AC Shilton

Wheeler lives in Fentress County, Tennessee, an area that like many rural communities has struggled to find economic stability as manufacturing jobs have moved overseas. When a CrossFit box called New Horizon Athletics opened there last summer, she joined it. Flash forward to March 25, 2020, and Wheeler was feeling much better about herself. By eating right and doing modified versions of CrossFits classically high intensity workouts, shed dropped 52 pounds.

That day, as the coronavirus was spreading around the country, forcing businesses and restaurants to close, she noticed a semi-truck parked up the street from the medical office where she worked.

CrossFitter Dannette Wheeler with her dogs Blue (foreground) and May (behind her).

The truckers explained their plight. They had 44,000 pounds of lettuce bound for restaurants throughout Middle Tennessee, but none of those places were open to receive fresh food anymore. The truckers needed somewhere to unload it.

Almost a quarter of the 18,000 people in Fentress County live below the poverty line, and public schools offer their free lunch program to all the kids in the district. Wheeler knew those schools were closed, and many of her friends and neighbors had been laid off. Families who were previously teetering on the edge of food insecurity could easily tip into hunger.

So she opened up her phone, and asked a friend to shoot a quick video. It took a few takes because she was so nervous. In the final product, however, she stands confidently in the back of the trailer, giant crates of lettuce all around her. Her message is clear and simple: Come get what you can use. Bring a bag and tell a friend. Stay Healthy Fentress County," she says at the end of the message.

Wheeler posted that video to a same-named Facebook Groups pageStay Healthy Fentress Countythat had gone live just two days earlier. The effort was started by her CrossFit coaches, Adam and Amanda Wood, who wanted to create a hub for the community to share more health information, lend support to each other, and stay connected as calls for self-isolation spread. No one knew if the idea would work. This was a totally different kind of exercise in wellness.

As the Covid-19 outbreak hit the country in early March, independently owned gyms came face-to-face with two grim realities: First, some members might cancel their memberships if they couldn't use their facilities. Second, even those who wanted to support small businesses might bail if they lost their jobs. Recessions are not generally kind to the fitness industry. During the Great Recession, <a href="https://www.crainsnewyork.com/article/20090506/FREE/905069988/fitness-chain-crunched-by-recession%22%20%5Ct%20%22_blank" id="24ae03cf-2593-3efd-aea1-781e1d529d08"> Bally and Crunch </a> both declared bankruptcyand those were the big guys.

But at New Horizon Athletics in Fentress County, Adam and Amanda Wood didnt panic. Adam grew up in the area and had recently returned because he felt God calling him to help improve health in the county seat of Jamestown. In 2019, The Atlantics CityLab reported that while rural America has 21 percent of the countrys population, it has just 12 percent of all the gyms. Part of that is because rural places are often poor, making disposable income for memberships scare. CityLabs analysis also found that the average household income for neighborhoods with gyms and fitness studios is nearly $73,000, more than double the average in Fentress County.

The Woods always saw their gym as a way to help some people. Now they wanted to create a free model that could help everyone. They both felt that, perhaps for the second time in their lives, God was revealing his plan for them.

The Woods are in their mid-30s. They met half a decade ago while working in the service industry in Gainesville, Florida. Amanda was a Florida native, and Adam a transplant. After a stop in the mountain town of Brevard, North Carolina, and contemplating a few different career paths, they opted for the not-exactly reliable option of opening a gym in a place that seemed to need the most. I felt like God was calling me home, Adam says.

Over the course of their first year, classes began to fill even though a membership costs more than $100 a month. Members like Wheeler joined before the gym even opened. She signed up in June of 2019 as a founding member about a month before classes started.

Pre-COVID-19, New Horizon Athletics CrossFit Coach Adam Wood leads members in a post-workout cheer and pledge to be the light we wish to see in the community.

For the Woods, the biggest problem was balancing the costs of running their operation with the knowledge that some people still couldnt afford to use it. "We know this is a privileged service," says Amanda. "But our heart from the beginning was to make a difference in this community." As the novel coronavirus spread, the Woods decided to voluntarily close their gym. They kept thinking about how to make change on a bigger scale.

On March 21, 2020just a few days before the lettuce truck unexpectedly arrivedthe Woods notified members that the New Horizon Athletics would be closing indefinitely. But they also announced two new Facebook pages. The first was a members-only page, where gym regulars could post PRs and Adam and Amanda could demonstrate moves in their virtual programming. The other, though, was Stay Healthy Fentress County, a page devoted to reaching out to everyone in the community who wasnt a CrossFit member. The Woods asked their membership to spread the open-to-all page to anyone they thought might be interested in using their time in lockdown to get fit.

New Horizon Athletics coaches Amanda Wood (first row, second from right) and Adam Wood (Back row, far right) gather with box members after completing a 5K before social-distancing took effect.

