Dont know what to do

r16chh

Hi everybody,

I have been diagnosed with psoriasis arthritis currently on 25mg methotrexate tablets soon to be injection form, 4mg prednisolone, cant get any lower, 500mg sulfasalazine.
I am in full time employment and have been coping ok until recently where I am starting to struggle in certain points of my job.
I am concerned about going to my bosses with my issues as they might think I am unfit for my job.
One thing is happening in the next 6 months is voluntary redundancies, but do I go for it and walk away with a pay off or sit it out and hope the joints don't get any worse.
The problem is I just don't know what the future holds for me regarding the arthritis.

Any advice welcome.

Thanks Richard

janie68

Hi Richard

I had this problem too, for my type of job, I had to go to my bosses for help.

Initially it was hard for them to understand, so I was sent to occy health for assessment. I now work part time and also had an access to work assessment by the job centre who provided me with an electric wheelchair to get around and have an office chair to come as well.

These are some things you can consider, I think that giving up work is a very big decision to make and you need to consider other options first.

Be honest with your employers as you may find you are covered by the DDA and they have to consider reasonable adjustments for yuor workplace.

Hope this helps

Janie

helpline_team

Dear Richard,

Thanks for your enquiry to Helplines. Issues about health and fitness for work are very concerning and it's understandable that you may want to take time to come to some decisions on this.

An issue which is clearly being addressed at the moment is controlling your arthritis. If the rheumatology team are switching you to injectable mtx (methotrexate) I wonder whether they've discussed with you how long they aim to try this treatment? The point is that there are many treatment options and you may want to find out what options exist for you. As some people with psoriatic arthritis do not respond to mtx and do better on the options that may be helpful to be aware of this and involved in discussing it. (If you'd like to more about this and self-management skills generally why not give us a call?)

I wonder whether you've seen some of our booklets - especially working with arthritis
http://www.arthritiscare.org.uk/PublicationsandResources/Listedbytype/Booklets

If you'd like an information pack just email us your postal address (say that you spoke to me on the forum about PA and work)

hope we can help further

Guy

r16chh

Thanks for your replys, my problem is I work for the railway outdoors on the tracks so cannot change my workplace to suit my problems.
It is only some parts of my job I am stating to have trouble with and cannot see it getting better but worse as time goes on.
I really not sure how to takle it.

Thanks
Richard

helpline_team wrote:

Dear Richard,

Thanks for your enquiry to Helplines. Issues about health and fitness for work are very concerning and it's understandable that you may want to take time to come to some decisions on this.

An issue which is clearly being addressed at the moment is controlling your arthritis. If the rheumatology team are switching you to injectable mtx (methotrexate) I wonder whether they've discussed with you how long they aim to try this treatment? The point is that there are many treatment options and you may want to find out what options exist for you. As some people with psoriatic arthritis do not respond to mtx and do better on the options that may be helpful to be aware of this and involved in discussing it. (If you'd like to more about this and self-management skills generally why not give us a call?)

I wonder whether you've seen some of our booklets - especially working with arthritis
http://www.arthritiscare.org.uk/PublicationsandResources/Listedbytype/Booklets

If you'd like an information pack just email us your postal address (say that you spoke to me on the forum about PA and work)

hope we can help further

Guy

r16chh

Just been to see rheumy today about my Psoriatic Arthritis and they have said if I pass the DAS score I will be offered one of three types of anti-TNF Etanercept, Infliximab or Adalimumab.
Bit concerned about the tests though to see if I qualify, has anyone been through this.
If / when I'm offered the anti-tnf's is there pros and cons of each type.


Cheers

Richard

helpline_team

Hello Richard

The DAS test that your rheumy told you about is the Disease Actvity Score. This is used to reflect how well your arthritis is being controlled by your current medication. The rheumy measures inflammation/tenderness in 28 joint sites and this is combined with the results from your recent blood tests to work out the score.
A DAS of 2.5 or less = remission, whilst 5.0 or over indicates very severe disease activity. A score of 3.2 or above may merit a change in treatment. As you've been taking the highest dose of MTX and Prednisole as well this suggests your DAS would be quite high. The anti-TNF drugs you mention have very good evidence for their effectiveness. Infliximab is given by infusion and is not used very much these days, the other two are given by injection so much simpler - your rheumy nurse can show how to do it yourself.
If you'd like to read up more about the DAS, here is some very useful information:

http://www.rheumatoid.org.uk/download.php?asset_id=692&link=true

Hope that helps
Best wishes
Paul

dorcas

HI Richard,
I too have PA and have been on anti TNFs for 5+yrs; initially Etanercept but that was changed to Humira (adalimumab) which I self inject fortnightly. I have this in combination with MTX which I also self inject weekly.

After 'passing' the DAS test you will have to have clear chest X ray and TB test before starting on the biologics. Took couple of months for me to go through the process before I got started. Either rheumy or healthcare at home (if they are your provider they deliver the anti TNF to your home) will teach you how to self inject...gets easier with time, honest!

You'll also be carefully monitored by GP (blood tests) and very regularly attend at rheumy. You may also be asked to take part in ongoing research into the long term effectiveness of the treatment; that entails completing questionnaires at home and seeing liaison nurse at hospital.
hope that helps.

Welcome to the PA biologics club! Dorcas x