Mary Ellen McLaughlin-Wade parks her car outside a Durham laundromat and surveys the scene: the distance between her car and the door, the closest washing machines, the seating inside.
"I don't like those chairs," she says.
Those ubiquitous white plastic patio chairs are the only places to sit, and their slim legs have been known to give under Mary Ellen's weight.
She has no choice. Her flight home to Philadelphia is in two days. A car-moving company is picking up her sedan tomorrow, and this is just the first of many tasks she must complete today. She needs clean clothes.
She heaves her 342-pound frame out of the car. She has to move quickly because she can't stand in one place for very long. She leans on her cane and touches the car, the building, the door for support as she walks inside. Her voice is breathy. She starts tossing clothes into the machines. She asks for helps with the coins. She says in a panicked whisper: "I'm afraid I'm going to fall."
A fall is what started the chain of events that landed Mary Ellen on the northwest side of Durham on a Thursday in mid-December, struggling with clothes and coins and laundry detergent.
In May, she was in her home outside Philadelphia and fell. That's when she saw the open wound that wasn't healing. Such things can go unnoticed when a person carries 555 pounds on a 5-foot-3 frame. She went to the hospital for treatment and then spent three months in a nursing home.
In August, she came to the Duke Diet & Fitness Center, seeking to lose weight and regain her mobility.
While Mary Ellen was fighting for her health in Durham, her husband died - a tragedy that could have derailed her commitment to well-being. Instead, she decided to stay put, not attend the funeral, and make tough end-of-life decisions from hundreds of miles away. She put herself first.
Mary Ellen, 56, grew up outside of Philadelphia. She is chatty, funny and wide open, for instance, describing a chilly night as "so cold that just to walk outside, you'd have to pee."
Her father was a brick layer. Her mom was a hospital lab technician. Food was comfort in this Irish Catholic home, and everyone in her family was heavy. She studied for three years at Penn State University but dropped out after her brother was killed by an impaired driver. She came home to live with her grieving parents. She graduated almost a decade later from Villanova University with a communications degree.
While working at a hospital in the early 1990s, she met Jason Wade. Fourteen years her junior, Jason had close-trimmed hair, glasses and a bright smile. Mary Ellen, whose weight then fluctuated between 300 and 400 pounds, was a floor manager. Jason was a certified nursing assistant. He was charming, compassionate and doted on her.
Two years into their relationship, Mary Ellen realized Jason was struggling with an addiction to crack cocaine. She attributes her naïveté to a lack of street smarts. By then, it was too late: She was in love. They waited 13 years for her mother's approval before finally getting married.
With their strained family relationships, they depended on each other and survived as a team. He was the legs for both of them. She was the brains. Their theme song became Helen Reddy's "You and Me Against the World."
Mary Ellen's weight spiraled upwards after she was laid off in the fall of 2008 from her job as a marketing director for a small business association. Unbound from a workday routine, she started staying up late with her night-owl husband, snacking on chips and doughnuts and watching television. She would drink a two-liter bottle of Diet Coke every day, which she believes triggered her snacking.
In a year and a half, she gained 150 pounds and became more reluctant to leave the house. She weighed 555 when that fall led her to the hospital and nursing home.
During her first week at the nursing home - away from her late-night routine and Diet Coke habit - she lost 19 pounds. In three months, on a restricted diet, she would lose about 150 pounds.
As she lost weight, Mary Ellen decided she was ready to commit to weight loss. Her sister, a nurse practitioner, suggested she go to the Duke Diet & Fitness Center, known for its success with extremely overweight patients. Her lengthy stay at the Durham diet clinic, which can cost several thousand dollars a month, was possible because of a medical trust fund from her mother, who died in October 2009.
Getting started at Duke
Mary Ellen arrived in mid-August, weighing about 400 pounds. As part of her admission, the staff asked her to write down goals. Hers focused on being better able to get around in the world: not having to use a walker; overcoming her fear of stairs; being able to ride the clinic's shuttle bus.
Small accomplishments spurred her on. By week three, she had graduated from scooter to a walker. The first time she got into the pool to exercise, she had to get in and out using a lift. She recalls being so scared that she made the sign of the cross while being lowered into the pool. Now she could walk in and out by herself.
She also learned what had gotten her here: She didn't take care of herself. She realized that Jason could be manipulative and was trying to undermine her attempts at change.
"I'm learning to be healthfully selfish," she says.
While Mary Ellen was doing better, her husband's health was failing. Jason, who had kidney disease but was nonchalant about going to dialysis, had a heart attack that left him in a coma. It became clear that he would never recover.
She thought about going home for 24 hours - long enough to sign the paperwork to turn off the machines keeping her husband alive. In the end, she decided Durham was where she needed to be. She faxed the papers and was thankful for the distraction of doctors' appointments, water aerobics and nutrition classes. "If I didn't have this," she says, "I'd be sitting at home stuffing my face."
Jason died Sept. 16. The funeral was two days later - on their sixth anniversary. Mary Ellen planned the service, even though she wouldn't attend, making sure it included their favorite Helen Reddy song. She and her new friends attended a Sunday service at the Duke Chapel to honor Jason's passing. "I wouldn't have gotten through it unless I was here," Mary Ellen says.
By Thanksgiving, Mary Ellen had lost about 50 additional pounds, bringing her weight loss to about 200. She no longer needed the seat belt extender. She could walk with a cane. She could fit in a normal-size wheelchair. She could walk a mile in the pool.
She had learned how to eat and how much. She had found friends who understand how difficult it can be to navigate a world not designed for people their size. They dined together daily. They cheered each other when the pounds came off and were supportive when the pounds crept up or their weights plateaued.
About Mary Ellen, one friend, Phillip Lary, 53, says, "It was fun to watch her get stronger and stronger."
But Thanksgiving had been tough without Jason, without her family. She decided to go home before Christmas. And make a new start.
Her sister found an independent-living facility where Mary Ellen will live for the next three months. Someone there will prepare her meals. She can concentrate on getting to Weight Watchers and a gym, where she's excited to try an aqua Zumba class.
On the Thursday before her Saturday flight, she has errands to run. Once her laundry is ready, she has her nails done and her hair cut.
Transformation complete, she heads back to her hotel, where she talks about the future.
She doesn't have a goal weight. She has goals: to go grocery shopping without a scooter, to be able to stand still without the fear of falling, to get a part-time job, to visit the nursing home and show off her progress. As long as she continues to lose weight, she will be satisfied.
"Between being down here and the loss of my husband," she says, "it's like being reborn."
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