In fact, the greater health of the community was one of the reasons the Woods chose to close their gym more than a week before the Tennessee Governor, Bill Lee, issued his order closing non-essential businesses, particularly given that people who might transmit the virus could carry it asymptomatically to others who are vulnerable. In Fentress County, <a href="https://www.countyhealthrankings.org/app/tennessee/2020/rankings/fentress/county/outcomes/overall/snapshot%22%20%5Ct%20%22_blank" id="7ecc777d-fcba-3738-a872-ed53bb2cc827"> 27 percent of the adult population is obese </a> , and 17 percent has diabetes. A quarter of all adults smoke. Diabetes, high blood pressure, and smoking are all identified <a href="https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/people-at-higher-risk.html%22%20%5Ct%20%22_blank" id="6eed1787-c99f-333a-ad98-924e0d8cdc47"> as comorbidities that enhance the risk of complications </a> from Covid-19.

Stay Healthy Fentress County was designed to tackle those underlying issues. The key components are recipe sharing (like the couples eggroll in a bowl, a mix of ground turkey and cooked cabbage) and practical equipment-free workouts for non-gym disciples. One day theyll lead county residents through sets of wall sits and running intervals, and the next theyll encourage people to try hand-release push-ups mixed with sit-ups. Their short videos always offer a range of modifications so its clear: You dont have to be super-fit to do this, you just have to be willing to try.

The Woods figured their own members would share and contribute, and word of mouth might get more people to join or share some of the content on the page. If you've ever heard your friend talk about his triathlonor even a couch-to-5Kand thought if he can do that, I can do that, then you've felt this effect first-hand.

To that end, Wheelers first inclination when she spotted the lettuce truck was to call Adam and Amanda and have them post something. Instead, the duo had a better idea. "I told her she should make a video and post it to the group," Adam says.

Wheeler's first reaction was no way. The idea of putting herself out there was a non-starter. But then she realized this was the old Dannette talking; the version of herself who hid her body. She thought about how, at the end of every WOD, New Horizon Athletics members huddle up and promise to "be the light we wish to see in our communities."

"I filmed it three times," she says about the video. But within a few hours the post had 50 shares. The lettuce was gone within hours, too, but the site has kept growing. There are now 450 members, roughly a quarter of the population of Jamestown.

On May 4, the Woods reopened New Horizon Athletics but with strict social-distancing rules in place. Theyre not taking on new members because class sizes will have to shrink to accommodate more distance between participants. In a way, that boosts the demand for their free services more than ever, and they plan to continue posting short workout videos and recipes daily.

Occasionally they mix in reminders about mental healththat its okay to occasionally have a treat or skip your workout, especially at times like these. Community members are quick to chime in too. Recent posts show Strava files from walks around the neighborhood and videos of kids doing jumping jacks with their grandparents.

What makes the site special is that these are regular people trying to do just a little bit betternot Instagram stars who look suspiciously like they've never even seen a plate of biscuits and gravy. The names "liking" these small efforts are friends. That feels especially useful in a time when some of us are still unable to see the ones we love in person. Best of all, because it's run by two certified CrossFit coaches, so theres no questionable fad diets or fitness misinformation.

Wheeler is happy to have played a small part in this community effort. In fact, an old friend chimed in on her post with some simple but powerful words: You look great. Re-watching the video, Wheeler was glad she did it. Supporting others felt great too.

Members of New Horizon Athletics, a CrossFit box in rural Fentress County, Tennessee.

For years, Dannette Wheeler felt uncomfortable in her own skin. I was embarrassed of how much weight Id gained, says the 48-year-old nurse, who is 57 and at one point weighed just over 250 pounds. Once a social person, Wheeler started to stay in, avoiding friends who she feared might judge her.

Amidst COVID-19, a CrossFit Gym Fights for the Soul of a Tennessee County

Heres the deal: I am wound tighter than a tourniquet. While my innate anxiety makes me great at investigative reportingI check and recheck and then wake up in the middle of the night to triple check facts, its probably a less-desirable trait in a partner. I foster no illusions of being a total picnic to live with.

My husband, on the other hand, could maybe benefit from a touch more anxietyespecially when it comes to microbes. His food-safety practices are so lax, I wont even hang out in the kitchen if hes cooking. Id rather not know he just put the dish towel he used to mop up raw chicken juice BACK on the towel rack.

While Ive survived his questionable food hygiene for more than 10 years (mostly because I do 90 percent of the cooking), <a href="https://www.menshealth.com/health/a31158940/coronavirus-covid-19-what-to-know/" id="73ecdde3-f2a0-3b80-a618-8172a59438c7"> COVID-19 </a> has made the last two weeks, um, tense. A pandemic is about fighting an enemy we cant see. Thats an anxious persons nightmare. Compounding the problem is my asthma. If I get COVID-19, <a href="https://www.menshealth.com/health/a31483210/what-coronavirus-does-to-your-body/" id="67673ce1-ce98-317d-abc5-d6b4947a104f"> theres a significantly higher chance Ill have complications </a> , a fact I remind myself of, oh, 13,000 times a day. And, then, of course, were spending a lot more time together as we <a href="https://www.menshealth.com/health/a31444651/social-distancing-coronavirus/" id="0bf51c32-7a70-353c-acb4-90aebe34a9d6"> social distance from the rest of the world. </a>

Marriage counselors of the world, Im glad youre getting set up on telemedicine platforms, because this is your moment to shine. (Divorce lawyers, youre on deck.)

