Attorney David Hefferan talks to Dr. Srour about Chiropractic Health

On Behalf of | May 24, 2021 | Podcasts

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Chiropractic Health Dr Srour Joins us LIVE with David Heffernan Welcome to another episode of First off, let’s kill all the lawyers. It’s an off misquoted Shakespearean statement from back in the 1500s. But probably still hold some truth today when you talk to people. And you know, one of the things I’ve found over the last 30 years of practicing and doing personal injury work is people do like to bash lawyers until they’ve got a lawyer or need a lawyer. And so the thought behind this show was to talk about different areas of law types of law, trending topics of law. And one of the things I thought we’d do today, we’re going to shift gears a little bit. My guest today is Dr. Charles. Sure, sir. All right. I got it. I got it. Right, totally. I’m only saying that one time, you’re now Charlie, the rest of it. But he is a Doctor of Chiropractic. And we’re going to talk about some of the interplay, I think, between lawyers between chiropractors, I want to talk about his practice, educate a little bit about types of injuries, treatments, and everything else that are there. And I think there’s a lot of similarities in some things, Charlie, so mark, and I did a show a few weeks ago, you know, hopefully, the governor will sign this, this change of law, and the auto law, which is going to get rid of PIP and the whole no fault scheme, which hopefully will then get rid of the one 800 car accident clinic and the chiropractic clinics that that you have there. So I think I think personal injury lawyers tend to get bashed a lot. I know chiropractors get bashed a lot, but but I want to show you that lawyers get bashed more, because I looked this up. So here’s the ultimate list of lawyer jokes. Okay, you see how thick this is? Okay. Although it’s a guy, it’s got a few good ones. So how many lawyer jokes are out there? There’s a lot of wager. Now there’s only three, the rest are true stories. So but, but then I looked up chiropractor jokes. It’s only like six pages. And frankly, there’s only one that’s any good in here. So how many chiropractors does it take to change a light bulb? How many? Just one but it takes six visits. Okay, so, so here’s, here’s the thing, you know, I mean, I’ve been helping people in South Florida along with my partner Mark care for 30 years. I’ve never chased an ambulance. I’ve never run into the back of an ambulance. You know, and, and I know that, that your chiropractic business is far different from what the people see on the billboards in the advertisements to go back and forth. So let’s talk about that a little bit. So let’s talk about you. First off, you’re from Canada, where you grew up. Alright, what brings you to the US. So I went to school, university, Toronto, then I graduated and did my chiropractic in California. Okay. It was just far distance wise, it was far timezone wise. So I wanted to be on the East Coast, I kind of fell backwards with an opportunity to work with a group guy who was the chiropractor for the Miami Dolphins, and hired me on the spot over a phone call. And I came down to South Florida, and kind of fell backwards into a great office with a great philosophy, sports injuries, which was my passion. I played tennis as a kid, and competitively throughout until To this day, and I just had a good opportunity to work with this guy and in that environment, and we ended up treating, you know, the Miami Dolphins for many years, the Florida Panthers for many years, some of the Marlin players. And you know, one thing led to another, I took over the practice, and my wife had kids and we and we love it here. And we’ve had you in South Florida since then. Yeah. So you run pro healthcare, which is where so pro healthcare is in North Miami. It’s a, you know, sports injuries was the base behind it. But since you know, practicing for 20 years, you start to expand into Family Health and some auto accidents. It’s multidisciplinary. We do chiropractic, physical therapy, massage therapy we have, we have mental health counseling. So we have several different you know, we tried to make it like a one stop shop for all of that. But at the same time, it’s more of a what my goal was always to be more of that concierge type. It’s not, I’m not a concierge doctor, but I try to offer those services where I’m involved, I’m doing the work. There may be a time where I need to hire others to do things for me as I get older, but, you know, as long as I can do it, and I’m in, I’m in there, I’m in the grind and I love doing it. Alright, so let’s talk a little bit about chiropractic medicine. And you talk I think, you know, you describe sort of a holistic approach. Yes. Okay. So, so let’s talk about what chiropractic medicine is because I want to dispel some of the myths, just like there’s myths about personal energy lawyers, you know, that they’re all chasing cases and the chiropractor’s, you know, they just want that 10,000 and paper, anything else, let’s talk about because chiropractic medicine been around a long time, you’ve already dispelled one myth, you’re actually very well educated. So there is, you know, you are a doctor. It’s not a medical degree, but but it’s still eight years of, you know, postgraduate education or more. And, and I got to see you did all kinds of things really well, like, you know, graduated magna cum laude, and Dean’s list. And so that’s impressive. So you’re well educated Now, what’s, what’s the practice about? So, you