fall and had surgery in December and was doing pretty well afterwards.

Long story short, from the information I have received from her mother, She knew a man that she met off of a christian singles website.. I dont know many details about it, but I do know that he drove from his home in Pennsylvania to hers in Cleveland Ohio posing as a balloon delivery man, to then gun down her father killing him, and then to chase after her and gun her down in her neighbors front yard where she later died in surgery. This man then proceeded to commit suicide in his car when the police began to chase him.

Kathryn was an incredible person, and came from a loving, wonderful family. She was a fighter in every sense of the word, and never complained about the fact she was so sick. She always joked that she would one day ‘look hot’ in a bikini again. And she would always say there would be the day when we cushies would be happy and healthy again.

So heres to you Kathryn, I pray you are finally out of pain and that you are happy and cushings free in heaven. I will never forget you, you are in my heart forever. As much as it hurts to not have you here, I take comfort knowing you are smiling down from above. Fly on angel, fly on.”


Kathryn ‘Bridie’ and Albert Miller
Murdered May 1, 2007

~Ages 31 and 71, respectively ~Hometown: Mayfield Heights, OH

On May 1, 2007 Scott Esposito, 38, drove about six hours from his home in Macungie, PA to Mayfield Heights, OH. That’s where his love interest, Kathryn McBride ‘Bridie’ Miller, 31, lived. He showed up at her door with a dozen ‘I love you’ balloons. An attempt at reconciliation perhaps for, although Esposito’s family believed the two were still dating, those who knew Miller say that she broke off the relationship about six months earlier.

Miller lived with her parents. Her father, Albert Miller, 71, answered the door when Esposito arrived. The two exchanged words. Esposito subsequently shot Mr. Miller five times, killing him. Ms. Miller heard the commotion and tried to leave the house through the back door, Esposito shot her eight times as she fled. A neighbor called 911, but Ms. Miller was dead before help arrived. Esposito then tried to flee in his car. When cornered by police, he committed suicide with a gunshot to the head.

Police do not know exactly what caused Esposito’s rampage. He purchased a gun the day before the shooting. In his car he had over 500 rounds of ammunition. He did not have a suitcase or other personal belongings, suggesting that he planned to return home the same day or perhaps that he contemplated his suicide in advance. Police hope to access the couple’s email exchanges to learn more.

Esposito called Ms. Miller when he was en route to her house. She called her mother, who was not home, and told her Esposito was coming, but it does not appear she feared him. It seems, though, that she asked her father to turn Esposito away, resulting in the argument Mr. Miller and Esposito had at the door.

Ms. Miller met Esposito via an online dating site for Catholics. There are conflicting reports about how long ago they met. It may have been as long as two years ago. They saw each other infrequently – because they lived 400 miles apart – but emailed and talked via phone daily when they were together. A friend said Ms. Miller became concerned over Esposito’s ‘irrational’ behavior and ended the relationship in October 2006. One news story said the couple had a brief on and off relationship last fall and only limited contact since December.

Esposito had a bachelor’s degree in business administration and worked as an independent insurance broker. He lived with his parents and older sister, who had spina bifida, so he could help care for them. He had no criminal record. His family says the shooting was completely out of character for him.

Mr. Miller ran his own employee placement agency from his home. An employee of the business was in the home at the time of the shootings, but was unharmed.

Ms. Miller, who had cerebral palsy, held both a Master’s degree in education and a certificate in speech pathology. She worked previously as a teacher.


From: http://www.cleveland.com/news/plaindealer/index.ssf?/
base/cuyahoga/1178181906224960.xml&coll=2

Shooter left behind 2 victims, questions
Man drove hours to ex-girlfriend’s house for ‘purpose,’ police say
Thursday, May 03, 2007
Damian G. Guevara
Plain Dealer Reporter

Mayfield Heights – Scott Esposito drove 400 miles from his Pennsylvania home Tuesday with balloons for his long-distance love interest. He also had a loaded gun.

Esposito ultimately gave Kathryn McBride Miller the bullets – at least eight hollow-point rounds to her head, torso and extremities. He also shot and killed her father, 71-year-old Albert Miller. As police closed in a short time later, Esposito put the black, .22-caliber Luger in his mouth and pulled the trigger.