<h1> There are the facts, and then there's the delivery </h1>

As a health reporter, Ive done enough germ stories that I know Im not totally crazy for feeling like my husband needs to lather up more often and with more vigorreal research in <a href="https://journals.sagepub.com/doi/abs/10.1177/14690446040050030401" id="18d0ccf0-2a50-3f66-a27e-2ebb5b6b4393"> 2004 </a> and <a href="https://link.springer.com/article/10.1007/s10389-017-0798-z" id="8e3a71ab-c60e-366d-a2d6-39063ca7376f"> 2017 </a> found that men just arent as likely to wash their hands as women are.

Yelling its the sudsing action that kills the germs, you need more soap! over his shoulder isnt going to get me anywhere, though. An analogy I bring up with couples in my practice is your mom or dad shaking their finger and saying dont do that? It just brings up a lot of defensiveness, says Julie Lundy, a South Carolina-based licensed professional counselor who works with many couples. The second you start scolding, your partner is going to feel at least a bit infantilized. Theres no worse feeling than that.

Cleanliness is especially tricky, because hygiene is so wrapped up in class and moral values. Think of the insults we sling aroundso often dirty is the adjective before a slur. Maybe you really just dont want to diethats fair. However, telling your partner theyre unclean will most likely trigger a visceral response.

And so Im trying a new tactic: Im making the conversation about us.

If youve spent any time in couples counseling, youve probably learned about I statements. With an I statement you start by owning your feelings. For example, instead of saying you need to wash your hands more often, you would say, I feel worried about how my body will react to COVID-19, and I would like to do everything we can together to try and minimize our risk.

Yes, this method feels weirdly robotic the first 20,000 times you use it. And it does not always work, especially if your partner isnt willing to play along. In counseling, youll learn the proper response to an I statement is: I hear what youre saying. I feel [insert viewpoint here]. Its hard to do when youre quietly seething about some long-held grudge. I know. Ive been married for a long time and seen my share of raw chicken juice in places it doesnt belong.

If you can stick to the script, though, the result is a conversation that avoids personal attacks. Furthermore, it allows you to get his perspective, says Lundy. Thats important, because were going to have to deal with coronavirus as a team. And: You often end up discovering something interesting about your partner if you can keep emotions cool and talk things out. My health anxieties likely stem from a childhood spent in and out of doctors offices, trying to figure out why my lungs were so weak. Ive internalized that feeling of weakness, and now I feel like a ticking time bomb.

Im also trying to remind myself that I am a part of this problem. Anytime we're under stress or duress, that can affect our mood and our ability to relate to others, says Lundy. Last weekend, when the news turned from bad to worse to holy shit lets build a bunker, my fuse got incrementally shorter. Thats on me. Since realizing my anxiety worsens my temper, Ive been trying to find ways to self-soothe. Gardening is my go-to, and it takes me out into the yard and away from my favorite target: My husband.

While Chris may not be great at washing his hands and the coroner will someday have to pry his face out of his cold, dead hands, he loves touching it that much, he is great at other things. Last summer, when Corona was still just a mediocre beer, he had the foresight to restock our first aid kit and emergency food supply. Hes also a terrific organizer. All of our supplies are neatly arranged and inventoried. Thats something my ADD brain would never have accomplished. If you can find something your partner is good at and force yourself to appreciate it, it may make your fuse just that much longer. Trust me: It wont cure your critical tongue completely, but it will give you a beat where you can decide whether you really need to say this unkind thing or not.

And thats what, in the end, these next few months are going to come down to: Choosing grace whenever we can. Were all going to be stuck in close quarters. Some of us are now co-parenting full time. Thats a lot. Our collective anxiety feels so overwhelming, and there will probably be some grief and loss in the weeks to come. To get through this, were going to need to practice extreme compassionboth for ourselves and for our loved ones, germs and all. (But also, wash your hands. Come on, do it. At least 20 seconds.)

How This Couple Stopped Arguing About Germs

I might not be a marriage expert, but I will say this: the second that was only 17 seconds leaves your mouth, youll realize its not just <a href="https://www.menshealth.com/health/a31778994/classroom-experiment-germs-spread-hand-washing-coronavirus/" id="7cd2b9a7-2cb6-3d7d-aa38-b2d36b21f135"> coronavirus germs </a> being flushed down the sink drain. No, that whooshing sound is your partners last shard of goodwill sliding out via the plumbing.

This Couple Kept Arguing About Germs. Here’s How They Stopped.

