What do you think about adopting out of birth order? What about virtual twinning?

For those of you not part of the adoption community, these may seem like strange questions. But as someone who has been a part of the adoption community for 6+ years, of which about 4.5 have been as an adoptive parent, I have heard these questions asked, in one form or another, multiple times a week for years. And as an adoptive parent who has both adopted out of birth order and virtually twinned children, I feel qualified to be a voice speaking to both questions. Obviously specific counsel varies depending on individual situations, but this post should be taken as a collection of general guidelines.

First, some definitions. Adopting out of birth order is adding a child to your family who will not enter your family as the youngest. Displacing your oldest child is a particular form of adopting out of birth order in which the child who is joining your family will enter as the oldest child. Virtual twinning (also called artificial twinning) is adopting a child where there will be an age difference of less than 9 months between that child and another child in your family.

(from left to right, Atticus (whose birth order we disrupted by bringing home a sister older than he was); FangFang (the sister who is older than he is but joined our family after he did); Madeleine CaiQun (who is only about 4 months younger than our oldest and is thus her virtual twin); and Miranda (our oldest))

Second, I’d make this recommendation to all adopting families, but, in particular, if you are considering adopting out of birth order or virtual twinning, I think this counsel is important – please look for a well-recommended, experienced, wise social worker. A good social worker is worth more than their weight in gold. They’ve seen many, many adoptions. They have a lot of experience from which to draw and a lot of wisdom to offer. They are also, yes, tasked with evaluating whether a family meets the qualifications required to adopt from a certain program and what age(s) and gender(s) of child would be wise for that family to adopt, as well as what special needs that family is prepared to handle. Both when we virtual twinned and when we adopted out of birth order, our social worker was on board with us doing so. She has years of experience working with adoptive families, she’s seen a lot, and she knows our family well. We know she is there to support our family and to help everyone thrive, and we very much value her opinion. If she had not thought it was wise for us to pursue either situation, we would not have pushed her to approve us to do so. She has never thought it would be wise for us to adopt a child older than our oldest and has never approved us to do so – and we agree that to do so would be extremely unwise for us!

Conventional wisdom from social workers and experienced adoptive families has generally been that out of birth order adoptions should be undertaken rarely and with great thoughtfulness, particularly if a family is displacing their oldest child (which is very, very rarely recommended). The same goes for virtual twinning. Adoption is hard. Children who are being adopted have, without exception, experienced trauma, and that trauma is going to manifest itself somehow, and adoptive parents need to be prepared and parent well, often using a more limited range of strategies than those generally considered to be acceptable for parents in our society. Adopting out of birth order or virtual twinning adds additional variables and challenges to an already challenging situation. The immediate challenges may be any or all of the following, plus more:

  • Abuse (physical, sexual, verbal, etc) from a new child, who may have been exposed to absolutely anything in their former environment and now enters a family as not the smallest, weakest person.
  • Attachment difficulties, stemming in particular from 2 major concerns:
    • If there is abuse, it is hard for everyone to bond – the younger child being abused, the parents witnessing their baby being abused, and the new child, who is constantly tempted to lash out at their smaller (or same size) siblings.
    • If you bring in a new child as your youngest child, everyone understands that that child needs to be the “baby” of the family and should be treated as such. Bringing in a child who is not the youngest creates behavioral expectations for that child, that they be as mature as other children in your family and that they make room for babying a (likely regressing, due to the major change and potentially their own lack of understanding) younger child, as well.
  • Complex emotions on the part of children who may feel replaced by an older or similar-age child, moreso than they would by a baby.
  • Competition between similar age and/or similar developmental stage children.

Additionally, displacing an oldest child would set up difficulties in which the former oldest child (likely a child who, based on studies of birth order, likes to be a leader, likes to know what to expect, likes to be in control) is no longer the oldest child, and yet, they may remain the most mature child. The new child may refuse to follow the “lead” of the younger child in learning appropriate family behavior and instead may try to take the lead in promoting unsafe or inappropriate behaviors among all the children in the home. The now younger child may not appreciate having an older sibling who is less mature than they are. This can create tremendous tension. As an added concern, displacing an oldest child means that parents are now parenting a child who is at an age at which they have never parented a child before. It’s hard enough to figure out parenting, let alone adoption parenting, not to mention adoption parenting of a child who is years beyond any other child you have parented before.

