Paula STACEY-THOMAS 17/4/21 Paula STACEY-THOMAS 17/4/21

Infants Delivered Via Instrument-Assisted Birth May Have Lower Cervical Range of Motion

A 2018 study showed that at vacuum-assisted delivery and Caesarean section deliveries were associated with “a higher prevalence of reduced cervical spine ROM [range of motion]"This study showed that normal range of motion was not particularly common after vaginal birth without interventions, but it also showed that reduced cervical spine (neck) range of motion was more common in vacuum assisted births and caesarean sections.

The study took in data from 176 infants under 112 days old and found that vacuum-assisted delivery and Caesarean section deliveries were associated with “a higher prevalence of reduced cervical spine ROM [range of motion] when compared to a vaginal delivery without assistance.”

The study took its sample from a paediatric chiropractic clinic. While the number of infants studied is a potential limitation of the study, it yielded some enlightening results. Reduced cervical spine range of motion was apparent in:

76.1% of infants born vaginally without intervention
75% of infants delivered with forceps
88.9% of vacuum-assisted deliveries
82.3% of infants born via caesarean section

The normal range, for the sake of the study, was a mean rotation of between 110 and 75 degrees (lateral flexion) in infants aged 2-10 months. The authors of the study noted that, “the cortical effects of altered cervical spine motion in infants has yet to be researched.” However, they did note that in adults, altering normal cervical spine motion is associated with:

increased risk of alterations in autonomic function
increased nociception
cortical dysafferentation

They also noted that while this information is missing for the infant population, “afferent systems and cortical perceptions of pain are well developed by 30 weeks gestation.”

The most common effect of restricted neck movements in babies that we see at The Chiropractic Domain is discomfort for both parent and baby when feeding. If you baby is unable to turn their head each way, proper latching on both sides can be prevented.

Currently, 19% of vaginal deliveries require assistance and the risk of birth injury is four times higher than normal with forceps and three times higher than normal with vacuum extraction.

We know the delivery of a healthy baby is all that matters, and while vaginal deliveries without instrument assistance are preferred, they aren’t always possible. However, this study certainly creates a bit of increased awareness around the forces placed on infants during birth and the resultant reduced range of motion in around 75% of cases.

This study is clearly only a beginning, as the size of the sample was a limitation, and the sample was taken from a paediatric chiropractic clinic.

Paula STACEY-THOMAS 7/4/21 Paula STACEY-THOMAS 7/4/21

Chiropractic and the breast/chest feeding baby

We have 12 cranial nerves that begin at the brain and brainstem, travel throughout the skull and exit via the small holes (foramen and canals) to supply voluntary and involuntary muscles for movement, and sensory information like sight, smell, taste, touch, hearing, and balance. Breastfeeding is no small task for the small human. It “is a synchronized event requiring the infant to suck, swallow and breathe. Performing this coordinated event requires 6 of the 12 cranial nerves; 22 cranial bones articulate at 34 sutures/places; and 60 muscles that are voluntary and involuntary.” The human body is incredibly complex and while the art of chiropractic celebrates this, the science of chiropractic is still being studied and proven.

More than you might think.

Chiropractic is concerned with the spine and bones as the protector of the nervous system. We have 12 cranial nerves that begin at the brain and brainstem, travel throughout the skull and exit via the small holes (foramen and canals) to supply voluntary and involuntary muscles for movement, and sensory information like sight, smell, taste, touch, hearing, and balance. Breastfeeding is no small task for the small human. It “is a synchronized event requiring the infant to suck, swallow and breathe. Performing this coordinated event requires 6 of the 12 cranial nerves; 22 cranial bones articulate at 34 sutures/places; and 60 muscles that are voluntary and involuntary.” The human body is incredibly complex and while the art of chiropractic celebrates this, the science of chiropractic is still being studied and proven.

Dr Paula has a particular interest in working with babies and has undergone further training in adjusting babies and working with tongue ties and other oral restrictions. As a result, over her 24 years as a chiropractor she has developed close professional relationships with orofacial myologists, dentists, and lactation consultants.

A 2019 case study showed improvements with latching after chiropractic care. The 4-day old infant was released from hospital after consults with lactation consultants and the mother was not satisfied with the interventions, such as nipple shields, offered as the baby still was “only able to be fed from a bottle and had to be held in very specific positions.”