With the shooter and his victims dead, police on Wednesday were trying to make sense of the rampage. Investigators met with relatives to learn more about the relationship between Miller, 31, and Esposito, 38, of Macungie, Pa., about 65 miles northwest of Philadelphia.

Esposito dated Miller sporadically last fall, but their contact had waned since December, Lt. Chris Sonnhalter said. Miller never reported any trouble between the two to authorities, and her family knew of Esposito, Sonnhalter said. It remained unclear how Miller and Esposito met, but the two never lived in the same area, Sonnhalter said. Police are looking at their e-mail exchanges for clues.

“Obviously, he had some bad intentions . . . whether to end his life or someone else’s,” Sonnhalter said.

Sometime before the killings, Miller learned Esposito was traveling across Pennsylvania to see her, Sonnhalter said. Early in the day Tuesday, she called her mother at work about the pending visit but did not express any alarm.

Kathryn Miller was a former teacher who had a license in speech pathology. She was a graduate of Xavier University and the University of Virginia, where she earned a master’s degree in education. She taught in Hudson schools for one year, in 2002-03.

Her father, Albert, ran an employee-placement business from his home, police and neighbors said.

Police found a work badge belonging to Esposito in his green Jeep Cherokee but learned little about the man Wednesday. He had no criminal record.

Neither the Miller family nor Esposito’s relatives could be reached for comment Wednesday.

Police believe the bespectacled Esposito wanted to maintain a romantic bond with Miller against her wishes and became angry when spurned.

“It was about the relationship,” Sonnhalter said. “I think he brought that gun to Cleveland for a purpose.”

Sonnhalter gave this account of the slayings:

Esposito, driving the Jeep Cherokee, arrived at the Millers’ Woodhawk Drive home in Mayfield Heights at 3:45 p.m. Clutching the balloon bouquet, Esposito knocked on the door.

Albert Miller answered. Nobody witnessed the confrontation, but police believe the men argued.

Esposito shot the elder Miller five times in the chest.

Kathryn Miller was watching television in the family room. She heard the commotion and tried to flee the house through a garage door.

Esposito fired at Miller as she ran into her front yard.

She collapsed near a neighbor’s door, leaving behind a trail of blood.

There was a third person at the Miller home: a woman who worked for Albert Miller was in a basement office and was unharmed.

Esposito got in the Jeep and sped away from the house. Woodhawk Drive is a dead-end street, so Esposito headed east toward SOM Center Road.

Three police cars blocked him in as he neared the intersection. As officers surrounded the vehicle, Esposito put his new gun in his mouth and fired.

One officer discharged a shot that struck Esposito in the right arm and shattered the passenger-side window of the vehicle.

Investigators found a box containing more than 500 rounds of ammunition in Esposito’s Jeep. He had purchased the Luger at a Pennsylvania store Monday evening for about $200.

Plain Dealer reporters Donna J. Miller and Ellen Jan Kleinerman and news researcher JoEllen Corrigan contributed to this story.

To reach this Plain Dealer reporter:
dguevara@plaind.com, 216-999-4334

HOME | Sitemap | Abbreviations | Adrenal Crisis! | Glossary | Forums | Bios | Add Your Bio | Add Your Doctor | MemberMap | CushieWiki

In Memory of Kathryn McBride ‘Bridie’ Miller ~ May 1, 2007

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in-memory

From the Message Boards at http://cushings.invisionzone.com/index.php?showtopic=21816

“My name is Caroline and I dont post often but have met a few of you guys and read the board regularly, it has definitely been a godsend to cushies everywhere. The reason I am writing tonight is I have just received devastating information about a dear friend of mine, and a woman some of you may have met during testing. Her name is Kathryn Miller and she is a patient of Dr. Ludlam, that is how she and I met. She was diagnosed with cushings late last fall and had surgery in December and was doing pretty well afterwards.

Long story short, from the information I have received from her mother, She knew a man that she met off of a christian singles website.. I dont know many details about it, but I do know that he drove from his home in Pennsylvania to hers in Cleveland Ohio posing as a balloon delivery man, to then gun down her father killing him, and then to chase after her and gun her down in her neighbors front yard where she later died in surgery. This man then proceeded to commit suicide in his car when the police began to chase him.

