Psoriatic Arthritis-Newly Diagnosed

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Suzanne59
Suzanne59 Member Posts: 7
edited 5. Sep 2019, 17:26 in Living with arthritis
I've suffered with Osteoarthritis for over 30 years, mainly spine, hands,hips and have had several steroid injections in one of my hips. Over the last year my mobility has become much worse but last year I started to get quite severe pain in the tips of my fingers. It was decided that this was caused by compression in my cervical spine & I was prescribed quite a high dose of Gabapentin, which did work for a few months. I had loads of blood tests at the time and my ALT liver enzyme kept being raised so I was eventually referred to Gastroenterology. Whilst at this appointment the Consultant noticed I had Psoriasis pitting in my nails and sent me off to get my hands x-rayed (they are quite badly affected by Osteoarthritis). The xrays came back showing Erosive Arthropathy and I was then referred to Rheumatology. I saw a brilliant Consultant this week who at first told me he was positive I was suffering from the rarer, inflammatory type of Osteoarthritis in my hands but when he looked at them on ultrasound he changed his mind as there was an awful lot of inflammation in my hands. I have recently developed a few,very small patched of Psoriasis and he has now diagnosed me with Psoriatic Arthritis, given me a steroid injection and wants to see me in 6 weeks to start on DMARDS. I'm relieved in some ways to get to the bottom of the hand pain which at times is really very painful but also concerned about being started on DMARDS.
What experience does anyone have of these drugs,especially for Psoriatic Arthritis? I'm really unsure what to expect. Sorry for the long post!

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  • [Deleted User]
    [Deleted User] Posts: 3,635
    edited 30. Nov -1, 00:00
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    Hi Suzanne
    Welcome to the forum,so sorry you are going through a lot of pain at the moment . Everyone on the forum understands about pain and Arthritis as we all have various forms of it. We are also friendly and welcoming and understanding what you are going through. . Enjoy talking on the forums the most popular being Living with Arthritis and Chit Chat.
    All the best Christine
  • Suzanne59
    Suzanne59 Member Posts: 7
    edited 30. Nov -1, 00:00
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    Thanks Christine!
  • stickywicket
    stickywicket Member Posts: 27,731
    edited 30. Nov -1, 00:00
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    Hi Christine. Try not to fret. Easier said than done, I know. I've had RA for most of my life and that led to OA precisely because there were no modern DMARDS around back then. When I finally got onto methotrexate and hydroxychloroquine things got a whole lot better for me. Yes, there might - possibly - be a side effect or two but we have to bear in mind that the regular blood tests we have are designed to spot any potential problems before they become actual ones. I've been on my meds regime for about 20 years now and the only problem has been occasional low haemoglobin levels, always sorted by a short course of iron tablets.

    Now, not taking the meds that we need to suppress our overactive immune systems - that causes real problems.

    I hope yours work as well for you as mine have for me.
    If at first you don't succeed, then skydiving definitely isn't for you.
    Steven Wright
  • dreamdaisy
    dreamdaisy Member Posts: 31,520
    edited 30. Nov -1, 00:00
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    I began my first, auto-immune, arthritis back in 1997 when I was 37 and it was finally diagnosed as psoriatic in 2006. Mine began without any psoriasis and in the 'wrong' joint (my left knee rather than my fingers and toes) but it's made up for lost time and done them too. It led in due course to osteoarthritis which was diagnosed in 2011 but I have no idea how long that had been going on as the other hid it very effectively.

    The inflammation from the osteo is, for me, localised and disperses after a few hours with rest. I cause it myself by overdoing things so it's avoidable but the increased discomfort from the OA due to inclement weather is not, alas. The inflammation from the PsA is out of my control, affects my whole body and it can take weeks until I feel 'better' within myself. It is a rare occurrence now thanks to methotrexate and humira (I inject and have very little trouble with them) but it's all too little, too late in terms of saying the meds 'work'. They have slowed the progression of the PsA but no more, they have never reduced the pain and never will because in my case the damage is done and cannot be undone. The steroids should make a difference to how you feel but they merely mask, they do not tackle the underlying cause off the trouble which is an over-active immune system. The meds suppress this to reduce disease activity and thus minimise joint damamge.

