Original subtitles

Joyce: I HAVEN'T BEEN OUT OF THE HOUSE IN OVER 3 YEARS.

Woman #2: SOMEWHERE IN ME IS THIS LITTLE GLIMMER OF HOPE.

I JUST WANT TO BE A NORMAL PERSON.

YOU CAN'T DO IT, AND THEN I JUST GET MAD.

Woman #3: IF I DON'T MAKE A CHANGE NOW,

I'M SCARED IT'S GOING TO BE TOO LATE.

IT HURTS!

Woman #4: I REFUSE TO STOP FIGHTING.

I HAVE TO DO THIS FOR MY CHILDREN.

I'M A LITTLE HUNGRY. I DIDN'T EAT ALL DAY.

DON'T WORRY. YOU HAVE EATEN THE FOOD

THAT BELONG TO NEXT 3 YEARS AHEAD OF TIME, OKAY?

--Captions by VITAC-- www.vitac.com

CAPTIONS PAID FOR BY DISCOVERY COMMUNICATIONS

Joyce: WHEN I WAKE UP IN THE MORNING, MY FIRST THOUGHTS

ARE A COMBINATION OF DISGUST AT HOW MY LIFE IS NOW AND SHOCK

THAT I WAS EVEN ABLE TO MAKE IT TO ANOTHER DAY

BECAUSE EVERY MINUTE OF IT

IS A STRUGGLE NOW FROM THE FIRST MOMENT TO THE LAST.

SO I QUESTION WHY GOD EVEN WAKES ME UP...

JUST TO GO THROUGH ANOTHER DAY LIKE THIS.

I'M JUST A PRISONER HERE DOING NOTHING

BECAUSE OF HOW BIG I'VE GOTTEN,

AND MY WEIGHT MAKES IT SO HARD FOR ME TO BREATHE.

I HAVE TO USE OXYGEN A LOT OF TIMES

JUST TO GET THE AIR MY BODY NEEDS.

SO I KNOW MY HEALTH IS IN A REALLY BAD PLACE

BECAUSE OF THAT, AND IT'S AT THE POINT WHERE

I CAN'T EVEN TAKE CARE OF MYSELF OR LIVE ON MY OWN ANYMORE.

I HAVE TO PAY ONE OF MY FRIENDS TO BE MY CAREGIVER

AND HELP ME DO EVERYTHING NOW.

DAWN?

DAWN?

MORNING. -MORNING.

YOU READY TO GET UP?

I AM.

DAWN LIVES WITH ME AND TAKES CARE OF ME,

AND WITHOUT HER, THINGS WOULD BE EVEN WORSE

BECAUSE I CAN'T EVEN GET OUT OF BED ON MY OWN.

THAT'S HOW BAD OFF MY BODY IS NOW.

AND THEN, ONCE I'M UP, I'M BARELY EVEN ABLE TO GO

A FEW FEET AT ONE TIME.

MY WEIGHT IS TOO MUCH FOR ME TO MOVE AROUND.

AND I ALSO HAVE BAD LYMPHEDEMA ON MY LOWER BODY

THAT MAKES ANY MOVEMENT OF MINE REALLY PAINFUL,

SO I HAVE TO DO EVERYTHING RIGHT HERE IN THE SAME ROOM,

INCLUDING GOING TO THE BATHROOM.

SO I HAVE A PORTABLE POTTY CHAIR THAT'S NEXT TO MY BED.

AND WHEN I'M DONE, DAWN HAS TO CLEAN ME UP,

AND THAT'S PROBABLY THE MOST HUMILIATING PART OF MY DAY.

OKAY. BUCKET IS READY.

I'M GOING TO GO AHEAD AND STAND UP AND GO ON OVER.

OKAY.YOU WANT TO HOLD THIS UP?

YEP.

WHAT I DO FOR JOYCE IS GET HER OUT OF BED IN THE MORNING,

HELP HER GO TO THE BATHROOM,

AND THEN I BATHE JOYCE PROBABLY TWO TO THREE TIMES A WEEK.

IT'S A VERY LONG PROCESS, AND BY THE END OF IT,

JOYCE AND I ARE BOTH EXHAUSTED.

BATHING ME IS A VERY EXTENSIVE PROCESS

BECAUSE OF HOW HARD IT IS TO GET TO ALL THE AREAS OF MY BODY.

WE WASH THE LOWER PART OF MY STOMACH

AND UNDERNEATH IT IN MY BED, BUT ONCE SHE'S DONE...

OKAY.

...SHE HAS TO USE A HAIR DRYER TO DRY THOSE AREAS

BECAUSE IF ANY MOISTURE GETS CAUGHT UNDER A FOLD,

IT'LL GET TRAPPED THERE, AND MOLD CAUSES SORES

THAT WILL GET INFECTED.

BUT DAWN ALSO HAS TO RUB A ZINC-OXIDE CREAM ON ME

TO HELP PREVENT SORES BECAUSE,

WITHOUT IT, THE NATURAL CHAFING I HAVE UNDER MY FOLDS

CAN START TO BREAK THE SKIN OVER TIME,

AND I'M CONCERNED ABOUT THE SORES

BECAUSE THAT'S ONE OF THE THINGS

THAT HAS PUT ME IN THE HOSPITAL BEFORE.

YOU CAN GO AHEAD AND SIT UP.

SO YOU CAN'T RUSH ANY OF THE PROCESS,

OR IT WILL BE REALLY BAD FOR ME.

ONCE SHE DOES THAT, I HAVE TO MOVE BACK ON THE POTTY

TO CLEAN MY BACKSIDE AND OTHER AREAS

THAT GET EASILY INFECTED IF WE IGNORE THEM.

MORE . OKAY.

AND AFTER THAT, WE MOVE TO THE LAST LOCATION.

OKAY.

AND WE FINISH THE UPPER HALF OF MY BODY

AND MY LEGS SITTING IN THE RECLINER WITH,

LIKE, SPONGE WASHING.

BUT THE ENTIRE BATHING PROCESS CAN TAKE CLOSE TO AN HOUR,

AND I'M COMPLETELY PHYSICALLY AND EMOTIONALLY EXHAUSTED

BY THE TIME I'M DONE.

AND DAWN KNOWS I'LL BE STARVING AT THAT POINT,

SO SHE ALWAYS HAS SOMETHING READY FOR ME TO EAT.

I GET SO EXCITED THAT I FINALLY GET TO EAT.

IT'S THE MOMENT I'VE BEEN LOOKING FORWARD

TO SINCE I FINISHED MY LAST MEAL THE NIGHT BEFORE.

THAT FIRST BITE IS THE BEST MOMENT OF MY DAY.

WHEN I'M EATING, I THINK OF NOTHING.

THAT'S WHAT THE BEST PART OF IT IS,

IS WHEN I'M SITTING THERE EATING,

I HAVE NO WORRIES ABOUT ANYTHING.

I'M JUST THINKING ABOUT HOW GOOD THE FOOD IS.

AND THAT'S MY LIFE.

I'LL SIT THERE IN MY RECLINER FOR THE REST OF THE DAY,

AND DAWN WILL BRING ME FOOD,

AND I'LL EAT IT UNTIL IT'S TIME TO GO BACK TO BED.

I BASICALLY JUST LIVE TO EAT NOW,

AND I NEVER LEAVE THIS ROOM, AND THAT'S NOT GOING TO CHANGE

UNLESS I GIVE UP FOOD AND STOP EATING LIKE THIS, BUT I CAN'T.

IT'S WHAT MAKES WAKING UP WORTH IT FOR ME NOW.

THE ONLY THING I CAN REALLY THINK OF

IS IF SOMEHOW I COULD CHANGE MY PAST,

BUT THERE'S NO WAY I CAN DO THAT.

EARLY ON WHEN I WAS REALLY YOUNG,

I WAS A NORMAL-SIZE CHILD.

MY PARENTS GOT DIVORCED, LIKE, WHEN I WAS AROUND 3,

AND MY FATHER WAS NOT PRESENT IN MY LIFE AFTER THEY DIVORCED,

SO I WAS MOSTLY JUST WITH MY MOTHER,

BUT THINGS CHANGED WHEN I WAS 7 BECAUSE THAT'S WHEN MY MOM

STARTED DATING SOMEONE WHO WOULD BECOME MY STEP DAD.

HE HAD THREE SONS AND A DAUGHTER,

BUT WHEN THEY DECIDED TO GET MARRIED,

MY MOM MOVED IN WITH THEM

BUT SENT ME TO LIVE WITH MY GRANDMA.

I FELT ABANDONED BY MY MOM LIKE SHE DIDN'T WANT ME ANYMORE.

SO I WAS UPSET AND REALLY HURT BY THAT,

BUT I DID LOVE BEING WITH MY GRANDMOTHER

BECAUSE SHE GAVE ME CONSTANT ATTENTION

AND WAS ALWAYS FEEDING ME

AND MAKING SURE I HAD WHAT I NEEDED,

AND I THINK THAT'S WHEN MY LOVE FOR FOOD PROBABLY STARTED,

BUT SHE FED ME SO MUCH THAT I PUT ON

AROUND 40 TO 50 POUNDS WHILE I WAS WITH HER.

I WAS 8 THEN AND WAS AROUND 90 TO 100 POUNDS,

SO I WAS GETTING BIG,

BUT I WAS CONSTANTLY ASKING MY MOM

WHEN I COULD GO BACK WITH HER, AND AFTER A WHILE,

SHE EVENTUALLY HAD TO COME AND GET ME TO TAKE ME BACK,

BUT WHEN SHE DID, SHE WAS SHOCKED AND VERY UPSET

BECAUSE OF HOW BIG I'D GOTTEN.

WHEN JOYCE WAS LIVING WITH MY MOTHER,

I HAD NO IDEA MY MOTHER WAS FEEDING HER SO MUCH,

AND WHEN I SAW JOYCE AS LARGE AS SHE WAS,

I WAS JUST HORRIFIED,

AND I WAS REALLY ANGRY AT MY MOTHER,

THAT SHE HAD ALLOWED MY DAUGHTER TO GAIN THAT MUCH WEIGHT.

Joyce: AFTER THAT, MY MOM TOOK ME BACK TO KANSAS

TO LIVE WITH HER AND MY NEW FAMILY,

BUT IT WASN'T HOW I THOUGHT IT'D BE THERE

BECAUSE SHE HAD PUT ME ON A STRICT DIET

AFTER I LEFT MY GRANDMOTHER'S,

SO I WAS IN THIS NEW PLACE WITH A NEW FAMILY,

AND I COULDN'T HAVE THE ONE THING THAT COULD COMFORT ME

AND HELP ME FEEL BETTER,

SO I WAS REALLY UPSET WITH MY MOM,

AND FOR THE NEXT FEW YEARS,

IT SEEMED LIKE WE WERE FIGHTING CONSTANTLY.

THANKFULLY WHEN I WAS 12, MY MOM AND STEP DAD GOT A DIVORCE,

AND WE MOVED OUT,

AND I WAS SO RELIEVED TO BE OUT OF THAT HOME

AND JUST WITH MY MOM.

WE STILL HAD A LOT OF CONFLICT THOUGH BECAUSE SHE KEPT ME

ON THESE ABUSIVE DIETS TO TRY TO GET ME TO LOSE WEIGHT,

BUT IT DIDN'T HELP ME LOSE EVER BECAUSE,

NO MATTER WHAT ANYONE DID, I'D FIND WAYS TO GET FOOD.

AND OVER THE NEXT COUPLE OF YEARS,

I GOT MY LICENSE AND A JOB AT A FAST-FOOD PLACE,

AND AT THAT POINT, I WAS BEYOND MY MOM'S CONSTANT REACH.

SHE COULDN'T STOP ME FROM EATING WHAT I WANTED,

AND SO, AT 16, THAT'S WHEN THE WEIGHT STARTED PILING ON ME,

BUT MY MOM COULD EVENTUALLY TELL WHAT I WAS DOING,

AND WHEN SHE FIGURED IT OUT, SHE WAS REALLY UPSET,

AND SHE TRIED TO GET ME TO STOP EATING.

HER GOAL BECAME TO GET ME AWAY

FROM WORKING AT A FAST-FOOD PLACE,

SO SHE HELPED ME START A HOME DAYCARE CENTER.

I WAS HESITANT TO WORK WITH MY MOM,

BUT I COULDN'T RESIST BECAUSE THAT'S WHAT I WANTED TO DO.

AND I LOVED IT, AND I WAS THANKFUL MY MOM

DID THAT IN THE END,

BUT IT STILL DIDN'T STOP ME FROM EATING LIKE I WANTED,

AND BY THE TIME I GRADUATED HIGH SCHOOL

AND I WAS 18, I WAS AROUND 350 POUNDS.

AFTER HIGH SCHOOL, I WAS WORKING AT THE DAY CARE FULL-TIME,

BUT I WAS STILL EATING JUST AS MUCH AND GAINING,

AND BY THE TIME I WAS 20, I WAS WELL INTO THE MID-400s.

BUT WHEN I WAS 21, I STARTED SEEING SOMEONE,

AND WHEN THINGS STARTED TO GET SERIOUS BETWEEN US,

I STARTED HAVING THESE NIGHTMARES WITH ME

AND AN EVENT THAT HAPPENED WITH ONE OF MY STEPBROTHERS.

WHEN I WAS 8,

MY MOM AND STEP DAD LEFT MY STEPBROTHER TO BABYSIT ME.

I WENT TO SLEEP, AND I WOKE UP WITH HIM SITTING ON MY BED,

AND HE WAS RUBBING MY BACK, AND THAT IS THE INITIAL MEMORY

THAT I HAD FOR YEARS UPON YEARS UPON YEARS.

THE DREAMS ARE JUST KIND OF WHAT FOLLOWED THAT,

ME TRYING TO FIGHT HIM OFF.

LIKE, ONE DREAM WAS, LIKE, LITERALLY ME

OF JUST SCRATCHING IN HIS ARMS.

AT THAT POINT, I DIDN'T KNOW IF THEY WERE JUST DREAMS

OR IF I WAS REALLY PIECING IT TOGETHER MYSELF OR WHAT HAPPENED

BECAUSE IT'S ALL JUST SO DISTORTED,

SO I WENT TO THE COMMUNITY COUNSELING CENTER

AND WENT AND TALKED TO SOMEONE

AND JUST TRY TO PIECE TOGETHER WHAT HAPPENED.