Kathryn was an incredible person, and came from a loving, wonderful family. She was a fighter in every sense of the word, and never complained about the fact she was so sick. She always joked that she would one day ‘look hot’ in a bikini again. And she would always say there would be the day when we cushies would be happy and healthy again.

So heres to you Kathryn, I pray you are finally out of pain and that you are happy and cushings free in heaven. I will never forget you, you are in my heart forever. As much as it hurts to not have you here, I take comfort knowing you are smiling down from above. Fly on angel, fly on.”


Kathryn ‘Bridie’ and Albert Miller
Murdered May 1, 2007

~Ages 31 and 71, respectively ~Hometown: Mayfield Heights, OH

On May 1, 2007 Scott Esposito, 38, drove about six hours from his home in Macungie, PA to Mayfield Heights, OH. That’s where his love interest, Kathryn McBride ‘Bridie’ Miller, 31, lived. He showed up at her door with a dozen ‘I love you’ balloons. An attempt at reconciliation perhaps for, although Esposito’s family believed the two were still dating, those who knew Miller say that she broke off the relationship about six months earlier.

Miller lived with her parents. Her father, Albert Miller, 71, answered the door when Esposito arrived. The two exchanged words. Esposito subsequently shot Mr. Miller five times, killing him. Ms. Miller heard the commotion and tried to leave the house through the back door, Esposito shot her eight times as she fled. A neighbor called 911, but Ms. Miller was dead before help arrived. Esposito then tried to flee in his car. When cornered by police, he committed suicide with a gunshot to the head.

Police do not know exactly what caused Esposito’s rampage. He purchased a gun the day before the shooting. In his car he had over 500 rounds of ammunition. He did not have a suitcase or other personal belongings, suggesting that he planned to return home the same day or perhaps that he contemplated his suicide in advance. Police hope to access the couple’s email exchanges to learn more.

Esposito called Ms. Miller when he was en route to her house. She called her mother, who was not home, and told her Esposito was coming, but it does not appear she feared him. It seems, though, that she asked her father to turn Esposito away, resulting in the argument Mr. Miller and Esposito had at the door.

Ms. Miller met Esposito via an online dating site for Catholics. There are conflicting reports about how long ago they met. It may have been as long as two years ago. They saw each other infrequently – because they lived 400 miles apart – but emailed and talked via phone daily when they were together. A friend said Ms. Miller became concerned over Esposito’s ‘irrational’ behavior and ended the relationship in October 2006. One news story said the couple had a brief on and off relationship last fall and only limited contact since December.

Esposito had a bachelor’s degree in business administration and worked as an independent insurance broker. He lived with his parents and older sister, who had spina bifida, so he could help care for them. He had no criminal record. His family says the shooting was completely out of character for him.

Mr. Miller ran his own employee placement agency from his home. An employee of the business was in the home at the time of the shootings, but was unharmed.

Ms. Miller, who had cerebral palsy, held both a Master’s degree in education and a certificate in speech pathology. She worked previously as a teacher.


From: http://www.cleveland.com/news/plaindealer/index.ssf?/
base/cuyahoga/1178181906224960.xml&coll=2

Shooter left behind 2 victims, questions
Man drove hours to ex-girlfriend’s house for ‘purpose,’ police say
Thursday, May 03, 2007
Damian G. Guevara
Plain Dealer Reporter

Mayfield Heights – Scott Esposito drove 400 miles from his Pennsylvania home Tuesday with balloons for his long-distance love interest. He also had a loaded gun.

Esposito ultimately gave Kathryn McBride Miller the bullets – at least eight hollow-point rounds to her head, torso and extremities. He also shot and killed her father, 71-year-old Albert Miller. As police closed in a short time later, Esposito put the black, .22-caliber Luger in his mouth and pulled the trigger.

With the shooter and his victims dead, police on Wednesday were trying to make sense of the rampage. Investigators met with relatives to learn more about the relationship between Miller, 31, and Esposito, 38, of Macungie, Pa., about 65 miles northwest of Philadelphia.

Esposito dated Miller sporadically last fall, but their contact had waned since December, Lt. Chris Sonnhalter said. Miller never reported any trouble between the two to authorities, and her family knew of Esposito, Sonnhalter said. It remained unclear how Miller and Esposito met, but the two never lived in the same area, Sonnhalter said. Police are looking at their e-mail exchanges for clues.

