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Marian U (MaidM), Adrenal Bio

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HI!

I had Cushings symptoms for about 20 years (I am 43) before I finally had surgery at NIH on August 29, 2012.  Before 2 years ago, I had never even heard of Cushings.  Without the aid of a very perseptive medical accupuncturist, I would probably still be suffering today.   Perhaps, if I had heard about it sooner, I wouldn’t have suffered for so many years.  My goal is to help as many people as possible in battling this devastating disease.

I am so happy that I have a new chance at a real life! Feel free to contract me.  Below is a piece I wrote before surgery and my stats.

🙂 Marian

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My Experience with Cushing’s Syndrome

The changes came about gradually.  So gradually, that it is very difficult to pin-point exactly when the overall change became larger than the sum of individual changes and thus was something that was difficult to ignore. For my whole life, I was “Marian” and then one day, I was someone else.  I had become someone unrecognizable: the “Not Marian.”

One of my favorite books, “The Tipping Point,” by Malcolm Gladwell, expands on the premise that little changes make a huge difference.  Individually, the changes I experienced were easily explained.  I was tired. I had nighttime hot flashes.  I gained weight. I was moody and forgetful.  My sight was blurry.  I often typed or said the wrong word. I couldn’t sleep. I couldn’t remove my rings without soaping up my finger first.  One day, I forgot how to roll down my car windows.  I experienced moments of panic where I was driving and couldn’t remember what road I was on or where I was going. When I mentioned any or all of these symptoms in a group of women over forty, I heard a cavalcade of similar stories, usually expanding into an animated discussion centering on menopause and aging.

I also noticed that I stopped getting compliments.  People, except my amazingly supportive husband, just didn’t say that I looked nice or pretty anymore.  I tried not to be vain; I thought that I probably had just reached the point where I aged enough that I no longer was going to get the attention that I used to get.  I had “hit” the proverbial “wall.”

It is easy to look in a mirror and only see a stylized version of yourself.  But, photos are more precise.  For some time, I had noticed something “off” in the photos that were sometimes posted of me on-line.   They just didn’t look like me anymore.  I untagged myself and brushed them off as bad photos with only the vague realization that the “Marian” I thought I was, was no longer me.

My epiphany came in the form of the photos on my work identification cards, taken about three years apart.  Not only do I look like I have aged about ten years — I also look completely different.  My face is much fuller, my features are distorted, my eyes are sunken, my hair is stringy, and my skin is sallow.  I look like a bad photo copy of my former self.

Now, I realize that how I look is a small part of who I am as a person.  However, it is also the part of me that everyone sees first.  I remember being in the dressing room at Target and catching a glimpse of the “Not Marian” in the mirror.  I was astonished at my reflection and cried.

A friend suggested that I just realize that this “Not Marian” is who I am now.  I don’t think that this bad advice; it is just advice that is easy to say, but difficult to follow.  I often compare my sense of futility regarding my desperate attempts to become “Marian” again to Hercules’s labor of cleaning the Aegean Stables.  I exercised four or so times a week.  I went to a diet doctor.  I ate under 1200 calories a day.  I bought new clothes.  I got my nails done.  Despite these efforts, I only saw minor improvements in the way I looked and felt.  I still felt as though I was always wearing a rubber suit over my skin that covered my former self.

In many ways, the diagnosis of Cushing Syndrome was a relief.  Finally, there was an explanation for the way that I felt and, though serious, Cushing’s is generally a completely curable disease.   But, knowing I have Cushing’s presents another problem, when is it appropriate to tell peop

My initial inclination was to tell everyone.   I wanted to explain the difference between the “Marian” you remember and the “Not Marian” that you see now is a result of this rare disease I have.   “It’s not really me!  It’s the Cushing’s.”  I tried it a couple of times with mixed results.

Mostly, people said that they had not noticed a significant change in the way I looked or behaved.  My closer friends were more tolerant, expressed concern, and asked questions.  The reality is that nothing (except maybe vacation recaps) is more uninteresting in light conversation than talking about illnesses and ailments.  And though it was significant to me, the changes were not readily observable.  So, I will try not to talk about it.

I know that my upcoming surgery is not a panacea, though it is nearly impossible not to view it as such.  I have scrolled through hundreds of websites and blogs looking at photos and reading synopses of people before and after treatment.  I have connected with someone who was successfully treated for a Cushing’s syndrome through Cushing’s Support and Research Foundation.  Ultimately, my hope is that the loss of me is only temporary and that through successful treatment of the disease; I can begin to feel like “Marian” again.

STATS

July 2010: MRI at Kaiser showing a pituitary adenoma. High 24 Hour cortisol. Low DHEA.  Low ACTH. Referred to NIH.

Late July 2010:  CT at Kaiser showed “suspicious” tumor on left adrenal. (High HU, e.g. cancer)

Sep 2010: NIH testing.

