'Everyday heroes' saving own lives
West Virginia is among the top five on just about every national chronic disease list. The state leads the nation in diabetes and obesity, according to the Gallup Healthways poll.
Surveys show that many West Virginians do not realize obesity is a leading cause of many chronic diseases. Many also feel those diseases are hereditary, and there is nothing a person can do to prevent them.
The state's children raise major red flags for the future. West Virginia University screens thousands of schoolchildren every year. In 2010-11, they found that 24 percent of fifth-graders have high blood pressure, 26 percent have high cholesterol, and 29 percent are obese. Eighteen percent of kindergartners and 23 percent of second-graders are obese.
There has been little public discussion of this problem. "The Shape We're In" project aims to stir up that discussion. Written and photographed by California Endowment Health Journalism Fellow Kate Long, it will be divided into three parts in The Charleston Gazette, the state's largest newspaper:
• Children at risk
• Programs that work
• Communities making a difference
Some segments will be accompanied by West Virginia Public Radio pieces.
Part 1: "This is a public health emergency"
Part 3: Putting the pieces together
Part 4: Health officials say W.Va. can reverse its chronic disease numbers
Part 5: W.Va. man: diabetes programs work
Part 7: Daily activity affordable, Department of Education says
Part 8: Wood researchers: Active kids do better academically
Part 9: Rocking the gym at 7:30 a.m.
Part 10: Nebraska school district lowers obesity rate
Part 12: 'Everyday heroes' saving own lives
Part 13: W.Va. ranks first in heart attack, diabetes, eight other categories
Part 15: Great Kanawha food fight
Part 17: W. Va. slammed with sugar
Part 18: Glenda and Jill vs. diabetes
Part 19: This is how bad diabetes can be
Part 20: Recognize diabetes before it's too late
Part 21: Logan hardest hit by diabetes
Part 22: Even if your relatives had diabetes, you don't have to
ALKOL, W.Va. -- In the chilly dark, Karen, Annie, Melisa, Michele and Shannon are striding down the middle of a twisting country road, a half-hour from any four-lane. Overhead, Lincoln County stars shine bright. They're laughing and teasing with their friends, telling stories. They feel good.
They have lost an average of 71 pounds a person since June.
A hound barks. Karen Harris points out a constellation. By 8:30 a.m. they'll walk four miles on the little-traveled road.
Reflective stripes on their Mud River Volunteer Fire Department jackets glow, bobbing in the dark as they walk up the hill. "People see stripes floating, they know it's us," Melisa Ferrell says.
"Car coming!" Shannon Hager hollers.
Everyone moves to the right, careful not to fall into the ditch.
The driver waves. "Keep it up!" he yells, giving a thumbs-up.
"People out here know what we're doing," Annie Toney said.
These are tough, tender women, EMTs and firefighters. They go into burning buildings and rescue people who have heart attacks up hollows. They cook chicken dinners for the community when the power goes off. They raise kids. When the Fire Department floods, they clean it up.
They have no YWCA, no track, no sidewalks, no gyms. They do have doctors who told them they had high risk of diabetes and heart attacks.
They've been walking isolated Bulgar Road five mornings a week since June, whoever shows up.
Annie's swinging her arms as she walks. She has dropped 90 pounds, from 333 to 243 pounds. "Got a ways to go, but I'm getting there. My 10-year-old's thrilled. He says, 'I can get my arms all the way around my mommy now!'"
In the evenings, five days a week, at 5 p.m., they're back at the fire hall, pounding donated exercise machines beside the fire engines, dancing in front of the big-screen TV to Richard Simmons and country music DVDs they got on eBay. They're serious.
"We got tired of being sick and tired," Melisa Ferrell says. "And we got tired of being fat. The fire chief said we could set up in the fire hall, so that's what we did. We told people what we were doing, and they gave us exercise machines they weren't using."
She walks quietly in the dark, then says, "Last winter, my doc said I'd be diabetic within a year if I didn't get my cholesterol under control. He said it was up to me. So I thought, OK, buddy, this weight is coming off."
She's lost 112 pounds so far, down from 368. Her cholesterol is normal now.
"I don't want to be skinny skinny," she says. "I don't want to be fat fat. I just want to be healthy."
A woman in a passing car stops to tell the women they inspire her. "I lost two pounds this week, working out at home," she says. "If I didn't have such a long drive to work, I'd be out here with you."