As I said, despite all of these additional challenges, we’ve chosen both to virtual twin and to adopt out of birth order. So why did we do it?

With our first adoption, our daughter Miranda was almost 3, and we brought home a 2.5-year-old daughter, Madeleine CaiQun. Although only about 4 months apart in age, the two would be on either side of our school district’s age cut-off date for entering kindergarten, meaning that if we did choose to enroll them in public school, they’d be in different grades, and for social activities based on children’s grades, they’d be in different groups. We felt that would cut down on competition. We also knew that Madeleine CaiQun was significantly behind developmentally, so we figured that the girls wouldn’t really be competing with each other. We’d view Miranda as the older child and Madeleine CaiQun as the younger, and even though their technical birthdays were close together, we’d still create a pretty firm birth order.

(me with my virtual twins, together in China, 2013)

For the most part, that has played out well for us, and I really don’t think we hit most of those initial challenges I mentioned above. However, what I think we under-prepared for were the challenges we are facing now, 4.5 years later, as the girls are preparing to start 1st and 2nd grades, and there are many ways in which there is not such a firm-seeming “birth order.” Based on our experience (and those experiences of other families we know who are a similar length of time into the process), I’d encourage families to consider the following:

  • How will you handle it if your child at home is more advanced than your new child across the board?
  • What happens if the “younger” child or child who joined the family later, actually is better than the “older” child in certain areas? How will the older child feel about having a younger sibling who is more advanced than they are?
  • How will you avoid constant comparison of your children? How will you interact with other adults in your children’s lives, who may have a tendency to compare them? What about other children making comparisons?
  • How will you navigate social situations? What if one child is more social than the other? What if the two enjoy being together but invitations are not always issued to both children? What if the two don’t enjoy being together?
  • How will you navigate extra-curricular activities? The kids do the same activities (convenient, but it’s a lot of time together and can lead to competition)? Different activities (gives kids some space but is a lot less convenient)? What about the social implications of whatever choice you make with regards to those extra-curricular activities?

(my virtual twins together, 2016)

In terms of adopting out of birth order, we avoided some of the challenges by virtue of who our children are. We knew that FangFang, though 14 months older than Atticus, would be significantly smaller than he would be and definitely behind him in terms of gross motor skill development – she wasn’t going to be bullying him. Additionally, because of her needs, we’d have to “baby” her in a lot of ways, often carrying her and assisting her in other ways. Also, Atticus, as a third child, was quite used to the reality that the world did not revolve around him, and because we also had other families and kids in and out of our house frequently (even caring part-time for a friend’s little boy close in age to Atticus), he was used to sharing us with other kids. We also knew that Matt’s flexible schedule would allow him to be helpful with any challenges that did arise once FangFang came home.

Even so, it was a difficult transition for him. I’m not sure it would have been significantly less difficult had we brought home a younger toddler, but the reality is that it was hard on him. There were many instances those first weeks after I arrived home in which either Matt or I had to be fully engaged with Atticus for a period of time while the other cared for the other three kids.

(my two littles with me, soon after I returned home from China with FangFang – if one was sitting with me, the other also had to be there, December 2016)

Again, based on our experience, but also the experiences of others whom we know who have adopted out of birth order, I’d encourage families considering adopting out of birth order to consider these questions:

  • What will you do if your new child attempts to bully your younger child? How will you keep your younger child safe? Are you willing and able to keep your new child with you – as in, within your line of sight – at absolutely all times?
  • How will you facilitate bonding between a new child and the younger child they are bullying, between the new child and any older siblings who don’t appreciate seeing their youngest sibling be a target for this new child, and between you as parents and this new child?
  • How will you give your new child the babying they need to attach to you as parents, while also caring for your other, particularly younger, child(ren)?
  • How will you care for your younger child(ren), who will probably be stressed out by the addition of this newest child, and so will probably be regressing? Can you baby both your new child and your younger child(ren), all at the same time? What resources do you have to do so?
  • If your children are not bonding well and require constant supervision, do you have other people in your life who can provide the intense care that they need? If not, how will your marriage handle not being able to get away for time without kids?
  • Assuming your new child comes home with some special needs, you will likely now need to spend significant time at doctor appointments, in the hospital, at therapy appointments, and/or on the phone coordinating all of these needs, etc.; how will your other children, particularly any younger children, who are less able to understand the reason for all of this time away, handle this? How will you equip them to handle it well?

