People who yearn to become entrepreneurs and those who run their own businesses can recite the benefits: the flexibility, the fulfillment, the excitement and the challenge. Many feel an intense pride and sense of accomplishment.

But there are downsides -- like, there's no such thing as calling in sick.

Well, almost no such thing. Sometimes, even the most dedicated boss is forced, by illness or by an accident, to take time off -- even though it can wreak havoc on a small company.

Here are a couple of businesses that have had to deal with just that, and how they made it.

Toni Footer, The Write Image

In many ways, Toni Footer's story is familiar. Her children were 3 and 9 when she realized she would be getting a divorce and needed to go back to work. She took a part-time job with a specialty stationary and custom letterhead company. Eventually, though, she realized she needed to work for herself -- for the money and the freedom.

So she started a business, The Write Image, out of her house in Potomac 17 years ago. Selling custom stationary and invitations, she has experienced the prototypical ups and downs of entrepreneurship. It is not just a day job, but also an evening, weekend and the-wee-hours-of-the-morning job. But it works, and when her children were young, she could always bag work for a baseball game, if she had to.

Footer was lucky -- she fell into a nice niche doing letterheads for doctors around town, and the 1980s were great. But when managed care came, much of that business, she said, "just went away." She scrambled to find new clients, and has pulled her company beyond where it was. Her revenue is approaching $250,000 a year as she has gotten other corporate clients and branched into social invitations, brochure writing and logo design.

She clearly relishes the one-on-one process of getting to know a client, or anyone. When a reporter comes to her warm, tidy office, soft music is playing and she provides Starbucks and cookies. And she asks a lot of questions herself -- she can't help it. How is she going to help a future bride pick the right invitation if she doesn't know her?

But for all the ways Footer's story is typical, she also has dealt with more adversity than most business owners. She suffers from Crohn's disease, a chronic gastrointestinal illness that involves frequent pain, the occasional painkiller and even surgery. Her circumstances -- first the divorce and then the demands of business -- have actually helped her cope, she said.

"It's not good for your kids to see you like this, and also it's not good for business," she said.

"I choose not to be in bed, because then the disease really robs you of a lot."

Of course, Footer said "choose," but she didn't really have a choice.

"If you want to be in your own business, and you want to do well in your business, then you have to be in business," she said. "If people want your business, they want you."

Like many people with chronic conditions, Footer has learned to work around her illness: If she has to take a painkiller, she makes sure she doesn't do it when she has to be lucid. And she does her work wherever she has to.

"I've gotten some very good clients in the hospital," she said, as if this is normal.

But this life is wearing, even if rewarding. The demands of her schedule and her health have made her susceptible to the emotional toll that owning a business can take, especially a service business.

More people today are penurious and unappreciative, she said. Despite many "wonderful" clients, she has more unpleasant encounters that are making the whole thing harder to take.

For a couple of hours, Footer talked about her business and her life. It troubles her, clearly, that she has given so much and yet the rewards -- the non-financial kind -- are getting more spare.

"I think life has gotten tougher. . . . People are very entitled and have forgotten how to treat people," she said.

"I get people who haggle with me, `How about an extra 5 percent off, or how about this, how about that,' " she said. "And I don't know how to respond to that."

After nearly two decades, she is finding what may be the most difficult part of being in business.

"I have to set limits, and that's very hard," she said. "It's very hard to know what you're worth."

Wes Weidemann, Weidemann Associates

Tamra Thetford, office manager for Weidemann Associates, took the message. It was a few days after Christmas and Wes Weidemann, the company's key manager, had been in a serious skiing accident.

Thetford knew to be worried -- for Weidemann. She didn't know until a few days later to be worried about the business, too.

A rapidly growing consulting firm that gets women in developing countries involved in home-based businesses, Weidemann was critical to the operation. But on his first vacation in a decade, on the slopes in Colorado, he had broken his back, shattered his arm and suffered major soft tissue injuries. He was in the hospital for days, and recuperated at home for weeks after that.

"For the first couple of days, I was like, `I'm just going to keep doing what I'm doing, and try to head things off,' " Thetford said. She knew with the help of a few other employees she could keep answering questions from teams already in the field. But "eventually it grew to, `How are we going to continue to attract new business?' " she said.

That is critical for any business, of course. But for a consulting firm that survives contract to contract, rainmaking is the business. The firm was actually founded by Weidemann's wife, but while she had struggled with an illness of her own, her husband had become crucial in the Arlington office. Together, they were the driving force, and the well-known names, in the business.

Weidemann spent the first three weeks after his accident dealing with his pain. Then, he said, "it occurred to me that the business was really suffering." So he came back to work in February.

Thetford and one of the firm's most regular independent consultants, Dina Towbin, had been pitching in overtime to deal with backed-up questions, paperwork and all the people who demanded to talk to Weidemann and wouldn't take "No" for an answer. When Weidemann came back they breathed a sigh of relief. At first.

Was he productive? "Counter-productive," Towbin said.

"Pretty quickly we started getting calls saying, `Where's this, where's that,' " Thetford said. "Things we didn't even know about."

Weidemann had been taking calls and agreeing to do things that he would then forget about. He had not realized, he said, that when you are badly injured, your attention span and energy level also suffer.

Without telling him, Thetford and Towbin turned off his phone ringer and began intercepting his work. Finally, Towbin confronted him: Go home, she said, and don't come back till you're better.

Weidemann realized she was right and left. Before his accident, the business had been growing so fast -- reaching revenue of $1 million to $2 million a year -- that he already had been trying to build a system in which people could fill in for each other and the company wouldn't be so dependent on any one person. Now he had to put it to the test.

"I know who steps up, and who's willing to take charge when not asked to," Weidemann said. "There were some surprises in there."

Towbin and Thetford stepped up their work again -- insisting people talk to them rather than Weidemann and making more decisions on their own. By spring, Weidemann was back. But with no new contracts signed in the first five months of the year, business was slow. Only now is the company surpassing where it was before The Accident.

And Weidemann sill hasn't fully recovered. He has his energy back, and is doing 60-hour weeks again. But he still can be forgetful, he said, and he has physical limitations with his right arm. He may yet need surgery.

There's motivation to recover: Weidemann and his staff are devoted to the business of helping poor women in poor countries. Around the office are the fruits of the company's labor: little hand brooms, dog leashes and cat toys made by women in rural Peru. Products like these, which Weidemann consultants design and train women to make with money from the World Bank or the U.S. Agency for International Development, are exported to this country. They can triple what these women earn -- to more than $4 a day from $1.50 a day.

Even if he's not quite himself yet, Weidemann said his misfortune improved the structure of the company. More people can do more things, he said, and communication is better.

"They can tell me to get lost, and that's important," he said.

And the ringer on his telephone? "It's still off," he said.