Welcome to the Scharrer family's real life story! Most of our story is written for, and about, our four kids and the spice they add to our lives. It's our story of happiness, craziness, and sometimes ridiculousness. We've journaled through childbirth, the terrible two's, private school (and our public school experience), an autism diagnosis, medical school, residency, and long-term mission work in Africa.

Now we're following a new adventure, which involves a 45 foot motorcoach, homeschool, and as many ski slopes as we can go down in one year.

For posts from while we were living in Zimbabwe and updates about our future plans in Zimbabwe, please see our mission blog...


28 May 2012

Update on Erik's shoulder - THIRD blog post ever!

Job.  An amazing man with amazing faith.  Now, I wouldn't say I'm "suffering," but even if I was, this helps put it all in perspective.  I got nothing on that guy.

For starters, if you need to catch up on any of the back-story, here are links to the first and second posts.  Now, onto the news...

On Tuesday, 4 months to the day, I had my second EMG.  I always say it, but I have to give props to all the support I have.  I am continually grateful to my residency program and friends in Rochester, as well as Kara's support network including her friends from Side-by-Side, a sibling to the Christian Medical and Dental Association (CMDA) for medical spouses and significant others.  For the week prior to big day, I had my annual training at Camp Ripley for the Army, and the support I have from my Commander and everyone else in my Unit is just one more thing for which I am thankful.

This repeat EMG was originally scheduled for June, but I had an appointment mid-April when we decided to move it up.  My patience was thinning and, while nerve healing is a "slow process" (how many times have I heard that?!), I was anxious to move beyond the uncertainty.  In retrospect, I was also somewhat pessimistic since it was nearly 3 months after the accident and I still didn't have any significant improvement, so I thought, "Why put off the inevitable?"  That being surgery.

The anxiety-provoking uncertainty seems to ebb and flow in relation to my appointments, which I suppose is normal for anyone going through a serious injury or illness, so as the second EMG was approaching, my thoughts about the anticipated results became more frequent.  Interestingly, this created an internal dilemma.  What was it that I was really hoping the EMG to show?  Over the past 4 months there really hadn't been any significant improvements in strength of my left deltoid, tricep, or spinati, and the skin over my left upper arm was still numb.  It might seem like a no-brainer that I would want to see a change in the EMG to show at least some return of muscular function at the cellular level.  However, this "good news" of healing doesn't really help with the uncertainty issue, as it would be an indication for more watchful waiting without knowing to what extent the healing might continue.  The bottom line is that I want this to be better as soon as possible, which might be faster if the EMG showed no improvement and we pursued surgical intervention.  More importantly, though (so, the bottomer line), is that I also want the best possible outcome, which would probably come from my body healing itself, particularly with this mechanism of blunt trauma and the fact that it's a partial injury with retention of distal function (i.e. my wrist and hand work well).

As the appointment approached, that ebb and flow was ramping up, and my anticipation started to become more one-sided.  I was really hoping for improvement on the EMG.  Even if I had to struggle with this injury a little longer, but 10 years down the road I had a higher degree of recovery, it would be worth the immediate bother.

[This is my third blog post ever, and I think I've picked it up quite quickly.  None of you really care about all the yada yada above (no pictures even!) -- "just show me the money!"]

Supraspinatus above the scapular spine.
Infraspinatus below the scapular spine.
To get to the point of this post, the EMG didn't show any changes in nerve conduction or myocyte activity.  I had a different neurologist this time who also used ultrasound at the bedside primarily to evaluate muscle architecture and visually watch for contraction, or flattening, of the muscle in real-time.  One positive thing from the appointment was his comment that my muscles appeared to have normal, but diminished, architecture still.  He also did two other things this time.  One was to test the supraspinatus, which wasn't done last time, just the infraspinatus.  The supraspinatus is buried underneath the trapezius muscle, which was another benefit to using ultrasound.  As expected, this didn't show any activity, either.  Really just confirming what we already knew.  He also stabbed me closer to the spinal root and said the paraspinal muscles looked normal on EMG, which is a good sign and is evidence against a complete axonal injury, such as an avulsion of the nerve.

After my EMG, I had an appointment with the Brachial Plexus Guys.  It was a pretty brief appointment and we got right to the point.  We scheduled surgery for July with an MRI of the brachial plexus (the first MRI was just of the shoulder joint, not the nerves), another EMG, and another appointment the day before to have a solid game plan in place.  At this time, they still don't know if it will be a nerve transfer or a nerve graft, though it sounded more likely to be a transfer.  What is the difference, you ask?  Washington University has a really good website describing nerve transfers and nerve grafts with a lot of other really good information on the left side of the screen.  I like this description:

Nerve transfers involve taking local nerves with less important or redundant functions and “transferring” them to restore function in a more crucial nearby nerve that has been severely damaged. The surgeon will use functioning nerves that are close to the target muscle or sensory area, and these nerves are transferred or “plugged in” to the injured nerve that no longer functions. The nerve that has been “plugged in” now supplies that function. For example, if a breathing nerve is used to restore elbow flexion, the patient may initially have to take a deep breath to move the arm. The brain then learns this trick and soon the patient is able to move the arm simply by thinking about moving the arm.