“Obviously, he had some bad intentions . . . whether to end his life or someone else’s,” Sonnhalter said.

Sometime before the killings, Miller learned Esposito was traveling across Pennsylvania to see her, Sonnhalter said. Early in the day Tuesday, she called her mother at work about the pending visit but did not express any alarm.

Kathryn Miller was a former teacher who had a license in speech pathology. She was a graduate of Xavier University and the University of Virginia, where she earned a master’s degree in education. She taught in Hudson schools for one year, in 2002-03.

Her father, Albert, ran an employee-placement business from his home, police and neighbors said.

Police found a work badge belonging to Esposito in his green Jeep Cherokee but learned little about the man Wednesday. He had no criminal record.

Neither the Miller family nor Esposito’s relatives could be reached for comment Wednesday.

Police believe the bespectacled Esposito wanted to maintain a romantic bond with Miller against her wishes and became angry when spurned.

“It was about the relationship,” Sonnhalter said. “I think he brought that gun to Cleveland for a purpose.”

Sonnhalter gave this account of the slayings:

Esposito, driving the Jeep Cherokee, arrived at the Millers’ Woodhawk Drive home in Mayfield Heights at 3:45 p.m. Clutching the balloon bouquet, Esposito knocked on the door.

Albert Miller answered. Nobody witnessed the confrontation, but police believe the men argued.

Esposito shot the elder Miller five times in the chest.

Kathryn Miller was watching television in the family room. She heard the commotion and tried to flee the house through a garage door.

Esposito fired at Miller as she ran into her front yard.

She collapsed near a neighbor’s door, leaving behind a trail of blood.

There was a third person at the Miller home: a woman who worked for Albert Miller was in a basement office and was unharmed.

Esposito got in the Jeep and sped away from the house. Woodhawk Drive is a dead-end street, so Esposito headed east toward SOM Center Road.

Three police cars blocked him in as he neared the intersection. As officers surrounded the vehicle, Esposito put his new gun in his mouth and fired.

One officer discharged a shot that struck Esposito in the right arm and shattered the passenger-side window of the vehicle.

Investigators found a box containing more than 500 rounds of ammunition in Esposito’s Jeep. He had purchased the Luger at a Pennsylvania store Monday evening for about $200.

Plain Dealer reporters Donna J. Miller and Ellen Jan Kleinerman and news researcher JoEllen Corrigan contributed to this story.

To reach this Plain Dealer reporter:
dguevara@plaind.com, 216-999-4334

HOME | Sitemap | Abbreviations | Adrenal Crisis! | Glossary | Forums | Bios | Add Your Bio | Add Your Doctor | MemberMap | CushieWiki

In Memory: Judy Kennedy – December 15, 2019

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Judy died on December 15, 2019, after battling lung cancer, Atrial fibrillation, and total body weakness.  She was a great warrior for her children.

 

 

From 2008: Siblings Deal With Rare Cushing’s Diagnoses

By KALEY LYON

klyon@dailynews.net

COLBY — As a junior in high school, Justin Kennedy began getting sick and missing school on a regular basis.

He was fatigued, unable to sleep at night and gaining weight rapidly. He also was unable to focus on his school work and began experiencing memory loss.

After several doctor’s appointments, Justin was diagnosed with Cushing’s disease, a rare disorder caused by excessive cortisol levels resulting from a tumor on the pituitary gland.

At the time of Justin’s diagnosis, his younger sister, Jessica, also was showing symptoms of the endocrine disorder. Her diagnosis came at the same time.

“I think they both have had symptoms since they were little,” said their mother, Judy Kennedy.

Other symptoms include a round facial shape, flushed cheeks, excessive hair growth, skin discoloration and depression, Judy Kennedy said.

Weight fluctuation is uncontrollable. Weight is gained at a high rate, despite diet, exercise and other efforts, Jessica Kennedy said.

“The weight has a mind of its own,” she said.

The diagnosis, following many doctor’s appointments and tests, came last November. Today, Justin, 19, keeps busy with a job at McDonald’s, and Jessica, 15, is a freshman in high school taking online classes.

One of the most bothersome symptoms of the disease is the toll it takes on the sleeping schedule. Her children often are unable to sleep until early morning, Judy Kennedy said.