Nov 2010:  NIH re-read the results of CT and MRI. NO pituitary adenoma and BENIGN tumor on left adrenal.

Dec 2010 – April 2011:  Unable to replicate high cortisol test at NIH. Diagnosed as pseudo Cushings due to stress. Yearly follow up recommended.

April 2012:  Follow up testing at NIH.  Cortisol is high.  CT of adrenal tumor is stable.

June 2012.  Second cortisol at NIH is high.  Diagnosis cyclical Cushings.  Will not operate.  Note that I do not look like clinical Cushings, so that was part of the problem.

July 2012: Bone density loss of 25% in three years confirmed through Kaiser.  I happened to luckily have had a previous bone scan so that they could compare.  The current bone density scan wouldn’t have been enough because I didn’t have osteoporosis yet.

Aug 6, 2012: Referred for surgery on Aug 27.

Aug 26, 2012: Enter NIH.  Surgery postponed but I can’t leave because of the testing!

Aug 29, 2012.  Surgery!  The surgery itself was easy.

Sep 2, 2012:  Left NIH

Returned to work half days Sept 4 and full time Sep 10.

Cheryl D (tigereye2010), Pituitary Bio

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I am a 46 year old female who was diagnosed with Cushings Disease in December of 2009.

In May of 2010 I had my first surgery to remove the Pitutitary tumor.  It has been two and a half years and still tumor free.

I have other health issues due to the Cushings.  I am a mother of two children and four beautiful grandchildren.

My husband has been wonderful through all this and so has my family.

Sarah (Sarah), Pituitary Bio

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I was diagnosed with Cushing’s Disease January 2011. The doctors suspect I was suffering from it for at least 2 years prior to diagnosis.

I originaly thought I was just losing weight and having skin problems due to stress and getting older – even though I was still in my mid-late twenties.

A family friend and nurse told my mom one day that she thought I had Cushings and encouraged my mom to get me to look into it. Thank goodness I did. I had honestly nearly given up because I was so ashamed to go to doctors who just told me I needed to work out more and eat less. I was making an effort to lose weight but nothing worked! I told my mom no at first but after a few phone calls of her crying and begging me to go I finally agreed. I sat down at my computer and googled symptoms and sure enough I fit almost every descriptor on the Cushings list.

It took a few months to get into a specialist but my family doctor rushed it. I was so lucky to have this doctor. She was actually just covering for my regular doctor but she was the first one to take me seriously and really investigate my concerns.

Now, two years and three pituitary surgeries later things are looking good! I am back to work and feeling better than I can remember feeling in a long time. I have kept a blog sporadically documenting my experiences with Cushings that I invite you to read for more details on my bio. I hope that my story can be an inspiration to those who are feeling hopeless. I often felt that way but tried to stay positive and believe that one day I would be cured and fingers crossed, it seems like I am 🙂

It is possible to come out on top!! Best of luck to everyone 🙂

 

http://pushingthroughcushings.blogspot.ca

Anthony G, Pituitary Bio

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The opening in a GE Signa MRI machine

The opening in a GE Signa MRI machine (Photo credit: Wikipedia)

58 year old male.

In 2009 was in excellent health. Have suspected something wrong with me for two years. Just was not feeling like my old self.

Diagnosed with Cushings October 8th, 2012. Developed symptoms of: Stomach extension (looked like I was pregnant), round face, skin easily bruses and tears, edema on feet and legs, high blood pressure, depression, brittle hair and hair loss, lack of concentration, & blury vision. Cat scan and MRI were negative, IPSS proved positive for Cushings.

Pituitary surgery performed on December 4th, 2012. Two microedenomas identified and removed.

Recovery pending.

MaryO, Self Care

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Info from MaryO. Luckily, AIU posted something on Facebook that gave me the perfect information to share today:

 

They also shared this information, which I already knew and put into good use just yesterday:

Feeling overwhelmed? You’re not alone.

Managing adrenal insufficiency during extreme stress can feel like carrying the weight of the world — but tiny steps rebuild your strength.

We created this simple guide to remind you:

• Rest before exhaustion.

• Stay hydrated and balance your electrolytes.

• Breathe deeply to calm your nervous system.

• Celebrate every small win.

• Listen to your body if you need to stress dose or inject.

You are healing, even now. You are not alone.

Learn more and find community at www.aiunited.org

 

As a person with secondary adrenal insufficiency, I find often find myself in a situation when I need to stress dose and balance the electrolytes.  Many Cushies I know eat salt for this purpose but I don’t like salt.  If I’m eating pretzels or something else with removeable salt – i take it off.

I don’t know if I found it by myself on amazon or someone recommended it but I always have a product called – TaDa! – SaltSticks nearby.