    I was born with eczema and went on to develop asthma when I was seven so more auto-immune nonsense was always on the cards but I remember my genuine shock when OA was diagnosed too. I honestly thought I had ticked the arthritis box, I did not realise one could have both. Another of life's rich travesties. There are around three hundred auto-immune inflammatory conditions including eczema, asthma, psoriasis, gout etc. so an accurate diagnosis can be a complicated affair, especially when the individual concerned does not show the right symptoms in the right places. I am not a doc but I wonder if you have always had something auto-immune grumbling away but not severely enough to be diagnosable until now. The human body is a weird and wonderful thing, mostly weird and, in my case, rarely wonderful. It is, however, as it is and I have no choice but to get on with living with it as best I can. The meds help me do that and I am very grateful for them. DD
    Have you got the despatches? No, I always walk like this. Eddie Braben
  • Suzanne59
    Suzanne59 Member Posts: 7
    edited 30. Nov -1, 00:00
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    Thanks for the replies, they are very helpful. I've not really noticed any improvement since I had the steroid injection. I agree though that I've probably been suffering with some kind of autoimmune problem for quite some time and it took a Gastroenterologist to eventually get to the bottom of it!
  • stickywicket
    stickywicket Member Posts: 27,731
    edited 30. Nov -1, 00:00
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    The autoimmune stuff can be really tricky to diagnose. They're not like the old litmus tests I recall fróm my schooldays ie red = one thing and blue = another. It's more like trying to piece together a jigsaw with no picture on it in which some of the pieces will fit everywhere and others nowhere. Pity the poor rheumatologists! And patients :wink:

    There can be a gastro link, though (not always, of course :roll: ), which has proved useful for you. i hope you can now start to get on top of it all with the help of the DMARDS.
    If at first you don't succeed, then skydiving definitely isn't for you.
    Steven Wright
  • pinkteapot
    pinkteapot Member Posts: 48
    edited 30. Nov -1, 00:00
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    I have psoriatic arthritis too and, touch wood, methotrexate (DMARD) has been a godsend for me.

    I would say:

    1) Everyone’s different in terms of side effects and which drug suits them. Don’t panic at the horror stories of side effects you read online. The people who are fine on a drug don’t tend to post! Go into a drug open-minded.

    2) Don’t be too upset if the first drug they try doesn’t work, or does give you bad side effects. It’s trial and error finding the right one for you. I reacted badly to my first DMARD but, four months in, my second has only minor side effects and I’ve got my hands back!
  • Suzanne59
    Suzanne59 Member Posts: 7
    edited 30. Nov -1, 00:00
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    Thanks again for the responses. They've been a great help. I'm waiting for a letter from the Rheumatologist with a plan but he did say I would start the DMARDs in 6 weeks time.
  • dreamdaisy
    dreamdaisy Member Posts: 31,520
    edited 30. Nov -1, 00:00
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    Psoriatic arthritis causes inflammation in the entheses, the bits where muscles and ligaments are attached to the bones. It traditionally begins in the smaller joints (so your body got that right) but GPs may well confuse it with osteoarthritis because they know a very little about an awful lot. In my case it began in my left knee and my then GP didn't confuse it with anything as she was completely unaware of auto=immune inflammatory anything apart from asthma and eczema. Mine is now, finally, where it 'should' be (toes and fingers) and is also affecting my elbows as well as both knees (it's still partial to a big joint).

    Injected steroids do not always have the desired effect, I was always advised to rest for forty-eight hours sfter my joints were done and for twenty-four after a 'General Butt' (depo in the backside) but only one ever worked (right ankle, for OA) after three months it wore off so now I don't bother. DD
    Have you got the despatches? No, I always walk like this. Eddie Braben
  • CitizenErased
    CitizenErased Member Posts: 9
    edited 30. Nov -1, 00:00
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    Hi Suzanne,

    I was diagnosed with PsA last year. In my case, I'd had it in my left knee for years but hadn't really reduced my ability to perform day to day tasks and I could even manage strenuous activity like football for years.

    After an ill-thought out operation on said knee, the disease progressed in to my other knee and both ankles and I was finally diagnosed in September last year when there was little doubt it could be anything else!

    I was initially placed on Sulfasalazine which I took for 6 months. It was a good drug and meant that whilst I would never go back to football, I could cycle, swim, walk down the stairs. Sulfasalazine was 3 tablets, twice a day after food. I tolerated the drug very well with the only side effect being a very minor headache which passed after two weeks.

    My consultant though I could do better though and stuck me on Humira which is the self injection. I've had 3 doses and despite being told that it would take 3 months to kick in, was astonished with the results. After 3 days of my first injection, I was pretty much 100% pain free and my joint swelling reduced dramatically. I could even go for a run! I did have a side effect which I could best describe as "brain fog" which was especially worse after alcohol but really wasn't that bad considering the benefits.

    Now saying that, since last Wednesday, I seem to have relapsed. My right knee has swelled up again and I'm getting familiar pains in my feet. I have my next injection on Thursday and I'm hoping that will sort me out a bit.

    in summary - don't be afraid of the drugs - as already mentioned, some will suit others more and there's always another option. They are, on the whole, very well tolerated and the difference is well worth it.

    Good luck!
  • Suzanne59
    Suzanne59 Member Posts: 7
    edited 30. Nov -1, 00:00
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    Thanks for taking the time to reply. Interestingly I have received my Consultant letter today and he is going to start me on Sulphasalazine. I now need to start exercising and trying to walk more. As I work full time I've really struggled with fatigue and found myself going to bed ridiculously early in order to cope. Time go get myself sorted and be positive!
  • Suzanne59
    Suzanne59 Member Posts: 7
    edited 30. Nov -1, 00:00
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    Thank you Grace, I will do