Posted on 08/24/2003 11:42:05 AM PDT by Dubya
GRANBURY - The nurse wasn't the first person to ask his weight. The question crossed the mind of perhaps every patient in the medical clinic's waiting room the moment he filled the doorway, a huge man dressed for the sweltering heat in a catalog-ordered cotton T-shirt, size XXXXXXXXL, and a pair of XXXXXXXXXL shorts.
Pushed along in a wheelchair by his 79-year-old stepfather, Mike Laird felt the sidelong glances.
On public display, he ignored the outright stares.
How heavy is he?
Laird told the nurse that he weighs "probably 650."
That's just a guess.
"I may be 700 pounds."
Morbidly obese, Laird can't walk unassisted.
Braced against an aluminum walker, he can take only a few steps and stand for less than one minute before his legs, swollen and discolored, give way.
After the nurse left the examining room and closed the door behind her, Laird repositioned his upper body as he regularly does, rocking forward and leaning back in his oversized seat. Eyes shut, he uttered a low groan.
Some days, he said of his discomfort, are better than others.
This day wasn't one of the good ones.
Leaving home poses many challenges and is a painful ordeal.
Almost two-thirds of adults in the United States are overweight, and 30.5 percent are obese, according to a 1999-2000 study by the national Centers for Disease Control and Prevention in Atlanta. But in a society that glorifies trim, toned bodies and markets diet books and weight-reduction products of all kinds, few have empathy for Laird and millions of others like him.
This 48-year-old man has spent more than two years contacting medical facilities that perform what is known as bariatric surgery, which results in radical weight loss. Laird believes an operation is the only permanent solution to his obesity, and his last resort.
One option, gastric bypass, is a risky and expensive procedure that involves stapling off a section of stomach to form a pouch that can hold only a small amount of food.
Laird's efforts have left him frustrated and disheartened.
Some hospitals told him that they won't accept a patient his size. Some said they don't have equipment that can accommodate his weight. Some, he was told, won't accept Medicare.
Laird can't afford the surgery.
"I don't have $35,000 to $50,000."
His only income is a monthly Social Security disability check.
Laird lives alone in a 16-foot-by-60-foot mobile home in Thorp Spring.
During his longest, loneliest days he feels like a prisoner segregated from a shaming world.
Laird knows his quality of life diminishes each month, each week, each day. He recently lost his balance at home and collapsed onto the floor. At first, he tried to pull himself to his knees in the determined, desperate manner of a fallen prizefighter attempting to beat the referee's count.
He couldn't summon the strength.
A telephone was on a table near the sofa, eight feet away. Willing himself to stay calm, he began inching across the living-room carpet, squirming and resting by turns.
Breathless, he reached the receiver 45 minutes later.
After phoning neighbors, who weren't at home, he dialed 911.
Firefighters and paramedics -- four strong men, working together -- hoisted Laird into his chair. He was shaken, embarrassed, exhausted.
"Being dependent on others now is one thing that bothers me most," Laird said.
He thought of his aging mother and stepfather. "It's still hard for me to ask for help."
Jean Akins, 68, underwent breast cancer surgery and a kidney operation this year. But she worries less about herself than she does about her oldest son's safety and life-threatening condition.
Her Sunday school class remembers him in their prayers.
Laird's obesity is associated with a very high risk of disease and death. Studies show that the mortality rate among the morbidly obese (those at least 100 pounds above their ideal body weight) is two to 12 times higher than among individuals of normal weight.
Laird's mother can still hear the warning of the solemn-faced doctor who took her aside in a hospital corridor and flatly predicted that if her son didn't lose weight, he wouldn't live another 10 years.
The timeline is etched in her mind.
"That was 10 years ago, in September," she said.
Last year, she wrote a desperate plea for help to celebrity weight-loss guru Richard Simmons. He surprised Laird with a phone call and mailed him a diet program and a video demonstrating exercises he could perform from his wheelchair. But Laird didn't adhere to the regimen for long.
"I guess my heart wasn't in it," he acknowledged. "I already had tried so many other things -- everything."