“When there was a chance for her to do online high school, it was such a relief,” she said. “We don’t have to worry about what time she starts her school work.”

Appetite fluctuation is another side effect. The two go through phases where they have healthy appetites, then hardly eat at all, she said.

That’s because the disease puts their bodies through various cycles, which can last for less than a day or for months at a time, Judy Kennedy said.

It’s predicted that about 15 people in a million are diagnosed with the disorder, which can make it difficult to find support and get answers, she said.

The family, however, discovered an online support group and has enjoyed the opportunity to communicate with other families in similar situations.

“I honestly do not know where our family would be if I wouldn’t have found that support group,” Judy Kennedy said. “Even though it’s still awful, it’s better to know that other people have the same symptoms.

“There are people on the streets who have this and have no idea,” she said. “And their doctors don’t either.”

Both teenagers also are preparing for surgery. In mid-May, the family will travel to Houston, where the siblings will have the tumors removed from their pituitary glands. This is expected to resolve the hormonal imbalances, Judy Kennedy said.

“I’m looking forward to that day,” she said.

This Topic on the Message Boards


JESS AND JUDY ARE MEMBERS OF THE CUSHING’S HELP AND SUPPORT MESSAGE BOARDS.

Jess and Judy answered questions in an online Voice Chat January 17, 2008. Archives are available.

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Taylor D, Pituitary Bio

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FLORENCE, S.C. – After struggling with a mysterious illness for nearly three years, Florence resident Taylor Davis is using her diagnosis of Cushing’s disease to raise awareness.

Davis was a healthy young adult when she started as a student at the University of South Carolina in the fall of 2015, but soon into her college career, she began experiencing several symptoms, such as weight gain, insomnia and panic attacks. Davis spent the next three years going from doctor to doctor trying to get a diagnosis for her symptoms.

Since her diagnosis, she has been trying to raise awareness through social media about her experience with Cushing’s disease.

Cushing’s disease is a hormonal disorder caused by high amounts of cortisol, or the stress hormone, in the body, according to the Mayo Clinic website.

During her freshman year, Davis began struggling with insomnia and started gaining weight. At the time, Davis brushed them off. Davis’s symptoms progressed to having panic attacks during her sophomore year.

“I’d be driving down the road, and my whole body would start freaking out,” Davis said. “I’d get heart palpitations, my heart rate would go crazy. I felt like I couldn’t breathe. It was intense panic attacks.”

In addition to the onset of panic attacks, Davis’ insomnia got worse, and she continued gaining weight. Davis also began losing clumps of hair, but she searched the internet and thought it was just normal.

The summer after her sophomore year, Davis said. she went to the doctor for answers with little luck.

“My doctor just kind of like brushed it off,” Davis said. “She told me it was probably just stress from school and stuff like that, and that I needed to diet and exercise more, but I was like, ‘A girl can only diet and exercise so much.’”

As Davis started her junior year, she said. her symptoms progressed to losing larger amounts of hair, which left bald spots that she tried to cover with extensions. At the time, Davis attributed the hair loss to bleaching her hair.

Then Davis began craving copious amounts of salt and large amounts of water.

“I started drinking water bottles by the case each day” and having to go to the bathroom frequently, Davis said. “It would just run straight through me.”

By the time the spring semester came, Davis’ panic attacks began causing blurred vision, nausea and dizziness. She said they felt like heart attacks.

Davis’ mother, Amy Lewis, got her admitted to McLeod Regional Medical Center for testing over spring break. Her kidneys were tested. An MRI and other tests were conducted, but Davis received no answers except that she was fine.

Davis’s panic attacks continued to get worse, so she and her mother began researching all of her symptoms for answers. Their research pointed them toward Cushing’s disease.

After another episode that caused Davis to pass out, her family took her to the emergency room. This time, the doctor had an answer: a brain tumor on her pituitary gland.

“It was so crazy the feeling I had at that moment,” Davis said. “I was so relieved, because I was so terrified for months at that point, and no one was going to help me because I had all of these problems.”

After the emergency room visit, Davis had to wait weeks for an endocrinologist appointment in Florence, but the doctor said she didn’t know enough to diagnose her.

