Psoratic arthritis and working in healthcare

liz101 Member, NewlyRegistered Posts: 5

I recently been diagosed with psoratic arthritis by my rheumatologist (as in 3 days ago). I'm 30years old and I have had psoriasis for 20years, though it is mild and doesn't bother me in any way. I work as a junior doctor in paediatrics, which is pretty high powered and intense at times.

I developed a swollen right thumb joint 3 months ago and a swollen toe (which doesnt bother me) and since I have a bit of background knowledge got referred to rheum quite quickly. My bloods have all been normal, including infammatory markers.
Despite this I was really shocked when the consultant told me that it was PsA and that she recommened me starting methotrexate and enrolling on a trial with a biologic as well as soon as possible.

To me the thought of being on these high power drugs is a big deal, I am around sick children everyday and I am not sure if the treatment that is being recommened is worse than the acutal thumb swelling, which only gives me mild pain and causes discomfort when I write some days.

Does anyone else know of other people taking DMARDS or Biologics that work in healthcare and how they cope, for example with the increased risk of infection.



  • moderator
    moderator Moderator Posts: 4,082
    edited 30. Nov -1, 00:00
    Welcome to Arthritis Care Forums liz101 from the moderation team

    As mods we are here to help with any problems you may have on the message boards.

    There are lots of lovely people here with a wide range of experiences with arthritis and the problems of living with the condition. Just join in wherever you like you will be made very welcome.

    I look forward to seeing you posting on the boards.

    Best wishes

    Mod JK
  • stickywicket
    stickywicket Member Posts: 26,023
    edited 30. Nov -1, 00:00
    Hello Liz and welcome from me too.

    You do have a dilemma, don't you? What has, for some time, been merely psoriasis has suddenly changed into something much more significant, demanding and, potentially, damaging to your career.

    I do understand the reluctance to take meds which could make your life with the 'Little Germ Factories,' as my son used to refer to my grandson's Day Care friends, much more compromised. It really is a tricky one as you must feel you are balancing one not-parricularly-bad thumb against a drug / drugs which will make you open to all sorts of infections.

    What I have learned, over 50+ years of RA, is thay all the autoimmune forms of arthritis come in various degrees of progression. I was lucky. Despite being diagnosed back in 1961 when I was 15 and DMARDS weren't on offer, I muddled through until after the birth of my first son in 1970. Then it got tough. Now, 3 new knees amd 2 new hips down the line, things are on an even keel thanks to methotrexate and hydroxychloroquine buy there were tough times in between.

    Being on meth and / or biologics isn't all bad news. Have an annual flu jab and be assiduous with hygiene - hand gel and wipes - and make sure those around you are too

    Essentially I think you could do with another chat with your rheumatologist - or GP if that's easier. It must seem a big step and you do need an imformed decision. It might represent a golden opportunity to nip this nasty disease in the bud. But it must feel to you like overkill.

    Try reposting on the Living With Arthritis forum where I think you'll get more replies. Good luck with your decision making. lI'll try to pop back on here bit I'm currently in Los Angeles visiting a son and I don't have much free time.

    PS. Knowing what I now know I would, personally, take the DMARD and ask why I was, unusually, also being offered a biologic at this early stage. It's unusual. Is it a trial?
    “There is always a well-known solution to every human problem - neat, plausible, and wrong.” H.L. Mencken
  • liz101
    liz101 Member, NewlyRegistered Posts: 5
    edited 30. Nov -1, 00:00
    Thanks for the reply.
    I'm going to be having abother chat with my rheumatologist soon. I still haven't come to a decision need a little more time to get my head around it.
    The biologic is a trial so I know it's not usual treatment, it's double blind so I could get the biologic or get a placebo. I think if o do decide on treatment at this stage I would go with the trial but like I said I'm still assessing my options

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