Fasting. Weight Watchers. Liquid diets. Pills. "Over-the-counter stuff," he said.
One doctor put him on a 500-calorie-a-day diet. He lost weight.
"But when I went back to eating a more normal amount, I gained the weight back, and more," he said. "It's my metabolism, I guess. The way my body works."
He takes prescription medication day and night to help control high blood pressure and other conditions caused or exacerbated by his size and sedentary lifestyle. His lymph glands swell. His back aches. He needs knee replacement surgery, but he won't become a candidate for the operation unless he loses at least 400 pounds.
His nose bleeds. He experiences night sweats and chills. Most days, he hurts all over.
A handwritten sign taped to the front door of Laird's mobile home speaks of his trusting nature and offers this instruction to his few visitors:
"If you don't see me in the living room or kitchen, please come in and announce yourself. I am probably in the back of the house."
In the bedroom.
After he visited the doctor, a worn-out Laird returned to bed.
He spends about 19 hours a day on his back, atop a king-size mattress on a frame his stepfather, Max Akins, built from heavy lumber.
A telephone within reach, he rests.
At times he dozes, sedated by pain pills.
He watches television.
Reads his Bible.
His dog, Missy, keeps him company, the small pet often curled up in sleep on a pillow near his nightstand.
How does he cope with the solitude and his fears?
"Mike has the biggest heart of anyone I know. He just can't get out and show it," said Dennis Rocheleau, a longtime friend and prayer partner who lives in Metamora, Mich. "His spirit amazes me. Others in his situation would have given up a long time ago."
What keeps him going?
As Laird tried to frame an answer, he swallowed hard and gazed at the ceiling fan, its blades lazily slicing the air above his bed.
The silence in the room grew.
"I have a strong faith," he said finally, as the tears came. "I know surgery won't cure all my health problems. But I keep hoping that if I could get some of this weight off, I'll be able to have a little better life. If my time comes, I'm ready. But I keep a positive outlook. Maybe somehow, some way, some day, a door will open."
Forced isolation
A 1973 graduate of Haltom High School, Laird missed his 30-year reunion. He would have enjoyed visiting with some of his former classmates, but he felt too self-conscious and embarrassed to attend.
"People," he said, "don't know the shame you sometimes feel."
Seated at his kitchen table, Laird produced a color photo.
A high school senior smiled out from the graduation picture, a pleasant-looking 6-foot-2 youth dressed in a tuxedo, bow tie and ruffled blue shirt.
"I wasn't always like I am now," Laird said.
As a teen-ager, he weighed about 265 pounds.
Laird grew in size during the 12 years he worked for a grocery store chain. He dieted periodically, but soft drinks topped his list of weaknesses. For years, Laird drank as many as 20 Coca-Colas a day. His thirst unquenchable, he gulped them, he said, one after another, habitually, "the way people smoke cigarettes."
After degenerative arthritis in his knees and feet forced him to quit work, Laird's weight steadily rose like the needle on a pressure gauge -- 400, 450, 500 pounds.
Five years ago this Christmas, while still able to get around, he slipped on a patch of ice outside his home and broke his kneecap and left leg in three places.
The injury left him in a wheelchair despite two months of rehabilitation. He hasn't walked unaided since.
Last year, while on a hospital bed equipped with a scale, Laird learned, to his dismay, that he was pushing 600 pounds.
Unkind cuts
Inez Roach asked, "Mike, you eaten today?"
It was 1 p.m.
Laird's caregiver spends two hours each weekday afternoon at his home cleaning, washing clothes, changing the bedsheets. She shops for him and runs other errands.
Once a week, they play board games and watch a rented movie.
Laird doesn't eat breakfast.
"I've seen these people on TV who eat a pound of bacon and a dozen eggs," he said. "Even if I could eat that much, I couldn't afford it."
This day, he had skipped lunch.
Laird handed Roach a to-do list that included a trip to the supermarket to buy dinner items -- frozen vegetables and skinless chicken breasts on sale for $1.28 a pound.