Upon examination the chiropractor noted

low right/high left occiput (with head tilted and rotated to the left).
prone and supine leg length checks indicating cervical and pelvic involvement.
spinal examination (motion palpation) revealed right C1 vertebral segmental joint dysfunction.
Posterior vertebral segmental joint dysfunction were noted at T1, T2, and T4
Hypertonicity was also noted in several muscles.

While the case report goes into far greater detail of examination findings and how the care plan progressed, it should be noted that the infant began nursing at the breast (using a nipple shield) after the first adjustment. The mother said that the patient “had better range of motion of his neck and would turn both directions easier.”

By the third visit, he was able to nurse using the shield but did not have to be held in certain positions. One week later, after his next visit, he had full cervical range of motion and was continuing to thrive with no need to supplement with a bottle.

It was then that the chiropractor referred the family to a paediatric dentist for a review of possible oral restrictions and a tongue tie was released.

Two weeks later, there was a complete resolution of all the infant’s presenting complaints. These had included “limited range of motion… excessively recessed jaw, inability to open wide, and cranial asymmetry.”

Parker noted (at the completion of the care plan) that, “the resolution of these challenges suggests that there is a possible connection, specifically between an upper cervical… and cranial dysfunction. This case report shows the effectiveness and value of chiropractic care for infants with breastfeeding difficulties.”

This is only one baby and one study, so further study is required before we can say for certain that chiropractic was the corrective force behind this babies’ improvements, but it does show that close working relationships with other professionals is crucial to proper diagnosis and holistic care after release from hospital.

It is our hope at The Chiropractic Domain that families feel empowered to find what works for them.

It is the basis of chiropractic that small deviations from proper alignment can have a chain reaction throughout the entire body. An infant’s ability to breastfeed successfully can be disturbed if there is disruption of the proper functioning of either the musculoskeletal or nervous system that supplies the sutures connecting the plates of the skull.

Chiropractors’ potential to help parents successfully breastfeed has been well documented as far back as 1997, we’ve linked them below if you’re interested in some extra reading. Please note that a few of these links are restricted by pay walls, but the free-to-read ones are closer to the top.

Pain distribution in school aged children

Musculoskeletal pain experienced by adults is reasonably well researched, but pain in children is not. Last year the findings of a three-year study performed in Denmark was published looking at the pain distribution patterns of children between 8 and 16 years old. This study finished with 1,169 participants – which is a significant sample size when looking at children of that age across all industrialised countries.For the purposes of the report, pain was defined as at least one week of pain during a school year. While we know that “pain can start early in life and increases throughout adolescence,” it is the specifics offered up by this study that make it noteworthy.Other concerns that accompany childhood and adolescent pain include negative impacts on “sports participation and physical activity in childhood” as well as “psychological distress, poor relations with peers, absence from school, puberty and decreased quality of life.” To this end, it is important for both parents and clinicians to know when and how to bring in interventions.

For the purposes of the report, pain was defined as at least one week of pain during a school year. While we know that “pain can start early in life and increases throughout adolescence,” it is the specifics offered up by this study that make it noteworthy.

Other concerns that accompany childhood and adolescent pain include negative impacts on “sports participation and physical activity in childhood” as well as “psychological distress, poor relations with peers, absence from school, puberty and decreased quality of life.” To this end, it is important for both parents and clinicians to know when and how to bring in interventions.

The percentage of children who did not experience pain during the school year was just 28.5%. 71.5% of children did experience at least one episode of pain lasting one week.
Of this percentage, 60% experienced lower extremity pain, 28.7% experienced spinal pain and the upper extremities came in last at 22.6%.
2% of participants reported pain in more than one region, and of these, the most common was spinal and lower extremity pain (13.2%).
Twice as many girls reported pain in all three sites compared to boys (10% vs. 5%).

The study did have limitations, one being that parents reported the pain states. When the children themselves were asked, they often had other pain to report. Parents (admittedly less so than doctors) underestimate a child’s pain and overestimate their child’s wellbeing and quality of life, so this study’s findings are likely conservative when we factor that in.