I KEPT ALL OF THIS TO MYSELF. I DIDN'T TELL MY BOYFRIEND.

I JUST BROKE UP WITH HIM.

I DIDN'T EVEN TELL MY MOM UNTIL RECENTLY,

BUT WHEN I TOLD HER WHAT HAD HAPPENED,

SHE DIDN'T REALLY HAVE MUCH OF A REACTION TO IT.

UNFORTUNATELY WHEN I TOLD HER,

IT WAS IN THE MIDDLE OF AN ARGUMENT.

I DIDN'T SAY IT THAT KINDLY.

SHE JUST SAID, "YOU NEVER TOLD ME ANYTHING LIKE THAT,"

AND I SAID, "YEAH, I DIDN'T WANT TO GET EVERYBODY UPSET OR MAD,"

AND IT KIND OF WAS NOT A SUBJECT THAT KEPT ON GOING.

AT THE TIME WHEN ALL THESE REPRESSED MEMORIES

HAD COME BACK, I JUST TRIED TO MOVE PAST IT

AND GET ON WITH MY LIFE.

I FOCUSED ON BUILDING THE DAY- CARE BUSINESS WITH MY MOM,

AND I KEPT GETTING BIGGER, AND I WAS JUST UNDER 500

BY THE TIME I WAS 25.

AND AROUND THAT TIME IS WHEN MY FATHER PASSED AWAY.

HE HAD A HEART ATTACK AT 44 BECAUSE OF HIS WEIGHT,

AND I KNEW I WOULD END UP LIKE HIM IF I DIDN'T CHANGE,

SO I TRIED TO START CUTTING BACK

ON WHAT I WAS EATING TO LOSE WEIGHT,

BUT THE DAY CARE WAS GROWING, AND I WAS RUNNING IT ALL,

SO EVERY DAY I HAD A LOT OF STRESS,

SO FOOD ALSO HELPED ME DEAL WITH THAT.

IT GOT SO BUSY, I ENDED UP NEEDING HELP,

AND I HIRED MY BEST FRIEND, DAWN, TO HELP ME.

WHEN I FIRST STARTED WORKING FOR JOYCE AT THE DAY CARE,

IT WAS MAYBE 6 MONTHS AFTER

WE HAD INITIALLY MET THROUGH A MUTUAL FRIEND.

AT THE TIME, SHE COULD STILL MOVE SHORT DISTANCES

BY HERSELF WITHOUT A WALKER,

AND THEN JOYCE STARTED GAINING MORE AND MORE WEIGHT

AND JUST WENT DOWNHILL.

Joyce: I WAS IN MY MID-30s WHEN I'D GOTTEN UP TO AROUND 550,

AND MY WEIGHT WAS GETTING TO A POINT

WHERE IT WAS HARD FOR ME TO GET AROUND LIKE I NEEDED,

AND THAT STARTED TO AFFECT THE DAY CARE AND MY BUSINESS

BECAUSE IF I CAN'T REACT FAST TO SOMETHING,

IT COULD BE DANGEROUS FOR THE KIDS,

SO EVENTUALLY IT GOT TO A POINT WHERE I WAS TOO BIG,

AND I HAD TO CLOSE IT, AND IT WAS HEARTBREAKING FOR ME.

AND THEN, A FEW YEARS LATER,

I STARTED DEVELOPING A REALLY BAD LYMPHEDEMA ON MY LOWER BODY,

AND THAT COMBINED WITH MY WEIGHT

CAUSED ME TO BE BEDRIDDEN WHEN I WAS 38,

AND I HAD TO HIRE DAWN TO MOVE IN WITH ME

AND BECOME MY CARETAKER.

Dawn: AS TIME HAD PASSED, JOYCE NEEDED SOME EXTRA HELP,

SO I ENDED UP MOVING INTO THE HOUSE,

LIKE, A PERMANENT FIXTURE IN THE HOUSE.

I HAVEN'T BEEN OUT OF THE HOUSE IN OVER 3 YEARS.

I'M ALREADY 44,

AND I'M THE AGE NOW THAT MY DAD WAS WHEN HE DIED,

AND I THINK I'M EVEN BIGGER THAN HE WAS AT THIS AGE,

SO I'M TERRIFIED THAT I'M CLOSE TO DYING RIGHT NOW

AND THAT I'M GOING TO DIE BEFORE MY TIME

BECAUSE I LET FOOD KILL ME.

HI, JOYCE.HEY, MOM.

COME ON, BEDBO.

I CAN START THE LASAGNA.

MM.

I KNOW MY FAMILY AND DAWN ARE ALL WORRIED ABOUT ME TOO,

AND THEY DON'T THINK I'M GOING TO MAKE IT MUCH LONGER,

BUT JUST LIKE ME, THEY KEEP DOING WHAT THEY'VE BEEN DOING

AND HELP ME EAT THE STUFF I'M NOT SUPPOSED TO HAVE NOW,

AND I KNOW WHEN I DO THAT, MY MOM IS JUDGING ME

WHEN I EAT A LOT, BUT AS MUCH AS IT BOTHERS ME,

THERE'S PART OF ME WHERE I DON'T CARE.

I ALMOST KIND OF HAVE THE ATTITUDE OF, LIKE, DUH,

I DON'T GET THIS BIG EATING SMALL AMOUNTS,

SO WHY WOULD YOU EXPECT ME TO DO SO?

SO I JUST WANT TO SAY, YOU KNOW, "SHUT UP AND GIVE ME THE FOOD

AND THEN LEAVE IF YOU HAVE A PROBLEM WITH IT."

SOMETIMES WHEN I SEE JOYCE

EATING LARGE AMOUNTS OF FOOD, I'M LIVID.

I'M JUST LIVID, BUT I'M REALLY ALWAYS REALLY FEARFUL.

I LIVE IN A LOT OF FEAR BECAUSE I JUST...I JUST...

I JUST FEEL LIKE SHE'S GOING TO DIE

AND THAT THERE'S NOTHING I CAN DO ABOUT IT.

HERE YOU GO.THANKS.

THAT LOOKS GOOD.IT DOES LOOK GOOD.

Dawn: I THINK JOYCE IS AT THE POINT NOW WHERE SHE KNOWS

SHE REALLY DOES HAVE TO DO SOMETHING.

JOYCE CAN'T GO ON MUCH LONGER LIKE THIS.

IT'S GOING TO KILL HER.

Joyce: I KNOW I CAN'T KEEP DOING THIS FOR MUCH LONGER.

EVEN IF I LIVE PAST MY 45th BIRTHDAY,

SOMETHING HAS TO CHANGE SOON

BECAUSE MY ADDICTION TO FOOD IS KILLING ME,

AND IT'S TAKING EVERYTHING.

AND THE WORLD IS JUST PASSING ME BY.

I WATCH ON SOCIAL MEDIA THE WHOLE WORLD

HAPPENING AROUND ME, AND I'M SITTING HERE.

AND IT MAKES ME SO, SO SAD, BUT NONE OF MY SADNESS OR FEAR

HAS BEEN ENOUGH TO MAKE ME STOP FROM EATING,

AND I'M AT A POINT NOW WHERE I JUST DON'T KNOW WHAT TO DO.

Joyce #2: I ALWAYS WISH THAT THERE WAS JUST A PILL THAT SHE COULD TAKE

AND THAT SHE WOULDN'T, YOU KNOW, HAVE THIS HORRIBLE ADDICTION.

Joyce: I KNOW I'M CLOSE TO A BREAKING POINT,

AND THERE'S NOTHING I CAN DO ABOUT IT BECAUSE I CAN'T STOP,

AND I DON'T KNOW HOW TO CHANGE TO GET TO

WHERE I WON'T END UP EATING TO WHERE IT KILLS ME.

SO IT'S INEVITABLE AT THIS POINT

THAT I EITHER FIND SOME SORT OF HELP,

OR NOTHING ELSE IS GOING TO HAPPEN BUT DEATH.

Joyce: I CALLED DR. NOW IN HOUSTON

TO TRY TO GET HELP WITH MY WEIGHT BEFORE IT'S TOO LATE.

I CALLED ALL THE LOCAL DOCTORS, AND NONE OF THEM ARE EVEN

WILLING TO TRY AND HELP ME, SO GOING ALL THE WAY TO TEXAS

IS MY ONLY OPTION, AND I'M TERRIFIED ABOUT IT

BECAUSE THIS ISN'T GOING TO BE EASY AT ALL.

MY BIGGEST PROBLEM IS GETTING THERE, BUT DR. NOW

IS TRYING TO SET UP A TRANSPORT FOR ME

TO TAKE ALL THE WAY TO TEXAS, AND I'M REALLY HOPING HE CAN,

BUT THERE'S NO WAY FOR ME TO COME BACK

OR MAKE THE TRIP AGAIN,

SO THE WAY I FIGURE IT, THIS IS A ONE-WAY TRIP FOR ME,

SO THAT MAKES THIS EVEN SCARIER, BUT

DAWN IS WILLING TO BE DOWN THERE WITH ME

FOR AS LONG AS I NEED TO HELP ME AND TAKE CARE OF ME,

AND SHE'S ALSO PACKING UP ALL OUR STUFF

AND TRYING TO GET EVERYTHING TAKEN CARE OF

SO WE CAN BE FREE AND CLEAR TO MOVE DOWN.

SO POOR DAWN IS DOING PRETTY MUCH ALL OF THE WORK.

Dawn: I AM PREPARING TO GET

JOYCE AND I MOVED DOWN TO HOUSTON.

JOYCE HASN'T BEEN ABLE TO PHYSICALLY HELP ME PACK,

SO IT'S BEEN HARD,

BUT IT IS JOYCE'S LAST CHANCE TO GET THE HELP SHE NEEDS,

AND IF THERE'S ANYTHING THAT I CAN DO FOR JOYCE

TO GET BETTER, I'M GOING TO DO IT.

Joyce: DOING THIS IS A HUGE ACT OF FAITH AND TRUST,

BUT IT'S MY LAST HOPE AND OPTION,

AND I EITHER DO THIS OR DIE SOON,

SO I'M CONFIDENT ABOUT THIS CHOICE,

BUT I STILL FEEL REALLY SCARED.

UPROOTING MY ENTIRE LIFE HERE IS SCARY,

BUT I'M FINDING THE COURAGE TO DO THIS BECAUSE IT'S THE SHOT

THAT I HAVE TO TAKE TO BE ABLE TO LIVE.

BUT MY MOM AND AUNT ARE COMING TODAY

TO SUPPORT ME IN THIS CHOICE

EVEN THOUGH THEY DON'T WANT ME TO LEAVE.

HI, JOYCE.

-HI. -HELLO THERE.

HI! HOW ARE YOU?

GOOD, GOOD, GOOD.

HOW ARE YOU?GOOD. HOW ARE YOU?

GOOD.COME IN. SIT DOWN.

Lucille: SO HOW ARE YOU FEELING?

I'M DOING GOOD.

YOU LOOK GOOD.

YEAH, NOT TOO BAD.

YOUR NEW JOURNEY, RIGHT?

MM-HMM.

IT'LL BE REALLY GOOD.

HOW ARE YOU FEELING ABOUT ALL THIS?

IT REALLY IS A BIG RISK, YOU KNOW?

IT IS A RISK, BUT, I MEAN, WHAT ARE MY...

THIS IS KIND OF LIKE THE END, YOU KNOW?

IF I DON'T DO THIS, THEN IT'S JUST KIND OF WAITING

UNTIL MY BODY GIVES OUT,

AND I'M NOT HERE, SO IT'S WORTH THE RISK TO ME.

TEST ALSO.

MM-HMM.WE FEEL THE SAME WAY.

THIS IS LIKE YOUR LAST CHANCE.

Lucille: JOYCE HAS TO MAKE THE CHANGES TO SAVE HER LIFE.

SHE HAS TO. SHE HAS NO OTHER CHOICE TO BE HONEST WITH YOU.

BUT MY HOPE FOR JOYCE'S FUTURE IS FOR HER TO GET HER LIFE BACK,

TO BE ABLE TO DO ALL THE THINGS THAT SHE LOVES

BECAUSE SHE DESERVES THE BEST.

Joyce: IT MEANS A LOT FOR MY MOM AND AUNT TO COME OVER

AND SHOW ME SUPPORT AND LOVE.

THEY KNOW I NEED IT RIGHT NOW BECAUSE I'M REALLY SCARED.

THIS IS GOING TO BE ONE OF THE HARDEST THINGS

I'VE EVER DONE IN MY LIFE,

AND IT'S GOING TO TAKE EVERYTHING

I HAVE PHYSICALLY AND EMOTIONALLY TO DO IT.

YOU HAVE EVERYTHING PACKED?

HAVE A FEW LITTLE STUFF TO PUT HERE OR THERE BUT NOT MUCH.

OKAY. LET ME THROW THIS OUT THERE.

I GOT THE CALL LAST NIGHT FROM DR. NOW

THAT A MEDICAL TRANSPORT WILL BE HERE TO PICK ME UP

AT 5 A.M. TODAY TO TAKE ME ALL THE WAY TO HOUSTON.

IT'S GOING TO BE A STRAIGHT DRIVE,

BUT IT'S STILL GOING TO BE REALLY LONG.

IT'S ABOUT A 12-HOUR TRIP TO HOUSTON,

AND I'M AFRAID I'M GOING TO BE IN PAIN FOR THE ENTIRE TRIP.

AND THEN I'M REALLY WORRIED THAT THEY'RE GOING TO HAVE

A HARD TIME GETTING ME IN THE TRANSPORT.

IT'S BAD WEATHER, AND IF THEY'RE NOT GOING TO BE ABLE

TO GET ME IN THE VEHICLE,

THEN I'M GOING TO BE OUT IN THE ELEMENTS,

AND THAT'S MAKING ME VERY NERVOUS.

AND I JUST HAVE TO TRUST THIS IS GOING TO BE WORTH IT.

GOOD MORNING.

PRETTY GOOD.

OKAY.

-THAT'LL WORK. -YOU NEED HELP GETTING UP?

Joyce: OH, NO.

Man: YOU DO PRETTY GOOD.

YOU WANT TO COME OVER TOWARDS ME SOME MORE.

THERE YOU GO.

SIT STRAIGHT BACK. GOOD.

AND YOU SCOOT YOUR BUTT AS FAR BACK AS YOU CAN.

THIS IS IT BECAUSE I HAVE A LYMPHEDEMA.

THIS IS IT? IT'S ALRIGHT.