(the littles playing on “boats” together, July 2017)

Additionally, for anyone considering pursuing an out-of-birth order or virtual twinning adoption, I’d encourage you to be honest as you consider, are you pursuing this child because you truly believe that is what’s best for this child and for your existing family, OR are you pursuing adopting this older, harder-to-place child because then you don’t have to wait as long for a match?

In general, I think it’s good for families to be aware of guidelines that adoption professionals use as “best practices” and that experienced families consider to be wise. As many of us BTDT parents say over and over again in discussions within the adoption community, if you are proceeding with adopting, there are many unknowns. Think about what the worst case scenario is. If you’re not prepared for that, don’t proceed. There are many success stories of families adopting out of birth order and virtual twinning – and, honestly, the people with those stories are more likely to stick around as part of the Facebook groups and the resource lists for people preparing to adopt. But just because someone else’s experience went well does not mean that yours will, and if you can’t handle a harder version of what your potential future reality could be, it would be wise not to proceed.

I’d also recommend checking out this blog post, written by another adoptive mom who has been around for a while, in which she shares some wisdom and links to many other resources for people to read and think about as they consider proceeding with either of these scenarios.

And if you have any questions or want to talk more, please don’t hesitate to get in touch with me. You’ll notice that I shared very few details about our specific challenges and adjustments, which is purposeful on my part – I don’t think my children’s challenges should be google-able – but I’m happy to talk with you about your specific situation and offer more info that might be helpful about challenges we’ve faced (or have seen play out for others) in private interactions 🙂

FAQ: Home Almost Six Weeks! How’s FangFang adjusting? How are you?

At times it feels longer and at times shorter, but we’ve now been home with FangFang for almost 6 whole weeks! Some of the questions I get most frequently these days, in my few interactions with people who are not medical professionals or grocery store employees, are about the big picture of her adjustment and ours.

Attachment and bonding are always processes, processes with many variables and unknowns, processes best examined in retrospect. However, they are of such paramount importance for adoptive families that we adoptive parents are constantly on high alert, watching for indicators of progress (or lack thereof). We wonder to what degree our children are really getting it, that this is what family is; we wonder if they are really beginning to trust us; we wonder to what degree to indulge and to what degree to push; we wonder if we’re making the right decisions for our new children and for our families as a whole.

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You may remember that FangFang did not exactly appreciate my presence or attempts at caring for her in China. Having spent our time in China telling myself just to stay calm and positive and keep pursuing her in love regardless of what she did, I’ve needed to make sure I have been doing things to cultivate the warm, fuzzy love feelings for both of us. I’ll sometimes wrap her up in a blanket and rock her back and forth and look into her eyes, taking advantage of the oxytocin bump for us both. I’ll hold her on my lap while I read out loud or offer a hug or a kiss or a smile as we pass by each other. I try to take advantage of those 3-minute lulls in activity to do something relationship-building with her (and the other kiddos). We’ve incorporated more loving rituals into our lives as a family as a whole to build connections between all of us; for instance, before we begin our “reading school” time each day, the kids and I all sing the “Twinkle Twinkle Little Star, What a Wonderful Child You Are” song together. And as our time as a family of six grows, the love between us all is growing, too.

FangFang had actually decided pretty quickly after we left Sharon and Daniel that I was her person now, and that has been consistent, for which I’m thankful! The Ergo or Tula carriers, which she despised in China? She would now love to spend hours being worn and often protests when I tell her she needs to get down and play.

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She looks to us in new situations, and she frequently asks to be held – she’ll scoot up to me and put her arms up and ask, “Baby FangFang?” multiple times a day! She’s a pretty snuggly little girl. One night one of us casually mentioned something about love, and she, sitting next to me on the couch, looked up at me and put her hand on my cheek, and announced, “FangFang love.” Cue heart melt!

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She has continued to warm up to Matt more and more. She still prefers me, but she allows him to put her to bed, and if I’m unavailable, she’ll let him hold her, and she asks about him when he’s away from home.

She is generally a happy little girl, for which I’m very thankful, since that was the impression we got of her from the photos her foster home shared. I was worried that it would take a long time for her spark to come back after leaving them and coming to us. She does have occasional sad moments whose reason we can’t entirely discern and for which her English is insufficient to explain, which is very sad but is also very typical for kids adopted internationally. We try to hold her close and reassure her that we love her and she is safe, and eventually something (usually food) brings her back to her typical happy state!