Fuglkaer S, Vach W, Hartvigsen J, Boe Dissing K, Junge T and Hestbaek L (2020), “Musculoskeletal pain distribution in 1,000 Danish Schoolchildren aged 8-16 years,” Chiropractic and Manual Therapies, 45(2020), https://chiromt.biomedcentral.com/articles/10.1186/s12998-020-00330-9

McIvor, C. (2020). Pain distribution in school aged children - Australian Spinal Research Foundation. Retrieved 30 March 2021, from https://spinalresearch.com.au/pain-distribution-in-school-aged-children/

Brudvik, C., Moutte, S.-D., Baste, V., & Morken, T.. (2017). A comparison of pain assessment by physicians, parents and children in an outpatient setting. Emergency Medicine Journal, 34(3), 138–144. https://doi.org/10.1136/emermed-2016-205825

Lagattuta, K. H., Sayfan, L., & Bamford, C.. (2012). Do you know how I feel? Parents underestimate worry and overestimate optimism compared to child self-report. Journal of Experimental Child Psychology, 113(2), 211–232. https://doi.org/10.1016/j.jecp.2012.04.001

Loopstra, C., Strodl, E., & Herd, D.. (2015). A qualitative analysis of how parents assess acute pain in young children. Health Psychology Open, 2(1), 205510291456629. https://doi.org/10.1177/2055102914566290

Paula STACEY-THOMAS 4/4/21 Paula STACEY-THOMAS 4/4/21

Infant shoulder dysfunction

A recent Australian study revealed that a whopping 71.8% of 178 infants examined at a paediatric only chiropractic clinic between January 1, 2010 to 31st December, 2010 had glenohumeral joint dysfunction. The glenohumeral joint is the shoulder ball and socket joint. ...The take-away is that prolonged crying should be investigated, and chiropractors are trained to assess the entire musculoskeletal system.

By stark contrast a study in 2006 which reported shoulder dystocia at an occurrence of 0.6-1.2% of all deliveries, it represents a massive difference between shoulder issues picked up in neonatal examinations (i.e. following difficult births), and shoulder issues picked up by a chiropractor who is trained to look for issues with range of motion in infants.

Though these new findings are from just one year and is retroactive in it's view, it does make an argument to seek the assessment of a chiropractor if you're concerned and have been told to let them "just cry it out" (a frustration we hear from parents a lot).

The take-away is that prolonged crying should be investigated, and chiropractors are trained to assess the entire musculoskeletal system.

Keil, B., and Fludder, C., (2020). The Prevalence and Predispoding factors of infant glenohumeral joint dysfunction: a retrospective study of 178 cases. Chiropractic Journal of Australia.

Fludder CJ, Keil BG. The prevalence of extremity joint dysfunction in neonates and infants within a paediatric chiropractic clinic. Chiropr J Aust. 2017;45(4):359-367.

Mehta SH, Blackwell SC, Bujold E, Sokol RJ. What factors are associated with neonatal injury following shoulder dystocia? J Perinatol. 2006;26(2):85-88.

Paula STACEY-THOMAS 2/4/21 Paula STACEY-THOMAS 2/4/21

Are growing pains normal?

Firstly, what are “growing pains”? They are the leg muscle pains experienced by children and adolescents often at the calf, front of thigh or behind the knees, that do not have an obvious cause. Despite the name, growing is not what causes the pain, except in the case of Server’s disease, where the calf bone has grown faster than the Achilles tendon. Growing pains are often worse in the afternoon or evening. Sometimes, the pain can wake a child from their sleep. The cause is not known, but running, climbing, or jumping during the day might increase the risk of leg pain at night.

Firstly, what are “growing pains”? They are the leg muscle pains experienced by children and adolescents often at the calf, front of thigh or behind the knees, that do not have an obvious cause. Despite the name, growing is not what causes the pain, except in the case of Server’s disease, where the calf bone has grown faster than the Achilles tendon. Growing pains are often worse in the afternoon or evening. Sometimes, the pain can wake a child from their sleep. The cause is not known, but running, climbing, or jumping during the day might increase the risk of leg pain at night.

All pain can cause worry, but typically the kinds of pains resolve themselves quickly.

Pains in the back, neck or headaches are not the same as growing pains and should be assessed. If your child has leg pain that is preventing them from going about their life comfortably, then assessment is advised to rule out more concerning causes.

What can be done?

Unfortunately, not a lot can be done to prevent or treat growing pains, but stretching and gentle movement, like walking, may help some.

The takeaway message

The term “growing pains” has been used to describe any pain felt by a child or teenager for a long time, but this is not the case and is dismissive of what children feel. Growing pains relate to often at the calf, front of thigh or behind the knees. If your child is experiencing pain elsewhere, or their leg pain does not resolve itself quickly it is a good idea to have them assessed.

Berkowitz CD. Orthopedic injuries and growing pains. In: Berkowitz's Pediatrics: A Primary Care Approach. 5th ed. Elk Grove Village, Ill.: American Academy of Pediatrics; 2014.

Mohanta MP. Growing pains: Practitioners' dilemma. Indian Pediatrics. 2014;51:379.