She and her mom found an endocrinologist and neurosurgeon in Chapel Hill, North Carolina. The encodrinologist told her Cushing’s disease is too rare for her to have and said Davis needed to lose weight. The neurosurgeon told Davis an endocrinologist would have to prove that the tumor was causing Cushing’s disease before he would take it out.

By this point, Davis medically withdrew from USC because she could barely walk to class.

Determined to get answers, Davis joined several support groups on Facebook for Cushing’s disease.

The Facebook group led her to make an appointment with Dr. Theodore Friedman in Los Angeles, who was able to diagnose her with Cushing’s disease in October of 2018. In November of 2018, Davis had surgery to remove the tumor from her pituitary gland.

Since the surgery, the tumor removal has caused adrenal insufficiency, so Davis has to take a steroid-replacement medicine. She has been weaning herself off the medicine so that her pituitary gland will begin making cortisol again.

Davis has been using social media, especially Instagram, to post updates on her journey with Cushing’s disease. While she was at USC, she was a public relations major, and she has always loved telling stories.

“It just came natural to me as it (Cushing’s disease) started happening to start sharing my story,” Davis said.

Davis said she receives a few messages with questions about her experience every day from people who see her posts.

“ That (Cushing’s disease) really gets to me sometimes, but talking to those people, helping other people and sharing my story, that brings me back up,” Davis said. “That’s what keeps me happy and keeps me from getting to that dark depression.”

Davis said she is also in the process of starting a YouTube channel to document her experience with Cushing’s disease, because she wants to help others as they go through the process of a diagnosis.

This bio is from https://www.scnow.com/news/local/article_9c54e1e6-9615-11e9-84d3-8ff51e77dc88.html

Nikki C, Steroid-Induced Bio

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For Dunedin woman Nikki Cockburn, being one in a million is not a compliment.

She is one of the very few New Zealanders with Cushing’s syndrome, a very rare disease caused by excess production of cortisol.

Long afflicted by skin disease psoriasis, she had been prescribed the steroidal cream Dermol.

Over the years that she rubbed the cream on her skin she unknowingly boosted the cortisone levels in her body to the point where the symptoms of Cushing’s syndrome began to manifest.

“I was very unwell for a lot of last year. I was getting headaches a lot, my hair was falling out a lot … I had constant diarrhoea and because I have friends in their 30s who had bowel cancer I thought it might be that, but it went away again.

“I had insomnia, overheating, constant sweating, impaired cognitive function, and I was getting big, thick purple stretch marks over about 70 per cent of my body.”

Eventually a friend, who fortunately had heard of Cushing’s syndrome, raised that as a possibility.

“I went and looked it up and went ‘I’ve got that, I’ve got that, I’ve got that’ – it was like ticking everything off of a list.”

An official diagnosis soon followed, but during that consultation came the shocking discovery that all Cockburn’s agony could have been avoided.

She was told that in 2014 her doctor had received a letter from a dermatologist warning Cockburn should stop using Dermol immediately.

“I got offered the chance to meet him [her doctor] just after I was diagnosed but I knew I was so angry and upset that there wouldn’t be a positive outcome, and I’m a forgiving person,” Cockburn said.

“I ended up meeting him last month, took a support person and read out a letter setting out everything I have been experiencing … He apologised profusely and cried quite a lot in his talk with me. I could tell he was really remorseful.

“He was also honest. He told me that the alert wasn’t put on my file in 2014 – it was in fact put on there in 2012, which upset me even more.

“He had seen the sentence there, but somehow had missed it,” she said.

The clinic and doctor, which Cockburn did not wish to name, have since reviewed their processes and procedures for dealing with patient alerts and held refresher sessions on psoriasis treatment.

Cockburn now uses Dermol sparingly and is trying to replace it with a non-steroidal cream for her psoriasis.

Cushing’s syndrome, which affects between one and three people in every million, is an invisible illness. With make-up, a long dress and stockings on there are no obvious signs of anything being wrong with the outgoing 36-year-old.

“A lot of what is going on with me is going on inside, or are things you couldn’t see unless I was wearing shorts and a T-shirt,” Cockburn said.

“I’m normally in bed or lying on the couch, because one of the big side effects for me has been lower back pain and I now have gynaecological problems as well.

“Over the past few months my back pain has been horrific – I am in pain sitting here now – but I guess if you talk to anyone who is in daily pain they kind of get used to it.