Writing this post today, I actually looked at the directions and found that I’m supposed to take 2 at a time.  Oops!  One does help somewhat.  I’m sure that 2 will be even better.

To keep these and my hydrocortisone nearby, in addition to the actual bottles, I got some waterproof pill containers and keep them on my keychain.  The wider ones hold 2 of the SaltSticks exactly.

The narrower ones have hydrocortisone and Tylenol. The hydrocortisone is in the red pill container.

All 3 are on one ring which goes onto my larger carabiner clip so that they can be easily moved if necessary.

In my backpack, I have an adrenal insufficiency emergency kit of sorts that I got off ebay.  This also includes a bee sting kit.  If you want to know why, check out this post.  there is also information about my doctor, more hydrocortisone, benadryl, tylenol.

Both the keyring and the emergency kit have MedicAlert tags which include my member number so medics can find out just what I need, my DH number and my doctor’s number.

This info is also on my MedicAlert bracelet.  I bought this one years ago to honor Natalie’s memory – this is the same style she wore.

In the backpack is also a standard emergency kit that anyone might have. (boring!)


More on MedicAlert bracelets:

Shared with permission from https://aiunited.org/medicalbracelets/

Advice from a Volunteer Firefighter with Adrenal Insufficiency

My name is Jeannie, and I have been diagnosed with Secondary AI since March of 2015. To make a long story short, I was diagnosed with a pituitary adenoma in Feb of 2015. It was apron 8mm x 10mm at the time wit was found. On April 25th, 2015 I was getting ready for work in the early morning hours.. I passed out in my bathroom and was immediately rushed to the hospital by my husband. They did a secondary MRI and found that the tumor had tripled in size to 23mm x almost 41mm. My Cortisol was also so low it was undetectable by the lab. I was taken by ambulance to Emory University hospital in Atlanta where the Neurosurgeon I had been in consult with was. I arrived there on Sunday and was in Surgery Wednesday Morning. The surgery took 9 hours and recovery was close to 6.

Prior to this all taking place I was a volunteer firefighter, and had worked EMS for almost 16 years. I have been in nearly every situation possible. I see so many people that have our condition asking about Medic Alert bracelets, What kind they should have, what it should say on it, etc. So I have put together a short list to help out a little bit. This is coming from both someone who has this extremely rare disease, and also from the Emergency Medical Side of me. Knowing what We as medics look for in the field, How quickly things move, what we ask or need to know, etc.

Please know that this IS NOT Professional Medical advice, But this is advice coming from someone who can shed some light on how to potentially save your life if you should ever be alone, or without anyone who knows your condition and you fall unconscious or are unable to the the responders what your condition is.

First off if you are looking for a medic alert bracelet or wondering if you should get one.

**The answer is yes, If you have been diagnosed ANY TYPE of adrenal insufficient or are on replacement medication.. YES. you need one.**

Here are some of those reasons and some pointers on what they should look like / what they should say.

#1– If you are found unconscious, and there are not bystanders around to tell emergency crews what is wrong with you, You will go longer without your steroids. If we see on your bracelet that you are steroid dependent, it dissolves the ENTIRE guessing game of why you’re unconscious.

#2– It should have on there your emergency contact and a GOOD telephone number. That way if nothing else. We can call them. NOT EVERY EMS AGENCY HAS ACCESS TO THE “CLOUD” BASED SYSTEMS THAT STORE YOUR INFO. Please be sure that if your emergency contacts number changes.. You change it on your bracelet. There is nothing worse than wasted time calling a number that doesn’t belong to the person we NEED to talk to.

#3– DO NOT MAKE IT “PRETTY” OR “NOT SO OBVIOUS”. I can not stress this enough. Ladies I know that you want the cute ones that look like normal bracelets, and have pretty charms, etc on them… THE ENTIRE point of a medical alert bracelet is that someone needs to see it and know that they should look at it. If it looks like a regular bracelet or regular necklace and it isn’t obvious within the first 3 seconds once we get to you and look in the obvious places (neck/wrist). it will NOT get seen. I promise you, we are too busy trying to play the guessing game of why you are not responding, than to take a look at every single piece of regular jewelry and see if it might have a really small inscribing of what is wrong with you. Once again. Make it noticeable. We will see that we need to look at it. Once we do. The guessing game is more than likely OVER. and we can begin to treat you appropriately.

#4– Most EMT’s and Paramedics Don’t Understand or know about Addisons or the treatment involved. If nothing else, carry a letter from your doctor explaining what is wrong with you, etc. It is very rare, and NOT covered in most Paramedic courses. So please, for those of you that put “ADRENAL INSUFFICIENT” on your bracelet and NOT “STEROID DEPENDENT” please keep in mind that you may end up with the Paramedic that just graduated, is nervous, and will mistake adrenal insufficiency for Adrenaline insufficiency.. and try to give you epinephrine. Please understand that I have seen this almost happen. It is something that is easily misunderstood in the heat of the moment.