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She also loves the other kiddos, and they love her, though there is certainly a large amount of interpersonal drama between any and all of them, too. We’re trying to cultivate kind, generous hearts and develop good relationships, but everything is a work in progress!

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I’m not entirely sure how to read her interactions with others outside of our family. Thus far, we have kept her with either Matt or me at all times. We haven’t exactly cocooned (a common adoptive family bonding strategy, keeping your child’s world small for a period of time after they come home, staying home as much as possible), largely due to the necessity of medical appointments and evaluations – in addition to our visit to the Omaha clinic, so far she has seen our pediatrician, had a local X-ray, a CT scan, a private PT evaluation, a private OT evaluation, an evaluation by the school system, and met with a local orthopedic surgeon. We’ve also been going to our church worship gatherings on Sunday mornings and just keeping her in the sanctuary with us for the entire time, and we’ve had a few people come over for dinner since we’ve been home. She is definitely more of an extrovert than most members of our family – she loves interacting with others. For the most part, she warms up to people pretty quickly but still continually looks to us for reassurance and generally behaves appropriately with them, which is encouraging. However, we do notice some overly affectionate tendencies, and there was one night recently on which some friends stayed for dinner, and within minutes of their arrival, she was reaching out toward the guy for him to hold her – the return of the mommy shopping! We weren’t sure that she initially realized that he wasn’t Matt – but it was still a little disconcerting.

We’ll continue to take things slowly. In the grand scheme of things, 6 weeks is not very long, particularly for a child who has lived for over 3 years outside of a family. There are definitely moments during which Matt and I yearn for a date night by ourselves, or we think about being able to go to our missional community group meetings, or I wish it were easier to go hang out with friends. This is just a stage, though. Laying the groundwork for healthy, secure attachment is so important, and we want to respect that and take the necessary time to do it right, so we’ll hang in there, keep reading the signals, and do what we believe we need to do to facilitate bonding and attachment.

Overall, we are so glad that she really is settling in pretty well. She seems to be increasingly understanding that we are her family and that this is her home. She seems happy. She’s learning English and increasingly able to communicate her needs and desires. We’re all getting to know one another more and establishing these new family dynamics, and everyone seems to be doing pretty well with that. We’re worn out, both mentally and physically, and we know we still have a long way to go, but I don’t think we could ask for much more at this point in our journey!

Preparing to Parent a Child with OI: What Does that Look Like?

When I first heard of osteogenesis imperfecta (OI), I assumed that it just meant that the bones of the person affected by it would fracture more easily than those of other people, but as I shared here, there’s actually a bit more to it than that.

There’s also more to parenting a child with OI than I realized at first, and I’ve spent the last 9 months doing all that I can to learn about that. I began by talking to moms of kids with OI and adults with OI as we were reviewing our daughter’s file. Of course, I also talked with our pediatrician, who consulted with a local orthopedic surgeon, and I made contact with the orthopedic surgeon and endocrinologist who run the OI clinic in Omaha, offering some of the best care in the world for people with OI. All of that was incredibly helpful, and  I don’t want to discount the expertise of medical professionals, but OI is such a rare condition that very few doctors and nurses have experience with it, and I’ve so appreciated the opportunity to learn from the experiences of parents who are living right now the reality of life parenting children with OI.

One of the moms with whom I connected added me to a Facebook group of parents who had adopted children with OI so that I could ask questions there, and those mamas answered so many of my questions. And once we accepted Fang Fang’s referral and committed to moving forward with adopting her, I joined the Facebook group for all parents of children with OI, and that group is an awesome resource, as well. And these parents? They are amazing. Not only do so many of them take such excellent care of their own children, but they also have gone out of their way to pass on their wisdom to me (and to other expectant parents).

One thing I’ve learned from those parents is the importance of having a “break box” on hand at all times, whether we’re at home or out and about. Fractures can happen at any time, and we’ll want to be prepared. It’s true that we could go to the emergency room any time a fracture happens, but an ER visit is not always necessary, and even if it is required, we can do a lot to make our daughter more comfortable before transporting her. We should have medication available to address spasms and pain as a first line of defense. Then we should have splinting supplies, so that we’re able to immobilize limbs and splint any fracture at any time.

Another mama actually sent me a whole stash of supplies for the beginning of a break box, each labelled with instructions for use!

