When you are mapped, all the 'lumps and
fibromyalgia are recorded onto a blank outline of the body.
Dr St Amand suggests
that patients are mapped before starting guaifenesin and then at regular
Mapping is important since it is a way of measuring
your progress on guai. Also, if your maps start to deteriorate it can be a
sign that you are blocking from salicylates.
Body Mapping Charts
you go to be mapped, check that your mapper has a blank body map available. If
not then you can print out a copy by visiting this site (from Dr St Amand's
to the bottom of this page to see Dr St Amand's mapping technique.
note that the mappers listed on
this website are not specifically endorsed or recommended by the UK-FMS-GUAI discussion group)
80 Ruxley Lane
The Boughton Physiotherapy Practice
7 Boughton Parade
Easter Cottage Bishops Bridge
John Mullins BSc PhD DO ND MRN MICrA
33 The Parade
029 2048 2682
(Acupuncturist and Chinese Practioner)
209 Royal Mile
Dr Mark Cashley
Alba Chiropractor Clinic
146 Princes Street
W Harris (acupuncturist)
1091 EJ Amsterdam
468 52 83
Claire Ryall (Chartered Physiotherapist)
Physical Health Dynamics
16 St Cross Court
Linda Premadasa (Registered Osteopath)
61 Mill Lane
and also at:
Woodside Osteopathic Clinic
First appointment for new patients 45 minutes (to
include full consultation and examination as well as mapping), other
consultations 30 minutes. Please say when booking that it is for fibromyalgia
232 0676 and 07932 044 743
Co. Armagh, Northern Ireland:
If your mapper would like to
contact the group, then please email the internet coordinator with their
Dr St. Amand's mapping technique:
A patient's muscles and tendons are palpated to determine which
areas are most affected. This is called mapping, which he says is also
diagnostic when he finds affected muscles.
Dr. St. Amand maps the entire body by feeling the lumps and bumps of FMS
and drawing them to size on an outline of the body, noting location and degree
of hardness. (blank body maps are available
Mapping is objective evidence that shows clearing of the affected muscles and
tendons, and can detect blocking by some hidden salicylate.
A videotape is available that demonstrates the mapping technique. These are
available at www.fibromyalgiatreatment.com, and help in
teaching someone how to map. You can also buy with a credit card from the Marina
del Ray pharmacy in the USA. www.fibroconnection.com.
NEW 2005! Fiona Russell,
administrator for the UK discussion group is now selling protocol DVDs
(compatible for UK players) which include the mapping demonstration. Go to
homepage for more information.
It is possible to find a chiropractor, massage therapist, or physiotherapist
willing to learn. These people already know what normal muscle is supposed to
feel like and will not find it hard to learn mapping.
Although you may not be able to do a complete map on yourself, you may be able
to do a simplified form by paying careful attention to several areas of your
muscles that feel hard and lumpy to you, and follow them over time enabling you
to note improvements.
Dr St. Amand has outlined mapping on
page 163 What Your Doctor may NOT Tell You About Fibromyalgia.
Lumps can be smooth or cement like, soft or hard. When they begin to purge they
contain fluid and feel mushy.
Dr St. Amand maps the round or oval swellings in the trapezii at the top of the
shoulders, in the neck when the head is bent forward and in the shoulder blade
areas as large rounded, hard beads especially easily when the shoulders are
In the lower back you might be able to feel the bulging spasm of lumbar muscles
and the rounded lesions overlying the sacroiliac areas.
The left thigh contains lumps that should clear in the first month of treatment
on the correct dose without blocking with salicylates
Tendons: Most often affected are the right lateral shoulder (the deltoid
tendon), almost always the front of the right ankle and quite frequently the
soles of the feet.
They appear often 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.
Dr St Amand's experience the left thigh lumps should disappear in the
first month of treatment. The swellings are long and linear, running
down the outer side as well as the front of the left thigh (outside: vastus
lateralis; front: rectus femoris); usually only one lengthy one on the outside
(vastus lateralis) and one, two or three large, smooth swellings on the front
The one on the outer thigh (vastus lateralis) could be as long as the area
between the groin to the knee.
Dr St Amand says that the left thigh will clear in the first month. That does
not include the left hip area; which may take a long time. Only the muscle
portion counts for the anticipated, early reversal.
Dr St Amand says you will see the left thigh begin to break up within the first
month on a therapeutic dose and be cleared by the end of a month.
Members of Guai-Support have reported otherwise, stating that it often has taken
them longer to clear the above muscles in the left thigh. It is very hard to be
sure what is happening here given the fact that Dr. St. Amand is not personally
If you have already begun the protocol and are concerned about your dose check
this area out. Is the lump there? What size is it? Is it broken up into smaller
lumps? There are usually exceptions to every rule and a few members have
reported that their right thigh was the one to be worse and/or break up first.
Or even other areas. This is all so individual.
If you've been on the protocol for some time and still have large, especially
longish, lumps running down your left thigh you can at least be sure that you
are not clearing and need to raise your dose.
You cannot feel these lumps easily, or maybe at all, while sitting up.
The left thigh remains Dr St. Amand's very best guide as to the onset of
The long & linear swellings, running down the outer as well as the front of
the left thigh (outside: vastus lateralis; front : rectus femoris) are a radar
for whether you have reached your therapeutic dose.