When he could still shop, Laird once stacked a large supply of groceries into his cart, a mound of food, enough to last him a month. A woman shopper, assuming Laird gorges or eats constantly, poked her nose into his basket and made it her business to ask how long the groceries would last him.
A week, she asked? Two or three days?
Laird knows how many people perceive him and others his size. The obese are often viewed as lazy or lacking willpower or having some other character flaw. But morbid obesity is a chronic disease. Genetic, environmental, psychological and metabolic factors play a part, with weight gain promoting more weight gain, setting in motion a vicious cycle.
One day this summer, Laird complained of numbness in his face and arm. He couldn't fit on an ambulance gurney, so Roach rushed him to the hospital in Laird's 1986 Suburban. As she sat with her friend, who feared he was having a stroke, a woman in the waiting room whispered into the ear of her companion and pointed at Laird, as if he were a spectacle, a carnival sideshow attraction.
"It's as if people think he can't see or hear," Roach said.
The stranger's rudeness irked her.
As Laird sat silent, Roach turned to the gawker and said, "He can see your finger."
A ray of hope
Laird's phone rang one morning early this month.
About eight weeks after he sent in a lengthy medical questionnaire and a copy of his Medicare card, the University of Texas Southwestern Medical Center at Dallas called to ask if he wanted to schedule an appointment.
The first available date was Aug. 26.
"I'll take it," he said immediately.
When they meet, a surgeon will discuss the details and risks of surgery and the benefits Laird can expect. Eventually, a decision will be made whether to proceed and schedule a gastric bypass -- people heavier than Laird have successfully undergone the surgery -- or perhaps a less-invasive banding procedure that restricts food intake without stapling the stomach or permanently rerouting the intestines.
His spirits buoyed, Laird called his mother. He called an aunt. He shared the news with Rocheleau and several other close friends.
"I'm pretty hopeful," he said, "although in the back of my mind I know there's a possibility they'll tell me no."
And if he is rejected?
"I can't give up."
The next step
For as long as he can remember, Laird has loved pirate movies and other seafaring adventures set in the Age of Sail. By his count, he has watched Mutiny on the Bounty, the original version and remakes, at least 20 times. His kitchen curtains are printed with images of lighthouses. Seascapes and miniature sailing ships decorate the living room walls.
An explorer at heart, Laird once thought the ultimate adventure would be to take a cruise around the world.
Now his hope is that the plywood ramp outside his front door will become his gangplank.
His passageway to a grander voyage.
If his prayers are answered, and his patience rewarded, this gentle, soft-spoken man's trip of a lifetime will begin the moment he stands again on his own, a shadow of himself, and takes a walk around the block in a world he rarely sees except through his bedroom window.
Complications set in on 06/29/2003.
On 06/30/2003 the hospital told me he was brain dead, not breathing on his own, and could they please turn off life support.
I buried him 7/07/2003.
"But when I went back to eating a more normal amount, I gained the weight back, and more," he said. "It's my metabolism, I guess. The way my body works."
There must be some truth to that. It sounds like a horrible condition.
There's this new product called Diet Coke. It's amazing.
LOL. Well, I don't know that anyone is claiming that it's anyone else's fault. I just can't imagine anyone actually choosing (as that word is ordinarily used) to be in that condition. I suspect that there is something abnormal about the way his body functions and I have a lot of sympathy for him. ;-)
I had exactly that decision to make. I certainly wasn't anywhere near where this man is, but I was very close to hitting some benchmarks that qualified me for bariatric surgery. I work in an OR and help perform some of these cases. I see successful cases (the patients come back for tummy tucks etc) I see cases where there are serious/fatal complications. The surgery isn't foolproof, you can out eat (sabotage) this kind of surgery ... especially if you won't stop eating sweets. You can't eat more than a couple of oz at a time.
I'm a relatively intelligent person, and why it took so long for me to have this light bulb moment, I can't say. It finally dawned on me that one way or the other through surgery or through willpower I had to alter the way I was eating.
Since eating habits had to change no matter what, I decided that I wasn't willing to risk the surgical complications. I've been doing Atkins with good results when I don't cheat.
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