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You cannot believe how excited I was to get that box! I also started to add to it gradually as I learned more myself. There isn’t anything like a book you can read about how to parent a child with OI or even about OI itself, but I’ve gleaned so much wisdom from reading other parents’ posts in the Facebook group for parents of kids with OI, seeing what challenges other families face and what advice they receive.

This month another mom who sometimes travels through our area for work stopped by our house and gave me a whole morning of her time to talk about parenting her daughter who has OI and give me a hands-on splinting tutorial! What an amazing blessing! Fortunately, both Miranda and Madeleine CaiQun were willing to help us practice 🙂

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I’ve also learned about the need for a wheelchair – and specifically a wheelchair that is customized for her little body. Fang Fang is tiny, but she is 3, which means she’s at an age at which children are generally able to be mobile themselves. At home, she’ll be able to crawl or scoot, but that’s less socially acceptable at places like Target, and we’ll need to be able to facilitate her independent mobility. Additionally, we need to anticipate fractures. We don’t know when or how they’ll occur, but we do know they’ll occur, likely to major leg bones at some point, so we need to be prepared, and that means having a wheelchair available. We’ll also likely need a gait trainer and/or walker for her at some point, but we’ll wait for her physical therapist to weigh in on that.

I’ve been challenged to be an advocate for Fang Fang, even in medical contexts. I got a bit of a taste of that after Matt’s heart attack in February, but this will be more of a sustained need. Because OI is such a rare condition, I need to be an expert, and I need to be willing to discuss medical procedures and treatments with doctors. I need to ask that her blood pressure not be taken unless absolutely necessary, because the tightness of blood pressure cuffs can cause fractures. In case of fractures, I need to insist that I position her for x-rays, because well-meaning medical professionals who are not experienced in working with individuals affected by OI sometimes don’t know how to move limbs without causing further injury.

I’ve asked many questions of our pediatrician and of other OI moms, but I’ve also been seeking out other resources. I talked with the HR department at Mizzou to help me figure out which insurance plan would offer us the best financial coverage for all the needs we expect to have in the next year. There are two amazing mamas to kids with special needs who are part of our church, and both of them have been so gracious in answering my many questions. I’ve also talked with our local school system. And I’ve made contact with a local organization supporting individuals with disabilities. I have the information I need in order to get her set up with all the local support for which she’ll qualify as soon as she gets home.

By nature, I’m really a very dorky person, so I have actually enjoyed doing all this research and learning as much as possible about OI and how to care for Chen Fang once she’s home. Even if that weren’t the case, though, I believe I owe it to her to prepare as well as possible for her arrival, and I’m doing all I can to make that a reality!

FAQ: Adoption Travel – Who? When?

Some of the most frequently asked questions we’ve received as we’ve worked our way through this adoption process relate to travel.

First, who will travel? At least one adoptive parent is required to travel. Last time Matt, Miranda, my mom, and I all traveled to adopt Madeleine CaiQun, and it was an amazing trip, and that was absolutely the best decision for our family at that time.

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This time around, the logistics surrounding traveling as a family would be somewhat more complex given our greater numbers, and it would be tremendously more expensive, and we’re not sure that even if we had that extra money on hand, it would be wise for all of us to travel. Given the young ages of our children, we think it best for one of us to stay home with them and the other to travel. It’s reasonably likely that we’d travel during times Matt is supposed to teach, and on top of that, I’ll be our daughter’s primary caregiver, so it makes most sense for us to encourage her to bond with me first. That means that I’ll travel, and Matt will stay home. And I’m going to take Madeleine CaiQun with me. The cost of bringing one additional child is not all that high, and we saw, on our last trip, how beneficial it was for Mei Mei’s adjustment to our family to have a sibling there with us, and we’re hopeful that having her there will aid in our baby#4’s transition to our family. And of course there is the added benefit that she’ll have the opportunity to return to and visit the country of her birth. Additionally, any two of our children at home always get along better than all three, so my having her with me will hopefully make life at home easier for Matt and my mom, who has graciously agreed to stay home from China and instead help Matt maintain life on the home front.

