The Last Straw!!!

DOC! I think I broke my rib! Agh!

How did you manage to do that?

Ow-ow-ow! Don’t touch it! I think I broke it when I sneezed… I put heat on it right after it happened to try to ease the pain, but it just keeps getting worse!

(chuckles and shakes his head) Mr. Smith, you must have lungs like Hercules to break a rib by sneezing… We just took x-rays on you last week, and there was not even the slightest indication of a fracture. Are you SURE that there is nothing else that might have caused this pain? And remind me to talk to you about ice vs. heat later…

Stop poking me! You’re the devil, you know that? I am sure there is nothing else… I’m telling ya… I just sneezed… and POP! There it went!

If you don’t relax, Mr. Smith, it is going to make this even more uncomfortable. Stop squirming. Have you ever… say… fallen? Oooor, been in a car accident?

I’ll relax when you get yer thumb outta my back! YEOW! Well… I fell off of a loadin’ dock about 5 months ago… and got drug by a horse when I was 27… and was in a car accident about 3 ½ years ago… BUT THAT WASN’T my fault! He was in MY lane and I-

Mr. Smith… I think I know what we are dealing with here. Take a deep breath in- this is gonna sting a little- breathe all the way out… I’m gonna give a little push-

OWWW! FOR THE LOVE OF JAMISON AND ALL THINGS HOLY!!! I don’t like you very much right now doc! I… OW! You ARE the devil!

Does a sneeze cause a "slipped disc" or a “broken rib”?

A “slipped disk” in the low back and a jammed rib is almost always the result of several things. Just like in most chiropractic cases, the problem starts with a simple fall or imbalance that seems harmless enough, and then it continues to build until it becomes symptomatic. We have all heard the proverbial saying about the “straw that broke the camel’s back”… but I think it is a VERY fitting illustration.

Just like the patient above, a simple sneeze can make someone experience sudden back pain that then proceeds to leg pain or pain in the ribs that can mimic a broken bone; in some cases, it can even mimic a heart attack. However, it wasn’t the sneeze that caused the disc to "slip" or the rib to jam, but it does represent the final "straw" in a much more involved process. Some factors that contribute to the pain and symptoms of back injury include dehydration, unusual stress on the spine, and too much weight bearing on a concentrated area of the spine.

The spine works together as a whole, so if there is a mechanical problem in one part of the spine, even as far away from the low back as the neck, it can cause problems in another area of the spine. Imbalances and problems in the pelvis, sacroiliac joints, and low back, as well as restriction in joint motion in the mid-back and neck, can contribute to the process of disc degeneration and eventual injury in the entire body.

A "slipped disc" or jammed rib usually happens when a lot of these and other factors work together and cause disc injury. For example: A middle-aged blue collar worker who stands for long periods of time, suffers from dehydration, has poor posture from weak abdominals, and lack of range of motion from years of repetitive movement, then lifts a heavy piece of equipment and experiences sudden acute low back or rib pain. Or perhaps many months after lifting the piece of furniture, he experiences no pain at all until he sneezes. Bingo. “The last straw”.

SO! Can a sneeze break a bone? TECHNICALLY… yes. BUT! That is only in severe cases of osteoporosis or rare bone disease. By in large… 99.9% of the time, no. A sneeze cannot cause a bone to break.

"Staff" Infection

No, I didn’t spell that wrong. I am talking today about the importance of a good staff in your office. A wise chiropractor once said, “Give me a great doctor and a mediocre staff, and you will have a mediocre practice. However, give me a mediocre doctor and a great staff, and you will have a great practice.”

Whether or not you want to admit it, your staff sets the tone for the type of practice you will have. The patients see and hear from your staff more than they do you. Your staff is the face of your practice. If they are having a bad day, so will your practice. If they are on the top of the world, your practice will thrive.

We have all been to the dentist and seen that staff member at their office. She complains every time she is asked to do something. Especially if it differs from the way they have “always done things in the past since the practice opened 26 years ago.” She hasn’t been at her best since “the accident” 12 years ago, which she reminds everyone of at least three times a day. She starts drama with the other employees and acts like everyone’s mother and boss. It is not a priority to her to work quickly; 60% efficiency is enough. Although, when she is working at 100%, she is nothing to write home to mom about. She barks orders like she owns the place, but you know by her character and work ethic, that is not the case. Yet, each time you go in to see your doctor, there she is- still getting on everyone’s nerves and shooting angry looks at patients across the room.

Now, I know that she has been a familiar face in the office for some time now, has been there with you through thick and thin, and that you are loyal to the core. HOWEVER, the storms she has weathered with you have left her worn out with a bruised ego and a chip on her shoulder. Everyone sees it but you. Sometimes, the powder blue adjusting tables and lavender vinyl traction tables are not the only things that you need to let go of during spring cleaning. This is not heartless! This is a business decision to liberate you and your practice.

Here are some hints that it is time to let her go:

• If you pull up to your office and sigh because her car is not yet in the parking lot… it might be time to let her go.
• If you dread telling her that you are implementing a new office policy and know that she will not only not do it, but give you a laundry list of reasons why it is a bad idea… it might be time to let her go.
• If she doesn’t seem to understand, no matter how many times you tell her, that it is not appropriate to wear cartoon character underwear underneath her white scrub pants… it might be time to let her go.
• If she is out on vacation for a week, and none of the patients ask why she isn’t there… it might be time to let her go.
• If she is out on vacation for a week, and some of the patients make comments like, “Oh good, chiropractic wasn’t the profession for her,” and you have to explain that she IS coming back to the patient’s disappointment… it might be time to let her go.
• If she still doesn’t understand that her foot fungus and trouble with the in-laws over the weekend is not appropriate waiting room conversation… it might be time to let her go.
• If she rescheduled all of your patients one day just because she decided she needed a day off… it might be time to let her go.

Bottom line... if they are bringing your office down... its time to let them go.

Disinfect your office!