THEY'RE GOING TO GET YOU LEGS, WE'RE GOING TO SWING THEM OVER.

I'M GOING TO TRY AND SUPPORT YOUR BACK.

WE GOT THIS.

THERE WE GO. OKAY.

WE READY? -ONE, TWO, THREE.

I GOT YOU. HOLD ONTO ME. HOLD ONTO ME.

OKAY. JUST SLOW AND EASY.

THERE YOU GO.

HERE. GRAB MY ARM. THERE YOU GO.

THERE.

-ALRIGHT. -ALRIGHT.

-YES. -ALRIGHT.

-THE RIGHT SIDE POCKET. -I DON'T FEEL BALANCED.

-DON'T WORRY. -YOU'RE NOT. I PROMISE.

-JUST TAKE DEEP BREATHS. -HEY. WE GOT YOU.

-DEEP BREATHS. -WE GOT YOU.

Joyce: OH.

THIS IS SO MUCH SCARIER THAN I WAS EVEN IMAGINING,

AND I'M JUST TERRIFIED THAT THIS ISN'T GOING TO WORK,

AND SOMETHING'S GOING TO GO WRONG.

Man: SLOW, SLOW, SLOW, SLOW, SLOW.

DON'T PUSH. -WE'RE NOT.

-OKAY. -WE'RE PULLING.

MAKE IT STRAIGHT.

CAN SOMEONE HOLD MY HAND, ANOTHER PERSON?

-I GOT YOU. -I'M RIGHT HERE.

JUST WANT YOU TO HOLD HER HAND.

-AH. -IT'S OKAY.

-OH. -HEY, THAT WAS JUST YOUR CURB.

THIS TRIP IS A PRETTY BIG DEAL FOR BOTH

JOYCE AND I, SO I'M STRESSED AND ANXIOUS,

BUT I'M VERY READY TO SUPPORT HER,

AND SHE'S GOING TO BE IN FRONT OF ME ON THE MEDICAL TRANSPORT.

Man: ONE, TWO, THREE.

SO THAT WAY, IF THERE'S ANYTHING THAT IHAVE TO HELP WITH,

I CAN GO HELP JOYCE.

I'M JUST PRAYING THAT IT'S SMOOTH FOR HER,

THAT SHE JUST GETS THERE,

AND THERE'S NO PROBLEMS WITH ANYTHING.

-LOVE YOU. -I LOVE YOU.

YOU'RE IN GOOD HANDS.

THESE GUYS ARE GOING TO TAKE CARE OF YOU.

Joyce: I'M ALREADY IN SO MUCH PAIN,

AND THIS IS JUST THE START OF THE WHOLE DRIVE AND JOURNEY,

SO I DON'T KNOW HOW MUCH LONGER I'M GOING TO BE ABLE TO DO THIS

AND WHAT I'M GOING TO DO IF THIS GETS TO BE TOO MUCH FOR ME.

-HELLO? -HI.

DID YOU TAKE A DIFFERENT ROUTE?

AH.

ALRIGHT. JUST KEEP ME POSTED.

OKAY. BYE.

WE'VE ONLY BEEN ON THE ROAD FOR A LITTLE BIT,

LESS THAN AN HOUR, I THINK.

THIS IS HORRIBLE.

DAWN WAS SUPPOSED TO STAY BEHIND US TO HELP ME IF I NEEDED,

AND SHE'S NOT, SO I'M REALLY, REALLY SCARED RIGHT NOW

BECAUSE I DON'T KNOW HOW I'M GOING TO HANDLE THIS

AND DO WHAT I NEED TO BE ABLE TO MAKE IT TO HOUSTON.

IT'S JUST TOO MUCH FOR ME,

AND I DON'T THINK I'M GOING TO BE ABLE TO DO IT.

Dr. Nowzaradan: RIGHT NOW, WE ARE EXPECTING THE ARRIVAL

OF JOYCE DEL VISCO VERY SOON.

WE WERE ABLE TO ARRANGE A MEDICAL TRANSPORT FOR HER

BECAUSE, WITH HOW POOR THE STATE OF HER HEALTH SOUNDS,

SHE LIKELY WOULDN'T HAVE BEEN ABLE TO DO THIS TRIP ON HER OWN

WITHOUT SUFFERING A MEDICAL EMERGENCY.

THIS HAS STILL BEEN A VERY LONG TRIP FOR HER,

SO ONCE SHE ARRIVES,

WE NEED TO GET HER IN QUICKLY AND START RUNNING THE TESTS

WE NEED TO DETERMINE THE STATE OF HER CONDITION

AND IF THERE ARE ANY LIFE-THREATENING ISSUES

WE NEED TO ADDRESS.

HI, JOYCE. -HI, DR. NOW.

HOW YOU DOING?

I'M IN A LOT OF PAIN.

ALRIGHT.

WE'RE GOING TO GET YOU IN REAL QUICK

AND CHECK YOU OUT, OKAY?

OKAY. THANK YOU.

JOYCE'S CONDITION LOOKS TO ALREADY BE

SEVERELY DETERIORATED,

AND SHE LIKELY DOESN'T HAVE MUCH TIME BEFORE THINGS

GET EVEN WORSE FOR HER.

I DON'T FEEL SECURE, GUYS.

SO UNTIL THEN, WE HAVE A LOT WE NEED TO ADDRESS WITH HER

AND NOT A LOT OF TIME TO DO IT

BEFORE SHE GETS TO A VERY CRITICAL POINT

WE MAY NOT BE ABLE TO PULL HER BACK FROM.

GOING TO GET YOU IN THERE FIRST. WE'LL GET YOUR STUFF AFTER.

OKAY.

I HOPE I CAN USE THE BATHROOM.

I HAVEN'T USED IT ALL DAY.

Man: THAT WAY.

UH-HUH.

-YOU'RE NOT FALLING. -WE GOT YOU. WE GOT YOU. -YOU'RE NOT FALLING.

-NO, YOU'RE NOT. -WE GOT YOU.

-OKAY. -EVERYBODY LOCKED?

LET'S COUNT. ONE, TWO, THREE.

OKAY.

ALRIGHT. HEAD'S COMING UP.

HOW YOU DOING, DOLL?

I'M DOING OKAY.

HOW DO YOU FEEL YOU'RE POSITIONED?

I'M FEELING LIKE I'M LEANING THAT WAY.

Man #2: OKAY.

MUCH BETTER.

-AWESOME. -OKAY.

Dr. Nowzaradan: THANK YOU SO MUCH.

OKAY. THANK YOU.

YOU'RE ANGELS. -MUCH BETTER.

ALRIGHT. NOW THAT WE GOT YOU INSIDE, ARE YOU FEELING OKAY?

FEELING MUCH BETTER NOW.

DO YOU HAVE ANY PAIN ANYWHERE?

JUST A LITTLE BIT, LIKE, RESIDUAL PAIN

FROM BEING IN PAIN FOR SO LONG.

WE'LL GET YOU FEELING BETTER REAL SOON.

OKAY. THANK YOU.

MM. ALRIGHT.

AND NO SHORTNESS OF BREATH?

LITTLE BIT, YEAH.

IT'S HARD FOR ME TO TAKE A DEEP BREATH RIGHT NOW.

OKAY. LET ME LISTEN TO YOUR LUNGS.

TAKE A DEEP BREATH. ALRIGHT.

THE GOOD NEWS IS, YOU DON'T SOUND LIKE

YOU'RE IN ANY SORT OF RESPIRATORY FAILURE RIGHT NOW.

ANY OTHER ISSUES BOTHERING YOU?

YEAH, I'M A LITTLE HUNGRY.

I DIDN'T EAT ALL DAY.

WELL, DON'T WORRY.

YOU HAVE EATEN THE FOOD THAT BELONG TO NEXT 3 YEARS

AHEAD OF TIME, OKAY?

IT MAY BE MORE THAN 3 YEARS, DR. NOW.

IT IS MORE.ALRIGHT.

YOU KNOW THAT, RIGHT?

YES, I DO.

BUT WE'LL GET YOU SOMETHING, OKAY?

ALRIGHT. BUT ANYTHING ELSE BOTHERING YOU OTHER THAN HUNGER?

I DIDN'T GO TO THE BATHROOM THE WHOLE TIME?

YOU NEED TO GO TO BATHROOM?

I DO.ALRIGHT.

HOW MUCH YOU CAN GET UP AND DO ON YOUR OWN?

I CAN WALK A FEW STEPS WITH A WALKER.

OKAY. YOU GO TO BATHROOM BY YOURSELF?

I DO.OKAY.

I USE A BEDSIDE COMMODE.

BEDSIDE COMMODE?MM-HMM.

ALRIGHT.

WE'LL GET YOU ONE SO YOU CAN USE THAT NOW,

BUT THEN AFTER THAT, WE'LL GET YOU SITUATED TO A ROOM

AND GET SOME LAB WORK ON YOU AND RUN SOME TESTS

WE NEED TO DO TO MAKE SURE EVERYTHING IS OKAY.

-OKAY. -OKAY.

HOPEFULLY ONCE WE RUN THE TESTS WE NEED ON JOYCE,

WE ARE ABLE TO DETERMINE

THAT THERE IS NO IMMEDIATE LIFE-THREATENING ISSUE WITH HER

BECAUSE, WITH HER CURRENT CONDITION,

IT IS NOT LIKELY THAT SHE'LL SURVIVE

ANY SERIOUS MEDICAL ISSUES RIGHT NOW,

SO WE WILL NEED TO DO PT WITH HER TO GET HER STAMINA UP

AND STRENGTHEN HER PULMONARY SYSTEM

TO KEEP IT FROM GETTING ANY WORSE,

AND WE WILL LIKELY NEED TO KEEP HER HERE FOR A WHILE.

CAN I HAVE A HUG?

YOU MADE IT.

ALRIGHT.

WE'RE GOING TO GET YOU UP AND LET YOU GO TO BATHROOM.

I'M DR. NOWZARADAN.

I'M DAWN.AND YOU'RE...

SHE'S MY FRIEND AND MY ROOMMATE.

FRIEND AND ROOMMATE, OKAY, GOOD. ALRIGHT.

LET ME GET SOME HELP, AND WE'LL GET YOU UP.

YOU FEEL ANY BETTER, JOYCE?

MUCH BETTER, YEAH.

OKAY, GOOD.

BUT DO YOU KNOW HOW MUCH YOU WEIGH NOW?

ALRIGHT, THEN.

LET ME CHECK YOUR WEIGHT AND FIGURE OUT WHAT YOUR WEIGHT IS.

OKAY. LET'S GET YOU BACK IN BED

AND GET YOUR SIZE IN JUST A COUPLE MINUTE.

-OKAY. -OKAY.

THIS OFF?YEAH, THAT'S FINE.

Man: I'M JUST GOING TO TILT THE CHAIR BACK, IF YOU'LL JUST LEAN BACK,

AND THEN I'LL SCOOT YOU UP IN IT. OKAY?

OKAY.

YOU FEEL IT?UH-HUH.

OKAY.

Dr. Nowzaradan: OVERALL, WE HAVE A VERY DIRE SITUATION WITH JOYCE,

AND WE HAVE A LOT OF WORK TO DO WITH HER

BEFORE WE MAKE ANY SIGNIFICANT IMPROVEMENTS WITH HER HEALTH

TO GET HER IN A BETTER PLACE.

BUT WE'LL DO EVERYTHING WE CAN TO TRY

AND TURN THINGS AROUND FOR HER QUICKLY

BECAUSE IF WE DON'T, SHE WON'T SURVIVE MUCH LONGER.

Joyce: I CAN'T BELIEVE I MADE IT.

I THINK I'D BE REALLY RELIEVED IF I WASN'T IN SO MUCH PAIN,

BUT IT TOOK EVERYTHING IN ME TO DO THIS.

Dr. Nowzaradan: ALRIGHT. THIS YOUR BED.

WE'RE GOING TO GET YOU UP IN HERE, OKAY?

OKAY.

OKAY. READY?

-AAH. -ALRIGHT.

-ONE, TWO, THREE. -GOOD JOB.

-OKAY. -WE CAN PULL THAT SHEET.

LITTLE MORE, YEAH.

Man: ONE, TWO, THREE AND UP.

NOW UP.

OKAY. THERE WE GO.

HOW YOU DOING, JOYCE?

-OKAY. -OKAY, JOYCE.

NOW THAT WE GOT YOU SITUATED, LET'S SEE WHAT THE WEIGHT IS.

-YOU ALRIGHT? -YEAH.

OKAY. JUST KEEP BREATHING.

LOOKS LIKE YOU ARE 758. ALRIGHT, JOYCE.

SO IT LOOKS LIKE WE HAVE A LOT OF WEIGHT TO LOSE WITH YOU,

SO WE'RE GOING TO GET YOU STARTED ON SOME PHYSICAL THERAPY

AND A HEALTHY DIET.

BUT FIRST, WE'RE GOING TO RUN SOME TESTS TO MAKE SURE

THAT NOTHING IS HAPPENING WITH THIS 14-HOUR TRAVEL

AND NO BLOOD CLOT OR ANY OTHER ISSUES.

THEN WE'LL WORK ON GETTING YOUR WEIGHT DOWN

AND HELPING YOU GET MORE MOBILE.

OKAY? -OKAY, THANK YOU.

Dr. Nowzaradan: ALRIGHT. I'LL SEE YOU LATER.

OKAY. SEE YOU LATER.

HI.

HI.

Joyce: I'M IN SO MUCH PAIN, AND ALL I CAN DO RIGHT NOW IS REST,

BUT I'M HOPING ONCE I RECOVER, ALL MY TESTS WILL BE GOOD,

AND I'LL BE ABLE TO START MY WHOLE JOURNEY

TO GETTING HEALTHY AND A NEW LIFE

BECAUSE I'VE WAITED A LONG TIME FOR A CHANCE LIKE THIS,

AND I'M VERY READY FOR IT.

I JUST HOPE IT GETS A LITTLE EASIER FROM HERE.

Dr. Nowzaradan: OVER THE LAST MONTH,

WE HAVE BEEN ABLE TO MAKE SOME PROGRESS WITH JOYCE.

HER TESTS SHOW HER BODY

WAS STARTING TO STRUGGLE A GREAT DEAL JUST TO FUNCTION,

MOSTLY WITH HER RESPIRATORY AND PULMONARY SYSTEM.