I would obviously love to have Matt with me on this adventure, but having already traveled to China for an adoption trip once before, doing so without him this time feels manageable. However, I don’t think it would be wise for me to go without at least one other adult. I asked my brother and sister-in-law if either or both of them would be willing to accompany me, and they’ve both graciously agreed to do so, and I’m very grateful for that. They’ll be supportive and helpful and, of course, are much beloved by Madeleine CaiQun 🙂

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We’ll be a party of 4 traveling to China and party of 5 returning home! I am absolutely dreading leaving Miranda and Atticus for that long – I’ve never been away from them for anything like that length of time, and I’m sure I’ll miss them like crazy. As we’ve talked and prayed about it, though, we’ve become more and more convinced that this is the best travel scenario possible.

While the group of people traveling is pretty well set, our timing is less certain. I’m a part of a number of Facebook groups centered around providing support for families adopting from China, and in one of them there is a pretty reliable chart tracking current timelines for each step throughout the process. If the averages hold, we are likely to get our Letter of Acceptance (LOA), also known as Letter Seeking Confirmation (LSC), sometime this week. Our dossier was out of translation (OOT) last Tuesday, September 13, and we were out of review as of yesterday, Monday, September 19. We have probably lost a little bit of time because the CCCWA (the central governing body in China overseeing everything related to adoptions) was closed September 15 – September 17 for the Mid-Autumn Moon Festival, but they were back to work on Sunday, and usually the next steps (matching and issuing the LSC) are fairly quick, so hopefully we’ll make our way through that this week and get word that our LSC is on its way! This LOA/LSC step usually has the most variation and is thus the most crucial to our timing.

From there, the process gets a little confusing, but essentially we wait for several levels of US Immigration Approval. First we file our I800 (Petition to Classify Convention Adoptee as Immediate Relative) with USCIS. Once that application is approved, our paperwork is forwarded to the National Visa Center (NVC), where we will be assigned some new case numbers (our GUZ and invoice numbers) and receive information we’ll need to fill out the DS-260 form to apply for our child’s US immigrant visa. The NVC will also cable our file information to the US Consulate in Guangzhou. As soon as we are able to obtain a copy of the letter verifying that they have done so, our agency will drop off our Article V paperwork with the consulate in Guangzhou. The consulate reviews all of our paperwork and determines that everything is in order, and they issue our Article V to our agency, which is the last US immigration approval we need before traveling. While confusing in their layers, all of these steps are reasonably predictable in their timing, taking approximately 5-6 weeks in total.

At that point, everything is submitted back to the CCCWA, which has to issue us a Travel Approval (TA) – essentially an invitation to come pick up our child. TAs are coming pretty quickly these days – almost all that have been issued most recently have come in less than a week. There is no guarantee that that timing will hold, but we certainly hope it does. Once we have our TA, we request an appointment with the US Consulate in Guangzhou, and as soon as that is confirmed, we can get to work booking our travel! Usually you can leave about 2 weeks after TA is received.

All that to say, from LOA/LSC (which we hope to have this week) to travel can be approximately 9 weeks IF and only if everything goes perfectly. I’m giving us a 1 week grace period and hoping and praying like crazy to leave around December 8 or 9. Please, please, please pray with me that we’re able to do that! If we are able to travel then, we’d be gone for Matt’s finals week and the first week of winter break, which would be a pretty low key time for him at school and should make life here for him and my mom pretty smooth. Then we’d return around December 22 or 23 – just in time to have our family of 6 home for Christmas! It would be crazy – half of our family would be so incredibly jet-lagged for Christmas itself – but we’d be together, and that would be so amazing.

It’s entirely doable for us to travel then, but it’s by no means guaranteed. We really need to get our LOA/LSC this month, preferably this week, in order for it to be possible, and every other step needs to continue to go pretty quickly. If that doesn’t happen, we’ll need to make the decision about whether we travel at the end of December, which would mean getting our girl home faster and having more of Matt’s winter break left to enjoy all together but would also mean spending Christmas with half of us stateside and half in China; or travel in January, which means not traveling over Christmas but then bringing our little one home later and not having as much time over Matt’s Christmas break to settle into life together. I really don’t want to have to make that decision. I really, really want to travel and be home by Christmas. Would you pray with me that that can happen?

Our New Diet

In the 2 months since we’ve returned home from New York, some of the most frequent questions we’ve gotten have been about the dietary changes we’ve made. This area was really overwhelming for me at first – I wasn’t sure what changes we needed to make or how to find meals that met whatever standards we were going to follow. My first resource was the American Heart Association’s diet and lifestyle recommendations, which advocate for a low-sodium, low-cholesterol diet, featuring primarily chicken and fish, whole grains, and fruits and vegetables. That sounded doable, and in fact many of the recipes we were already using met those criteria.