The 250 residents are all thats left of a community that peaked at about 1,200 in 1970, and they think they know whats picking them off one by one, in a relentless, whos-next roulette. They cant avoid it in their homes. Or in their backyards. Or on the grounds of the abandoned factory where kids ride their dirt bikes. Locals have taken to calling Mindens main road Death Valley Drive.

Annetta Coffman has lived on this land for all of her 44 years. But in 2018 alone, 15 of her neighbors, people from age 12 to almost 90, died of cancer. Thats a full 6 percent of the towns current population. That year was a nightmare, she says, her voice more tired than sad a year after the fact.

Coffman lost her mother to breast, cervical, and uterine cancer in 2007. About five years ago, doctors discovered a tumor on the pituitary gland of her son, Dalton Kincaid. Hed stopped growing at four-foot-eleven and couldnt keep on weight, even if he ate 5,000 calories a day. His doctor told him he had to quit basketball, the sport he lived for, because he couldnt afford to burn extra calories. My doctor said he didnt even want me to play basketball with my friends, Kincaid says. No pickup ball, no messing around on the court on weekends.

Coffman recounts what theyve been through matter-of-factly, but her voice trembles with anxiety. Treatments shrank Kincaids tumors, yet despite a diet of 3,000 to 4,000 calories per day, even now, at age 20, hes still extremely lean. High energy and fast talking, he explains that he holds down a job at Walmart while going to school full-time at West Virginia University Tech. But recently hes been hit by blinding light sensitivity, and lately his eyes have been inflamed, like hes having an allergy attack, his mom chimes in.

Arbuckle Creek cuts through the valley where Minden sits and delivers trouble to its residents.

Coffman works two jobs in town, one at a chiropractors office and the other waiting tables at a restaurant. Minden is home, but she and the other remaining residents are desperate to move. Because theyre sure theyll die sooner if they stay. Ayne Amjad, M.D., an internist who lives 24 miles away and has become an advocate for the people of Minden, says her research estimates the cancer rate to be about 80 percent for those whove spent the majority of their lives in this valley.

Minden is a verdant place where Arbuckle Creek, the stream that carved the valley to begin with, runs between and behind its homes. The trouble is that when it rains, the water has nowhere to go but up. The creek bucks its banks maybe four, five, or six times a year, says Coffman. And when it floods, Kincaid adds, it runs for days. When the waters recede, theres sediment. In the riverbed and on the roads. In yards, in basements, in homes. Residents think that sediment, which is contaminated with leftover industrial chemicals, is what is making people sick. Its what they believe has poisoned threegoing on fourgenerations. For more than 30 years, the people of Minden have begged for help: from the state, from the feds, from anyone who will listen.

In 2017, due to their pressure, or just the way the cards flipped, the Environmental Protection Agency came to collect soil and sediment samples to determine whether Minden should be put on the National Priorities List, a government punch list of 1,335 places that have been evaluated and deemed hazardous and that require cleanup. In 2019, the townspeople felt theyd finally found an escape route when Minden was added to that list. They hoped to get moved, thinking relocation would offer a new start, as it has with other toxic sites.

Relocation was our goal, says Dr. Amjad. Brandon Richardson, a member of the Minden Community Action Team, says the news had people talking about the logistics of relocation, like whether theyd move as a group or take individual buyouts and each go their own way. But an October 2019 meeting with the EPA put residents back to where theyve been for 30 years: waiting. The EPA wouldnt even discuss relocation, Coffman says. Now Minden is in limbo, the townsfolk hoping to live long enough so that when the government finally acts, some people will be left to benefit.

Its a tough time to be a resident of a toxic community. From Minden to the Navajo Nationplaces large and small, coastal and notAmerica is dealing with the health fallout of industrial pollution. Since 2016, the federal government has proposed rollbacks on 85 environmental regulations. A number of these have gone into effect, and one in particular makes it easier for coal companies to pollute nearby streams. In addition, the governments 2018 budget slashed funding for remediation at Superfund sitesthe term for locations deemed so toxic they merit federal dollarsby 30 percent. From Love Canal (one of Americas first Superfund sites) to the Gulf of Mexico (site of the 2010 Deepwater Horizon oil spill) to Cancer Alley in Louisiana, theres a long history of industry burying toxic waste in American backyards and of residents having to raise hell to get it cleaned up. For Coffman, the sadness inside her at some point shifted to rage. Shes been holding on to that anger ever since, and joining forces with other people in and around town to try to do something about their plight.

WHEN THE NOW-DEFUNCT Shaffer Equipment Company started refurbishing electrical equipment for mining companies in the 1970s and 80s, Coffman was just a child. In much of West Virginia, coal keeps the lights on, and mining-adjacent businesses, like Shaffer, were welcomed in rural communities.

But at Shaffer headquarters, bosses were making decisions with far-reaching consequences: Something had to be done with the used transformers and oil. The company reportedly tasked employees with dumping the oil, which they did at several sites around town, including an old mine. Used oil was also repurposed by the company and local residents as heating fuel, and it was even sprayed on dirt roads to keep the dust down.