know, the practice is about what, you know, there’s many different philosophies, like there’s many ways to practice law, you know, you have your philosophy, your partner has his philosophy, maybe they’re the same, maybe they’re a little bit different. You know, chiropractic, the, the origin of it is really, it started out as manipulation of the spine, to free the nervous system, allow the body to heal itself without the use of surgery and drugs. That’s evolved over time. Whereas in the past, they were not accepting of rehabilitation and massage therapy and modalities, physical therapy, all the all the other things that go along with it. But as time has gone on, things change, and those kinds of things, because, you know, the realization of how important those things are not just about spinal manipulation, but you know, if someone has need certain rehab has certain weaknesses, and that kind of thing. So it’s, it is a holistic approach. And that’s kind of the you know, there was no way for the old philosophy chiropractor to work in a Miami Dolphins or, or, you know, a professional athletes, sort of arena with doctors that don’t think alike, right. So you have to mold yourself. Now, that’s, you know, when you’re doing your own thing in your own clinic, you have your philosophy, what is surgical, what is not surgical, when do I need to refer it out for, you know, an orthopedic consult or something like that. But that’s the basis of what we do, trying to heal or speed up the healing for patients without the use of drugs, surgery, when needed, then there’s a time in place. So have you seen a shift, because I know, for a long time, you know, Western medicine, didn’t want to acknowledge some of these things. And I had a case years ago, that involved in acupuncturist at the University of Miami. And I wound up doing some research on that and was blown away by the fact, countries were doing open heart surgery under acupuncture and things like that. Maybe it wasn’t documented in a textbook, but it’s 1000s of years of treatment and care. And again, a holistic approach of aligning things in the body and everything else. So have you seen that start to shift now? Where where there’s sort of a merging between these two? So, yes, and no, I mean, I’m not I’m not going to get into the political side of things. Big Pharma. And so what we see what good they’ve done for everyone. But at the same time, you know, what I tend to see in my office is, someone gets injured, they’ve tried everything else. And then often the last straw, and especially early in my career, and suddenly you get them better. And they didn’t need to go through what they went through. They, you know, they were not carried properly, they were mis diagnosed, they were treated improperly overly medicated, whatever it might be, and you get them better. And then suddenly, you become their guy, you know, that’s you’re there guy for everything. And so, they come to you for the advice that comes to you. So in one way it takes certain patients an injury that they are not getting, they’re not improving, they’re not getting better, their quality of life has gone down, and they’re looking for something else. And then there’s the other side are people who this generation is more open minded. And you start to see a merge of the two. There’s no question the population over the 20 years has changed. Now that you’re seeing chiropractors on the sidelines in professional, you know, every movie star talks about their chiropractor, you know, Hollywood, you know what it is, it’s more in the media. It is sort of becomes more popular. So it’s definitely shifted. And there’s definitely there’s that, you know, you have different connotations different in different arenas, but I work with many medical doctors, you know, nutritionists, I, you know, in my building where I, you know, my building, I’ve got all kinds of doctors to me and we cross refer Daly, and it’s a great relationship, I think it’s really important. So you talk about sort of the, what I guess would be the term maintenance because there’s, I think there’s a phase, and we’ll talk about that in a minute of treatment of acute injury and things like that, that there’s a great benefit to what are also seems now to be some philosophy of, of maintaining. And we’re seeing I think, that shift in mental health as well, that people are now starting to get more time to maintain their mental health. And some of these things are sort of coming out of the darkness say, no, it’s okay to sort of get adjusted and maintain you maintain your car, you maintain all these other things that are important to you, why wouldn’t you maintain your body and your brain? I think, what, what happens is, maintenance is different for everybody. And to be dictated by someone, and told, hey, you need to come here once a week for the rest of your life as a maintenance, that that to me doesn’t work. Maintenance, for me, everyone has a different level of active everyone has a has their own history. So it’s about figuring out what that person’s maintenance is for them, okay, you have a tremendous history of injuries, let’s say you’re a football player, well, you may need more maintenance than someone who’s, you know, a little more sedentary, or not, if that other person is sedentary, and is developing chronic issues as well. So maintenance is extremely important. And but understanding, you know, my philosophy is not just, I’m the one who’s going to maintain, its, I’m going to give you the tools, I’m going to help you, if you get injured, I’m going to