An example of re-routing the median nerve to the radial nerve in the forearm
(not something that I will have done, just an example of a nerve transfer).

If you browse around their site a little bit, you'll find this page describing the spinal accessory nerve transfer.  This is a good description of what they're planning on doing with me since my suprascapular nerve isn't working (innervating the spinati muscles).  It will be interesting, to say the least, to see how long it takes to train my brain to understand the re-routing of my nerves.  Speaking of recovery time, here was another quote that was on that site.  Something that reiterates something I've been told before:

Recovery of function after any nerve reconstruction can be a long process. Some patients have seen small signs of recovery as early as two months after the operation, but in most cases, return of function begins somewhere around six months, with full recovery in about two years.

This is when I shake my head, take a deep breath, and say, "Man!  This stinks!"

They're also talking about possibly transferring some intercostal nerves from my chest to restore some function (maybe to my tricep?).  Imagine watching me take a deep breath every time I need to extend my arm!

I said this last time, but I feel so fortunate to be at the WFMC with the world experts in this specific, somewhat rare, brachial plexus injury.  Something I heard last year at my interview was that while zebras (what we term rare medical conditions) are maybe a quarter-percent (0.25%) for the rest of the world, they're maybe 1-2% here.  These injuries are still rare, but anytime you have enough volume to create a specific schedule for "The Brachial Plexus Clinic," it's pretty impressive.  This sort of super-sub-specialization is a huge benefit to their patients (me!).  This is the time of year when they have the winter sports accidents getting scheduled for surgery after the 4-6 months of waiting time has proven ineffective, and they have "a bunch" of these surgeries lined up over the next month.  [This is another paragraph of yada yada to earn me some blogging clout, but here's the kicker...]  Seeing as how there are a few of these surgeries, granted they will all be slightly unique, and I've never actually seen a nerve transfer, I asked the NP (with whom I also went to St. Olaf, coincidentally -- and one of the main Guys is also an Ole) if I'd be able to scrub in on one of the upcoming cases.  She enthusiastically replied with a, "Yeah!" and she went to ask the other, non-Ole, Guy when would be the best time.  They had 3 cases the next day and I appreciated his response when he said a different day would be better so they could talk with me about the cases and do more teaching.  I thought that was neat and I'm hoping it works out to see how exactly it all works behind the scenes.

So, that's the plan.  Surgery in July.  More uncertainty.  More praying.

The last EMG doesn't give much information about how much interval healing has taken place, just whether the nerves are functional again.  So please keep praying because I have 6 weeks to get some progress or I will be subject to a Bard-Parker (i.e. "knife" -- it's a brand of surgical scalpels, like Kleenex is to tissues).  Also pray for patience.

Yet what we suffer now is nothing compared to the glory he will reveal to us later.  Romans 8:18

19 May 2012

Moms and Muffins

A few weeks ago, Skogen and Maida had "Moms and Muffins" at their preschool.  First I was able to go into Skogen's class and join him for juice, muffins, and a craft.

Skogen sitting at his chair.  He was so happy to have me there and I was so happy to be there! 

Our fingerprint caterpillars.  Skogen's is on the top and mine is on the bottom.  He drew his own face on his caterpillar and really surprised me with the placement of the eyes and mouth because I've never seen him draw a face on anything before.

Me and my boy :)

Maida sitting at her desk

A worksheet she filled out about me and a picture of me that she drew.  They were supposed to guess at all the answers.  I love that she thinks I'm 21 years old, I have gold hair, and she loves me because I'm beautiful.  :)

Me and my girl :)

Maida's class sang some songs for us.  It was so cute!  Maida wasn't shy at all and knew every word (which is totally different than her Christmas program!).  I was a little sad that Maida was the only little girl not in a skirt/dress, but she had a breakdown right before we went out the door and this outfit (holes in the knees and all!) is what we settled on to get her to go to her program.

A sweet card Maida made for me.  "If moms were berries..."
"I'd pick..."


I love my kids!!!  And I'm so proud to be their Mommy.

A Little Off Schedule

As was to be expected, our kids got off schedule a little bit while we were traveling.  Our dinner at T-Rex was proof of that...