SO IT'S BEEN EXTREMELY IMPORTANT FOR US

TO GET HER WEIGHT DOWN AS QUICKLY AS POSSIBLE

WHILE ALSO BUILDING UP HER STAMINA.

SO WE HAVE HAD HER ON A CONTROLLED DIET

THAT SHE HASN'T LIKED TOO MUCH,

AND WE HAVE BEEN WORKING TO DO PT WITH HER,

BUT SHE'S BEEN RESISTANT TO THAT AS WELL,

AND SHE NEEDS TO START COOPERATING

BEFORE IT'S SAFE TO SEND HER HOME

BECAUSE SHE CAN VERY EASILY UNDO THE PROGRESS

WE'VE MADE WITH HER SO FAR.

HI, JOYCE.HI, DR. NOW.

HOW ARE YOU?GOOD. HOW ARE YOU?

I'M DOING OKAY.

SO YOU'RE STILL NOT DOING EVERYTHING YOU NEED

WITH PHYSICAL THERAPY.

WHY IS THAT?

I REALLY AM TRYING, BUT MY BREATHING IS STILL A STRUGGLE,

AND SOMETIMES WITH PHYSICAL THERAPY,

IT GETS A LITTLE, YOU KNOW.

GET SHORT-WINDED?MM-HMM.

WE'RE GETTING YOU TO LOSE WEIGHT AND ADDRESS THAT,

BUT YOU HAVE TO COOPERATE WITH US TO DO YOUR EXERCISES

SO WE CAN MAKE THE SAME PROGRESS WITH YOUR STAMINA

THAT WE HAVE MADE WITH YOUR WEIGHT.

I REALLY AM TRYING, DR. NOW.

WHEN YOU CAME IN, YOU WERE 758,

AND YOUR BMI WAS ALMOST 160.

THAT'S EXTREMELY LARGE.

SO YOU KNOW WHAT NORMAL BMI IS?

LIKE, 30, RIGHT?

EIGHTEEN TO 25. YEAH.

BUT LET'S GET AN UPDATE WITH YOUR WEIGHT RIGHT NOW.

OKAY.

AND LET'S SEE IF WE CAN GET YOUR BED DOWN FIRST.

OKAY.

I'LL TAKE SOME OF THIS STUFF AND PUT IT OVER HERE.

OKAY. THAT'S GOOD.

LET ME CHECK YOUR STOMACH WHILE YOU'RE HERE.

SO THIS IS...DO YOU HAVE ANY STOMACH PAIN OR DISCOMFORT?

NO.

CAN YOU RAISE YOUR HEAD UP FOR ME?

LIKE I MENTIONED, YOU MAY HAVE SOME HERNIA IN HERE,

AND YOU DO HAVE A HERNIA IN BELLY BUTTON,

AND SO WE WILL HAVE TO FIX THAT AT SOME POINT.

ALRIGHT.

SO LET ME GET YOUR SHOES FOR YOU SO YOU CAN GET UP.

ALRIGHT. LET ME GET THE AIR MATTRESS.

YEAH.

ALRIGHT.

AND WHILE YOU'RE IN THAT POSITION,

LET ME CHECK YOUR LYMPHEDEMA AND SEE HOW IT'S DOING.

WHERE'S THAT COMING FROM, THE ABDOMEN?

YEAH, LIKE THE PANNUS.

IT LOOKS LIKE IT'S DOING BETTER, AND IT'S NO LONGER INFECTED.

BUT ULTIMATELY, WE HAVE TO REMOVE IT.

OKAY. LET ME HELP YOU UP.

IS IT GOING OVER THE BED?

SOMETIMES IT GETS STUCK.

THERE WE GO. THANK YOU. THANK YOU.

LET'S DO THIS WITHOUT OXYGEN

BECAUSE YOU DON'T NEED THIS ANYMORE.

ALRIGHT. SO CAN WE LEAVE THIS?

FOR A LITTLE BIT, YEAH.

I'LL JUST NEED THE WALKER.

YOU OKAY?MM-HMM.

OKAY. GOOD JOB.

Dr. Nowzaradan: YOU'RE DOING GOOD.

KEEP WALKING.

I CAN'T.

YOU CAN DO THIS, JOYCE.

Joyce: THIS MUCH ACTIVITY IS REALLY HARD ON MY BODY,

AND I DON'T THINK DR. NOW UNDERSTANDS THAT

AND JUST HOW MUCH THIS IS FOR ME.

BUT I DON'T KNOW IF I CAN DO A WHOLE LOT MORE

BECAUSE THIS IS REALLY PAINFUL,

AND I FEEL LIKE I'M ABOUT AT MY LIMIT.

BUT I'LL TRY TO STAND LONG ENOUGH TO GET MY WEIGHT.

I JUST DON'T KNOW HOW LONG I CAN LAST.

YOU READY?MM-HMM.

ALRIGHT.THIS IS THE FIRST TIME

I'M EVER STEPPING UP ON SOMETHING

FOR A REALLY LONG TIME, SO I'M A LITTLE NERVOUS.

OKAY. OH, DON'T BE NERVOUS.

ALRIGHT. WE'RE ALL SET.OKAY.

ALRIGHT, 388.

THAT CAN'T BE RIGHT.

I GOT TO SIT BACK DOWN. SORRY.

I'M ALMOST FALLING.

ALRIGHT. WE GOT YOU.

OKAY. ALRIGHT.

THREE EIGHTY-EIGHT WAS NOT RIGHT.

THAT WOULD'VE BEEN A MIRACULOUS LOSS.

WE HELPED YOU LOSE A LOT, BUT NOT THAT MUCH.

WE'LL JUST WAIT UNTIL YOU CATCH YOUR BREATH,

AND THEN I WILL REZERO IT,

AND WE CAN GET THE CORRECT WEIGHT.

I'D PREFER TO SKIP IT.

ON THE WAY BACK, I ALMOST WASN'T ABLE TO MAKE MY WAY BACK.

ALRIGHT.

WE'LL TRY AGAIN LATER,

BUT AT LEAST YOU GOT A LITTLE EXERCISE TODAY.

BUT THIS POOR LEVEL OF ACTIVITY IS NOT GOOD.

SO YOU REALIZE YOUR FUNCTION AND CAPACITY IS VERY, VERY LOW,

AND YOU'RE IN A VERY DANGEROUS SITUATION.

SO THIS IS A MATTER OF LIFE AND DEATH FOR YOU,

AND YOU'RE RUNNING OUT OF TIME.

YEAH, PROBABLY MEANS I'M STAYING HERE A LOT LONGER.

WELL, NOT NECESSARILY.

HOW LONG YOU'RE HERE IS UP TO YOU

AND HOW HARD YOU WANT TO WORK.

AND ONCE YOU GET TO THE PLACE

YOU NEED THAT IS SAFE, WE'LL SEND YOU HOME.

OKAY.OKAY?

MM-HMM. ALRIGHT.

LET'S GET YOU BACK TO YOUR ROOM SO YOU CAN REST.

OKAY.

Dr. Nowzaradan: SO FAR, JOYCE HASN'T SHOWN ME MUCH EVIDENCE

THAT SHE'S WILLING TO DO

WHAT SHE NEEDS TO TURN HER SITUATION AROUND.

AND UNTIL I START TO SEE SOME CHANGE WITH THAT,

IT IS TOO DANGEROUS TO SEND HER TO BE BACK ON HER OWN

BECAUSE SHE CAN'T AFFORD TO UNDO THE PROGRESS WE HAVE MADE

IMPROVING HER HEALTH AND GETTING OVER 100 POUNDS OFF OF HER.

SO THE CLOCK IS TICKING FOR HER, AND IF SHE'S NOT CAREFUL,

SHE'S GOING TO RUN OUT OF TIME VERY SOON.

I'LL PUT SOME OXYGEN ON.

THANK YOU.

ALRIGHT. YOU FEELING OKAY?

UH-HUH.

YOU GAVE ME A LITTLE WORKOUT WITH MY LEGS,

BUT I'M DOING GOOD.

WELL, THAT'S THE WHOLE IDEA.

YOU KNOW, YOU ARE 4'11".

FOR YOUR HEIGHT, YOU SHOULD BE UNDER 100 POUNDS,

SO YOU STILL HAVE 500 POUND TO LOSE BEFORE YOU HIT YOUR GOAL,

AND THAT'S NOT GOING TO BE EASY TO DO.

BUT IF YOU DO WHAT YOU NEED,

THEN WE'LL BE ABLE TO GET YOU TO THAT POINT.

OKAY?

THANK YOU FOR HELPING ME.

WELL, THAT'S MY JOB.

BUT REMEMBER, ALL THE HARD WORK IS GOING TO COME FROM YOU.

OKAY? OKAY.

ALRIGHT. I'LL BE BACK TO SEE YOU AGAIN SOON.

IN THE MEANTIME, GET YOU SOME HELP TO GET YOU BACK IN THE BED.

OKAY. THANK YOU.

YOU'RE WELCOME.

Joyce: I REALLY WANT TO GO HOME BECAUSE IT'S REALLY HARD BEING HERE,

BUT I'M HAPPY ABOUT THE PROGRESS I'VE MADE SO FAR

AND HOW MUCH MY HEALTH HAS IMPROVED.

EVEN IF DR. NOW DOESN'T AGREE WITH ME ABOUT THAT,

I REALLY AM WORKING HARD, AND I HAVE NO DOUBT

I CAN KEEP THIS GOING ON MY OWN AND SHOW

DR. NOW I CAN DO THIS WITHOUT HAVING TO BE HERE.

I'M REALLY EXCITED ABOUT TODAY BECAUSE DR. NOW SAID

I COULD FINALLY LEAVE AND GO TO THE NEW APARTMENT

DAWN SET UP FOR US, AND I'M LOOKING FORWARD TO THAT

AND BEING IN A NORMAL PLACE AGAIN.

IT'S BEEN SO HARD HERE, BUT I KNOW IT WAS IMPORTANT.

THEY NEEDED TO GET MY HEALTH TO A MUCH BETTER PLACE,

SO I'M VERY GLAD TO HAVE BEEN ABLE TO GET THAT HELP,

BUT I'M ALSO VERY GLAD THAT IT'S OVER WITH

AND THAT I'M FINALLY GOING TO GET TO LEAVE.

HI.HEY.

OH, MY SOUP.BROUGHT YOU SOUP.

AND MY LITTLE SOUP TRAY.

OVER THE PAST MONTH, I HAVE SEEN SOME POSITIVE

IMPROVEMENT WITH JOYCE, NOT AS MUCH AS I HAD HOPED,

BUT ENOUGH TO GIVE ME HOPE

THAT SHE'S STARTING TO GO IN THE RIGHT DIRECTION.

SHE'S BEEN TRYING A LITTLE HARDER WITH PT,

BUT SHE STILL ISN'T WALKING ON HER OWN,

AND SHE STILL CONVINCED HERSELF

SHE NEEDS HER OXYGEN TANK TO BREATHE

WHEN THERE IS NO REASON FOR IT.

SO WE STILL HAVE A LOT OF WORK TO DO WITH HER.

BUT I THINK THERE IS SOME LIGHT AT THE END OF THE TUNNEL

WITH HER ATTITUDE AND CHOICES SHE'S MAKING,

SO I'M HAPPY ABOUT THAT PROGRESS.

A MONTH AGO, WHEN WE GOT AN ACCURATE WEIGHT,

SHE WAS DOWN TO 637 FROM 758, SO SHE LOST 121 POUNDS

IN THE FIRST MONTH ON A CONTROLLED DIET.

AND NOW THIS ONE, WE HAVE HER DOWN TO 553

FOR A TOTAL WEIGHT LOSS OF 205 POUNDS IN 2 MONTHS,

AND WE HAVE HER IN A MUCH BETTER PLACE

THAN SHE WAS WHEN SHE ARRIVED A COUPLE MONTHS AGO.

SO I FEEL LIKE WE CAN TAKE THE NEXT STEP OF SEEING

HOW SHE DOES ON HER OWN AT HOME.

-HELLO. -HEY.

HI, DR. NOW.HOW Y'ALL DOING?

GOOD. HOW ARE YOU?

I'M DOING GOOD.

SO YOU READY TO GO HOME?

I'M SO READY TO GO HOME.OKAY.

SO WE'RE GOING TO GET YOU GOING HOME,

BUT LEAVING A CONTROLLED ENVIRONMENT

ISN'T SO YOU CAN GO ON VACATION, OKAY?

I KNOW.

YOU NEED TO KEEP WORKING HARD AT HOME

TO MAKE MORE IMPROVEMENTS WITH YOUR MOBILITY

BECAUSE SO FAR, WE HAVEN'T BEEN ABLE TO GET YOU

TO WHERE YOU'RE WALKING ON YOUR OWN,

AND THERE'S NO REASON FOR THAT.

SO WE'RE GOING TO SEND PT TO YOUR HOME THREE TIMES A WEEK.

OKAY?OKAY.

IT'S VERY IMPORTANT YOU STICK WITH YOUR DIET

AND CONTINUE LOSING

TO GET AS MUCH WEIGHT OFF YOUR BODY AS POSSIBLE.

YOU THINK YOU CAN DO THAT?I WILL.

I'M GOING TO 100 PERCENT DO THE DIET ON MY OWN.

I PROMISE.OKAY, GOOD, BECAUSE IN 1 MONTH,

I WANT TO SEE YOU AT MY CLINIC FOR ANOTHER APPOINTMENT,

AND I WANT YOU TO LOSE 50 POUNDS BY THEN.

OKAY, WOW. THAT'S A GOAL.

IF YOU STICK TO THE DIET, THAT SHOULD BE EASY FOR YOU.

OKAY? OKAY.

ALRIGHT.WILL DO.

BUT THEN, HERE IS THE OTHER THING.

OKAY.

WE'RE NOT SENDING ANY MEDICAL TRANSPORT

FOR YOU TO PICK YOU UP.

YOU GOT THAT?I'LL DO MY BEST.

I'LL TRY, DR. NOW.

I HOPE SO.

BUT THERE'S ONE MORE THING I WANT YOU TO DO.

WHAT'S THAT?

I WANT YOU TO GET OFF THIS OXYGEN.

YOU DON'T NEED IT.

SO WHEN YOU GO HOME, YOU NEED TO WEAN YOURSELF OFF OF IT.

YOU'RE ASKING A LOT, DR. NOW.

I'M NOT ASKING FOR ANYTHING YOU CAN'T

OR YOU SHOULDN'T DO, OKAY?