Oncologist Hassan Amjad, M.D., noticed that a large number of his patients were coming from Minden.

Later it was discovered that the oil was contaminated with PCBs (polychlorinated biphenyls), heat- and pressure-resistant chemicals primarily used as insulating fluid. But those chemicals are also connected to birth defects, stillbirths, and cancer. Based on that and on the fact that PCBs can take a very long time to degrade in the environment, in 1979 the EPA ruled them a toxic substance and banned their manufacture. By then, however, the waste was all over Minden, and it was continuing to spreadin the soil, in the water, and everywhere the water went every time the creek overflowed.

Minden is so small that it doesnt have its own doctor. But in the early 80s, in nearby Oak Hill, oncologist Hassan Amjad, M.D. (Aynes father), began noticing that a disproportionate number of his cancer patients were from Minden. He raised an alarm first with the West Virginia Department of Environmental Protection and then at the federal EPA. Soon federal employees in hazmat suits were tromping through Minden, testing various places around town, including the site of the Shaffer Equipment Company. The EPA discovered that one sample, from 4,000 cubic yards of oil-soaked soil, was contaminated with PCBswhich can leach into groundwater or be inhaled. The level in the sample was 260,000 parts per million. The EPAs acceptable limit for those chemicals in soil is one part per million.

Minden residents asked the EPA to conduct a community health study, but the agency investigators response was that studies of similarly exposed populations in the U.S. had not resulted in elevated PCB blood levels.

Ayne Amjad, M.D., picked up the fight to help Minden residents after her father, Hassan Amjad, M.D., died in 2017.

So the elder Dr. Amjad started collecting as much data as he could on his own. The problem with chemical-related cancers, especially those associated with PCBs, is that causation can be tough to prove definitively. (The kinds of cancers that PCBs seem to be linked to are the most common forms in the general population, such as lung, colon, and breast.) This makes it easy for public-health officials to say, Look at the towns smoking rates. Look at the residents diets. Look anywhere but at the chemicals. In fact, when West Virginia state senator Stephen Baldwin recently asked a state official about health in Minden, they said that if there are public-health problems here, its because of peoples poor choices, he says.

But even without a health study, the town had the EPAs ear for a minute in 1984. That December, agency workers arrived touting a new technology that would help break down the PCBs. It didnt work. The chemicals remained. So the EPA moved to plan B. It would truck out tainted soil and build a berm along Arbuckle Creek to prevent the migration of any remaining PCBs at the Shaffer site.

Percy Eddie Fruit, 65, a longtime resident whose home is within sight of one of the EPA cleanup locations, remembers watching trucks roll through town. At first, residentsincluding Fruit and Coffmanthought the EPA had done its job. So did the EPA. In December 1988, an agency team inspected the completed work and declared that the restored site area remained in excellent condition and that no threat to public health or the environment existed. Not quite.

THE PEOPLE OF MINDEN were supposed to move on with their lives. And they did. Coffman had a family. Fruit worked as a pipe fitter installing sprinkler systems. He took care of his two daughters and spent his weekends and his spare cash fixing up the home he grew up in.

But as the years passed, the residents kept seeing signs that maybe the job hadnt been finished. A cache of barrels lingered on the old Shaffer Equipment Company site. And they werent empty.

Yet all the while, people let their kids ride their bikes there, thinking it was safe, because the area hadnt been properly fenced off. Both residents and the EPA would later discover that the constructed berm isnt effective if its being eroded by the constant flooding that happens every time the skies open up.

The town organized and sent letters to the EPA and to state and local representatives, and the agency came back to Minden in 1991 and 92. Things were looking up even more in 1993, when the EPA tried to hold Shaffer accountable by suing the company to recoup the costs of cleaning up the town.

Percy Fruit doesnt like to talk about cancer, because its been too much of a presence around him. His mother and three brothers all had cancer.

But more dirt was uncovered: The suit was thrown out of trial court because the man the EPA had put in charge of the cleanup turned out to have lied to his employer. He didnt have the college degree or the masters degree in organic chemistry hed claimed. The EPA appealed and the parties ultimately settled, with Shaffer paying $600,000 to partially offset the agencys costs, now well into the millions. Minden isnt suing Shaffer, since theres no money to be had. (Shaffer has since filed for bankruptcy.)

And the town cant sue the EPA at this point. Suits typically cant be brought to challenge an EPA remedy at a Superfund site until that remedy has been finalized. Once the EPA has selected a remedy, then anyone who has standing could challenge the remedy and say its not good enough, says Kenneth Kilbert, an environmental-litigation expert at the University of Toledo College of Law. In Mindens case, the EPA is still determining what the final remedy will be. And thats not as simple as it sounds. The agency works on reducing risk to an acceptable level, not eliminating it, Kilbert says. From a risk perspective, that makes sense. But not if youre the person living next to it.

Fruit and his neighbors would agree with that. Even after additional cleanup in the early 90s, some of the residents still felt as though something wasnt right. Fruit noticed that people around him kept getting sick. I had a bunch of neighbors pass away from cancer, he says. His gut told him that the danger had not passed. Soil samples tested in 2017 showed he was correct. The toxins are still there. And the residents are, too.

