FAQs: Mapping
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1. Why is it important to map the left thigh?
2. Does Dr. St. Amand map all areas that hurt?
3. How often does Dr. St. Amand map his patients?
4. What do the left thigh lumps feel like?
5. Why does my left thigh still hurt once it has
cleared?
6 If my left thigh has cleared, why am I finding new lumps and/or swelling in
my
body?
7. What will my map look like when I am clearing?
8. What will my map look like if I am blocking?
9. Why are my maps changing so slowly now that I've been on the protocol for
a
while?
10. Which tendons commonly swell when cycling?
11. If my map is clear, why do I still have cycles and/or symptoms?
12. Where can I find a blank body map and symptom checklist?
13. Who can map me?
14. What is mapping and how is it done?
1. Why is it important to map the left thigh?
Dr. St.
Amand’s has identified that 100% of his adult patients have significant
lumps in their left thigh that clear within a month when the patient is
on the proper dose of guaifenesin. Therefore, these lumps are
the earliest and most reliable indicator to help determine when a patient has reached
the proper dose of guaifenesin. top
2. Does Dr. St. Amand map all areas that
hurt?
No. Dr. St. Amand only marks abnormalities that he can palpate, not a
patient's pain.
The amount of pain a patient feels does not depend upon the size of their
lumps. Small lumps
can produce a lot of pain if they are pressing on a nerves. Some patients have a
high pain threshold, and report very little pain, even if their lumps are
as widespread as someone who reports substantial pain. Pain tolerance is
inherited and varies greatly. Many fibromyalgics are also taking
multiple medications that obscure pain sensation.. top
3. How often does Dr. St. Amand map his
patients?
Dr. St. Amand maps a patient before he or she starts guaifenesin.
Then, after one month, he does the initial re-map. It is at this session that
he raises the
patient's dose if the left thigh has not cleared.
Frequency following this intial remap depends on several things. First
of all, if the patient's left thigh is clear, his or her dose is established
and there is no hurry to remap. At this point he might typically see
this patient again in two months just to confirm progress.
If, however, the patient's left thigh is still involved, and his or
her dose has been raised, Dr. St. Amand would re-map again monthly until
the proper dose is established.
Once we have ascertained the proper dose for a patient,
intervals vary. Some people need or want more reassurance of progress,
others feel confident
to continue without blocking and wish to return in 3 or 4 months. Eventually
we see patients once a year, or whenever they might wish to be remapped. top
4. What do the left thigh lumps feel like?
The lumps in the left thigh that
are important to determining dosage are found along the outside of the thigh
in the vastus lateralis and on the top in the
rectus femoris. These lumps are long, about 18-24 inches in the vastus lateralis,
and two or three 8 - 12 inch lumps in the rectus femoris. top
5. Why does my left
thigh still hurt once it has cleared?
There is a nerve running through the thigh
that begins in the uppermost, slightly posterior side of the hip where the
ligaments and tendons are quite slow to
clear. Pressure on the nerve sends pain down the thigh into the same areas
where the muscles have already cleared. Remember that while the surface of
the thigh may have no palpable areas left in it, there are still areas in the
hip that can put pressure on nerves. In addition, the undersides of muscles,
tendons and ligaments may still have areas of swelling. top
6. If my left thigh
has cleared, why am I finding new lumps and/or swelling in my
body?
It’s a normal part of the clearing process for lumps to swell and
shrink and come and go. When a lump is being actively worked on, it often swells
with
fluid, then shrinks again when the cycle ends. Lumps often go through repeated
cycles before they are completely gone, so you may experience cycling in the
same location more than once. This is a normal part of reversal and does not
indicate you are blocking or on too low a dose. However, if you continue to
see more lumps and bumps and are feeling progressively worse you should do
a blocking test. top
7. What will my map look like when I am clearing?
If you are clearing, your
lumps will become progressively softer, smaller, and more mobile. Larger lumps,
such as those around the hips and the tops of
the shoulders, often break up into smaller lumps before disappearing. Although
they will come and go, the overall trend is toward smaller and fewer lumps.
If
you are on the correct dose of guaifenesin the lesions on the front and side
of your left thigh should be completely gone after one month. top
8. What will my
map look like if I am blocking?
When a person blocks, their map shows an overall
increase in the size and number of lesions. Lesions in the shoulder muscles
are particularly likely
to re-grow when a person blocks. This is very different from the normal swelling/shrinking
and moving around that lumps do when you are cycling. With normal cycling,
there is an overall trend towards smaller, fewer, softer, more mobile lumps.
When someone blocks, the overall trend is towards larger, harder, more widespread
lumps. top
9. Why are my maps changing so slowly now that I've been on the protocol
for a
while?
This is normal. Clearing slows down later in the protocol as you begin to
cycle tendons and ligaments. These structures receive less blood flow than
muscles. Therefore, it takes longer for them to clear than the lumps in muscles.
Maps change very slowly later in the protocol compared to maps done earlier
in the protocol. top
10.
Which tendons commonly swell when
cycling?
Tendons can swell anywhere.
However, swollen tendons are especially common in the right upper arm (the
deltoid tendon), the front of the right ankle,
and often the soles of the feet. They often swell on the outside of the lower
legs, the left more than the right. The inguinal ligaments in the groin are
usually swollen for part of their length only, the left more than the right
and more often in women than men. top
12. If my map is clear, why do I still have
cycles and/or symptoms?
A map only shows the lumps and bumps that can be felt.
There are many other structures affected by fibromyalgia that are too deep
to feel. In addition,
the mapper can only feel the lumps on the tops of your muscles. Others are
located on the edges and underside but cannot be felt. These areas continue
to cycle even after the obvious lumps have cleared up. Another possibility
is that since even healthy people have small lumps and bumps from everyday
wear and tear, if your map is completely clear, your mapper may be using
a different technique than Dr. St. Amand uses.
Also, guaifenesin cannot reverse
damage done by osteoarthritis. Nor does it ease the symptoms of other medical
problems. If you have another
condition that causes pain for example, guaifenesin will not reduce or
eliminate that pain. However, people with multiple medical problems in
addition to fibromyalgia can still benefit from the relief guaifenesin
provides from the symptoms caused by their fibromyalgia. top
13. Where can I find
a blank body map and symptom checklist?
A copy is posted on our website. Body Map and Symptom Checklist
14. Who can
map me?
Although there are medical doctors in addition to Dr. St. Amand who
follow the protocol and are willing to map, their numbers are few. Some people
discover their own doctors are willing to learn if they are asked. Others
may feel uncomfortable, but there are alternatives. Massage and physical
therapists, chiropractors and others who work with their hands may be willing
to learn if you ask. Some fibromyalgics even find family members to map
them. Others map their own left thighs, although most report this is difficult
to do. top
A list of practitioners is available at:
Fibromyalgia Treatment Center,
Doctors and Practitioners
15. What is mapping and how is it done?
A map is a diagram of the human
body that shows the size, location and hardness of a patient’s “lumps
and bumps” of fibromyalgia.
These lumps and bumps are nodules in the muscles that are characteristic
of the syndrome. In addition to the lumps in muscles, tendons and ligaments
can swell. Such swellings are also mapped.
Mapping is a tool to determine
whether a person has reached his or her cycling dose. Maps are also done
to monitor progress on the protocol
and to detect blocking.
The mapper feels for the contracted portions of
muscles, tendons and ligaments and draws them onto a blank map. Dr. St.
Amand uses darker
markings to indicate hard lumps, and lighter markings to indicate those
that are softer. top
A video or DVD that teaches how to map can be ordered from:
Fibromyalgia
Treatment Center, Books, Tapes, and CDs
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