OKAY. THANK YOU.OKAY.

ALRIGHT. I'LL SEE YOU LATER.

THANK YOU.YOU TAKE CARE.

I'M REALLY HOPING JOYCE IS TAKING HER SITUATION

AS SERIOUSLY AS SHE SAYS AND THAT SHE CONTINUES TO IMPROVE

AND DO WHAT SHE NEEDS TO KEEP HEADING IN THE DIRECTION

WE HAVE HER BECAUSE SHE CAN'T AFFORD TO WASTE ANY MORE TIME

PLAYING GAMES OR MAKING EXCUSES.

HER BODY IS NOT GOING TO BE ABLE TO TAKE THE STRAIN

OF HER WEIGHT FOR MUCH LONGER,

ESPECIALLY IF SHE STARTS TO GAIN AGAIN,

BUT I'M ONLY GIVING HER A MONTH BEFORE I WANT TO SEE HER AGAIN

JUST IN CASE SHE GOES OFF THE RAILS.

WE CAN INTERVENE AND STOP HER

BEFORE SHE UNDOES ALL HER PROGRESS.

AND THE PT I'M SENDING TO SEE HER

WILL BE ABLE TO MONITOR HOW SHE'S DOING TO MAKE SURE

WE CAN PREVENT ANY MEDICAL EMERGENCIES

IF HER BODY STARTS TO STRUGGLE TOO MUCH

FROM ANYTHING SHE'S DOING.

SO WE HAVE SET JOYCE UP TO HAVE THE BEST CHANCE

POSSIBLE TO START DOING WHAT SHE NEEDS.

SO WHAT HAPPENS FROM HERE FOR HER

ALL COMES DOWN TO HOW SHE DOES

AND THE CHOICES SHE MAKES THIS NEXT MONTH.

Joyce: I'VE BEEN OUT OF THE HOSPITAL FOR A COUPLE OF WEEKS,

AND IT'S BEEN REALLY NICE TO BE BACK IN AN ENVIRONMENT

THAT ISN'T SO STRESSFUL,

AND MY MOM HAS BEEN DOWN THE PAST WEEK

GETTING EVERYTHING IN PLACE AND MAKING IT NICE HERE.

DR. NOW SENDS OVER PT THREE TIMES A WEEK,

AND THAT'S BEEN HARD,

BUT I HAVE ANOTHER SESSION TODAY,

SO WE'LL JUST HAVE TO SEE HOW IT GOES.

-HEY! HEY, DAWN. HOW ARE YOU?

-I'M GOOD. -HEY, JOYCE. HOW'S IT GOING?

HI, CLINT. HOW ARE YOU?

IT'S GOOD TO SEE YOU.

Joyce: IT ALWAYS FEELS LIKE THEY PUSH ME A LITTLE TOO HARD,

AND BECAUSE OF THAT, MY KNEE HAS BEEN REALLY HURTING,

BUT I'M HOPING THAT I DON'T DO ANYTHING TO MAKE MY KNEE WORSE

BECAUSE IT'S FINALLY FEELING BETTER.

I'M THINKING MAYBE NOT DOING THE OXYGEN AS MUCH

AND TAKING IT OFF WHILE WE'RE WORKING.

Clint: WELL, YOU KNOW WHAT? LET'S DO THIS.

WHY DON'T YOU GO AHEAD AND TAKE IT OFF NOW,

AND WE'LL GET STARTED,

AND WE'LL CHECK YOUR OXYGEN THROUGHOUT THE SESSION.

OKAY?

DR. NOW HAS BEEN WANTING ME TO STOP USING MY OXYGEN

BECAUSE HE THINKS I DON'T NEED IT.

SO I STOP, BUT SLEEPING AND EXERCISING ARE THE ONLY TIME

I STILL GET WORRIED I DON'T HAVE IT

BECAUSE IF IT GETS TOO HARD FOR ME TO BREATHE,

I'M REALLY SCARED ABOUT WHAT COULD HAPPEN.

SO HOPEFULLY I CAN HANDLE IT ALL TODAY AND DO WHAT I NEED.

WE'RE GOING TO DO MARCHING IN PLACE.

I'VE BEEN WORKING REALLY HARD TO DO WHAT I CAN

AND MAKE PROGRESS WITH MY ABILITY TO DO MORE.

I KNOW IT'S NOT AS MUCH AS PT AND DR. NOW WANTS,

BUT I REALLY AM PUSHING MYSELF TO DO AS MUCH AS I CAN.

ALRIGHT. FEELING GOOD?

YOU READY, CATCH YOUR BREATH?

MM-HMM.SO WHAT WE'RE GOING TO DO IS,

WE'RE GOING TO WALK OVER TO THE BED.

SO I WANT YOU STANDING UP RIGHT HERE IN FRONT OF YOUR CHAIR.

DR. NOW WANTS ME TO GET TO HIS CLINIC IN A COUPLE WEEKS

WITHOUT A MEDICAL TRANSPORT,

SO I HAVE TO GET TO WHERE I CAN HANDLE

WALKING TO A CAR AND GETTING IN BY THEN,

OR I'LL MISS MY CHANCE TO SHOW DR. NOW

I CAN DO THIS ON MY OWN.

SO I'M WORKING TO GET MY STAMINA UP TO DO THAT

AND HIT MY WEIGHT-LOSS GOAL BECAUSE I HAVE TO GET SURGERY.

WITHOUT IT, I DON'T HAVE A CHANCE.

GOOD JOB.THANK YOU.

REALLY GOOD, JOYCE.

ALRIGHT, LADIES. ALWAYS NICE TO SEE YOU.

NICE TO SEE YOU.

KEEP IT GOING, OKAY?

SEE YOU MONDAY. HAVE A GOOD WEEKEND.

-OKAY. -BYE.

-ALRIGHT. BUH-BYE. -BYE.

Joyce #2: HE REALLY DOES WORK YOU,

BUT LOOK AT THE PROGRESS YOU'VE MADE.

WHEN SHE FIRST CAME DOWN HERE, SHE COULD BARELY WALK TWO STEPS

WITHOUT HER WALKER, AND, LIKE, TODAY, YOU COULD SEE HER WALK

FROM HER CHAIR TO HER BED, WHICH IS PRETTY AMAZING.

Joyce: I THINK THAT WAS A GOOD WORKOUT TODAY,

AND I'M PROUD OF MYSELF FOR DOING WHAT I NEEDED.

SO I REALLY AM GIVING THIS MY ALL TO GET TO

WHERE I NEED AND MOVE AHEAD.

IT'S JUST A LOT.

I'VE BEEN WORKING REALLY HARD THE PAST MONTH,

BUT I'M STILL STRUGGLING TO GET UP AND WALK,

SO I'M NOT 100 PERCENT SURE WHY.

I'VE DONE PT EVERY TIME THEY COME OVER,

AND I'VE COMPLETELY STUCK TO THE 1,200-CALORIE-A-DAY DIET.

THE ONLY THING I CAN FIGURE IS THAT MAYBE FOR MY BODY,

I CAN'T LOSE WEIGHT ON 1,200 CALORIES.

I THINK I'M DONE.OKAY.

THANK YOU.

AND BECAUSE I'M STILL STRUGGLING TO WALK,

THERE'S NO WAY I CAN GO ANYWHERE WITHOUT A MEDICAL TRANSPORT.

AND I TOLD DR. NOW'S OFFICE

THAT IF THEY WANTED TO SEND A TRANSPORT FOR ME,

I'D BE THERE, BUT THEY DIDN'T, SO THERE'S NOTHING I CAN DO.

DAWN CAN'T PUSH ME IN A WHEELCHAIR

ALL THE WAY TO A VEHICLE AND THEN INTO THE CLINIC.

SO I TOLD TOLD DR. NOW'S OFFICE

THAT WHEN THEY CALLED TO FOLLOW UP WITH ME,

AND THEY SAID DR. NOW WANTED TO SET UP

A VIDEO CALL TO SEE ME AND TALK TO ME,

I'M FIGURING BECAUSE HE THINKS I'M NOT DOING WHAT I NEED.

THERE YOU GO.

BUT I REALLY, REALLY AM,

AND I'M WILLING TO GO SEE HIM IF HE'D HELP ME GET THERE.

OKAY.

HI, JOYCE. HOW ARE YOU?

GOOD. HOW ARE YOU?

I'M DOING OKAY.

SO WHAT'S GOING ON FOR YOU TO MISS YOUR APPOINTMENT?

I'VE HAD SOME TRANSPORTATION ISSUES, AS YOU KNOW,

SO I'VE BEEN TRYING TO FIGURE OUT HOW TO GET THERE.

I DID LOOK INTO AN AMBULANCE,

BUT IT WAS JUST TOO EXPENSIVE FOR ME

TO AFFORD TO GO THAT WAY.

WELL, JOYCE, YOU SHOULD HAVE LOST ENOUGH WEIGHT THAT TODAY,

YOU SHOULD BE ABLE TO WALK AS MUCH

AS YOU NEED TO THE CLINIC AND COME AND SEE US,

BUT THAT'S NOT HAPPENING.

SO WHAT'S GOING ON WITH YOUR EATING HABIT?

I AM STILL FOLLOWING THE CALORIES,

BUT I THINK I'M GOING TO HAVE TO TAKE IN A LOT LESS CALORIES

THAN 1,200 TO MAKE ANY DIFFERENCE.

YOU'RE EATING TOO MUCH.

YOU'RE EATING FIVE TO SIX TIMES WHAT YOU SHOULD BE RIGHT NOW,

AND THAT FOOD IS MORE IMPORTANT THAN SAVING YOUR LIFE.

NO, IT'S NOT. IT'S JUST...

IT'S BEEN A STRUGGLE FOR ME TO FIGURE OUT HOW MANY CALORIES

I NEED TO GET IT OFF FASTER.

I MEAN, I...ALL HOME-COOKED, LOW-FAT, LOW-CARB,

HIGH-PROTEIN FOOD.

IF IT'S LOW-FAT, LOW-CARB, BY NOW,

YOU SHOULD'VE LOST SOMETHING, BUT THAT'S CLEARLY NOT THE CASE

BECAUSE YOU LOOK LIKE YOU HAVE GAINED.

NO, THAT'S NOT TRUE.

I HAVE LOST WEIGHT BECAUSE I CAN FEEL IT IN A LOT OF WAYS.

YOU KNOW, MY CLOTHES FIT BETTER, AND IT'S EASIER FOR ME TO SIT UP

THAN IT WAS WHEN I LEFT THE HOSPITAL.

SO I KNOW I'M MAKING PROGRESS,

BUT I MAY NOT HAVE LOST THE AMOUNT OF WEIGHT

THAT I SHOULD BE LOSING.

BUT THAT'S BECAUSE I THINK THE DIET IS WRONG,

AND 1,200 CALORIES IS STILL TOO MUCH FOR ME.

JOYCE, YOU'RE DELUSIONAL IF YOU BELIEVE THAT.

IT JUST MEANS THAT YOU'RE DOING OKAY

BECAUSE YOU FEEL LIKE YOUR CLOTHES ARE BAGGY.

I CAN SEE YOU RIGHT NOW, AND I CAN TELL YOU HAVE GAINED.

THE ONLY QUESTION IS HOW MUCH,

AND THAT'S WHY IT'S IMPORTANT WE SEE YOU IMMEDIATELY

BECAUSE IF YOU UNDO THE PROGRESS WE MADE WITH YOU,

YOUR SITUATION IS GOING TO GET MUCH WORSE VERY SOON.

I'M OFF OF MY OXYGEN.

I'M NO LONGER USING OXYGEN.

YOU HAVEN'T NEEDED TO USE THAT FOR A WHILE.

YOU JUST CONVINCED YOURSELF YOU NEEDED IT.

SO THE ONLY PROGRESS WITH THAT IS YOU NO LONGER

PRETENDING YOU CAN'T BREATHE ON YOUR OWN,

SO THAT DOESN'T SHOW MUCH PROGRESS EITHER.

WELL, I CAN WALK, SO THERE'S THAT.

I CAN WALK FURTHER, TOO.

HOW FAR YOU CAN WALK?

I WALK ABOUT 40 FEET.

WELL, PT DOESN'T AGREE WITH YOU ABOUT THAT.

BUT IF THAT'S TRUE, THEN WHAT'S THE PROBLEM

WALKING TO THE CAR TO COME HERE?

IT'S JUST TOO FAR STILL AND TOO HARD FOR ME TO DO.

JOYCE, I WANT YOU TO STOP MAKING EXCUSES

AND COME TO THE CLINIC IN THE NEXT 48 HOURS

IF YOU WANT TO KEEP DOING THE PROGRAM.

OKAY?OKAY.

YOU CAN GET HERE WITHOUT MEDICAL TRANSPORT.

YOU DON'T NEED THAT, AND IT IS JUST AN EXCUSE

NOT TO DO MUCH PHYSICAL ACTIVITY,

AND SAYING YOU WON'T FIT ISN'T A GOOD EXCUSE

EITHER IF YOU WANT TO USE THAT AS YOUR NEXT EXCUSE,

BECAUSE THERE ARE TAXIS

WHERE YOU CAN USE A WHEELCHAIR OR A SCOOTER.

SO YOU NEED TO FIGURE IT OUT AND GET HERE IN THE NEXT 2 DAYS

SO WE CAN SEE WHERE YOUR WEIGHT IS AT

IF YOU WANT TO CONTINUE WITH THE PROGRAM.

YOU GOT THAT?

YES, I DO.

WE HAVE A LONG WAY TO GO TO GET YOU TO WHERE YOU NEED,

BUT THE WAY IT'S BEEN GOING,

I DON'T THINK WE'RE EVER GOING TO GET THERE,

AND THAT'S MY CONCERN.

SO YOU NEED TO WORK HARD TO SHOW ME YOU CAN DO THIS,

AND WHAT I NEED TO SEE FROM YOU

IS SOME EFFORT TO TURN YOUR LIFE AROUND

AND EVIDENCE YOU'RE WILLING TO DO

WHAT YOU NEED TO SAVE YOUR LIFE.

IF YOU DON'T DO THIS AND KEEP MAKING MORE EXCUSES,

IT'S NOT GOING TO BE GOOD FOR YOU.

RIGHT.

I DON'T WANT YOU TO THINK THAT THAT'S THE CASE

BECAUSE I AM WORKING VERY HARD.

I JUST KNOW THAT I HAVE TO LESSEN.

