Hi, Rachel. I am another PA'er, though I have no spinal involvement of the
arthritis. (have muscle probs there, but that's a different story!)
(the car guys would call this next part a dope slap)
You really, really need to be seeing a rheumatologist. PA is not truly a
joint disease, but rather an auto-immune disorder, or an immunological
disease. Treatment of arhtritis, especially auto-immune arthritis is far
more complex than many people realize and you need to see a doctor who
specializes in it. PA is NOT just a joint disease, and it does NOT effect
just the joints. You need a doctor who is fully alert to tendon and muscle
involvement as well as other complications that can develop from the disease
- such as the fibromyalgia I've developed after years of PA. Also, RDs
(rheumatologists) know much more about the fine distinctions between the
flavors of arthritis and the meds that treat them best. This includes
details about which of the new meds seems to work better for PA than for RA,
which additional probs are most likely to happen with each flavor, etc.
I know the side effects of the medications for auto-immune arthritis are
frightening, but the reality is there is no other way to effectively treat
these diseases at the moment. What is happening is that your immune system
for some reason is failing to recognize your healthy joints as healthy,
normal parts of your body and is attacking those joints. The only way
currently to stop or at least slow this process is to dampen down the immune
system. The meds that are available for this now are far more specialized
and with a more specific action than previously. They are also far, far more
effective than the options even 15 years ago. Avail yourself of these meds
and you can prevent further joint damage NOW, so you will suffer less of
permanently damaged joints. As you have spinal involvement for which a
relatively easy joint replacement is not available, you really should work
actively at preventing damage NOW.
The longer you hold off on taking any of the DMARDs (disesase-modifying
anti-rheumatic drugs), the more permanent, unrepairable damage will occur in
your affected joints. In the case of your spine, that also means you'll be
getting a lot of pressure on spinal nerves which will cause all sorts of
havoc throughout your body. Now is the time you have to decide what quality
of life you want in the years and decades to come. I know it's hard to have
to face this so young. My first inklings of PA came in my teen years though
as my dad had RA I expected that to be my flavor of arthritis. It fully
exploded on me at 28 and I've been dealing with this for almost 22 years now.
Believe me, the DMARDs we have now and the current thinking to use them
early is a real blessing. And until they figure out a way to reset our
immune systems, these drugs are our best option.
Meanwhile, keep in mind that the side effects are just possible problems -
you won't necessarily develop those problems! I've been on at least 14
different NSAIDs along the way. I had side effects from a few, but most of
thsoe changes were an attempt to find the most effective med for me. As for
DMARDs, I took plaquenil with no side effects, but it only helped for a few
months. If your psoriasis is moderate to severe, they probably won't even
try you on it as it can cause the skin disease to worsen.
Mtx helped for a while alone. Initially I had some major fatigue from it,
but my body adjusted over time so that was no longer a problem. No other
side effects, until we took me off it last year as part of trying to solve an
ongoing mystery of strange lab results. When mtx alone began failing for me,
we added arava. I actually did well on that combo and even kept my liver in
line with milk thistle and NO alcohol, but it isn't really recommended to
take those 2 together, esp. at the dosages I was on.
When we got better prescription coverage, we traded arava for
enbrel. I have
had no side effects from it other than a bit of stinging or pain during
injection. Giving yourself the shot is actually much easier than you might
imagine. I had long since gotten over my old fear of needles thanks to
allergy skin tests and desensatization shots, but still didn't like the idea
of sticking myself. It turned out the needle goes in very easily. My
brother, a long-standing diabetic, tells me the modern silicone-coated
needles are much easier to use. I am very careful to stop the enbrel for any
infection and for more severe viruses as I've always been prone to developing
infections. Overall, I've done well with it thus far.
One of the even newer meds,
humira or
orencia - I forget which, appears to be
even more effective for PA that the others.
Oh, and while I'm at it, are you familiar with the National Psoriasis
Foundation? Hopefully you are. They really are a wonderful source for info
about Ps and PA.
--
Nann
remove the Gator cheer to email me
Simply the thing I am shall make me live --- William Shakespeare
Psoriatic Arthritis anyone? 
I woke up this morning in so much pain (its raining out) and
. I took take milk thistle daily as
Linear Mode