Kliegman RM, et al. Musculoskeletal pain syndromes. In: Nelson Textbook of Pediatrics. 20th ed. Philadelphia, Pa.: Elsevier; 2016. http://www.clinicalkey.com. Accessed Aug. 3, 2016.

Uziel Y, et al. Five-year outcome of children with "growing pains": Correlations with pain threshold. Journal of Pediatrics. 2010;156:838.

Dohsan, S. (2015). What a Pain! Kids and Growing Pains (for Kids) - Nemours KidsHealth. Retrieved 31 March 2021, from https://kidshealth.org/en/kids/growing-pains.html

Growing pains - Symptoms and causes. (2016). Retrieved 31 March 2021, from https://www.mayoclinic.org/diseases-conditions/growing-pains/symptoms-causes/syc-20354349

Growing pains | betterhealth.vic.gov.au. Retrieved 31 March 2021, from https://www.betterhealth.vic.gov.au/health/HealthyLiving/growing-pains

What to do when your child has growing pains. (2018). Retrieved 31 March 2021, from https://www.health.qld.gov.au/news-events/news/children-growing-pains-Severs-disease-treatment-cause

Paula STACEY-THOMAS 2/4/21 Paula STACEY-THOMAS 2/4/21

Kids quality of life improves with chiropractic care.

A recent U.S. Study found that “following a course of chiropractic care, the QoL [Quality of Life] of children (8-17 years old) improved beyond chance as assessed by their parents."The study used the “Patient-Reported Outcomes Measurement Information System” or PROMIS collection method and surveyed 724 parents, 80% of which were under chiropractic care themselves. The participants presented to chiropractic clinics for their children for a combination of wellness care as well as relieving symptoms. The researchers noted that “All PROMISE QoL [quality of life] measures changed from T1 [baseline] to T2 [comparison point] in a statistically significant manner. More importantly, the changes were associated with improvements in QoL. [1]”The paper specifically looked at anxiety, depression, fatigue, pain and physical function, with anxiety, pain, and physical function showing the greatest improvements under care.Another interesting note is this: we know that parent-proxy questionnaires give some room for error in terms of estimations. However, Alcantara et al cite other research that indicated that parents tend to over-estimate their child’s Quality of Life. Therefore, the difference could be even greater than we currently think.There is a lot more to be done in the way of research with it comes to chiropractic for kids, and chiropractic for wellness.

A recent U.S. Study found that “following a course of chiropractic care, the QoL [Quality of Life] of children (8-17 years old) improved beyond chance as assessed by their parents."

The study used the “Patient-Reported Outcomes Measurement Information System” or PROMIS collection method and surveyed 724 parents, 80% of which were under chiropractic care themselves. The participants presented to chiropractic clinics for their children for a combination of wellness care as well as relieving symptoms.

68.1% of respondents brought their child in for a combination of wellness care and for relief of symptoms.
21.4% brought their child in for wellness care only (however only <1% of parents said that their child had no symptoms.)
10.5% brought their child in solely for symptom relief

The researchers noted that “All PROMISE QoL [quality of life] measures changed from T1 [baseline] to T2 [comparison point] in a statistically significant manner. More importantly, the changes were associated with improvements in QoL. [1]”

The paper specifically looked at anxiety, depression, fatigue, pain and physical function, with anxiety, pain, and physical function showing the greatest improvements under care.

Another interesting note is this: we know that parent-proxy questionnaires give some room for error in terms of estimations. However, Alcantara et al cite other research that indicated that parents tend to over-estimate their child’s Quality of Life. Therefore, the difference could be even greater than we currently think.

There is a lot more to be done in the way of research with it comes to chiropractic for kids, and chiropractic for wellness, but these kinds of studies indicating improvements paints part of the picture of why we are so passionate at The Chiropractic Domain about providing care for all ages.

Paula STACEY-THOMAS 1/4/21 Paula STACEY-THOMAS 1/4/21

April 2021

Wellness and Wisdom Newsletter:April 2021

Paula STACEY-THOMAS 30/3/21 Paula STACEY-THOMAS 30/3/21

Fast Facts About Chiro for Kids

In Australia, chiropractors provide care to more than 30,000 paediatric patients (0-18 years old) every week.Chiropractors are taught a range of techniques to care for patients and modify all care to suit the age, presentation and development of the patient.There is very little evidence of harm associated with chiropractic care of paediatric patients.All Australian chiropractors abide by a national Code of Conduct to ensure best practice and maintain the highest level of professional competence and ethics, including:Ensuring the needs of the patient are at the forefront of all care;Ensuring there is informed consent from the paediatric patient’s parent or guardian;Carefully explaining the risks of care and alternatives to care to the parent or guardian; andIdentifying any ‘red flags’ to the paediatric patient and investigating, managing, co-managing or referring to an appropriate health practitioner.Manual Therapies are valued by parents and form part of a comprehensive approach to paediatric care.Chiropractors can play an active role in monitoring development, motor skills, and wellbeing through assessments.