TWELVE HUNDRED CALORIES IS TOO MUCH FOR ME.

YOU KEEP SAYING THAT, BUT YOU'RE EATING FIVE TIMES THAT,

AND YOU EITHER DON'T REALIZE THAT

OR THINK YOU CAN CONVINCE ME OF THE DELUSION YOU WANT.

NO.

BUT I'M TELLING YOU RIGHT NOW, UNLESS YOU QUIT THE PROGRAM,

WE'LL FIND OUT WHERE YOUR WEIGHT IS

AT WHEN YOU GET HERE, AND WE'LL SEE.

OKAY?OKAY.

I'M GOING TO WORK MY HARDEST AT GETTING TO BE

AT THE CLINIC WITH TRANSPORTATION AS SOON AS I CAN.

I'M GOING TO WORK VERY HARD.

WELL, YOU HAVE 2 DAYS.

I THINK THAT'S A LITTLE UNFAIR, BUT I'LL DO MY BEST.

GOOD. OKAY, JOYCE.

I HOPE TO SEE YOU SOON.

IF YOU NEED ANYTHING, LET ME KNOW.

I NEED MEDICAL TRANSPORT.

NO, YOU DON'T.

SO IF YOU NEED ANYTHING ELSE, LET ME KNOW.

I KNOW MY BODY, BUT OKAY.

WHATEVER YOU SAY, DR. NOW.

ALRIGHT.

I DON'T THINK DR. NOW IS BEING FAIR

BECAUSE WHETHER HE BELIEVES ME OR NOT,

I KNOW I'M DOING EVERYTHING I'M SUPPOSED TO BE DOING.

I CAN'T HELP THAT THE RESULTS DON'T SHOW THAT.

IT'S THE PROGRAM THAT'S FAILING, NOT ME.

BUT I'M GOING TO LET THIS GET ME DOWN OR DISCOURAGE ME,

AND I'LL KEEP WORKING JUST AS HARD AND EVEN HARDER NOW

BECAUSE I'M GOING TO HAVE TO ADAPT THE PLAN

I HAVE TO WORK FOR ME, AND I ALSO HAVE TO FIGURE OUT

HOW TO GET TO HIS OFFICE IN THE NEXT 2 DAYS,

BUT I JUST DON'T KNOW HOW RIGHT NOW.

THIS IS NOT SAFE.

AFTER I TALKED TO DR. NOW A COUPLE DAYS AGO,

DAWN GOT ME A SCOOTER TO TRY TO USE TO GET AROUND.

I THINK WE SHOULD GET THE WHEELCHAIR

JUST IN CASE SHE NEEDS IT.

AM I ON?

JUST GO. YOU'RE ON IT.

I CAN'T JUDGE IF I'M ON THE SIDEWALK.

I CAN TELL YOU. I'LL TELL YOU IF YOU'RE ON THE SIDEWALK.

THE BACK OF ME.

AND THEN I CALLED MY MOM, AND SHE FLEW BACK DOWN

IMMEDIATELY TO MAKE SURE I GET TO DR. NOW'S.

AM I GOOD?

WE FOUND A WAY TO GET A TAXI

AND GET TO JUST DRIVE YOUR SCOOTER INTO IT,

AND IT GETS SECURED.

AND I'M PRAYING I'M ABLE TO DO THIS

WITHOUT SOMETHING REALLY BAD HAPPENING.

OKAY. I'LL SEE YOU GUYS OVER THERE.

-BYE. -BYE.

Joyce #2: SEE YOU OVER THERE.

Joyce: AND I'M REALLY SCARED RIGHT NOW,

AND I REALLY DON'T THINK THIS IS A GOOD IDEA,

BUT I DON'T REALLY HAVE A CHOICE.

IF I WANT DR. NOW'S HELP, I HAVE TO DO THIS SOMEHOW.

THANK GOD I MADE IT WITHOUT ANYTHING BAD HAPPENING,

BUT THIS IS REALLY PAINFUL,

AND IT'S PUTTING A LOT OF STRAIN ON MY BODY.

I HAVE TO TRY TO USE THE SCOOTER AND GO IN THE CLINIC,

BUT I HATE IT BECAUSE IT'S SO PAINFUL

TO SIT IN WITH HOW I HAVE TO SIT,

AND I'M REALLY SCARED I SHOULDN'T BE DOING THIS

BECAUSE I ALREADY FEEL LIKE I'M AT MY LIMIT.

UH-OH.

CAN YOU MAKE IT? OKAY.

I CAN'T HANDLE THAT HUMP ON THE SCOOTER.

I HAVE TO WALK IN WITH THE WALKER...

-DO YOU NEED YOUR WALKER? -I NEED A WALKER.

...BUT HAVE THE WHEELCHAIR READY.

THIS IS TAKING SO MUCH OUT OF ME.

I WISH DR. NOW WOULD JUST LISTEN TO ME AND SEE THE FACT

I CAN'T WALK YET ISN'T MY FAULT,

AND SO HAVING TO DO THIS IS ABUSIVE AND NOT RIGHT.

WHENEVER YOU'RE READY. ARE YOU THERE?

YEP.

OKAY.

OKAY.OKAY.

-ARE YOU OKAY? -JOYCE.

Joyce: WE HAVE TO DO THE WALKER AGAIN

I THINK BECAUSE I DON'T THINK THIS FITS THROUGH.

OKAY.

YOU'RE RUNNING ME OVER.

READY.

I'M RIGHT BEHIND YOU.

THANK GOD I MADE IT HERE, BUT I DON'T EVEN KNOW

IF I HAVE ANYTHING LEFT TO GET ON THE SCALE.

I'LL DO MY BEST.

I'M JUST COMPLETELY AND UTTERLY PHYSICALLY EXHAUSTED.

THAT CAN'T BE RIGHT.

THERE'S NO WAY THAT'S RIGHT BECAUSE I'M WORKING SO HARD.

I KNOW I LOST WEIGHT, A LOT OF WEIGHT!

SO THAT'S WRONG. IT HAS TO BE WRONG.

I JUST WISH DR. NOW WOULD BELIEVE ME.

I'M DOING EVERYTHING RIGHT,

SO THE PROGRAM AND THE DIET HAS TO BE WRONG

BECAUSE NONE OF THIS MAKES SENSE.

COME IN.

-HELLO. -HELLO, DR. NOW.

HOW ARE YOU ALL DOING?

I'M IN A LOT OF PAIN RIGHT NOW.

WELL, I KNOW IF STOP CONVINCING YOURSELF YOU CAN'T GET UP,

AND GIVING EXCUSES NOT TO DO ANY ACTIVITY,

YOU WOULD BE ABLE TO GET AROUND EASIER.

BUT THIS LEVEL OF ACTIVITY IS STILL LESS THAN

WHAT YOU SHOULD BE DOING EVERY DAY.

BUT THE BIGGER PROBLEM RIGHT NOW IS THAT IN THE PAST 6 WEEKS,

YOU'VE PUT BACK ON ALMOST 60 POUNDS.

DO YOU WANT TO TELL ME WHY THAT IS?

I'VE BEEN DOING EVERYTHING I'M SUPPOSED TO,

AND THEN ACTUALLY WITH THE EATING HABITS,

I'VE BEEN DOING REALLY, REALLY WELL,

SO I DON'T KNOW OTHER THAN THE FACT THAT I'M PUTTING ON

WATER WITH MY LYMPHEDEMA, LIKE, SITTING HERE HAVING IT HANG LOW

AND NOT HAVE MY LEGS UP MORE FREQUENTLY LIKE I USUALLY DO.

SO YOU'RE SAYING YOU GAINED 60 POUNDS OF WATER

ON THE CAR RIDE HERE BECAUSE YOU'RE SITTING UP?

THAT'S NOT REALITY.

HONESTLY, I REALLY...

I DON'T KNOW WHAT ELSE I CAN TELL YOU, BUT IT'S THE TRUTH.

YOU WANT TO BELIEVE WHATEVER YOU WANT,

BUT THAT'S NOT GOING TO CHANGE THE FACT

THAT YOU ARE KILLING YOURSELF,

AND YOU'RE NOT GOING TO LIVE MUCH LONGER LIKE THIS.

I'M SORRY. I CAN'T DO THIS,

AND I DON'T THINK I'M GOING TO BE ABLE

TO MAKE IT BACK IN THE TAXI LIKE I DID.

THE CAR RIDE IS TOO MUCH FOR ME,

AND I THINK I NEED TO GO TO THE HOSPITAL.

I MEAN, I JUST DON'T...

I DON'T HAVE THE ABILITY TO WALK.

LIKE, I'M VERY DIZZY, AND I THINK I'M HAVING A HEART ATTACK.

YOU DON'T LOOK LIKE YOU ARE.

NOW YOU DO.

YOU WANT TO GO IN THE HOSPITAL?

YES.

LIKE, MY HIPS ARE JUST SO SPREAD OUT RIGHT NOW,

AND ALL I KNOW IS SOMETHING WRONG WITH MY HEART

AND MY WEIGHT HAS BEEN ON MY KNEES,

SO ITS MAKING MY FEET AND MY LEGS FALL ASLEEP.

IT HURTS SO BAD, AND I NEED TO LAY DOWN BEFORE I PASS OUT.

IF YOU THINK YOU'RE DYING, WE GET YOU TO THE HOSPITAL

AND GET YOU CHECKED OUT.

-ALRIGHT. -OKAY. -OKAY.

THIS IS A VERY BAD SITUATION WE HAVE WITH JOYCE.

NOT ONLY IS SHE GAINING AGAIN

AND HEADING IN THE WRONG DIRECTION WITH HER HEALTH,

BUT SHE'S CONVINCING HERSELF SHE'S DOING THE DIET

AND EVERYTHING SHE NEEDS WHILE ALSO PLAYING GAMES

AND TRYING TO MANIPULATE THE SITUATION.

SO THIS IS A VERY SERIOUS PROBLEM,

AND IT'S ONLY GOING TO GET WORSE

IF WE CAN'T GET HER TO WAKE UP BEFORE IT'S TOO LATE.

BUT TO BE SAFE, IF SHE IS CLAIMING THERE IS AN ISSUE,

WE'LL GET HER TO THE HOSPITAL

AND RUN SOME TESTS TO SEE WHAT'S GOING ON,

BUT THERE IS NO REAL POSITIVE OUTCOME TO THIS SITUATION

BECAUSE EITHER SHE'S SUFFERING A MEDICAL EMERGENCY

WHERE HER BODY WILL START GIVING OUT,

AND THERE WILL BE LIKELY NOTHING WE CAN DO TO HELP HER,

OR WE WILL DETERMINE THERE IS NOTHING WRONG,

AND SHE'S MAKING ALL THIS UP TO GET OUT OF THIS SITUATION

AND GET A MEDICAL TRANSPORT HOME.

EITHER WAY, THE SITUATION IS BAD,

AND WE ARE IN A VERY DANGEROUS PLACE WITH JOYCE.

Dr. Nowzaradan: EARLIER TODAY, JOYCE CAME IN FOR AN APPOINTMENT AT THE CLINIC.

WE HAD A HARD TIME TO GET HER BACK IN THE OFFICE,

AND SHE STARTED COMPLAINING ABOUT A NUMBER OF ISSUES

CLAIMING THE ACTIVITY SHE HAD FROM THE TRIP THERE

PUSHED HER BODY TO THE LIMIT,

BUT WE FINISHED GIVING HER A CHECKUP

AND RUNNING SOME TESTS,

AND THERE ARE NO IMMEDIATE MEDICAL ISSUES WITH HER

THAT WE NEED TO ADDRESS.

SO SHE'S FINE, AND SHE LIKELY MADE THIS ALL UP

TO GET OUT OF AN UNCOMFORTABLE SITUATION

SHE DIDN'T WANT TO BE IN

AND TO GET THE MEDICAL TRANSPORT SHE WANTED.

NOW THIS IS EXTREMELY MANIPULATIVE BEHAVIOR

THAT I AM VERY CONCERNED ABOUT.

HI, JOYCE.HI, DR. NOW.

HOW ARE YOU FEELING?

I'M FEELING QUITE A BIT BETTER NOW THAT I'M LAYING DOWN.

WELL, AS YOU KNOW, ALL YOUR TESTS ARE LOOKING GOOD, OKAY?

ARE THEY?YEAH.

THANK YOU.

SO YOU'RE NOT HAVING A HEART ATTACK OR DYING.

OKAY, WELL, I'M VERY RELIEVED.

WELL, I THINK YOU ALREADY KNEW EVERYTHING WAS FINE,

BUT IT'S ONLY A MATTER OF TIME BEFORE YOUR BODY

ACTUALLY GIVES OUT AND DECIDED

THAT YOU THINK YOU'RE DOING OKAY.

BUT YOU'RE NOT ABLE TO WALK.

TWO MONTHS IS ENOUGH TIME TO MAKE

A 100-POUND WEIGHT LOSS, OKAY?

BUT YOU GAINED 60 POUNDS INSTEAD,

AND IT'S BECAUSE YOU'RE NOT STICKING TO THE DIET

AND YOU'RE LYING ABOUT IT.NO, I'M NOT.

I'M STICKING TO A 1,200-CALORIE DIET.

LIKE, I WATCH IT VERY CLOSELY, AND SO IF I NEED LESS CALORIES,

I'LL HAVE TO TAKE IN LESS CALORIES.

OKAY, JOYCE, I'M NOT PLAYING GAMES,

SO HERE IS WHAT WE'RE GOING TO DO.

I WANT YOU TO START GOING TO PSYCHOTHERAPY, OKAY?

SO WE'LL SET THAT UP WITH YOU, AND YOU NEED TO GO TO THAT.

I'VE ALREADY HAD THERAPY WHEN I WAS YOUNGER.

YOU NEED MORE.

OKAY, BUT I NEED MEDICAL TRANSPORT TO GO.

I CAN'T PUT MY BODY THROUGH THIS AGAIN.

IF YOU AGREE TO GO TO THERAPY,

I WILL GET YOU MEDICAL TRANSPORT TO DO IT, OKAY?

OKAY, THAT'S FAIR.

AND THEN I WANT YOU TO COME BACK TO SEE ME AT THE CLINIC

WITHOUT MEDICAL TRANSPORT IN 1 MONTH,

AND I WANT YOU TO LOSE 50 POUNDS IN THAT TIME.

OKAY.

SO I WANT YOU TO BE ABLE TO COME TO OFFICE AND WALK, OKAY?