Karen Harris and Annie Toney already finished work for the day. They work night shift security at the big Hobet mine. They got off at 4 a.m. Single mothers, they both support their kids.
They walk on in silence. Their four miles will take them past crowing roosters and barking dogs and bleating goats and people stirring in their houses and trailers. They'll laugh most of the way.
"This is the best part of my day," somebody says.
'My blood sugar's normal now'
As they walk, they tell stories. Annie tells about the time the fire chief drove the truck up a steep, narrow dirt road to reach a fire. "I was looking out the window at that drop-off, and I was praying, 'Dear Lord, do not let us fall off this mountain!'"
The hoses froze up once they got up to the fire, she said, and "I had icicles hanging in my hair." Everyone laughs. They've been there.
"Now that I lost weight, they've started shoving me through windows again," Michele Egnor says. She's the only firefighter who can fit through some openings. "For a while there, I got too big. Now I fit again."
Once she squeezed through the window of an overturned car to reach a woman trapped inside, she says. "I kept her calm till the Jaws of Life got there," she said.
She has two kids at home. "I've got the energy to play with them now," she said. "My son loves to wrastle. He's my little wild man."
She has lost 52 pounds since June. "I don't have sugar anymore," she says. "My blood sugar's normal now. The doctors took me off my medicine. They were amazed.
"Stress did it to me. I gained all that weight when my ex-husband was on life support. I turned to food for comfort. It put me in a diabetic state."
Michele walks awhile, then says, "I don't know why people think you can't beat diabetes. You can."
'It's not just the weight; I'm in better shape'
Most of them smoke. "We know that's not good, but one thing at a time," they say.
Their philosophy about eating: "For now, we eat what we always ate, just less of it," Melisa says. "Except pop. We quit drinking pop, most of us. We used to drink a lot of pop. Cases of it."
Five evenings a week for two hours they go at it in the fire station.
"The fire hall makes all this possible," she said. "People heard what we were doing and donated exercise machines. We bought exercise DVDs on eBay.
"I figure we've spent maybe $250 on the whole thing."
Everyone's welcome. "People come and go," Karen Harris said. There are eight regulars, including Melisa Ferrell's husband and son and Karen's daughter. They weigh in every few weeks. By their records, they have shed 416 pounds between June and January.
Karen lost 48 of those pounds. "It's not just the weight," she said. "I'm in better shape now. My triglycerides used to be out of sight, up in the 700s. Now they've dropped into the 200s."
"There's diabetes all over my family, and I don't want it," says Shannon Hager. As of Feb. 1, she'd lost 55 pounds.
Annie Toney cut her blood pressure medicine in half while she lost the 90 pounds. She has a new grandson. "Lots to live for."
"I don't get child support or alimony, so me and my young'uns live on just what I make," she says. "But nobody can say to me, 'I took care of you.'"
Kevin Ferrell, Melisa's husband, a diabetic, can't walk the road since he got hit by a car while trying to help get people out of a wreck. He has a steel rod in his leg. With limited workouts, he's lost 17 pounds.
Melisa's son, R.J., baby-sits the women's kids while they work out. "He's lost 30 pounds just chasing the kids," Melisa said.
Karen's 14-year-old daughter, Ashley, works out with them in the evenings after school. She's lost 12 pounds so far. An honor student, she wants to be a pediatrician.
They keep other people alive
Streaks of dawn light the ridgelines. The walkers stand at the top of a hill, quiet, looking down at the valley where a mean dog lives, right before the road starts up a steep hill.
"I fit into a size-6 jeans yesterday," Michele says. "I'm down from a size 14.
"We all make more or less minimum wage," she says, "so now we've lost all this weight, there's this question of where to get new clothes."
Somebody tells her to tie a rope around her pants like the "Beverly Hillbillies." They laugh and start down the hill. "Better get your Moses stick ready, Melisa," Annie says.
Melisa keeps a big stick hidden in a ditch before the mean dog's house. She finds it. When the dog runs out, snarling and snapping, she shakes her Moses stick at him while the others file past, up the steep hill.
"When we first started, we couldn't even walk a quarter-mile," Karen says. "Now look at us."
Sometimes Karen and Annie work security 24 or 48 hours straight for Hobet. "Need the money," Annie says. "Glad to have it."
"But our kids miss us," Karen says. "That's the tough part. My son called me up on the job the other day and said, 'Mommy, I miss you. I want you to come home,' and I said, 'You know I can't.' It killed me."