IT'S STARTING TO LOOK like no one is going to save Minden except the people who live there. The residents are trying to draw a direct line between whats happening to their health and what happened to their town. For more than 30 years, the elder Dr. Amjad pushed to gather as much data as possible showing the effects of PCBs on Minden residents.

Proving causation between a chemical and a type of cancer can take years and many more dollars than Minden has. But Dr. Amjad thought he was close to discovering a new type of lymphoma linked to PCBs when he died suddenly of a heart attack in 2017, says his daughter, Ayne. She has her own medical practice, and although her father had always jokingly told Mindens residents that shed someday take over his advocacy work, she wasnt expecting to step in so soon.

But in the weeks after he died, while she was still processing her grief, everyone started calling, she says. They didnt know what to do and thought everything he did would be lost. When she had the strength to go into his office, she began sorting through decades of paperwork.

She hasnt been able to prove the lymphoma connection yet, but she has added two other strategies to the towns fight.

The first is an effort to get the state to help collect more accurate cancer data. The second is a plan to look beyond the EPA for a solution.

Despite the fact that Minden is on the National Priorities List, the states Department of Health &amp; Human Resources, which oversees the West Virginia Cancer Registry, says that its current data does not support the existence of a cancer cluster in the town. Thats largely due to how the data is gathered. If you live in Minden your whole life but move and are diagnosed with the disease while living elsewhere, you will no longer show up as a cancer case related to Minden.

The younger Dr. Amjad worked with Senator Baldwin to introduce legislation to change that, but the Health Department pushed back, saying it would be too complicated to sort the data any other way but by where people lived at the time of diagnosis. The necessary information cant just be pulled from basic medical records. To collate the data by where residents lived most of their lives would require in-person interviews, which the cancer registry doesnt have the manpower to conduct.

This means that a lot of cancer cases arent counted. Fruits mother, who cleaned the Shaffer Equipment Company offices, died of cancer in 1992. She counts toward Mindens total. But his three brothers, all of whom have had bouts of cancer that they have so far survived, dont, because they moved away.

Fruit doesnt really like talking about cancer, because its been too much of a presence among the people around him. Whenever the phone rings, he gets a pang of worry about what kind of news hell be getting. Rather than talk about cancer (If I speak, its going to happen, he says), he prays. And then he gets busy. You have to put your faith into action.

ON A HOT JUNE morning last year, Fruit got out of bed early and headed to Mindens small community center. Im always in pain, he says with a dark chuckle, referring to his hip, which is badly in need of a total replacement. He knew the uphill, mile-plus hike out of the valley that Minden sits in would cause misery tomorrow. But that was tomorrows problem.

Thirty years ago, on an equally muggy June weekend, Lucian Randall, a local activist, led a march out of Minden to protest the valleys pollution with PCBs. Randall pushed an oil drumlike the ones full of PCB-contaminated oil that were dumped all over this townup one of Mindens hills.

Fruit was a young man then, off serving in the Army, but his mother kept him informed about the fight back home. He never thought that three decades later, as a 65-year-old man, hed be leading a march up the same hill protesting the same thing. But here he was, bad hip and all.

The march was supposed to draw attention to Mindens ongoing plightand nod to the pilgrimage its residents hope to someday take, marching up and out of their toxic town, when they get the funds to relocate.

In one response from the EPA, last November, the agency stated that at this time, the environmental data/risk does not show that relocation is an appropriate response action. Dr. Amjad is helping the town look elsewhere for a solution. Shes investigating whether the consistent flooding in Minden at least qualifies residents for some level of disaster relief from FEMA.

Frustrated by the waiting and worrying, Percy Fruit led a symbolic march out of Minden last June, pushing a barrel like those that had been dumped around town.

But for now, theyre still trapped. Living on waste has made their homes worthless. Fruit says hes put $60,000 into his home over the years. Its value today is just $38,000. Coffman owes $20,000 on her double-wide mobile home, which is too damaged from flooding to move. So Im either going to leave it and be in debt, or just stay until its paid off. That would be in another ten yearswhich is ten more years of chemical exposure.

Even if the elusive relocation happens, that still wouldnt be the end of it. The residents would have to decide if they want to move together as a community, with neighbors staying neighbors in a brand-new development built just for them, or if everyone would rather take a cash buyout for their home and start over wherever they wish.

Coffman prefers the latter. Were going to get cancer, she says. Shes spent the past 30 years raising money for people who cant afford funerals; shes been going to memorials, making casseroles for friends, planning candlelight vigils, and watching people she loves die. If all her neighbors relocated together, it would be more of the same. Weve been exposed to it for too long. People are still going to be dying. And I dont want to see that.