“I’ve forgotten what it is like to feel well.”

Cockburn decided not to pursue a health and disability commissioner complaint, but the Accident Compensation Corporation is investigating her situation.

With treatment, Cushing’s syndrome can be managed, but Cockburn’s prognosis is uncertain, which has led to anxiety and panic attacks.

“I have been very open on Facebook – I blog about my journey, what is happening to me,” Cockburn said.

“What has happened to me has happened – you can’t change it, you can’t take it back – but I sure as hell can stop it happening to other people by raising awareness.”

From https://www.nzherald.co.nz/nz/news/article.cfm?c_id=1&objectid=12232161

In Memory: Kathryn McBride ‘Bridie’ Miller, May 1, 2007

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in-memory

From the Message Boards at http://cushings.invisionzone.com/index.php?showtopic=21816

“My name is Caroline and I dont post often but have met a few of you guys and read the board regularly, it has definitely been a godsend to cushies everywhere. The reason I am writing tonight is I have just received devastating information about a dear friend of mine, and a woman some of you may have met during testing. Her name is Kathryn Miller and she is a patient of Dr. Ludlam, that is how she and I met. She was diagnosed with cushings late last fall and had surgery in December and was doing pretty well afterwards.

Long story short, from the information I have received from her mother, She knew a man that she met off of a christian singles website.. I dont know many details about it, but I do know that he drove from his home in Pennsylvania to hers in Cleveland Ohio posing as a balloon delivery man, to then gun down her father killing him, and then to chase after her and gun her down in her neighbors front yard where she later died in surgery. This man then proceeded to commit suicide in his car when the police began to chase him.

Kathryn was an incredible person, and came from a loving, wonderful family. She was a fighter in every sense of the word, and never complained about the fact she was so sick. She always joked that she would one day ‘look hot’ in a bikini again. And she would always say there would be the day when we cushies would be happy and healthy again.

So heres to you Kathryn, I pray you are finally out of pain and that you are happy and cushings free in heaven. I will never forget you, you are in my heart forever. As much as it hurts to not have you here, I take comfort knowing you are smiling down from above. Fly on angel, fly on.”


Kathryn ‘Bridie’ and Albert Miller
Murdered May 1, 2007

~Ages 31 and 71, respectively ~Hometown: Mayfield Heights, OH

On May 1, 2007 Scott Esposito, 38, drove about six hours from his home in Macungie, PA to Mayfield Heights, OH. That’s where his love interest, Kathryn McBride ‘Bridie’ Miller, 31, lived. He showed up at her door with a dozen ‘I love you’ balloons. An attempt at reconciliation perhaps for, although Esposito’s family believed the two were still dating, those who knew Miller say that she broke off the relationship about six months earlier.

Miller lived with her parents. Her father, Albert Miller, 71, answered the door when Esposito arrived. The two exchanged words. Esposito subsequently shot Mr. Miller five times, killing him. Ms. Miller heard the commotion and tried to leave the house through the back door, Esposito shot her eight times as she fled. A neighbor called 911, but Ms. Miller was dead before help arrived. Esposito then tried to flee in his car. When cornered by police, he committed suicide with a gunshot to the head.

Police do not know exactly what caused Esposito’s rampage. He purchased a gun the day before the shooting. In his car he had over 500 rounds of ammunition. He did not have a suitcase or other personal belongings, suggesting that he planned to return home the same day or perhaps that he contemplated his suicide in advance. Police hope to access the couple’s email exchanges to learn more.

Esposito called Ms. Miller when he was en route to her house. She called her mother, who was not home, and told her Esposito was coming, but it does not appear she feared him. It seems, though, that she asked her father to turn Esposito away, resulting in the argument Mr. Miller and Esposito had at the door.

Ms. Miller met Esposito via an online dating site for Catholics. There are conflicting reports about how long ago they met. It may have been as long as two years ago. They saw each other infrequently – because they lived 400 miles apart – but emailed and talked via phone daily when they were together. A friend said Ms. Miller became concerned over Esposito’s ‘irrational’ behavior and ended the relationship in October 2006. One news story said the couple had a brief on and off relationship last fall and only limited contact since December.