help you, I’m going to treat you I’m gonna maintain you I’m going to, you know, balance things up, but to give you the tools so that you can do things on your own to help. And that’s how I got into this field was I was injured, wasn’t getting better, with regular, you know, pain medication treating symptoms. And so, I went to the chiropractor that my dad sort of forced me to go to because I wasn’t getting better. And, and it was a philosophy that turned me on to it. It was, well how are you sleeping? Well, you can’t sleep like that, because of that. So if you don’t change what you’re doing, you’re gonna be right back in the office for another treatment, right? So treat, get them better. Give them the tools so that they don’t reinjure or that we’ve come up with a cause? And then have them come in maybe it’s once a month, maybe it’s once every six weeks, maybe it’s every two weeks, to sort of maintain what we’ve done. And if you have chronic injuries, yeah, okay, you may have to come in a little more frequently. But there’s also things you can do. And I think the education is just as important as what I do for the patient. And I think that’s a tremendous philosophy, because you are, you’re giving them the tools. And I think too many times and, you know, get we saw it with Big Pharma with opioids and everything else was here, just take these take these. And while they probably effectively masked a few things, they buried everything else. And and and then and then the hook behind it was was horrendous. So we’re seeing that. Alright, let’s talk now. There’s obviously a natural marriage between lawyers to do personal injury work like Mark and I do. And doctors, chiropractors, everybody else because much as we’d like to, I don’t get to go in court and say, Okay, here’s all the injuries. Let me tell you what they are, you know, I’ve got to have people that document that I’ve got to have people that treat that. So let’s talk about that component of your practice that is accident related. What are what are the type of injuries because get thing it’s hard for me as a lawyer, often, you break your arm, I can put an X ray up, anybody on the jury can go, oh, that bone was like this. It’s now like this. That’s broken. Right. But we talk about soft tissue, we talk about whiplash. And again, I think phrases that get abused by people scoffed at, but let’s talk about that what happens with the mechanics of a car accident? That may not result in broken bones? Right. So you bring up a good point. Yeah, I had a situation yesterday. lady comes in car accident. went to the hospital, from the from the scene. So they’ll they’ll take they’ll take it the job of the people in the hospital is not to tell you you’re fine. It’s, it’s to examine, make sure you’re not going to die, right and get you out of there. Right. So they do a couple x rays, okay, nothing’s broken. They don’t need to be concerned about their their liability is gone. Now go somewhere to treat, you know, to fix yourself any therapy, whatever it might be. So, patients Academy, then they’ll say, Yeah, I went to the hospital and nothing’s broken. And they said nothing’s broken, but I’m in a lot of pain. Well, okay, so let’s discuss that. Why are you in pain? Well, x rays are not the gold standard for any soft tissue injury, okay. So if they’re so let’s define that. What is soft tissue mean? So soft tissue means So when you do an X ray, you’re basically imagine a screen here, oh, you know, you’re looking at a white screen, the person stands here, and you’re getting black paint shot at you. Okay, so all this black paint of the X ray would be shot at you. And the result will show on the screen, while bones stops the black paint from going through. So you’re gonna see the bone on the screen. And so you pull up an X ray. And you see, it’s, it’s perfect for to see if there’s any broken bones, okay? What you’re not going to see is the spaces in between, right, the areas that the black paint penetrates, which is all the soft stuff in your body, right? Whether it’s muscle, whether it’s disk, whether it’s cartilage, you’re not going to see that you’re going to see this space where it where it’s supposed to be. So when we talk about ligaments, muscles, tendons, discs, cartilage, which is basically everything that holds the bones together, everything else, right, you need to do that would be an MRI, and MRI is the gold standard to look at any of those structures and their integrity. So what’s the difference between MRI and an X ray, so like I said, X ray specific for bone, okay, because that black paint k cannot penetrate the bone. So if there’s a crack in the bone, you’re gonna see a black line, that was that’s not supposed to be there, right, or if the bone is off, right, you’re gonna see a white line here, white line here and the space that’s not supposed to be there. An MRI, you’re going to get the same image. But now we’re talking about other structures, you will see the you will see the bone on X ray, I mean, I’m sorry, on MRI, but you will also see muscles, discs, any tears and that type of thing. So it’s a more costly form of imaging, but it’s going to show a lot more. So when you say, you know, what’s a soft tissue injury? Well, a soft tissue injury could be a strain muscle, it could be a disc herniation. You know, it could be a cartilage tear, any of those constitutes soft tissue injury, and there’s different grades of that. Alright, one of the things we see a lot ligaments, and again, if it’s torn, kind of easy to see. But I think the mechanics that you see with the