OKAY.

AND BE ABLE TO STAND ON A SCALE WITHOUT ANY HELP.

YOU GOT IT?YES, I GOT IT.

ALRIGHT.

WE'RE GOING TO GET YOU GOING HOME,

AND IF YOU NEED ANYTHING OTHER

THAN MEDICAL TRANSPORT, GIVE ME A CALL.

OKAY, THANK YOU, DR. NOW.

ALRIGHT.

AND THIS TIME, I WANT TO SEE REAL CHANGES, OKAY?

OKAY.NOT FIGURE OF SPEECH.

OKAY.OKAY?

ALRIGHT.I'LL SEE YOU LATER.

OKAY, BYE.

Dr. Nowzaradan: HOPEFULLY, PSYCHOTHERAPY WILL BE ABLE TO GET THROUGH TO JOYCE

TO WHERE SHE STARTS DOING WHAT SHE NEEDS,

BECAUSE SHE CAN'T GO ON MUCH LONGER LIKE THIS,

AND RIGHT NOW THINGS DON'T LOOK GOOD FOR HER.

Joyce: I FEEL LIKE DR. NOW HAS BEEN A LITTLE TOO HARSH,

BUT I'M JUST REALLY RELIEVED TO BE OKAY,

AND THAT THERE'S NOTHING REALLY BAD HAPPENING WITH MY BODY.

BUT I'M COMPLETELY DRAINED FROM ALL THIS,

AND I SHOULDN'T HAVE PUT MY BODY THROUGH IT

OR HAD TO ENDURE THIS.

IT WAS TOO DANGEROUS, SO I CAN'T DO IT AGAIN.

IT'S TOO RISKY.

BUT RIGHT NOW I JUST WANT TO GET HOME AND RECOVER FROM THIS

AND THEN KEEP TRYING TO DO WHAT I NEED,

EVEN THOUGH DR. NOW DOESN'T BELIEVE ME

WHEN I TELL HIM HOW HARD I'M WORKING.

BUT RIGHT NOW I JUST NEED TO REST AND RECOVER FROM ALL THIS

BECAUSE IT WAS TOO MUCH FOR ME.

TODAY, I'M HEADED TO THERAPY.

I WAS HOPING THE THERAPIST COULD COME TO ME,

BUT DR. NOW SAID I HAVE TO GO THERE,

BUT AT LEAST HE AGREED TO GIVE ME MEDICAL TRANSPORT,

SO I CAN WITHOUT KILLING MYSELF.

BUT I'M ONLY GOING BECAUSE DR. NOW MADE IT A REQUIREMENT

BECAUSE I'VE ALREADY HAD THERAPY IN THE PAST,

AND I'VE TALKED ABOUT EVERYTHING I NEED AND LET IT ALL GO.

I HAVE NO BIG PAIN OR PROBLEMS

WHEN IT COMES TO THAT STUFF OR MY PAST,

SO I KNOW I DON'T HAVE ANY ISSUES

THAT ARE DRIVING ME TO EAT OR ANYTHING LIKE THAT.

SO THIS IS A BIT OF A WASTE OF TIME, BUT DR. NOW

HAS MADE IT A REQUIREMENT OF HIS PROGRAM, SO I'M DOING IT.

JOYCE. HI.

HI, LOLA.

NICE TO MEET YOU.NICE TO MEET YOU.

IT'S A PLEASURE.

OKAY.

I'M SO GLAD YOU COULD JOIN ME TODAY.

ME TOO. OKAY.

SO NOW TELL ME A LITTLE BIT ABOUT YOURSELF.

WHERE DID YOU GROW UP?

MOST OF MY LIFE I GREW UP IN KANSAS CITY, MISSOURI.

OKAY.

I'VE BEEN RAISED BY JUST MY MOM.

TELL ME ABOUT YOUR RELATIONSHIP WITH YOUR MOTHER.

SHE WAS YELLED AT A LOT, SO SHE'LL YELL AT ME.

SHE WOULD, YOU KNOW, SAY HATEFUL THINGS.

OKAY.

AND A LOT OF IT'S ATTACHED WITH ANGER.

AND HOW DO YOU MEET THAT ANGER?

WHAT DO YOU MEET IT WITH?

I HAVE TO BUILD ABOVE HER...

OKAY....TO GET HER TO STOP

WOW, AND SO YOU MEET THAT ANGER...

I EXCEED IT......WITH AMPLIFIED RAGE.

BECAUSE YOU CAN'T GET IT TO STOP

WITHOUT DOING THAT.

WELL, LET ME SAY THIS, JOYCE,

REGARDING YOUR RELATIONSHIP WITH YOUR MOM.

IF SHE OR ANYONE ELSE SHOULD BECOME NEGATIVE

AND COUNTERPRODUCTIVE TO YOUR JOURNEY,

THEN YOU WOULD HAVE TO REEVALUATE THEIR ROLE

IN YOUR LIFE.

NOW, JOYCE, IN YOUR LIFETIME HAVE YOU EVER BEEN

SEXUALLY ASSAULTED OR MOLESTED?

I HAVE.

I'M SO SORRY THAT HAPPENED TO YOU.

AND AT ONE POINT, IF EVER, DID YOU DISCLOSE TO ANYONE?

I DIDN'T FOR YEARS BECAUSE I DIDN'T REMEMBER IT ALL,

AND THEN I STARTED GETTING REALLY INTENSE DREAMS

OF STUFF THAT HAPPENED.

AND SO AS THOSE COGNITIONS STARTED TO BECOME MORE CONSCIOUS

FOR YOU, WHAT WAS YOUR FIRST THOUGHT?

I DIDN'T WANT TO UPSET MY MOM, AND THEN WHEN I GOT TO AN AGE

WHERE I FELT COMFORTABLE, I TOLD HER.

WHAT WAS THAT LIKE FOR YOU DISCLOSING TO YOUR MOM?

IT WAS IN ONE OF OUR MAJOR, MAJOR EXPLOSIVE ARGUMENTS,

AND IT DIDN'T HAPPEN WELL.

SO IS THERE PART OF YOU THAT FEELS SHE ALLOWED IT TO HAPPEN?

NO, SHE ALLOWED ME TO BE IGNORED.

THAT'S WHAT I FEEL.

OKAY.

THAT'S WHAT I...I DON'T...

WHAT HAPPENED WITH HIM WAS NOT HER FAULT AT ALL.

RIGHT.

I DON'T BLAME HER, BUT I DO BLAME HER FOR IGNORING ME.

OKAY.

AND SO WITH THAT BEING SAID,

WHAT I WOULD REALLY LIKE TO SEE HAPPEN

IS THAT I'D LIKE TO HAVE YOURSELF AND YOUR MOM

COME BACK AND SEE ME FOR A FAMILY SESSION.

OKAY.

SO THAT WE CAN JUST TALK ABOUT WAYS TO SUPPORT ONE ANOTHER

ANDWAYS TO CONTINUE HEALING THIS RELATIONSHIP.

DOES THAT SOUND LIKE SOMETHING YOU'D BE INTERESTED IN DOING?

YEAH, I CAN DO THAT.OKAY.

SO THAT'S YOUR ONLY HOMEWORK FOR NOW

IS TO PERSUADE MOM TO COME ON IN FOR A FAMILY SESSION.

SOUNDS GOOD.

I APPRECIATE YOUR TALKING WITH ME TODAY, JOYCE.

THANK YOU FOR TALKING WITH ME.

OKAY. NO PROBLEM.

AND I LOOK FORWARD TO SEEING YOU AND MOM BACK HERE, OKAY?

OKAY. ALRIGHT.

I'LL LET DAWN KNOW YOU'RE DONE.

Joyce: THAT DIDN'T GO LIKE I THOUGHT IT WOULD

BECAUSE I THINK IT ACTUALLY DID HELP SOME.

I WASN'T EXPECT THAT, BUT I GUESS THERE ARE

SOME ISSUES I NEED TO WORK ON, ESPECIALLY WITH MY MOM.

HEY.HI.

YOU OKAY? MM-HMM.

OKAY?

I LOVE MY MOM, BUT SHE'S DONE THINGS THAT HAVE REALLY HURT ME,

SO NO MATTER HOW SCARY OR HARD IT IS,

I HAVE TO TALK TO MY MOM ABOUT THAT.

AND HOPEFULLY SHE'S WILLING TO COME HERE AND DO THIS WITH ME

BECAUSE IF SHE DOESN'T, I SEE NOW THAT I WON'T

BE ABLE TO MAKE ALL THE CHANGES I NEED IN MY LIFE.

Joyce: IT'S BEEN A MONTH SINCE MY LAST DR. NOW VISIT

AND STARTING THERAPY,

AND SINCE THEN I'VE BEEN FOCUSING ON DOING BETTER

AND WORKING REALLY HARD TO MAKE PROGRESS,

BUT IT HASN'T BEEN EASY FOR ME.

I THINK I'M GOING TO MAKE SOME EGG WHITES

WITH THE PEPPERS AND ONIONS AND A LITTLE BIT OF SAUSAGE.

OKAY, I'LL GO GET THE STUFF.

AFTER MY THERAPY APPOINTMENT WITH LOLA, I REALIZED

THAT I'M NOT GOING TO BE ABLE TO TRULY TURN MY LIFE AROUND

UNTIL I DEAL WITH THINGS WITH MY MOM,

BUT SO FAR, I'VE BEEN TOO SCARED TO ASK MY MOM

TO GO TO THERAPY WITH ME.

OKAY.

I'LL BRING YOU THE PEPPERS AND STUFF

SO YOU CAN START CUTTING THEM.

OKAY.

LAST TIME I TALKED TO HER, SHE SAID SHE WAS THINKING ABOUT

COMING DOWN AND VISITING ME AGAIN IN A FEW WEEKS,

AND IF SHE DOES, I THINK IT WOULD BE EASIER TO ASK HER THEN

BECAUSE SHE'LL ALREADY BE HERE.

I DON'T WANT TO WAIT THAT LONG,

BUT I DON'T REALLY HAVE ANOTHER CHOICE,

AND UNTIL MY MOM COMES DOWN,

I'M DOING AS MUCH AS I CAN TO LOSE MORE WEIGHT

AND TO WALK MORE.

DR. NOW STILL HAS PT COMING THREE TIMES A WEEK,

AND I'M WORKING HARD WITH THE EXERCISES THEY GIVE ME,

SO I'M EXCITED ABOUT THAT.

AND ME AND DAWN ARE ONLY EATING HEALTHY STILL.

I FEEL LIKE I'M DOING REALLY GOOD

EVEN THOUGH I STILL MAY NOT BE ABLE TO WALK AS MUCH

AS DR. NOW WANTS ME TO.

I'M SUPPOSED TO SEE HIM AGAIN

FOR ANOTHER APPOINTMENT NEXT WEEK,

BUT HE'S NOT SENDING ANY MEDICAL TRANSPORT,

SO I'M NOT SURE I'M GOING TO BE ABLE TO DO THAT

IF DR. NOW WON'T HELP ME GET THERE AGAIN.

SO DESPITE NOT BEING ABLE TO DEAL

WITH MY ISSUES WITH MY MOM, I'M TRYING TO GET TO THE POINT

WHERE IT WON'T BE TOO MUCH FOR ME.

I'M JUST NOT SURE

IF I'LL BE ABLE TO GET TO THAT POINT BY NEXT WEEK.

ME AND MY MOM ARE HERE TO HAVE A THERAPY SESSION TOGETHER.

SHE CAME INTO TOWN A COUPLE DAYS AGO,

AND I ASKED HER IF SHE'D DO THIS WITH ME.

AND SHE SAID SHE'D DO WHATEVER I NEED TO HELP ME GET HEALTHY,

AND I'M REALLY THANKFUL FOR THAT BECAUSE IT'S IMPORTANT

I DO THIS TODAY.

I'M ABLE TO FINALLY TALK TO MY MOM ABOUT THE PAIN

SHE CAUSED ME GROWING UP AND HOW SHE HURT ME

BECAUSE WHAT HAPPENED WITH MY STEPBROTHER WAS HER FAULT

SINCE SHE PUT ME IN THAT SITUATION,

AND I NEED HER TO UNDERSTAND THAT

SO I CAN GET PAST THAT PAIN AND BETRAYAL.

SO I REALLY HOPE I'M ABLE TO DO THAT TODAY

AND THAT THIS GOES WELL.

HI, LADIES.

HI.

JOYCE, IT'S SO GOOD TO SEE YOU AGAIN.

NICE TO SEE YOU AGAIN.

AND YOU MUST BE MAMA JOYCE.

YES, I AM. NICE TO MEET YOU.

PLEASURE TO MEET YOU.

OKAY.

SO JOYCE, YOU HAD A CHANCE TO MEET WITH ME INDIVIDUALLY,

AND SO WHAT ARE SOME OF THE THINGS THAT YOU FEEL LIKE

IT'S IMPORTANT FOR YOURSELF AND MAMA JOYCE TO ADDRESS?

I THINK MY BIGGEST THING IS IN OUR RELATIONSHIP,

I DON'T WANT US TO BE HATEFUL OR NOT AS KIND TO EACH OTHER

AND NOT AS UNDERSTANDING.

OKAY, MAMA JOYCE, WHAT ARE YOUR THOUGHTS ABOUT THAT?

I THINK THAT OUR RELATIONSHIP HAS BEEN VERY VOLATILE.

I THINK THAT WE'VE BEEN HATEFUL TO EACH OTHER.

WHAT'S BEEN AT THE ROOT OF THAT VOLATILITY?

WELL, I WAS RAISED IN A VERY VIOLENT FAMILY.

VIOLENT? YEAH.

AND, LIKE, AND SO I THINK I JUST STRUGGLED WITH A LOT OF ANGER

AND A LOT OF RAGE AND THINGS LIKE THAT.

BECAUSE IT'S HOW YOU WERE SOCIALIZED.

YEAH, THAT'S HOW I WAS SOCIALIZED,

AND SO I THINK EVEN THOUGH I'VE WORKED REALLY HARD ON MYSELF

AND I'M CALMER THAN I'VE EVER BEEN,

SHE'S, LIKE, REALLY MUCH MORE CALMER THAN I AM AS PERSON.

I'M NOT. THAT'S NOT MY PERSONALITY.

WELL, THE THING THAT HAPPENS WHEN A PERSON

GROWS UP IN DOMESTIC VIOLENCE

IS THAT THERE'S A HIGH LEVEL OF EMOTION

EXPRESSED WITHIN THE FAMILY, AND SO THAT BECOMES YOUR NORM.