#5– If you have an emergency injection that you carry with you all the time, on your person, or somewhere close. PUT ON THERE THAT YOU HAVE IT! MOST ems agencies have standing protocol that they can assist with emergency medications (Don’t jump in here if you are one of those states that doesn’t allow it.. I said most) That way if we find you down, and look at your bracelet, AND see that you have emergency meds with you… guess what now, not only is the guessing game over, You’re ALSO getting the RIGHT EMERGENCY MEDS, instead of us having to either give you what we carry, or you having to wait until you get to the ER and the ER doc has to go through your file and figure out that you need the medication that’s been in your pocketbook the ENTIRE TIME.If you are unsure if your state allows this, or if you Local EMS agency can do this. Contact their local medical control and ask. If they do, Please offer to give a small talk on what the disease is and how to use the emergency kit. Most will know once they see the acto-vial, but if they do not, Please educate them. Explain to them that it can be the only thing that could save your life.

Please take the time and make sure that you have correct information on your bracelet. Secondary or Primary, the treatment in an Emergency situation is the same. So there is NO need for you to spell out if you are secondary or primary. Both get the emergency injection in case of a crisis. Both get fluid bolus, heart and blood pressure monitoring. Nothing is different when it comes to an emergency situation. If you have any questions on the wording or what to get on it. Be sure you at least have an emergency contact, That you are steroid dependent, and where your emergency injection is located.

IF you know that your local EMS agency uses the “cloud” for stored emergency info, you can spend the money to get it. But I worked for service that covered a county with over 100 sq miles, and we didn’t use it. It is unreliable and takes too much time to log in to the system, try to read the small number on your band, type it in, etc. When you can simply put the information on the band itself.

 


The image below sure looks like it was made by Sandra Boynton but I got it from another page on Facebook.

These tips are good for anyone who needs a little self-care – not just people with adrenal insufficiency!

 

What do you do for self care?  Please tell me in the comments.

 

Jane (Jane) Cushing’s Bio

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I was diagnosed with Cushing’s approximately 10 months ago. My health insurance ran out so I have had no treatment.

The psychological symptoms are very bad – depression, anxiety, loss of emotional control.

All I am able to do is go to work and that is becoming very difficult. Despair.

Laura C (Laura), Pituitary Bio

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In the early part of 2007 I was feeling very tired, was gaining weight even though I was eating 800 – 1000 calories a day and exercising 1 hour per day.  I would go to my doctor and she would dismiss me inferring that I was just an overweight, middle aged woman looking for a quick fix to loose weight and control my diabetes.  This went on for several months with me seeing her every 3 or 4 weeks with the same complaint.

Finally in mid 2007 I said enough was enough and demanded that she order some blood tests.   Well, she ordered  the 24 hour urine collection test for cortisol and lo and behold, my cortisol levels were off the chart.  I was immediately referred to my endo and after ruling out many other things with MRIs, CAT scans and full body scans with radioactive injections,

I was referred to my neuro surgeon and he saved my life.  The beginning of December of 2007, I had surgery to remove 1/2 of my pitutary gland that had micro (benign) tumors.  12 hours after surgery, my cortisol levels wer down to the high “normal” range.

Today, 5 years later, I have no cortisol issues at all and now my endo says I have a “history of Cushings disease”.

Peggy (concerned for spouse), Pituitary and Adrenal Bio

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I’m married to my best friend who’s health has steadily declined for around 15 years.  High Blood Pressure, Diabetes, weigt gain, mood change are part of the decline.

He had a pituitary tumor removed in May 2012 after a diagnosis of Cushings.  We know that he still has an adrenal tumor that the endocrinologist thinks was fed by the pituitary tumor.

My husband, my best friend, thinks they have ruined him forever.  He feels worse than ever before.  The doctors say it may take up to a year, that this has been coming on for a long time.  His blood pressure is now controlled and he has gone from 12 blood pressure pills a day down to 2 1/2 pills per day.  Other that that, he has a poor quality of life with no energy, no happiness.

I wish I knew more and could help and support him better.  I am the fixer in our life, our family, our business that we have worked in together for 10 years and I’m so sad for him.

Share Your Experiences with Cushing’s

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The popular website “How Stuff Work”s is doing a survey of all kinds of diseases and Cushing’s is one of them!

Share your information and help get the word out to the world in general.

(I’m MaryO on there and I shared about my pituitary surgery and its aftermath.  I hope this info helps someone else like these boards and related websites have)

The idea is simple. Everyone shares their experiences with different treatments. StuffThatWorks automatically transforms these experiences into data about which treatments work best, and for whom

The questionnaire is here: https://stuff.health/s/u0A9djA5

Together, we’ll figure out which treatments work best for Cushing’s syndrome.

 

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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

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