As we did more research, though, we began to wonder if those recommendations were really the best we could do, particularly with regards to heart health. There seems to be general agreement that consumption of red meat is harmful, but what we began to read was that even consuming a diet high in animal protein in general seemed problematic. The Lyon Heart Study demonstrated that patients following a Mediterranean-style diet (primarily plant-based foods, whole grains, limiting salt and red meat) had significantly better outcomes than patients following the standard diet prescribed for patients with cardiac issues. We watched Forks Over Knives and heard about the China Study and saw and read stories of people who had serious heart disease who had been able to reverse it by adopting a whole-foods, plant-based diet. We read about the better health outcomes, particularly regarding heart disease, that vegetarians have relative to omnivores. The arguments were compelling.

Curried Tempeh Grilled Cheese with Mango Chutney and Tomato Bisque
Curried Tempeh Grilled Cheese with Mango Chutney and Tomato Bisque

We discussed what we were finding with Matt’s doctor, who talked with us about how the American Heart Association’s recommendations are based upon collections of large-scale studies, which necessarily means that they are never going to reflect the absolute latest research. He and other doctors believe that the direction they will head in the next 10 or 15 years, though, is further away from animal-based foods and toward more plant-based foods.

And so, based on the evidence we’ve been seeing as we’ve researched healthy eating, particularly with regards to cardiovascular health, we’ve made some pretty drastic changes. We try to eat fish once or twice a week but otherwise avoid meat when reasonably possible (we’ve had about two servings of non-fish meat in the last 2 months), and we are reducing our dairy consumption (so far by about half). We’re also focusing on consuming whole grains, like brown rice, quinoa, whole wheat pasta, oats, and bread made with whole wheat flour. We’re making sure that vegetables – instead of being a last-minute add-on to a meat-based meal – are rather a centerpiece of what we’re eating each day.

Smoky Chili with Sweet Potatoes
Smoky Chili with Sweet Potatoes

At first it was really difficult to find meals and recipes that met these criteria. So much of what we consume in American culture is based around meat and simple, processed carbs. However, over the last couple months I’ve gotten better at finding, assessing, and sometimes slightly modifying recipes for our health and enjoyment. So that you all don’t have to suffer through some of the inedible meals we’ve tried, I’m including information here about some of the recipes we have enjoyed in recent weeks. In no particular order, these are the vegetarian meals we’ve been enjoying:

Homemade Pasta Sauce
Homemade Pasta Sauce (before its encounter with the immersion blender)

My very favorite new cookbook is Moosewood Restaurant Favorites – do yourself a favor and order it. Seriously, it’s glorious. I believe people should be compensated for their work, so I’m not going to post their recipes here, but I’d encourage you to get it. Many of the recipes we’ve most enjoyed are contained within this book, in particular the following:

  • Thai Butternut Squash Soup (p 58)
  • Thai Noodle Salad (p 100)
  • Southwestern Sweet Potato Corn Soup  (p 56)
  • Creamy Herbed Potato Soup (p 49)
  • Pasta with Asparagus and Lemon Sauce (p 224)
  • Peruvian Quinoa and Vegetable Salad (p 99)
  • Summer Vegetable Curry (p 123)

And here are some of the recipes we’ve most enjoyed for eating fish:

The same cookbook I mentioned above has also been a blessing with regards to recipes for preparing fish. So far we’ve tried and liked:

  • Spicy Caribbean Fish (p 240)
  • Creamy Fish Stew (p 247)
  • Teriyaki Fish (p 241)
Creamy Fish Stew
Creamy Fish Stew

I’d encourage you, if you’re concerned about your health and, in particular, want to enjoy a heart-healthy diet, to do your research about animal-based foods and plant-based foods. So much of what we eat and the diets we advocate in American culture are really harmful to our bodies. Not everyone is facing the same medical circumstances we’re facing, and not everyone has to make the same choices we’ve made, but I think many of us can do better than we’re doing to care for our bodies. So far Matt has lost about 20 pounds and is feeling immeasurably better than he did before, and I’m feeling good, as well.

If you’re interested in pursuing more of a plant-based pescetarian or vegetarian diet, I hope some of these recipes can be a blessing to you in your journey!