Other (smaller) lumps in the thigh will dissolve in time and while they remain
they don't indicate anything more than any lump anywhere else on the body.
Smallish lumps can arise and dissolve during cycling. Keep focused on the whole
body situation. If lumps are diminishing overall each mapping, then all is well.
Here are mapping suggestions from others on the protocol.
International list owner Tesa Marcon suggests:
Lay down on your right side and run your left hand down and up your thigh. You
should be able to feel it like that if you press firmly enough or get a
spouse/partner, family member or friend to help you. Once you have established
that the thigh lumps are breaking up, or indeed any lumps anywhere on your body,
you can be sure you are cycling and don't need to be checking them out all the
time but keep a close eye on products you use to be assured that you do not
block your medication.
Kathy Jebbia suggests: Sit on the floor with your legs directly under you. In
order words, butt to heels & hamstrings to calves. That position makes the
thigh really taut instead of mushy so all of the lumps stick out more.
Chris Bialowas suggests: If you can't get into the above position, try laying on
your back in bed with your hip and knee bent. This stretches the quads muscle
and makes the lumps easy to feel. Use some sal free lotion and run your 2nd, 3rd
and 4th fingers down the muscle belly.
Here is the technique used by Dr. St. Amand as explained by Charlotte using her
experience of visits to Dr St Amand along with some quotes from his mapping tape
"Dr St Amand says that the "amount of pressure he exerts in looking
for bumps and lumps, is about the same amount of pressure in massaging someone
you care for."
For Muscles: it is a smoothing action as if you were trying to get the muscle
ironed out. Whereas for Tendons and Ligaments it will be a rolling motion as
though you were examining a rope and trying to estimate its width.
A. The patient sits at the end of the table and Dr. St. Amand starts mapping.
B. He starts by mapping the TMJ area of the neck and sides. He also feel my
cheeks for deposits under the cheekbone. Then he maps the neck and sides and
down the entire back to the tailbone area. All the while he is marking the map.
He has you round your shoulders and he checks the shoulder area.
C. Now he maps both arms using both of his hands and he feels front and back of
the arms all the way down and includes your hands.
D. Then he maps your legs (you are still sitting up at the end of the table).
E. He maps your feet on top, sides and bottom.
F. Now he has you lie down on your back on the table and he examines with a
rolling motion the ligaments by the hip bone to the public bone and abdominal
He sweeps around to the sides to feel both hips and the outer portions. The left
one is more involved than the right. He uses more firm pressure than anywhere
else to feel the two bundles always on left thigh...the ones that should clear
in one month when the proper dosage is attained. The left vastus lateralis and
rectus femoris (part of the thigh muscles, the quadriceps). His sketches show
these two long, dark areas of spasm. When the left thigh is examined, the vastus
lateralis is often described as one of the most tender areas of the body.
He uses a large sweeping motion. He goes down the sides of the legs firmly and
on top all the while using both hands.
G. While still lying on your back he examines the back of your thighs; these are
the hamstring muscles which are more commonly involved on the right rather than
H. Now he has you roll on your left side with knee slightly bent up and he
examines the portion from the hip and butt area down. This area is almost
invariably swollen on both sides yet women complain more of pain on the right
side. Yet the left side is more commonly involved size wise than on the right
I. Now you roll on right side and he examines the sides of the thigh . He
examines the particular bundles of the left thigh as these are the ones that
clear in one month if you are doing the protocol correctly. He examines you from
the hip/butt area all the way down. This is one of the most painful areas.
J. Now the mapping is complete and Dr. St. Amand compares the new map with the
previous map. He does not look at the previous map until he has your new map.
Then he can compare the two and see if you have made progress, are on your
correct dose or are blocking.
Whether you find someone to map you or not it's a good idea to focus on
how you feel and notice all the exacerbations you experience over time.
Keep a note on your calendar or computer, some code you understand, to track
your cycles or lack of them. Using numbers to represent pain levels is not the
best idea. What is a "four" day now will mean something different as
you get better, though some have used this system successfully. Long entries are
Then, as you look back you will see if some things have disappeared completely,
like a knee that hurt off and on; if you are sleeping better, using fewer pain
meds, if you can exercise a bit more.
Then you should see some patterns emerging and progress over time. You
need to feel some improvement to know that you are cycling, even though it might
be subtle. If you are unsure then there is no substitute for mapping.
It is essential to find your correct dose as soon as possible so that you
don't end up raising your dose too high and suffering more than is necessary.
Dr. S A maps his patients every three months, and doesn't feel that a 6-week
interval is necessarily enough time for differences to be noted in maps. This is
particularly true the further along you are in the protocol.
In the first few months, you will typically see dramatic changes in your map
because large deposits are being cleared from muscles. As you progress in the
treatment, you begin to clear a lot of internal stuff that can't be detected on
a map. So you shouldn't be discouraged if your map clearing slows down; realize
you are clearing things that can't be palpated.
As long as your maps aren't getting worse (ie, new large deposits), then you
If you still think you are not progressing you could very well be blocking.
Check your product's ingredients again. Ensure that one of them hasn't been
reformulated to contain salicylates.
Always report a possible blocking situation please so products can be checked.
These notifications will also provide the very necessary opportunity for the sal
safe products list to be updated for the benefit of everyone.