Outside work, they're always on call for the Fire Department. They answer calls for heart attacks, people who fall off roofs, snakebites, brush fires, drug overdoses. The nearest Emergency Medical Service takes awhile to get there, Michele Egnor says, "so sometimes we're the ones who keep people alive."
They get paid nothing for that. Given the stress in their lives, why do they do it? "For the community," Karen says, in a tone that makes it clear she wonders why anyone would ask such a question.
"Spaghetti dinner's next Saturday at the station," Michele says. "How many pounds of sauce should I cook? A hundred?"
'We know what you can do to help yourself'
On the surface, people who study prevention of chronic disease might not give these women much chance of beating diabetes: They don't have college degrees or middle-class salaries. They have no sidewalks, running tracks or gyms. The nearest grocery store is 20 minutes away if you drive fast.
Yet so far they're beating the odds, partly because they believe they can.
"Lots of people think, 'My grandfather had sugar, my dad had sugar, so I'll have sugar, and there's no point in trying,'" Annie said. "They've had it fed into their brains that there's nothing they can do about it. But we take medical classes and stuff like that for the Fire Department, so we know what you can do to help yourself."
"At some point," Melisa says, "we'll hit a plateau, and it's going to get harder to take the pounds off." What then? "Maybe then we'll look at what we eat." She pauses. "Maybe the smoking."
The most powerful thing they have may be each other. Research says people who have friends who are trying to get healthy or lose weight have a much better chance of doing the same themselves.
Looking ahead 10 years, what do they hope for? They fall quiet. "I hope we're all together," Annie said after a pause. "If we make it that far, and we're all healthy," she said, "I hope we can still joke and cut up and be one big family."
Related Story: 'We don't read research; we just do it'
ALKOL, W.Va. -- Research says people who live in isolated areas, who don't make much money, who don't have a college education and who don't live near a gym or grocery store have a tough time staying fit or losing weight.
But the five core members of the Mud River Volunteer Fire Department -- the Mud River Pound Punchers -- lost an average of 71 pounds apiece in the last six months of 2011. They dramatically chopped their blood pressure, cholesterol and glucose levels.
"We don't read research. We just do it," said organizer Melisa Ferrell.
Why did the Mud River women succeed when they theoretically weren't supposed to? What can we learn from them? Several West Virginia health experts have theories:"They're everyday heroes. Nobody told them they couldn't, so they did," said Pat White, director of West Virginia Health Right. "It's attitude, determination and creativity. They're wonderful. They created their own structure.
• "They had no gym nearby, so they got a bunch of secondhand equipment and put it in the fire department. They didn't have a walking track, so they used the road. It's a little dangerous, so they wear stripes on their coats, to show up in the dark."
• "It's the support," said Gina Wood, director of the state Diabetes Prevention Program. "If only 10 percent of West Virginians would support each other that strongly in becoming more fit, it could make a huge difference in our diabetes rate."
• "They keep trying because they know they can prevent diabetes and heart disease with exercise and diet," Wood added. "A lot of West Virginians think if your family has diabetes or heart attacks, you're going to get it, no matter what you do. If you don't believe change is possible, you don't try."
• "People say information doesn't help," said Nancy Tompkins, who works for the West Virginia Prevention Research Center. "The Mud River story says otherwise."
• Research says support from friends is more powerful than a person's income or education or the fact that the person lives far from a gym or grocery store, Tompkins said. No matter what your income or education is, "If your friends are losing weight, you're more likely to lose too. If they're gaining weight, you're more likely to gain," she said.
• "The volunteer fire department gives them a structure and place," said Dr. Bob Walker, Health Sciences chancellor for the state higher education system. "That's really worth thinking about. It doesn't have to be the fire department or a gym. Any place in a community that has space and committed people will work."
• "They didn't try to change everything at once," Tompkins noted. "Lifestyle change is hard, so it's a good idea to take things one step at a time, the research says. They aren't counting carbs yet. They're eating what they were eating, but less of it. They cut out soda pop, but some are still smoking. One step at a time."
• "They have fun," White said. "Don't forget that. If they weren't having fun, they wouldn't want to come back so often. This is great stress relief. I hope lots of people look at them and think, yeah, my friends and I could do that too."
• Sally Hurst, who organizes diabetes prevention and control groups for Marshall University, has trained people in a dozen counties to lead support groups in churches and senior centers. "These women are the kind of people we'd like to recruit and train," she said. "As firefighters, they save other people's lives. Now they're saving their own."