17 May 2012

Oklahoma Vacation

Today was a very windy, but warm and cheerful, day...  I was able to shower this morning and shave my legs (which doesn't happen too often!).  I dressed the boys in matching outfits and Maida went to school with no tantrum about her clothes.  It rained a little last night, so instead of watering the garden and all of my plants, I got to spend some extra snuggle time with Skogen on the couch while Maida was at preschool and Klaasen took his nap.  All of these things, especially when they happen on the same day, make my whole day brighter.  However, nothing can compare to the delight I feel this afternoon as I anticipate the evening ahead.  Erik is home from a week away and we are more than happy to spend some much-needed time together!

Speaking of Erik being out of town... when he's out of town, he takes our only computer with him, so I am unable to blog.  Since we've both been traveling in opposite directions lately, the blog hasn't been updated very regularly.  Along with many little minor (but important!) details of our life, we've had a few big ones lately, too.  Our most recent vacation down to Kansas and Oklahoma to see our family was a highlight of the month!  To see all of the pictures from our trip, click here.  Otherwise, here are a few picture highlights...

Maida celebrated her real birthday at Uncle Tony's house!

We got to play with sweet cousin Kinley (Erik's brother's daughter).

We saw some of my family, including my Aunt Becky and Uncle Steve, my cousin Melody and cousins' wife Katie, and their children.  These three are second cousins (I think - or maybe first cousins once removed?) and are pretty close in age!

Melody's kids with my kids

We got to see Uncle Ron's motorcycle!

My sister-in-law, Karlie, and I got a pedicure and manicure!

Nana took us all to Chuck-E-Cheese for Maida's birthday!

Maida won 100 tickets on one game!!! (Does anyone know how to flip these pictures once they are uploaded to blogger?  They are flipped and saved on my computer, but don't upload that way.)

Nana and the kids before church

Aunt Lola and Uncle Ron surprised Maida with another birthday cake!

Mema and Deda with their great-grandchlidren!

Karlie and I got to bump bellies again!  We had Klaasen and Kinley within a month of each other.  These babies will probably be more like two months apart.

On the way home, we stopped in Kansas City and Maida learned how to swim across the pool alone in her lifejacket.

Erik and I surprised the kids for dinner one night!  They knew we were going someone special and they were SO excited!!!

We went to T-Rex, which was such a cool place!  Kind of like the Rainforest Cafe, but a thousand times better!

Erik is in town for only two days, so hopefully I can get some more milestones documented...

09 May 2012

Maida is FIVE!!!

May 4, 2007 - one day old,
in the special care nursery
Maida turned five years old on May 3rd.  I wouldn't be lying if I said it was a bitter-sweet birthday.  I loved, doted, and obsessed over Maida as a baby (isn't there just something special about your first baby?!), I enjoyed, but also stumbled through the toddler years (not really knowing beforehand how much attitude and stubbornness a little tyke could hold!), and now we've proudly made it to the school-age years.  What a blessing Maida has been these past five years and even though I wish she could have stayed a baby and a toddler just a little bit longer, I am excited for this next chapter of our life together.  It is a pleasure to be her mommy.
January 28, 2009 - 20 months old,
 first time skiing with Daddy

We celebrated Maida's birthday on April 28th with some of her friends.  Grandma and Bumpa were even able to make the five hour trip down to celebrate with our princess, too!  We had a Fancy Nancy tea party and even with all the stress of putting it together and several things going wrong, I think Maida and the girls still had a great time.

(I am so frustrated with these pictures!  I can't get them to flip and have had this post saved for a week, so I'm just going to publish...)

Our birthday invites

The tea table

Table before we added the girls' tissue paper flowers

The birthday girl

Our centerpieces

The yummy cupcakes

When the girls first arrived, we had them paint tea cups and saucers.

They did so well sharing and not getting paint everywhere!

The original plan was to drink out of the tea cups for the tea party, but I forgot to tell them not to paint the inside of the cup, so we quickly went to plan B.  :)

Grant, Skogen's best friend, was the only boy (besides his baby brother, Kolby) that came to the party.  Grant and Skogen painted coffee cups.

After painting the tea cups, the girls made tissue paper flowers to tie around the napkins on the tea table.

While some of the girls finished up the tissue paper flowers, Maida's Grandma  read the girls a book about tea parties.

The table complete with the tissue paper flowers!

To finish off the girls' most elegant attire, we painted their finger nails!

Erik was in charge of putting little stickers on their nails (bet he's never done this before!).

Erik lit five candles on her cupcake and then began the tea party!

The boys enjoyed some cupcakes at their own table.

The girls having tea (which was really party punch)!

The whole crew

We ended the party with presents!

The very last present was a doll house from Erik, me, and the boys.  We got it at a garage sale!  :)

The thoughtful presents Maida got from her friends.  Definitely a blessed little girl.

In the boy's party favors, we put some "Mater Teeth"

Our family with our FIVE year old!!!

We write to taste life twice, once in the moment and in retrospection.”
~Anais Nin