forces involved in automobile accidents, often strains or stretches ligaments, and what happens when, when that occurs. So that’s a good point. Sometimes you do an MRI, and it shows nothing. It says, normal, normal structures, nothing’s torn. And but the patient still has pain, and could potentially have what we call ligament laxity. Okay. So let’s say, you know, I put my finger back like this, okay. And let’s say you’re a strong guy, you pushed it, and you went too far. If I did an MRI of this finger, if I did an X ray, this finger, if I do any imaging, it’s not going to show anything, but I’m in pain. Right? Right. So something happened here, like, I’m not lying, I’m in pain, right. So if those fibers, whether it be ligament or tendon get pulled too far, almost like a frayed rope, they can stretch, okay, and that can cause inflammation and pain and that kind of thing. So when you talk about those kinds of things, more auto accident related the same as a whiplash, you get into an accident, you may not show symptoms, you may not show anything on the picture, but the patient may still have symptoms as a result of the ligaments getting strained. And sometimes it can be tested with certain x rays where we would, you know, flex the neck in a certain way, take a picture, extend the neck in a certain way, take a picture and see if the bones which is what the ligaments holds in place shift, then you can see the ligament laxity there, or on an orthopedic test, let’s say my wrist is only supposed to go this far, but it’s traveling way too far. You know, there there are ways to test as well. So, you know, the gold standard is that MRI for imaging, but at the same time, there are times where I’ll get an MRI sent to me a text message from my dad from someone. Hey, what do you think? The semi the MRI with the report? I said, Well, what do I think? I agree with the report. It says there’s a disc herniation at this level or whatever it might be right there. And is it Yeah, but is that surgical? That that’s a totally different? I can’t answer that. Because you have to look at the entire clinical picture. Because someone with for example, a disc herniation may not have any pain, it may be a completely asymptomatic situation, but their MRI looks miserable. And then you might have someone with a minor issue on the MRI and be in extreme pain and then there might be some thing more that needs to be done. So the whole clinical picture is important. The exam, the history, and then and then the imaging as well. And so everything together sort of gives you an answer as to Okay, what needs to be done. We’ll see. And that’s what terrifies me. So I’ve obviously played a lot of football banged around a lot. I don’t want to get an MRI of anything, because I’m afraid what it will show because I feel fine. Don’t show me so I, I have my shoulder years ago, yeah. And he goes, well problem my bicep tendonitis. It was inflamed. He goes, that’s what’s causing your pain. He goes, you’ve got a torn rotator cuff. Yeah, he goes, but that’s real old. He goes, so we’re not worried about that, you know, we’re gonna we’re gonna control this inflammation that you’re suffering from. Absolutely. And, and I tell patients that before MRI, that sometimes it’s good. You know, we have picked up cancer when we were taking an MRI of a neck because of neck pain after an accident, so they weren’t any pain, but we picked up thyroid cancer, and suddenly, they’re stage four, and they need all this treatment. And it pretty much saved their life because we because we found something inadvertently, right? But at the same time, I could be, you know, you may have strained your lower back just muscular and your back’s killing you, you say I want an MRI, we do an MRI, we may show three herniations. But that’s not the cause of your pain. The cause of your pain is the strain muscle, you’re gonna be fine. Those herniations you fell out of a treat when you were five, or whatever, right? You know. So doing an MRI is good, but it you know, it shows everything and it’s going to show old stuff, new stuff. So that’s why the whole clinical picture of the exam is just as important. The whole thing has to be together. Alright, so let’s play shown talk because your chiropractor so I know you brought a spine with you, I guess. Okay, um, let’s educate some people. We’re talking about discs and we’re talking about ligaments. We’re talking about the mechanics of an injury. So let’s let’s define some of these terms and show the mechanics of a whiplash because, again, it’s a term I think, you know, at least defense lawyers love to scoff at, oh, it’s whiplash, which people mean, you know, you got tapped in the rear and there’s nothing wrong with it. Right. you’ve dealt with it, we’ve dealt with it. We’ve had joint you know, patients and clients in exclusive exquisite pain as a result of a whiplash injury. So, alright, so walk us through this. Okay. So we’re going to try to keep it as simple as possible. This is looking at the spine from behind, okay. Okay. So this person is facing, let’s say, the back there, you have the pelvis. And these are the bones of the spine, which should be relatively straight. Okay. The head would be here, the neck is here, mid back, lower back, and pelvis. Okay. Okay. So now I’m going to turn as if I’m facing you, so this spine is now facing you. So when the baby’s born, they’re in that C shaped the fetal position, right? They start to lift their baby, by the way, they start to lift their head, and they develop this curve in the neck, okay, okay. Then they start