In Australia, chiropractors provide care to more than 30,000 paediatric patients (0-18 years old) every week.
Chiropractors are taught a range of techniques to care for patients and modify all care to suit the age, presentation and development of the patient.
There is very little evidence of harm associated with chiropractic care of paediatric patients.
All Australian chiropractors abide by a national Code of Conduct to ensure best practice and maintain the highest level of professional competence and ethics, including:
- Ensuring the needs of the patient are at the forefront of all care;
- Ensuring there is informed consent from the paediatric patient’s parent or guardian;
- Carefully explaining the risks of care and alternatives to care to the parent or guardian; and
- Identifying any ‘red flags’ to the paediatric patient and investigating, managing, co-managing or referring to an appropriate health practitioner.
Manual Therapies are valued by parents and form part of a comprehensive approach to paediatric care.
Chiropractors can play an active role in monitoring development, motor skills, and wellbeing through assessments.

Paula STACEY-THOMAS 23/3/21 Paula STACEY-THOMAS 23/3/21

School Holiday Special 2021

During the month of April 2021 to coincide with the school holidays all existing patients under the age of 18 will automatically receive an extra $5.00 off their consultation.If your child or grandchild has never seen us before, but you would like them to be assessed we are offering 50% off their first and second consult.Terms and conditions apply and can be found at the bottom of this webpage.

If your child/grandchild is not an existing patient and does not have a pre-existing health condition or does not require a tongue tie assessment*, book a "Baby/Child/Teenager - New Chiropractic Patient" appointment
Usually $114.00, April 2021 $109.00
Up to 35 minutes

*please note that if your child does require a tongue tie assessment, or has pre-existing conditions, we do not charge more, but we do need to schedule extra time, so please book the "New Patient" appointment type, so that the full assessment can be scheduled in one visit.

This a review was undertaken between March and October 2019 into spinal manipulations for persons under 12 years old.

Across nearly 22,000 submissions zero (0) reports of harm from chiropractic adjustments were reported.
98.4% of submissions reported improvements after chiropractic care.
99.1% of submissions reported that they were satisfied with the information provided by chiropractors about the benefits expected.
95.8% of submissions reported that they were satisfied with the information provided by chiropractors about the risks associated with care.
The reported benefits of chiropractic care within the review included
- relief from pain
- improved sleep quality
- a more relaxed, settled baby/child
- improved attachment and feeding from breastfeeding
- improved mobility/flexibility/range of movement
The most common risks associated with chiropractic care are
- tenderness across the 24-48 hours following treatment
- Tiredness (less common)
There is little evidence of other risks from chiropractic treatment in babies and children
To avoid risks, Dr Paula uses the adjusting technique best suited to each patient and the techniques used in the clinic on adults are not used on babies and rarely on children.
If Dr Paula foresees other risks for your child this will be discussed before any treatment is provided.

No chiropractic adjustment is ever performed without your expressed informed consent, and a thorough assessment has been conducted.

No treatment is provided without assessment and consent from a parent/guardian.
All patients under 15 years old must attend with a parent/guardian.
Bookings are essential, we cannot accommodate walk ins.
If your child has not attended in 12 or more months a reactivation appointment is required to allow the appropriate time to fully re-assess your child and adjust them
X-rays are rarely indicated for children. If your child does require x-ray, it is not included in the fees above.
This offer is only for the month of April to coincide with the school holidays.
A fee applies for non-arrival without notice. 24 hours notice to change an appointment is require or a fee may apply.
We do not have the facility to run accounts, payment is required at the time of service for standard consults.
New patient appointments must be paid at least 24 hours in advance, as it is at a significant discount.