YEAH, YEAH.

BUT I WANT TO MAKE CERTAIN THAT ANY OUTBURSTS OF ANGER

OR RESENTMENT CAN BE CURBED SO THAT YOU TWO DON'T GO AROUND

INJURING ONE ANOTHER ANYMORE.

YEAH.AND SO OPT OUT OF THAT.

TAKE THAT OUT OF THE WAY YOU TWO COMMUNICATE WITH EACH OTHER.

SO JOYCE, I KNOW THAT YOU'VE SHARED FEELING VERY ALONE

AND ISOLATED AS A CHILD

AND FEELING AS IF YOUR MOTHER WAS NOT ATTENTIVE TO YOU.

IS THERE ANYTHING THAT YOU WANT TO SAY TO MOM?

I THINK I'VE SAID IT TO HER BEFORE.

I DON'T HOLD IT AGAINST HER, AND I FEEL IT'S A FRESH SLATE.

IS IT HARD FOR YOU TO SIT IN YOUR MOTHER'S PRESENCE

AND POINT OUT THAT YOU FELT ALONE?

YEAH.

JUST, I KNOW THAT I'M IN A POSITION IN MY LIFE

WHERE I'M NEEDING HER HELP SO MUCH.

I'M NOT SAYING MUCH AT ALL OTHER THAN THANK YOU

BECAUSE WITHOUT HER RIGHT NOW THIS WOULDN'T EVEN BE POSSIBLE.

OKAY.

GUYS, THANK YOU SO MUCH FOR BEING HERE TODAY.

THANK YOU.THANK YOU.

YOU'RE WELCOME.

IT'S A PLEASURE TO MEET YOU.IT'S A PLEASURE TO MEET YOU.

NICE SEEING YOU AGAIN.NICE SEEING YOU, TOO.

Y'ALL HAVE A GREAT REST OF YOUR DAY.

YOU TOO. YOU TOO.

BYE LADIES.BYE.

I APPRECIATE MY MOM DOING THIS WITH ME.

IT MEANS A LOT, BUT I'M NOT SURE HOW MUCH IT'S HELPED

BECAUSE I LOST MY NERVE WHEN I WAS GETTING READY TO TALK

ABOUT THE STUFF THAT'S REALLY HURT ME ABOUT MY STEPBROTHER

AND, LIKE, HOW HURT AND BETRAYED SHE'S MADE ME FEEL.

I JUST COULDN'T DO IT, AND I DON'T KNOW WHY.

BECAUSE I'M SCARED I DIDN'T DEAL WITH THINGS

HOW I NEEDED TO GET PAST IT ENOUGH LIKE I SHOULD HAVE

BECAUSE I HAVE TO START MAKING BETTER PROGRESS.

I WAS HOPING DOING THIS TODAY

AND DEALING WITH THINGS WITH MY MOM

WOULD HELP GIVE ME WHAT I NEEDED TO BREAK PAST THE LIMIT

I'VE HAD ON MY PROGRESS.

BUT SINCE IT DIDN'T GO LIKE I NEEDED IT,

I DON'T KNOW WHAT'S GOING TO HAPPEN NOW,

AND I'M REALLY SCARED.

YOU'RE GOOD. I GOT YOU.

OKAY, WE'RE IN THE BACK, BACK UP, OKAY?

OKAY.

Joyce: IT'S BEEN 3 MONTHS SINCE MY LAST APPOINTMENT WITH DR. NOW,

AND I HAVE TO GO BACK AND SEE HIM BECAUSE HE GAVE ME

A 3-MONTH DEADLINE TO COME BACK, AND I'VE REACHED IT.

SO I CALLED DR. NOW AND PRETTY MUCH BEGGED HIM

FOR MEDICAL TRANSPORT.

AWAY WE GO.

AND THANKFULLY HE AGREED.

AFTER THE LAST THERAPY APPOINTMENT I DID WITH MY MOM,

I WAS A LITTLE DISAPPOINTED

BECAUSE I CHICKENED OUT ABOUT THE PAIN SHE CAUSED ME,

AND I'VE TRIED TO WORK UP THE COURAGE

TO FIND A WAY AND TIME TO TALK TO HER ABOUT IT,

BUT I JUST HAVEN'T BEEN ABLE TO.

IT'S BEEN TOO HARD,

BUT I DECIDED TO NOT LET THAT AFFECT ME AS MUCH AS POSSIBLE.

DR. NOW TOLD ME THAT MY LAST OFFICIAL WEIGH-IN WAS 611,

BUT I STILL THERE WAS A MALFUNCTION WITH THE SCALE

AND THAT I ACTUALLY WEIGH A LOT LESS.

AND SO I'M REALLY HOPING TO SEE A BIG PAYOFF

WITH A LOT OF WEIGHT LOSS TODAY.

JOYCE.

I'M HOPING I MIGHT ACTUALLY EVEN HIT THE 150-POUND GOAL

DR. NOW GAVE ME.

THERE'S JUST NO WAY.

IT JUST DOESN'T MAKE SENSE,

BUT I KNOW NOW THE SCALE IS DEFINITELY MESSED UP.

SO I'M REALLY UPSET BECAUSE ONCE AGAIN I'M FIGURING DR.

NOW ISN'T GOING TO BELIEVE ME

WHEN I TELL HIM THAT THE SCALE HAS TO BE WRONG.

HELLO.HI, DR. NOW.

HOW ARE YOU ALL DOING?

-GOOD. -HI, HOW ARE YOU?

I'M DOING FINE. THANK YOU.

ALRIGHT, JOYCE.

SO WE GOT THE MEDICAL TRANSPORT HERE

BECAUSE YOU'RE STILL NOT WALKING LIKE YOU NEED

AND MAKING PROGRESS WITH YOUR ACTIVITY.

AND ON TOP OF THAT IN THE LAST 3 MONTHS

YOU GAINED ANOTHER 12 POUNDS INSTEAD OF LOSING ANY WEIGHT,

MUCH LESS THE 150 POUNDS YOU SHOULD HAVE.

SO THINGS DON'T LOOK GOOD AT ALL.

AND I'M NOT INTERESTED IN ANY MORE EXCUSES OR GAMES FROM YOU.

SO IF YOU WANT TO MOVE AHEAD,

I'M GIVING YOU THE SAME ULTIMATUM AS THE LAST TIME.

FOR EVERY MONTH THAT PASSES FROM HERE,

YOU NEED TO LOSE 50 POUNDS.

BUT IF YOU DON'T COME BACK IN 3 MONTHS, YOU'RE DONE.

BUT THIS TIME, NO MEDICAL TRANSPORT WILL COME TO GET YOU,

SO YOU NEED TO BE WALKING ON YOUR OWN, TOO.

SO WE WILL KEEP SENDING PT TO YOU

AND PROVIDE PSYCHOTHERAPY,

BUT OTHER THAN THAT, IF YOU DON'T START LOSING

AND HIT THESE GOALS,

THEN AT THIS POINT YOU'RE ON YOUR OWN

BECAUSE WE'VE GIVEN YOU EVERY TOOL

AND EVERY OPPORTUNITY,

AND THERE'S NOT MUCH MORE I CAN DO FOR YOU.

AFTER A YEAR OF TRYING, YOU HAVEN'T LOST ANYTHING,

SO AT THIS POINT IT'S CLEAR YOU DON'T REALLY WANT TO DO THIS.

YOU...I JUST DON'T THINK YOU UNDERSTAND

HOW HARD THIS HAS BEEN FOR ME

AND THAT I'VE BEEN WORKING REALLY, REALLY HARD AT IT

AND I PUT EFFORT IN EVERY SINGLE DAY.

I JUST...I DON'T KNOW WHAT ELSE TO SAY.

I REALLY... I'M AT A LOSS FOR WORDS

BECAUSE I NEVER THOUGHT THAT THIS WOULD HAPPEN.

WELL, THIS IS ALL A RESULT OF YOUR CHOICES,

SO NOTHING IS GOING TO GET BETTER FOR YOU

UNLESS YOU MAKE THE CHOICES YOU NEED.

AND THE BOTTOM LINE IS YOU DON'T WANT TO.

AND UNLESS THAT CHANGES, WE CAN'T HELP YOU.

IF YOU HAVE A MEDICAL EMERGENCY, WE'LL TREAT YOU,

BUT I HOPE YOU WAKE UP BEFORE THAT HAPPENS

BECAUSE WE MAY NOT BE ABLE TO DO ANYTHING TO HELP YOU

TO SAVE YOUR LIFE AT THAT POINT.

SO I WISH YOU GOOD LUCK.

OKAY.OKAY.

BYE.BYE.

CAN I HAVE THIS WALKER?

I DON'T EVEN WANT TO LIVE HERE ANYMORE.

I JUST WANT TO GO HOME.

IT'S VERY UNFORTUNATE THAT JOYCE HAS WASTED SO MUCH TIME,

BUT AT THIS POINT, WE HAVE GIVEN HER EVERY TOOL

AND CHANCE WE CAN.

HOPEFULLY THIS ULTIMATUM WAKES HER UP,

BUT WITH WHAT JOYCE HAS SHOWN ME SO FAR,

I DON'T THINK IT'S LIKELY

I'M GOING TO SEE MUCH MORE OF HER

UNLESS IT'S FOR A MEDICAL EMERGENCY.

Joyce: I DON'T THINK DR. NOW IS BEING FAIR

OR REASONABLE AT ALL.

SO I'M REALLY UPSET, AND I'M NOT SURE

I EVEN WANT TO DO THIS ANYMORE.

YOU KNOW, I'VE GIVEN 100 PERCENT OF ME

TO THIS PROGRAM SINCE THE BEGINNING.

SO I'M NOT FAILING THE PROGRAM.

THE PROGRAM IS FAILING ME.

HOW IS THAT MY FAULT?

I KNOW I'VE MADE PROGRESS AND I'M DOING BETTER

BECAUSE I CAN FEEL IT, AND MY MOM SEES IT,

AND DAWN SEES IT TOO.

SO IF EVERYTHING I'VE DONE IS STILL NOT GOOD ENOUGH FOR DR.

NOW,

HOW DO I GO BACK AND FIND A WAY TO GET EVEN MORE NOW?

IT'S BEEN 3 MONTHS SINCE MY LAST APPOINTMENT WITH DR. NOW.

I WAS PRETTY UPSET AFTER IT,

BUT WHEN I CAME HOME, ME, MY MOM, AND DAWN

ALL TALKED ABOUT WHAT I SHOULD DO,

AND WE ALL AGREE THAT THE SITUATION THAT DR. NOW

PUT ME IN WHERE I HAD LESS THAN 3 MONTHS

TO MAKE THE PROGRESS HE WANTS WASN'T FAIR.

BUT THEY BOTH ENCOURAGED ME TO STILL NOT GIVE UP

AND TO KEEP TRYING,

SO THAT'S WHAT I'VE BEEN DOING, AND I CAN REALLY FEEL HOW GOOD

I'M DOING JUST IN THE LAST FEW MONTHS.

SO I THOUGHT MAYBE I'D PRACTICE GOING OVER THAT THRESHOLD

AND JUST KIND OF SIT OUTSIDE IN THE WHEELCHAIR FOR A LITTLE BIT.

DO YOU THINK THAT'S A GOOD IDEA?

Woman: YEAH.

OKAY, SO WE KIND OF HAVE TO CLEAR A PATHWAY.

THAT BETTER?YEAH.

OKAY.

BUT I'M STILL NOT ABLE TO WALK AS MUCH AS DR. NOW WANTS

OR GET IN A TAXI OR A REGULAR VEHICLE,

AND HE STILL WON'T SEND ME A MEDICAL TRANSPORT.

AND THE 3-MONTH DEADLINE HE GAVE ME TO COME BACK

WITH THE PROGRESS HE WANTED WAS TODAY.

DOES THAT DOOR OPEN UP ANY WIDER?

NO, THAT'S AS FAR AS IT GOES.

AND I'M WILLING TO GO BACK AND DO THAT,

BUT I CAN'T IF DR. NOW

ISN'T GOING TO HELP ME GET THERE.

BUT I'M NOT GIVING UP ON MYSELF.

I PLAN TO KEEP WORKING AS HARD AS I CAN

AND TO CONTINUE PUSHING MYSELF,

AND MY MOM HAS BEEN COMING DOWN EVERY MONTH

TO HELP ME AND ENCOURAGE ME.

THERE YOU GO.

Joyce #2: GOOD JOB.

VERY GOOD.

I STILL HAVEN'T WORKED UP THE COURAGE

TO TALK TO HER ABOUT THINGS,

BUT IT'S NOT AS HIGH OF A PRIORITY FOR ME

BECAUSE I'VE RESEARCHED IT,

AND I THINK GETTING MY ACTIVITY UP

IS GOING TO BE THE KEY TO MAKING MORE PROGRESS.

I'M SO EXCITED. THIS IS THE FIRST TIME YOU'VE BEEN OUT.

GIVE ME FIVE. YES, YES, YEAH.

GOOD DEAL.

WELL, YOU HAVEN'T BEEN ABLE TO DO THIS IN YEARS

TO GET OUTSIDE.

AT YOUR OTHER PLACE IN KANSAS,

YOU COULDN'T GET ON THE DECK AND SIT OUT THERE.

YOU COULD NEVER GET OUT THERE, SO THIS IS A BIG ACHIEVEMENT.

I'M SO PROUD OF YOU.

I CAME DOWN TO HOUSTON AND TOOK THIS LEAP OF FAITH

TO SAVE MY LIFE,

AND I'VE HAD TO GIVE UP EVERYTHING I'VE KNOWN,

AND IT COST ME MY LIFE IN KANSAS,

SO I'M NOT STOPPING UNTIL I ACCOMPLISH

WHAT I CAME HERE TO DO.

GOT IT. OKAY, I'M GOING TO GRAB YOUR WHEELCHAIR.

WHAT YOU THINK ABOUT THAT, GUYS?

GOOD.

ANOTHER THING YOU ACCOMPLISHED.

Joyce: I STILL HAVE JUST AS MUCH FAITH AS I DID

WHEN I FIRST STARTED THIS,

THAT AS LONG AS I KEEP DOING WHAT I AM AND STAY ON TRACK

THAT I'LL GET THE LIFE I WANT, AND I'M LOOKING FORWARD TO THAT.