Esposito had a bachelor’s degree in business administration and worked as an independent insurance broker. He lived with his parents and older sister, who had spina bifida, so he could help care for them. He had no criminal record. His family says the shooting was completely out of character for him.

Mr. Miller ran his own employee placement agency from his home. An employee of the business was in the home at the time of the shootings, but was unharmed.

Ms. Miller, who had cerebral palsy, held both a Master’s degree in education and a certificate in speech pathology. She worked previously as a teacher.


From: http://www.cleveland.com/news/plaindealer/index.ssf?/
base/cuyahoga/1178181906224960.xml&coll=2

Shooter left behind 2 victims, questions
Man drove hours to ex-girlfriend’s house for ‘purpose,’ police say
Thursday, May 03, 2007
Damian G. Guevara
Plain Dealer Reporter

Mayfield Heights – Scott Esposito drove 400 miles from his Pennsylvania home Tuesday with balloons for his long-distance love interest. He also had a loaded gun.

Esposito ultimately gave Kathryn McBride Miller the bullets – at least eight hollow-point rounds to her head, torso and extremities. He also shot and killed her father, 71-year-old Albert Miller. As police closed in a short time later, Esposito put the black, .22-caliber Luger in his mouth and pulled the trigger.

With the shooter and his victims dead, police on Wednesday were trying to make sense of the rampage. Investigators met with relatives to learn more about the relationship between Miller, 31, and Esposito, 38, of Macungie, Pa., about 65 miles northwest of Philadelphia.

Esposito dated Miller sporadically last fall, but their contact had waned since December, Lt. Chris Sonnhalter said. Miller never reported any trouble between the two to authorities, and her family knew of Esposito, Sonnhalter said. It remained unclear how Miller and Esposito met, but the two never lived in the same area, Sonnhalter said. Police are looking at their e-mail exchanges for clues.

“Obviously, he had some bad intentions . . . whether to end his life or someone else’s,” Sonnhalter said.

Sometime before the killings, Miller learned Esposito was traveling across Pennsylvania to see her, Sonnhalter said. Early in the day Tuesday, she called her mother at work about the pending visit but did not express any alarm.

Kathryn Miller was a former teacher who had a license in speech pathology. She was a graduate of Xavier University and the University of Virginia, where she earned a master’s degree in education. She taught in Hudson schools for one year, in 2002-03.

Her father, Albert, ran an employee-placement business from his home, police and neighbors said.

Police found a work badge belonging to Esposito in his green Jeep Cherokee but learned little about the man Wednesday. He had no criminal record.

Neither the Miller family nor Esposito’s relatives could be reached for comment Wednesday.

Police believe the bespectacled Esposito wanted to maintain a romantic bond with Miller against her wishes and became angry when spurned.

“It was about the relationship,” Sonnhalter said. “I think he brought that gun to Cleveland for a purpose.”

Sonnhalter gave this account of the slayings:

Esposito, driving the Jeep Cherokee, arrived at the Millers’ Woodhawk Drive home in Mayfield Heights at 3:45 p.m. Clutching the balloon bouquet, Esposito knocked on the door.

Albert Miller answered. Nobody witnessed the confrontation, but police believe the men argued.

Esposito shot the elder Miller five times in the chest.

Kathryn Miller was watching television in the family room. She heard the commotion and tried to flee the house through a garage door.

Esposito fired at Miller as she ran into her front yard.

She collapsed near a neighbor’s door, leaving behind a trail of blood.

There was a third person at the Miller home: a woman who worked for Albert Miller was in a basement office and was unharmed.

Esposito got in the Jeep and sped away from the house. Woodhawk Drive is a dead-end street, so Esposito headed east toward SOM Center Road.

Three police cars blocked him in as he neared the intersection. As officers surrounded the vehicle, Esposito put his new gun in his mouth and fired.

One officer discharged a shot that struck Esposito in the right arm and shattered the passenger-side window of the vehicle.

Investigators found a box containing more than 500 rounds of ammunition in Esposito’s Jeep. He had purchased the Luger at a Pennsylvania store Monday evening for about $200.

Plain Dealer reporters Donna J. Miller and Ellen Jan Kleinerman and news researcher JoEllen Corrigan contributed to this story.

To reach this Plain Dealer reporter:
dguevara@plaind.com, 216-999-4334

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