Lisa Fleming was already overweight when she gave birth to her first child at 15, and her weight only went up from there. But she knew it was absolutely time to make a change when, bedridden and weighing 704 lbs., she found maggots in the folds of her skin.

For the first time in years, Fleming, 49, is going to leave her bed — the same bed where her mom died due to obesity — and make the six-hour trip to get weight loss surgery.

“I’m tired, I’m hungry, and I’m not looking forward to having the paramedics move me out of this bed,” Fleming says in this exclusive clip from Wednesday’s episode of My 600-Lb. Life. “Lord, give me strength.”

Seven paramedics arrive with multiple emergency vehicles to get Fleming out of her bed, down a ramp and into an ambulance.

“The paramedics have to reinforce the ramp they’ll use to get me out of the house,” she says. “I can’t believe it’s come to this. But at least I’m doing something about it before it gets to be too late.”

And when they ask Fleming if she’s ready to go, she says that she “ain’t ever gonna be ready,” but tells them to go for it, because she knows “for a fact” that she’s “sick of this damn bed.”

Using her bed sheets and a dolly, the paramedics painfully lift Fleming out of her bed.

“Oh lord, please don’t let them kill me,” she says.

My 600-Lb. Life airs Wednesdays at 8/7c on TLC.