Iva Byler, mother of the three girls with Cohen Syndrome, made an even more drastic change eight years ago, after her third child in a row showed signs of this crippling disorder.
The eldest, Betty Ann, is 24 and functions at a 9-month level. Irma is 21 and functions as a 5-year-old; Linda, at age 18, can't even sit up.
"I knew as soon as I had the third one, I knew," she says. "They kept telling me, 'No, she's OK.' No, she wasn't. I could hear by her cry that she was gonna be like the others. Their cry is different. You can tell. After you've lived with it that long, you know."
Now, when she needs to go to the doctor, she wheels the girls into her van. She's left buggy rides, and the whole Amish lifestyle, behind. But the price was being shunned forever by the community, as well as her ex-husband and her two healthy adult children.
Irma's now tuned in to the 20th century, and Iva's plugged into the 21st. Using a genealogy Web site, she's figured out she and her ex-husband were distantly related, something that appears to be common among the Amish.
"I don't think the Amish really understand that it's a genetic disorder that causes the handicapping condition," Byler says.
The Amish think it is God's will; "Gottes Wille" is how they describe it.
Dr. Harold Cross, who's from an Amish background himself, has heard that for more than 40 years, since he first discovered the high incidence of genetic problems in the Amish in the 1960s.
"Although we used state-of-the-art medical technology and genetics technology at the time," he says, "we didn't know about the human genome. We weren't able to--to drill down and get to the specific molecular defects. So I always felt like we hadn't finished the job that we had started doing."
He's finishing the job now, learning by examining some of the children in Geauga County, Ohio, and teaming up with researchers in a London lab to find the actual genes that are causing the Amish disorders.
"What we're really trying to do eventually by pinning down the mutation is to find some kind of treatment," he says. "If we can find out what went wrong, we might be able to correct it."
They've already identified genes to several rare conditions, including a debilitating seizure disorder found in only 12 people worldwide, all Amish children.
There are no cures in sight yet, but these doctors are able to offer the next best thing: pre-marital testing, to help future parents avoid these tragedies.
It's a powerful new tool for the Amish, if they choose to use it.
Despite the illnesses in his family, Miller would not use such tests. "That's our-- our lifestyle is that way. We-- we trust God to take care of that, you know? We just, just the way we—we - live."
Joyce Brubacker, who comes from the slightly less-orthodox Mennonite faith, says at minimum the Amish and Mennonites should be testing their children as soon as they're born. That's what saved her daughter Shayla's life. After her first child, Monte, died of an unusual-sounding genetic condition called Maple Syrup Urine Disease, Joyce had Shayla tested, and she was positive.
With Maple Syrup Urine Disease, the body turns protein into poison, causing brain damage. Shayla was immediately put on a strict low-protein diet. Now, she's 20 years old and healthy.
If she had not been tested, Shayla says, "I probably would have been in a coma or died at that point, or had brain swelling which would have took me very dramatic. I mean it would just-- boom, boom, boom and I woulda been dead."
Right now, the best prevention for many of these mutations is to prevent intermarriage, which is hard to do.
Marrying outside the faith could create a healthier gene pool, but it would also ultimately destroy the very essence of what it means to be Amish.
"I have a son that married a girl, they share the same great-great grandfather," says Iva Byler. "And when he called me to tell me that he was gonna get married, I said, 'Do you realize that you already stand a big chance to have a handicapped child since you have three siblings.' And he says, 'Yes, I know.' He got married anyway."