Paula STACEY-THOMAS 8/3/21 Paula STACEY-THOMAS 8/3/21

Choose to Challenge

Happy International Women's Day! The theme this year is #ChooseToChallenge. I speak to you as a woman, somewhat disgusted by what we've been witnessing in the last couple of weeks in the media, and the treatment of the allegations that have been made through Canberra. Gender bias, demeaning women, sexual harassment, sexual assault. This is something that women still face on a daily basis, in all walks of life, and at all different levels of that particular spectrum. Enough is enough! There has got to be a change. All that aside for a moment, I hope that you get to spend it with some fabulous women in your life. Many of you are fabulous women in my life, and you make it a joy to do my job. So thank you.

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To all the women who are members of my clinic community.
Happy International Women's Day!

The theme this year is #ChallengeToChange. I try and stay fairly apolitical within the clinic because I want to make sure that people from all walks of life feel safe. But on this day, I speak to you as a woman, as I feel maybe like many of you do, somewhat disgusted by what we've been witnessing in the last couple of weeks in the media, and the treatment of the allegations that have been made through Canberra. Gender bias, demeaning women, sexual harassment, sexual assault, domestic violence, these are all nasty words. This is something that women still face on a daily basis, in all walks of life, and at all different levels of that particular spectrum. Enough is enough! There has got to be a change.

With the theme of Choose to Challenge, I suppose the challenge for those of us who might feel at times unwilling to speak out, we need to find better language, to have better conversations, so that we can create cultural change with men and with women, but also with the young people that we are raising. I worry for my daughters and worry for my sons, I know that I have a job to do, in trying to teach them what gender equality really is. I'm sure that other parents may share a similar view. It takes work. It takes leadership and leadership at the highest level of our country, which at the moment, one would question what the direction is, are they responding politically? Are they responding as human beings with compassion? That's what I wonder about on this International Women's Day.

All that aside for a moment, I hope that you get to spend it with some fabulous women in your life. Many of you are fabulous women in my life, and you make it a joy to do my job. So thank you.

When you surround yourself with fabulous women, you feel this amazing network where you know you've got someone you can confide in, with safety and without judgement, that can help you get you through your daily challenge. That is something that is particularly unique about women. Generally, we can be pretty good communicators. I hope you have a lovely day.

Yours in Health,

Dr Paula

Video

https://youtu.be/zzD9uj3gi4I

Podcast

https://open.spotify.com/episode/7nmA2CjKpjKgZowrtM8dS5?si=_qBqZXcSSH-Y90Qq0z_Ygw

Book an Appointment

Paula STACEY-THOMAS 2/3/21 Paula STACEY-THOMAS 2/3/21

Gift Vouchers at The Chiropractic Domain

We now offer online gift vouchers. After years of offering old-school gift vouchers in the practice, we've stepped into the 21st century and now offer customisable gift vouchers online via square.Below are some short explanatory videos about purchasing and using gift vouchers at The Chiropractic Domain.

Paula STACEY-THOMAS 28/2/21 Paula STACEY-THOMAS 28/2/21

"COVID Normal"

Paula STACEY-THOMAS 4/2/21 Paula STACEY-THOMAS 4/2/21

Our Phone Isn't Working

For reasons outside of our control our phone is diverting through to Chiropractic Life Mt Gambier, so if you do need to get in contact with us, here is how:

You can email us at appointments@thechiropracticdomain.com.au
You can reply to a recent SMS reminder you have received from us
To book a chiropractic appointment visit www.thechiropracticdomain.com.au/book-now
To book a Naturopathy appointment with Lisa visit lisascarfonaturopath.com
If you do need to call The Chiropractic Domain, call 0412 014 140
If you need to call Lisa, call 0421 706 494

Thank you for your understanding and we look forward to things being back to normal soon!For regular updates don't forget to follow us on social media:Facebook, InstagramDr Paula & The Chiropractic Domain Team.

Paula STACEY-THOMAS 14/1/21 Paula STACEY-THOMAS 14/1/21

New Year New Me?

“A new year a new me?” you might be asking. Well no, it’s probably the same ole you, same ole me, but maybe you can try to be a bit kinder to yourself this year.That’s my suggestion; that’s my theme. So one way you can do that, is do just ONE SMALL THING for yourself. Big audacious goals are great, but sometimes they’re overwhelming, but one tiny habit change can make a huge difference when it is something that is sustainable.

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Hello lovely people,

we’re in the second week of January, things are just starting to pick up and get going.

“A new year a new me?” you might be asking. Well no, it’s probably the same ole you, same ole me, but maybe you can try to be a bit kinder to yourself this year.

That’s my suggestion; that’s my theme. So one way you can do that, is do just ONE SMALL THING for yourself. Big audacious goals are great, but
some times they’re overwhelming, but one tiny habit change can make a huge difference when it is something that is sustainable.

