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From:
Susan Burger <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Wed, 8 Jan 2014 19:51:44 -0500
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I really appreciated Lynn Carter's response to CST having a "spiritual component".  

I hope it wasn't intended to be read as such, but one post seemed to suggest that followers of one specific branch of one religion ONLY follow evidence-based scientific medical practice, which might be interpreted that other religions or spiritual branches are less willing to follow evidence based medical practices.  I may have misinterpreted the intent of that post, but I think we can all agree that both evidence and spirituality play an important role in humanity without starting to compare which religion or spiritual path might be more open to accepting evidence based medical practices. And such a comparative debate might not be particularly productive.

As for building evidence, I had a very interesting discussion with my physical therapist after attending an excellent talk by a CST on how they have started measuring the fluctuations in the movement cerebrospinal fluid that has a rhythm just like the movement of blood throughout our body.  We know more about the heart rate than the rate of fluctuation of cerebrospinal fluid because we developed the technology of electrocardiograms and because we focused on the anatomy of the heart. So we have collected far more evidence about treatments for heart problems and arrhythmias.  Nevertheless, that does not mean that there is a real treatment effect that we will come to understand more fully as we investigate associations that are observed in clinical further and develop the tools to measure these phenomenon more fully.  

Similarly, in my physical therapists terrain we know more about bones because they don't decompose after death and because we developed X-ray technology than we do about fascia.  We know a lot about muscle tissue as well.  Yet restrictions in the fascia may have implications throughout the rest of the body that are every bit as important as problems with bones and with muscle. By the time we got through discussing my tight hip flexor I asked him if it was as if I had a lot of gristle that was impeding mobility and he agreed that was a crude explanation for what was happening.  Basically they used to think of connections merely as being between the joints but restrictions resulting from fascia can extend much farther throughout the body than previously thought.  

Now the reason why I think this is important is that humans are very capable of making intuitive leaps from observations. For instance, the cure for scurvy was discovered long before we could isolate and measure vitamin C.  Sometimes in the process of explaining something we observe, we later find out that the narrative was wrong.  Sometimes the treatment still turns out to be correct, but we can develop a better narrative based on findings from newer measurement tools.  Sometimes the treatment turns out to be correct for a smaller subset of conditions than was originally assumed to benefit.  Sometimes the treatment really does nothing and it was mere coincidence.    Something else associated with what was thought to be the treatment is really causing the improvement.  And sometimes, like when we thought the world was flat - our narrative turns out to simply be wrong.  And then sometimes newer measurement tools make us think the treatment was wrong and then we get even newer measurement tools and find out that there really was something to the original treatment.  I think of the return to using leeches for some specific conditions based on evidence.  

Anyway - the CST I listened too and Lynn Carter too provide me with a narrative that my epidemiology oriented brain can identify with and help me understand why that matches the experiences of my clients when CST does seem to help.
  
Best, Susan Burger, MHS, PhD, IBCLC, RLC

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