Psoratic Arthritis without inflammation??

keesrotten

Hi my name is Gareth. I am a 32 year old dairy farmer from Northern Ireland and i am new on here. For approx the last 18 months i have been suffering with a lot of joint pain and muscle weakness. I also have Psoriasis.

This started off with me getting very stiff when i sat down or rested and has now progressed to quite severe pains in my feet, ankles, neck and hands. I occasionally get pains affecting many other joints too including my jaw, shoulders and knees. However i have not got any inflammation in my joints.

I have been referred to a Rhumatologist and have had x-rays, Mri's and bloods taken. The bloods have came back clear apart from a marker which is present in 95% of people with arthritis. The X-rays have shown nothing and the MRI has only shown some inflammation in the connective tissue in my feet. Approx 5 Months ago i was given a injection of steroids into my backside. This eased the pains for 3 weeks but then i gradually got worse and worse again.

Today my Rhumatologist has said that i am an unusual case and has given me another injection of steroid to keep me going and has put me on a course of Methotrexate. This is another "test" as if it helps me he says it is likely that i have Psoratic Arthritis.

I was wondering if there is anyone here with PA or RA who does not suffer with inflammation of the joints????? I really would appreciate any help as my job does not allow me to take time off and i am in quite a lot of pain.

stickywicket

Hello Gareth. I've answered your post on 'say Hello' so won't repeat myself. To answer your further question on there – well, I think you're bravely asking the right questions and facing things square on. Living with PsA and having a physically demanding job will be tough. In itself it will cause stress, and arthritis thrives on stress. I so understand the 'making something which I did find enjoyable miserable to me now' and I think most people on here will be able to relate to that. I suggest you have a good talk with all concerned, see what measures can be taken short-term but if possible, long-term, try to find something a bit easier on the joints.

Lubs

Hi Gareth,

I also suffer from PsA (no inflammation in joints), no psoriasis, but I do have PsA, spondylitis and fibromyalgia. The last two have only been diagnosed this year.

I'm on methotrexate + infliximab (which I have infused every 6weeks), it helps a lot with the PsA, but everyone is different and reacts differently to the medicines prescribed. For example Phil Mickelson a golfer, can only play at a professional level because he takes Enbrel injections (something I could not tolerate). So sorry to say, you will have to go through trial and error with the medicines, they always start with the cheapest for the NHS. When you do not respond to the Disease Modifying Drugs, like methrotrexate they will then recommend Anti-TNF drugs.

Sorry I cannot be of more help, but it's a huge hill to climb until you find the drug that works for you! Like Sticky suggests you will need help with your work, and speak to all concerned. I've managed to work for 8 years with PsA, as a science teacher, but this year I can't seem to get out of bed, let alone get to work. Soon my SSP will stop and I will have no income, but my husband is great with helping me to do everyday tasks, etc. sometimes PsA can be aggressive and some days you are totally pain free!

Hope you find the drug that works best for you! Take care.
Lubs

LignumVitae

I have inflammatory arthritis - in that it is not rheumatoid and as yet hasn't done anything to be diagnosed as the other arthritises - psoriatic, AS etc. My bloods rarely show up huge inflammatory markers and my joints dont really balloon (but they feel it), I get stiff, sore and hot joints and that has always been enough to work with for my rheumatologist. Methotrexate has been my drug of choice since 2007, having a wobble with it at the moment but it doesn't work for everybody and it may be that if it doesn't sort you out other drugs of the same family (disease modifying anti-rheumatic drugs/ DMARDs) might work for you. I took two others before trying the meth and they didn't work for me.

Steroids will pep you up and give you some relief in the short term. It's important not to burn a steroid up in feeling better and doing things like you used to. I often do that if I am not careful (still after 14 years of it because I never ever learn :roll: ). Steroids don't stop you having arthritis, they just mask the symptoms for a while. I well understand the struggle of having something you used to love become a chore and it can then feel like the problem and that becomes a stress and that makes it all worse.

Is there any possible way you could take a break? Is there any way you could reduce the physical demands of the job even if just in the short term? Your body is working over time dealing with the arthritis and any physical demands make that harder. My first response when I flare up should always be reducing the demands on me ( :roll: I often fail to do that straight away because again, I never ever learn). I hope the meth works for you like it has for me - just beware it won't work over night.

keesrotten

Thanks for all your replies, i really appreciate them and have already learned loads about the condition. From reading the posts on the forum it seems that i am lucky to have a good rheumatologist only problem is it takes 4 months to get an appointment.

Its difficult to make any long term decisions at the moment as i have not been diagnosed with arthritis yet, but it is looking likely. If the Meth helps me then the Rheumatologist said that i most likely have it in some form.

This may sound stupid, but I didn't realize how serious the condition was going to get until i started posting and reading on here. i thought with treatment i could go on farming without any problems but it seems this will not be the case. i was given a steroid injection 5 months ago to keep me going until after my MRI, but it only lasted 3 weeks as i was probably working too hard.

Thanks for all your help and i'm sure you will hear more form me in the future.

