Listen to your body.
Get a doctor you really like and trust.
Jayne Miller smiles and laughs at her newfound mantras, truisms she's learned the hard way during the past two months. Hers is a good, hearty laugh, one that betrays not a hint of anything wrong - she neither looks nor sounds like a woman still recovering from brain surgery. Sitting on a picnic bench outside WBAL's TV Hill studios on a warm April afternoon, she seems as energetic and straightforward as ever, every inch the hard-driving investigative reporter who has been chasing after lying pols and corrupt businessmen for nearly three decades.
Now, she can smile about all that has happened. She can marvel at her good fortune and point blithely at the small patch of shaved skin, hidden beneath her otherwise untouched head of hair, that is pretty much the only outward sign that anything was ever wrong. And she can present her story, which will be part of WBAL's 11 p.m. newscast today, as less of a life-threatening experience than as a cautionary tale.
"The real moral of this story is just to listen to your body," says Miller, who turns 54 Saturday. "My body was clearly telling me something at the beginning of February, that this wasn't just another cold, this wasn't just a headache that was going to pass. There was something more seriously wrong here.
"I feel very lucky," she says, "that I listened to myself, I acted on it, and then I listened to my doctors."
Things were very different two months ago. Headaches, vomiting, listlessness. Miller, a newswoman at WBAL for all but two of the past 29 years, an investigative reporter and probably the most respected journalist on Baltimore television, and a woman who insists she's "never sick," was in terrible shape. More terrible than she knew.
"It started with a headache," she says. "I'm not a big call-the-doctor person. You shrug it off, you take something, an Advil here and there or whatever, and you kind of soldier through it. But this time, I picked up the phone and called the doctor. I told her I had this headache, kind of a tension headache, and that my ears felt clogged.
"She wasn't comfortable," Miller says, "that I had a headache that wasn't going away."
Nor was Miller's internist, Dr. Redonda Miller (no relation), comfortable that her patient, who had rarely complained about anything before, felt bad enough to raise an alarm.
"She's a very stoic person," says Redonda Miller. "You know your body, and you know when something's not right."
Miller underwent her first CT scan Feb. 11, and everything looked fine. "It showed like I had sinusitis," she remembers. But the symptoms only got worse; two days later, Miller checked herself into a hospital emergency room. A second CT scan revealed nothing out of the ordinary. About eight days passed.
"I started feeling a little better," Miller recalls, "and then I just really went bad."
Redonda Miller had seen enough to put her patient under the care of a neurologist. Recognizing symptoms that suggested a leak of spinal fluid, doctors tried a blood patch, where blood is taken from one part of the body and injected into another, in hopes of plugging any leaks.
By this time, CT scans had revealed a subdural hematoma, essentially a blood clot sitting outside the brain. In some cases, they heal themselves, but Miller's only got bigger - tripling in size in a matter of days.
"I had a checkup on the 20th of March, and by that time, it had gotten worse," Miller says. "They showed me the CT scan, said 'Here's what it looks like. We're going to have to go drain it.'
"I was in surgery the next day."
On March 21, Miller, spent an hour on an operating table at Johns Hopkins Hospital. Neurosurgeon Michael Lim drilled two small holes in her skull and drained blood that had accumulated in the area surrounding her brain. Untreated, the hematoma could have severely damaged Miller's brain and brain stem. And, as Lim puts it, struggling to sound neither too clinical nor too alarmist, "when the brain stem is damaged, or it's severely damaged, it can be incompatible with life."
The hematoma was likely caused by what doctors call intracranial hypotension, says Lim, in which fluid leaks outside of the brain and spinal cord. Doctors suspect Miller may have contracted a mild case of viral meningitis, and that the accompanying violent coughs and vomiting may have caused the tear.
Over time, such leakage reduces pressure inside the skull, causing the brain to sag. That increases tension on what are called bridging veins, which carry blood from outside the brain to the sinuses.
In Miller's case, doctors say they believe one or more of the veins ruptured, leaking blood into the area surrounding the brain. That added mass put pressure on the brain, essentially moving it off-center and contributing to the debilitating headaches Miller had.
"Intracranial hypotension is not that common," says Lim. "As an institution, I'm guessing that maybe we see one a year. I've probably seen one other case in the past five or six years."
Miller's recovery was swift. Operated on a Friday, she was sent home the next Monday. She started feeling better almost immediately.
Today, Miller insists, some four weeks into the recovery process, she feels "better now than before I started to get sick." She had a CT scan last week - it looked fine - and is scheduled for another one next month to help monitor her condition.
One happy byproduct of her health scare: After 30 years as a smoker, Miller hasn't touched a cigarette in two months. She stopped her half-pack-a-day habit "in the middle of all this," she says, and has felt little, if any, urge to start up again.
"The day I was told I had to have surgery, I hadn't been smoking for a couple weeks," she says. "And that's the kind of day, when I was smoking, that I would really have relied on it. But I got through that day without smoking."
Since returning to work Monday, Miller is already lining up stories for the coming weeks, including at least one she had been working on before getting sick. The doctors have cleared her to work as long as she feels up to it; Monday, she was in the office for seven hours. She's even been cleared to play a few holes of golf - important for a self-described "serious golfer" who's proud of her 9 1/2 -stroke handicap.
"The only thing left is to get my strength back," Miller says, "strength and stamina."
Going through brain surgery, Miller says, can't help but change you. Maybe it doesn't change your personality, she says, pledging to remain the dogged, in-control news reporter she's always been. But it certainly changes one's perspective.
"It has awakened me even more to the things that we cover every day," she says. "What are the things we cover every day? The debate over health care and health insurance. It certainly put me in the middle of that, and you understand the necessity of fixing this problem, so that care is available and affordable."
As for her on-air persona, Miller promises, "No one should fear. My head is as hard as ever."
WBAL news director Michelle Butt is glad to hear it. "Jayne is one of those touchstones for the newsroom," she says. "You just feel better when she's there. For our newsroom, we were a little off-kilter without her. So having her back, all is right with the world."
Still, Miller isn't entirely comfortable telling her story in public. She's used to being on the other side of the reporter's notebook, asking the questions and coming up with the quick follow-ups. But maybe, she says, some people will find comfort in hearing her story. Maybe some people will listen more closely to what their bodies are trying to say and make that first call to the doctor sooner rather than later.
"My doctor encouraged me to do this," she says. "She said, 'There are a lot of people who have followed you for years, and you've got some important messages to put out there.' "
What is a subdural hematoma? A subdural hematoma is a collection of blood on the surface of the brain that occurs when the vessels between the brain and its outer cover stretch and tear.
What causes them? Acute subdural hematomas are usually the result of a serious head injury. They rank as one of the deadliest of all head injuries because the bleeding is rapid and puts pressure on the brain. Chronic subdural hematomas are the result of a minor head injury, age, use of blood thinners, alcoholism or, infrequently, nothing at all. They can go unnoticed for weeks and generally respond well to treatment.
What are symptoms? Unconsciousness after head injury, headache, weakness, personality changes, numbness, slurred speech, nausea and seizures. Some symptoms can persist.
What is the treatment? Pressure must be alleviated on the brain, so sometimes a hole is drilled in the skull to drain the hematoma. The size of the hole depends on the hematoma size. Medicine to reduce brain swelling or seizures is used in other cases.
How common are they? Acute subdural hematomas occur in a quarter to a third of those who suffer a severe head injury. Chronic ones occur at a rate of one to more than five per 100,000 people a year, although new studies suggest they may be more common.
[Meredith Cohn][ Source: U.S. National Library of Medicine, National Institutes of Health and WebMD]