Kincaid doesnt want to leave. But after he graduates from collegewhere hes studying criminal justice, hoping to go to law schoolhell be moving on. If I have kids one day, I dont want them to grow up here, he says. The only way hell find himself back in Minden is if, by the time hes passed the bar, things still havent changed. By that time, though, hell be armed with a law degree.

Annetta Coffman has watched neighbor after neighbor get cancer. Five years ago, her son, Dalton Kincaid (left), was diagnosed, too.

IN A NARROW SHADOW of land between two steep mountainsides in West Virginia, residents of a town called Minden are dying. Not in that existential were all dying a little bit every day way, but in the blotchy-lesions-and-tumor-riddled-organs-that-eventually-stop-working way.

Life—and Death—in a Toxic Town

In March, Mens Health featured five triathletes from team PlayTri in Colleyville, Texas, gearing up for the Luck Of The Irish sprint triathlon on March 17, plus <a href="https://www.menshealth.com/fitness/g19542724/triathlon-training-guide/" id="0ab05e9d-6521-350f-a910-ec981b2b8384"> coaches best tips </a> on racing a sprint well. We caught up with these athletes post-race to see what they gleaned from the event, and what theyd do over if they had the chance. Their insights on why you should sign up for that race now:

<h1> 1. Youll Use Your Rest Time Wisely </h1>

Chase Sparrow, 30, hoped to end up in the top five finishers in his age group, and he achieved that-although it was a nail biter. Over the winter, Sparrow ended up with an overuse injury, which manifested as pure, intolerable pain in his piriformis. It was me neglecting recovery, he says blaming himself. It started off with one or two niggles, he says. Which he ignored, until suddenly, it was pain so bad he could barely walk.

Sparrow had to take off the months of October through December. But he used that time to mentally reset and work on his swim technique. After a full month off, his doctor cleared him to swim and he hired a coach. I've been really focused on the core fundamentals of getting better technique and its made a big difference, says Sparrow, who finished in 56:28.

<h1> 2. You Get The Cobwebs Out of Your Transitions </h1>

In sprint triathlons, which last about an hour, the time spent in transition matters. Getting the cobwebs out on exactly what you need and what order to grab it is the great thing about an early-season race. One of the main good things is that it helps you with that familiarization of the transition areas, so you know what to expect because that's the most confusing part, says Kelly Dillinger, 47. His goal for this sprint was to finish under an hour, and he nailed it, coming in at 59:56.

For most of the race, Dillinger and his teammate, Paul Wolf, battled back and forth. Paul and I were neck and neck. There was only a one-second difference between us on the swim, and I beat him on the run, but his transitions were faster, says Dillinger. That was a good reminder to Dillinger to work on perfecting this skill for his next race.

5 Reasons to Race an Early-Season Triathlon

<h1> 3. Your Winter Workouts Will Be Well Organized </h1>

Paul Wolf, 54, whose goal was to finish in under an hour, managed that handily-at 58:35-thanks to diligently following a training plan all winter. Wolf used a service called TriDot, which gives you computer-generated workouts based on when your next goal race is. It really was dialed-in specifically for me, so I knew what I needed to do to get ready for my next race, he says.

While Wolfs real goal race is the same Galveston, Texas half Ironman that Dillinger is training for, he says that having this early race on his schedule made him get organized sooner. Im a check-the-box kind of guy. Every day I had to check the box on my workouts.

The great thing about entering a short, early season race is that it gives you something to train for, but it doesnt have the weight (and expense) of the half- or full-Ironman distance events that come later in the year. So if your training doesnt go according to plan, its not a big deal to pull the plug (DNS = Did Not Start).

Thats the lesson Andrew Harley, 31, learned gearing up for Luck of the Irish. About a month ago, I had some pain in a metatarsal that shut down my running for a few weeks, he says. The pain was likely from a new pair of shoes he was trying. I am almost over that now and am reintroducing running back into the workout regimen. It feels comfortable at a moderate tempo but as soon as I turn the pace up, my foot reminds me I am not 100 percent, he says.

Harleys real goal race is a half Ironman in Costa Navarino, Greece. With that race less than a month away, Harley decided it was best to sit Luck of The Irish out. It was a tough call, but knowing its more important to be 100 percent in Greece, he felt this was the right one.

<h1> 5. The Race is a Confidence Booster </h1>

Everyone on team PlayTri calls April Hince The All Star because she can smoke everyone on the team. Which she did, winning overall female at the Luck Of The Irish Sprint Triathlon at 51:48. And she swears she didnt think shed do that well, since shed spent the week beforehand eating and drinking her way around the Bahamas on a cruise.

Doing an early season race gets you in swimsuit shape early, she jokes. And if you ace it, you have just a little more confidence as you head into your bigger goal races. Hince, for example, is trying to place in the top two in her age group at the 70.3 distance race in Galveston, Texas. If Im in the top two then I get to go to Nice, France this summer to compete, she says. Its going to be a hard goal to hack, since tons of quick folks show up to the Ironman Texas 70.3 race. But knowing shes got some serious fitness is a big boost.