LignumVitae

Oh no, please don't think it is terrible. I mean yes, arthritis is serious and managing it takes meds and commitment to exercise and yes, for some people it is incredibly life changing. That said, the worst case isn't the case for everybody. You really might find with the right meds or combination of meds you are able to live a normal life but you do always have to pay respects or due to arthritis. I've recently been involved in a project that will in a few months become live (if it gets funding) in my rheumatology department to inspire people to see what they can achieve - that project involved serious sportsmen and women (not me) who have arthritis. I do run, until I had my daughters I rock climbed, I surf (although my husband doesn't seem to understand that my version of surfing is still surfing) occasionally and when I'm not flaring I walk dogs up big hills most days. I was boxing at Christmas! Not dairy farming I admit but I couldn't have done something that tough without arthritis.

It does sound like you used up all your steroid working but to be honest, jabs never last me longer than 3 weeks and they aren't always effective. I think it depends how far down you are in terms of how far up they can pull you if that makes sense.

Do stick with us - we are a treasure trove of support, humour and understanding and most of us have experience that we will share if it helps.

keesrotten

I'll definitely be sticking around on the site. Even just sharing things with people who understand seems to help.

The problem with dairy farming is that no matter how bad I am i still need to be out if bed for 6am, then do 3 hours of repetitive manual work. Then back again at 5pm for another 2 hours. That's the work that MUST be done 365 days a year. When you add in everything else that needs done to keep the farm running (field maintenance, tractor work, calving cows etc) it can take up a lot of time and energy.

At the best of times it's quite stressful and difficult managing all that and making time for my wife and 2 young kids. I think trying to do it with arthritis might be too much and will worsen my condition.

I think the best thing is to take one day at a time and to keep stress levels down until I get a diagnosis.

LignumVitae

I had a thought in the middle of the night...is there a branch of the National Farmers Union in Ireland and if so might they have a relief fund/ support where maybe a student or retired farmer or somebody could come and cover some of your duties? Even a small break - say one lie in a week might give you a chance and a bit of relief.

keesrotten

Thanks, Ill have a look into it. I have been speaking to a guy who can do some relief milkings for my father and i, so we can both have a break. It probably sounds silly to you guys but it is quite responsibility to leave someone in charge of your cows. Each one is different and requires individual attention and they are prone to illness and infections. This guy has lots of experience and is very dependable.

The main problem now is deciding what to do long term. I have not actually been diagnosed with PA yet, if the Meth helps me the Rheumatologist says it it likely i have it. If i do have PA i think the most sensible thing to do for me and my father would be to stop dairy farming and find an easier method of earning a living from the farm. For now I'm just taking one day at a time and keeping the stress levels down until i know more about my condition.

dreamdaisy

That does not sound at all silly - cows are remarkable creatures, each is an individual and of course will have preferences and dislikes etc. One thing that should be remembered is as your immune system will be suppressed by the meth you will be far more prone to infections so you will have to be careful.

When our immune systems are suppressed and we catch a bug it can take us some time to start producing symptoms - by the time we do the infection can have a great hold on us and we can be very poorly. We can have a temperature and not be aware of it - I don't mean to scaremonger but it is necessary to be aware of this. At the first sign of a sore throat or feeling more-under-the-weather-than-usual I check my temp. and, depending on the day of the week, I'll decide whether to take my meth or not. (This is on the advice of my hospital and I've been taking meth for years.) You must have the annual 'flu jab, that is essential.

Depending on how things progress with you it may well be time to start thinking about a change of career. Arthritis is a demanding, selfish, uninvited and uncaring lodger in our bodies and we do have to make adjustments to our lives. I am pleased that you have found someone reliable for your cows but there is no need to make hasty decisions just yet. Rest as much as you can, tiredness is part-and-parcel of an auto-immune arthritis and resting is important, eat as healthily as you can (that weight loss is scary) and listen to your body: if it is saying 'I've had enough' then stop what you are doing. Even better stop when you think you can do more. DD

LignumVitae

I'm also really pleased you know the cows so well, it totally bucks the idea of industrial factory farming. They are so important to your farm and so you must love and respect them. I do love cows, they are auch beautiful creatures.

I'm with DD, don't start thinking about the long term just yet, or maybe think but don't make decisions. If you can, get some help for now, get your arthritis under some kind of control and see how things look now. Things were very different for me before meth. Do you have anti-inflammatories? They might help you a bit.

keesrotten

Thanks for the great advice again. I tried taking Ibuprofen anti inflammatory pills, but they messed with my stomach and made me feel drunk all the time so i stopped. They didn't do much for my pains either. I have started taking Tramadol which my GP prescribed, it dulls the pain and makes working much easier.

farmgirl

Hi, I have psa and oa, I'm due to start taking the methotrexate injections' in 2 weeks time, I'm desperately hoping it will reduce my swelling in my fingers!!. I live on a farm and have horses and hens to look after so I can feel for you, one thing I have learnt is you must try and protect your external joints from the cold, I can remember last winter trying to empty my wheelbarrow and sobbing with the pain in my bloody fingers!!
The warmer I could keep my joints, the better.
I'm still having problems excepting my disease as I feel I'm quite young at 57 to be so bad.
Good luck