to stand and walk. And they developed this curve in the lower back. So that’s the normal sort of ash shape of a healthy spine, right from the side view, right? From the back view is straight, right sign you these are normal curves, they help with the cushioning when you’re walking, running, or you know, any impact throughout the day. Those curves are there for a reason. Okay. Now, these are the bones and they’re separated by these discs and those are like your shock absorbers. Okay? And in between, you have these nerves, spinal nerves that exit the spine, and they go to the rest of the body controlling everything, right, okay. So, the mechanics, let’s say have a typical rear end collision, patients in their car had a red light, and they get hit from behind. Okay. So typically, whether it’s a 10 mile an hour, 30 mile an hour, typically the patient’s wearing their seatbelts, they’re gonna get hit. And the first reaction will be where the head and neck quickly go forward. Sure, okay. Because you’ve got you’ve got the upper part of your body restrained by by seatbelt. Correct. So, that part of the accident, now you’re getting almost like when someone pushes you quickly from behind and you’re not expecting it. You have ligaments that attach each vertebra to each other, and though and muscles and tendons and those if they’re forced forward like that quickly, will stretch. Okay, and Then after that, you get the results of that you and your head comes snapping back, right, then you get the joints, they kind of snap back onto each other and sort of pinch each other and can cause pain, inflammation and that type of thing. That’s the first sort of, you know, minor would be a minor whiplash, where the discs are not involved. Okay, so that’s like, what they call a sprain strain or a whiplash where it’s just muscle, and ligaments, and maybe some nerve involvement, some inflammation, because those tend those tendons and ligaments get stretched, without expecting it, and the results is pain. Okay? Now, you know, in a more severe situation, that same thing can happen in a quicker situation. Or let’s say, if the patient’s head is, you know, they’re looking into the rear view or something like that, they will step forward quickly cause a brief, quick compression to the front of the disk, right? causing that jelly material and disk to get forced back into the nerves here. And that’s usually a little bit, that could be a very severe situation. But it’s definitely more involved than just a regular sprain, strain injury, that so you’ve got these discs that are encapsulated, sort of like a gel like and so so they’re gonna crush, if they crush that can push out and push back on a nerve. Right? So I like to think I explained it as the jelly doughnut model. You have that jelly doughnut or the jelly material on the inside, right, the cartilage of the dopey part on the outside. So if I squished one side, something’s gotta get jelly. Don’t the jelly mature is gonna pass out the other side, right? So here’s the jelly here. If I force this forward, and now I’m squishing the front, where’s the jelly going to go? out of the back? Okay, go back and left back and right. And this is an example of a lower back, right? herniation. It’s coming back and to the right. And that’s from the quick compression on the front of the disk. And then the result of that is the pain and the numbness tingling, all the symptoms that we see. All right. So how important is it for people when they get into an auto accident to get evaluated early? Well, yeah, that’s I mean, you know, what happens is often, we’ll see that patients come in, and they’ll say, you know, the first day or two, I wasn’t bad, and then they want to come in. After that. They said, I can’t move now. And so sometimes there’s a lot of adrenaline, and at the end, they don’t want to go to the hospital, they don’t want it, they don’t want to spend the time. But it’s important that at some point after an accident, you’re evaluated, because there can be a whole host of symptoms that come on spine brain, that you you wouldn’t even associate with the accident, because it’s days later, or, you know, Brain, Brain fog, you know, the brain is just swimming around in its own in a skull. So you can hit centers of the brain that can cause confusion, dizziness, and all kinds of things. So the evaluation is extremely important, not just for the spine, but for the whole body. Wonderful. Well, we have certainly learned a lot today about spine accidents, some hopefully the myths and dispel them about personal injury lawyers about chiropractors, that as with everything, there’s some out there, and they’re on the billboards, and they’re gonna see him there. And there’s others that care about what they do. Okay. And Charlie, I know, because we’ve dealt with you firsthand and seen the quality of care you provide your patients, that this sort of compassion and empathy that you’re showing today is an everyday thing for you. And so I really appreciate you coming in again, pro healthcare. Dr. Charlie Brewer, okay. I’m calling him Charlie makes it easy. But there’s, there’s hopefully again, maybe some lawyers we can take off the list, maybe some chiropractors wouldn’t take up less. I don’t know where their chiropractors in 1500 When Shakespeare wrote then we will have to go back and look because I don’t remember a quote about killing all the chiropractors but let’s not kill them all. Charlie, great having you in today. Really appreciate it. I appreciate it. Attorney David Heffernan Kaire & Heffernan, LLC (305) 372-0123