Triathlon season usually stretches from summer to fall, when lakes are warm and days are long enough to get in after-work runs and rides. But entering an early season tune-up is a good idea. Its just good to get back into the mental side of racing, says Paul Wolf, a triathlete from Texas.

What happened? He was in great shape, Cohen says. One of those guys who never misses a day at the gym. So of course, he was on the keto diet. Being in ketosis may have caused the breathalyzer to give a false positive. Armed with this info, Cohen was able to get the DUI dropped.

Heres how that can happen: In ketosis, your liver breaks down fat for fuel, creating acetone as a byproduct. Some of that acetone is then released through your breath as isopropyl alcohol. The question is, can breathalyzers tell the difference between ethanol alcohol and isopropyl alcohol? It depends.

The inexpensive models that people buy for self-checking their BAC are probably not accurate if they're on the keto diet, says Alan Wayne Jones, PhD, a professor in forensic technology at Sweden's Linkping University. These devices rely on semiconductor technology. Inside the device theres a metal film that measures the change in resistance depending on the number of molecules that hit that film, explains Keith Nothacker, the CEO of , a California-based breathalyzer manufacturer.

Basically, regular air expelled from your lungs has a different quantity of molecules than air containing alcohol. From there, the device estimates your BAC, Nothacker says. But Dr. Jones has never seen any evidence that the devices can detect whether those molecules are coming from ethanol or isopropyl.

Most police, however, carry fuel cell-based breathalyzers in their cars-and heres where things get complicated. Fuel cell breathalyzer manufacturers-including Nothacker-say their devices can tell the difference between ethanol and isopropyl. However, Cohen says hes never seen peer-reviewed data showing that when either one substance or the other is present, this is indeed the case. Furthermore, When you mix them together, which is what would happen if you were drinking and in ketosis, we dont know that the fuel cell devices can differentiate, he says.

One of the few papers that does exist on this topic was done by Dr. Jones. In 2006, <a href="https://www.nature.com/articles/0803444" id="b9481ea7-873c-3f01-aaaa-bd1f7c987692"> </a> examining why a man on a low-carb diet was struggling to start a company vehicle, which was fitted with a breathalyzer ignition lock. Under some circumstances, acetone can be converted in the body to isopropanol, and that is oxidized like ethanol by fuel cell breath analyzers, he says. If a person drank isopropanol, the fuel cell instruments probably could not distinguish it from ethanol, especially if it was combined with grain alcohol.

Nothacker, however, disagrees. He says his companys fuel cell breathalyzers are ethanol-specific and wont create a current with isopropyl, which is what flags a positive result. In 17 years of business, he says, its never been a problem.

And it may not matter: In many states, the preliminary breath test results cant be used in court. Generally, if youre arrested for a DUI, they bring you into the station, where youll re-test on a machine that uses infrared spectroscopy. These machines can tell the difference between isopropyl and ethanol alcohol, Cohen says. In some states, you can also request a blood test (generally at your expense), which, again, can tell the difference between the two alcohols.

Also, lets be clear: Claiming youre on the keto diet while stumbling around during a field sobriety test is not going to be a get out of jail free card. Officers rely on instinct when sniffing out whether someone is drunk or not, says Ranolph Rice, a Baltimore-based DUI attorney. First they start with the observation phase. Are there signs that lead us to the next point? Odor is the biggest sign, obviously, he says. If you smell like booze, officers arent going to have any sympathy for whatever diet you may be on.

Furthermore, its probably rare for a keto diet to push you up and over the legal alcohol limit. If youve had a drink or two, maybe. But acetone alone probably cant make you blow a .08, Rice says. Hes more concerned about clients who have had past DUIs, who now have breathalyzer ignition locks on their cars. In Maryland, those devices keep your car shut off at a much lower level than the DUI limit. If you blow .02 or higher BAC, youve violated your interlock, and theyre going to add another month to your program, Rice says. He theorizes that a .02 could, in theory, be achievable for a sober person on the keto diet.

Other medical conditions can cause breathalyzers to malfunction, too. Diabetes can cause false positives, for the same reason as the keto diet. GERD or acid reflux can be problematic too. If you belch or vomit, youve got stomach alcohol. If thats present in your mouth, it may read that, Cohen says.

So what should you do if youre pulled over? Cohen and Rice both have the same super-simple advice: Dont drink and drive, ever. If you know youre sober, ask to be taken back to the station to use the infrared spectroscopy machines. The blood test, however, is more complicated, Cohen says. While it wont mark a false positive for being on a low-carb diet, it may catch something else-like medicines you take for ADHD or anxiety. Thats not going to look good mixed with alcohol, he says, even if you end up under the limit.

The Keto Diet Can Mess With a Breathalyzer Test

Jay Cohen, a Houston-based  , recently had a client with a strange case. When he got out to do the field sobriety test, the guy mostly seemed fine. But then he blew into a breathalyzer and ended up with a well-above-the-limit test.

How Being on the Keto Diet Can Trick a Breathalyzer Into Thinking You're Drunk

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