So as a suggestion, a few things that have worked for me.

I started setting my alarm 15 minutes earlier
I started making my breakfast the night before
Booking an exercise class, or making an appointment with someone keeps me accountable
Make sure that you always book that next appointment before you leave the clinic; so that you don't go backwards

Look after yourself and I will see you very soon!

Yours in Health,

Dr Paula

Video

https://youtu.be/R7JTyRw1OTo

Podcast

https://open.spotify.com/episode/03khNoVurkstaenz0U1BgM?si=Ct00eAQ9TW2MfG2_OBGqGQ

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Paula STACEY-THOMAS 13/1/21 Paula STACEY-THOMAS 13/1/21

CA Stephanie

Today we have Stephanie helping us out as Lynne and Lisa can't be here. If you haven't met he before, Stephanie is Dr Paula's 13 year old. She has been a helper to us in the past, but this is the first time on her own, so please be patient.

Paula STACEY-THOMAS 2/1/21 Paula STACEY-THOMAS 2/1/21

Hicaps Available

What is HICAPS? HICAPS is an acronym for the Health Industry Claims and Payments Service.The HICAPS machine allows us to process Medicare claims, private health claims and card transactions at the time of each appointment.

The HICAPS machine allows us to process Medicare claims, private health claims and card transactions at the time of each appointment.

On the very rare occasion that there is an error we may need to reset the machine, or you may need to pay in full with cash, card or direct deposit and follow up with your health fund. We will email your receipt to you (or print it on request) so that you can claim your private health portion with your fund directly.

Here is a summary of the most common (though still rare) errors and what needs to happen.

Code	Receipt Print Out	Description	Next Step
2	Mship Under Invest (19)	Membership under investigation	Seek alternate method of payment – card holder to follow up with fund
10	Rebate to MBR Pendg	Rebate to Member Pending	Seek alternate method of payment – card holder to follow up with fund
12	Declined (8)	Declined	Seek alternate method of payment – card holder to follow up with fund
14	Invalid Card Nbr	Invalid card number (no such number)	Seek alternate method of payment – card holder to follow up with fund
40	Mship Not Covered	Membership not covered	Seek alternate method of payment – card holder to follow up with fund
42	Mship Ended at DOS	Membership ceased/suspended at date of service	Seek alternate method of payment – card holder to follow up with fund
54	Expired card	Expired card	Seek alternate method of payment – card holder to follow up with fund
56	Invalid Mship Nbf	Invalid Membership numbers	Seek alternate method of payment – card holder to follow up with fund
91	System Inoperative	Health Fund system currently unavailable	We need to reset the machine and try again
P0 – PZ	Refer Health Fund	Refer to Health Fund	Seek alternate method of payment – card holder to follow up with fund
BZ		Communication Error	We need to reset the machine and try again
LC		Unexpected loss of carrier	We need to reset the machine and try again
TO		Time Out Error	We need to reset the machine and try again
LR		Terminal Logon Required	We need to reset the machine and try again

Paula STACEY-THOMAS 11/12/20 Paula STACEY-THOMAS 11/12/20

December 2020 Update from The Chiropractic Domain

Wellness and Wisdom NewsletterDecember 2020 Edition

Well, it is finally in December in the year we thought never end. We all know how topsy-turvy and challenging it has been, so I am not going dwell on that.

I would love to tell you about some exciting offers and updates this month:

For those who are starting to think about Christmas and looking for a few ideas we have the famous Dr Graeme hand-held massagers.

These are the ones I use on the clinic but mostly I recommend them as a fabulous way to take a layer of tension out for those super tight muscles that get tight form poor posture or over-use in just a few minutes

Click and Collect

We have some gift-wrapped and ready to go home for someone you care about for $89 each

Also, some of you may have seen our stock of “Archies” supporting and fashionable thongs. With hot weather beginning its better to be in these than bare feet or completely flat things…after many weeks they can save your feet and legs and knees from needless aching to do not enough support. They also make great stocking filler and extremely reasonable priced at $35. Great for both adult and kids they come in a range of colors and sizes. You can come in- clinic to try one or both products can be bought online for click and collect

Click and Collect

Some examples of cases we have been working with recent with positive results include ,

neck and shoulders issues
headaches
knee joint aggravation and post-surgical swelling
jaw pain

Some of you may not know that in Dr Paula’s treatment approach, she also has been using “Cold laser therapy” (Low-level Pulsed Laser therapy). She has recently upgraded her laser to one that is higher quality and more efficient. She has been using as an adjunct or Chiropractic Care in cases of pain and inflammation from injury or a flare-up of a chronic issues.

Book Cold Laser Appointment

This year we are working right up until Christmas eve , doing an extra Shift on Thursday 24h December from 8:30-11:30am to make sure you can get in your final adjustment for this amazing 2020 year we have all experienced.
As you come in for your December adjustment, we would love give you our complimentary hand-made Bath salt/ foot soak salts. These carry the TCD signature essential oil blend to promote resilience and relaxation for that tired body and feet.

We shall close for a break with our families and re-open on Monday January 4^th.

Finally heart-felt thank-you to our very loyal client community – that’s YOU for supporting us to support you across this very unique year. We have certainly all learnt a lot and been stretched in ways we could never have expected. Please reflect on the amazing nature of your own nervous system and how its adapted to all sorts of stresses and help you to get through. As your Chiropractor is my absolute privilege to adjust you to help your spine and nervous system keep you going. We are here for you and look forward to doing so into 2021!

Yours in Health Dr Paula & Team

Watch the video

Book Online

Paula STACEY-THOMAS 11/12/20 Paula STACEY-THOMAS 11/12/20

[Video] 4 Reasons to visit us in December 2020

https://youtu.be/YIW9PWYwk8w

Book Online

Click & Collect

Paula STACEY-THOMAS 1/12/20 Paula STACEY-THOMAS 1/12/20

QR Codes and Masks

Yesterday afternoon we were advised that from the 1st of December (today) masks must not only be worn by staff at The Chiropractic Domain, but also by patients.

When you arrive you will also need to sign in via a QR code to help in possible contact tracing efforts by SA Health.

Please avoid bringing visitors with you to the practice, to ensure physical distancing.

We are committed to continuing to provide you with a safe clinical setting. All staff have undergone Covid training to help stop the spread.

Regular updates will continue to go out via our Facebook page, so please follow us there.

Here at the Chiropractic Domain we are grateful that we can continue to play our small part in helping you to keep well and feel supported.

Please continue to maintain distance between other, wash your hands, stay home if you’re unwell.

Paula STACEY-THOMAS 18/11/20 Paula STACEY-THOMAS 18/11/20

Practice on Pause for Lockdown

Today the South Australian Chief Allied & Scientific Health Officer advised that all allied health practices in South Australia must close for the duration of the six day ‘circuit breaker’ period from 12:01 am tonight (Thursday, 19 November) to help stop the spread of COVID-19.
All allied health practices, including chiropractic, must close for the next six days unless services can be provided through telehealth.

As such the Chiropractic Domain will be closed with the goal of returning on Wednesday the 25th of November, unless we are otherwise advised by the SA Health authorities.

If you have an appointment on or after November 25th, your appointment will go ahead as planned unless you hear from us, or we hear from you to reschedule.

For those in need of urgent chiropractic advise please email Dr Paula at dr.paula@thechiropracticdomain.com.au.

Stay well, wash your hands, and we look forward to seeing you on the other side.

Bookings are available online from the 25th of November onwards.

A summary of the findings

Chiro for Kids Special

Standard visits for all patients under 18 years old get an extra $5.00 off their standard or reactivation visits.

New patients under 18 years old get 50% off their first AND second visit.

References

What do chiropractors have to do with breastfeeding?

More than you might think.

Review of a recent case study

Further reading

Chiro for Kids Special

Standard visits for all patients under 18 years old get an extra $5.00 off their standard or reactivation visits.

New patients under 18 years old get 50% off their first AND second visit.

References

A summary of the study

What the study found

Chiro for Kids Special

Standard visits for all patients under 18 years old get an extra $5.00 off their standard or reactivation visits.

New patients under 18 years old get 50% off their first AND second visit.

References

A summary of the study

The take-away is that prolonged crying should be investigated, and chiropractors are trained to assess the entire musculoskeletal system.

Chiro for Kids Special

References

What are growing pains?

When is it concerning?

Chiro for Kids Special

Standard visits for all patients under 18 years old get an extra $5.00 off their standard or reactivation visits.

New patients under 18 years old get 50% off their first AND second visit.

References

A summary of the study

Chiro for Kids Special

References

April 2021 is all about Chiro for Kids

References

Talk to us about having your child assessed by Dr Paula

Appointment Types

Is Chiropractic Safe for Babies and Children?

Terms and Conditions

Blog

Video

Podcast

Give the Gift of Health

Blog

Video

Podcast

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