New guy

Best to research the disease and know what is available for treatment. 

Usually MTX and or Humira are the standard in stopping the progression. Psa is crippling if medication is not taken and it's a progressive disease. 

Have you had psoriasis?

 

It sounds like you have arthritis. If your arthritis is caused by old age, one day tou may need joint replacements.

If you have an autoimmune form of arthritis, you may be given steroids, NSAIDs which are non steroidal anti inflammatory drugs, if both of these were to fail the next step would be Biogics & DMARDs, disease modifying anti rheumatic drugs which actually change dusease.

Rest, not to be confused with sleep, is very important. True rest can not be achieved if one is stressed.

Hi, yes I have psoriasis on both knees and all my nails on my hands are quite pitted. Should really explain a bit more about me. It started off 2 years ago after a bout of shingles and quit bad neuralgia I started to get a rash on 1 knee then slowly it spread to the other knee, a couple of weeks after this I could notice I was struggling a bit to get up in the mornings which was odd as I'm now only 40 and quite active and my job keeps me active as well. I used to have to walk just over a mile first thing in the morning to get to work and on 1 particular day I set off with a small niggling pain in my foot which later turned into the walk from hell. I was stuck almost half way at half 5 in the morning and absolutely crippled in pain with my foot in the freezing cold and couldn't move for the pain. I struggled on and eventually made it to work but took hours for it to go away.

I went to the doctors about this and they explained it could be a thing called Mortons neuroma which is a build up of scar tissue between the toes and would need operated on to get rid.. And immediately put me on a course of cocodamol, amytriptaline.

Since then 2 years ago things have progressed and the pain has moved to both feet and knees in the mornings and during the day, I've been sent from pillar to post from podiatrist to msk, x ray, ultrasound, doctors and then the full circle of them again. Eventually I changed my doctor as I didn't think he really cared about my situation and I wasn't getting anywhere. My new doctor has had a bit of trile and error obviously thinking the same as the other in that it's mortons neuroma and it's just taking its time to actually show itself.

At this point now I'm taking cocodamol, amytriptaline, dihydrocodine, gabapentin, naproxin and obviously omeprazol. This has been going on now for just under 6 months when I changed doctors and she referred me to the hospital.

The hospital visit went well and the doctor immediately suspected Psoratic arthritis the second he seen my patches on my knees and heard my symptoms.... All of this is relatively new go me as I was expecting it to be mortons and be getting booked for an op... Thank God they didn't!!

I have an amazing wife who has supported me and put up with my every little gripe and moan about pain over the past 2 years and wants to learn and understand what is ahead of us. We have 3 small children the youngest being only 7 months and the oldest 5 years and I feel I'm slowing down already and really don't want to miss the years of them growing up and being a dad n doing all the fun dad things I want to do with them.

Thank you to any who can shed some light on what's ahead and how to deal with the bad days or help with questions I should be asking rheumatologist or doctors,

Hi Jay,

I agree, you have psoriatic arthritis.

Mayo Clinic, an esteemed USA institution, on treatment

quote

NSAIDs. Nonsteroidal antiq-inflammatory drugs (NSAIDs) can relieve pain and reduce inflammation. Over-the-counter NSAIDs include ibuprofen (Advil, Motrin IB, others) and naproxen sodium (Aleve). Stronger NSAIDs are available by prescription. Side effects may include stomach irritation, heart problems, and liver and kidney damage.

Disease-modifying antirheumatic drugs (DMARDs). These drugs can slow the progression of psoriatic arthritis and save the joints and other tissues from permanent damage. Common DMARDs include methotrexate (Trexall), leflunomide (Arava), and sulfasalazine (Azulfidine). Side effects vary but may include liver damage, bone marrow suppression and severe lung infections.

Immunosuppressants. These medications act to tame your immune system, which is out of control in psoriatic arthritis. Examples include azathioprine (Imuran, Azasan) and cyclosporine (Gengraf, Neoral, Sandimmune). These medications can increase your susceptibility to infection.

TNF-alpha inhibitors. Tumor necrosis factor-alpha (TNF-alpha) is an inflammatory substance produced by your body. TNF-alpha inhibitors can help reduce pain, morning stiffness, and tender or swollen joints. Examples include etanercept (Enbrel), infliximab (Remicade), adalimumab (Humira), golimumab (Simponi) and certolizumab (Cimzia). Potential side effects include nausea, diarrhea, hair loss and an increased risk of serious infections.

Newer medications. Some newly developed medications for plaque psoriasis can also reduce the signs and symptoms of psoriatic arthritis. Examples include apremilast (Otezla), ustekinumab (Stelara) and secukinumab (Cosentyx).

unquote

Rest is very important...prop up and read to the wee ones.

Warmth, all arthritis hates cold and damp...keeo an electric heatinf pad available.

Elevation and ice controls swelling and reduces pain.

An electric mattress pad on top of your mattress with a memory foam topper on top of the electro mattress pad wil keep your body warmed up while you sleep. When we sleep out metabolism reduces, leaving arthritis cooled down which translates into morning stiffness. Make you room cool, in summer I leave mine on 1 but during winter or rain, more like 4-6.

Walking to work is detrimental to your psoriatic arthritis while it is flaring.

By saving energy (hire the neighbor boy to mow the lawn), you have energy available to attend a wee one evening event at school.

Save your joints....why use yiur fungers to pry a lid off when a screw driver will accomplish the task and save your finger joints.

Do not carry with your arm extended, flex your elbow and use you chest to spread the load.

See and follow with a rheumatologist.

In the meantime, you can try one of the NSAIDs available over the counter. Be sure to eat before each dose. Take the medication every day. If you need supplemental pain control consider acetaminophen.

acetaminophen caution: read the labels of everything you take. Acetaminophen is a component of many medications. You di not want to overdose. You do not want to take more than 2800 mg of acetaminophen per day. You never want to dose acetaminophen any more frequently than 6 hours. This is to protect your liver.

Remember, NSAIDs take time for you to feel the result. The result is cumulative. It is not like takibg an aspirin and feeling better in forty minutes. Do not exceed the recommended dosage.

You will have bumps in the road, but you have an excellent chance of catching this, getting things managed with medication and having lots of fun with your family.

hugs to all

judith

Hi Jay As you will find out there are loads of medications that can be used to control the condition sadly it is not curable but it can be managed, Because there are loads of medication you can be treated with it is a case of finding which works for you or combination that will work for you, This can be a long process as some of the medication such as Sulfasalazine and Methatrexate can take up to 3 months to work fully. there is also numerous painkillers that can be prescribed to assist with pain relief. 

As with meds there are risks of side effects which can be monitored with blood tests. sadly it can be a long road to some sort of normality depending on your Rhumatologist. 

Thank you all very much for you info and input and also your time. I don't ever wish to mean anybody to be poorly or unwell but it's nice to know I'm not alone in this struggle and that there are genuine nice people here to offer some advice and put my mind at rest about what lies ahead of myself and my family. I don't wish to be a burden to my wife of children later on in life and I have mixed feeling about growing old and ending up needing lots of aids and help with mobility... Thinking the worst but I can't help it

Jay,

Just the fact that you are concerned about becoming an invalid tells me that you will never. No matter what life throws at you, you will hit it back.

Children only care that dad sees them, that dad teaches them, that dad is the leader, that dad loves mom, that dad tells them when they have made dad's heart smile.

I have observed two types of people with disease....the disabled and the differently abled...

I currently have physio for mine and have to use a walking stick. I'm waiting on hearing about getting aids to help me such as grab rails as it makes me unsteady plus the pain is very severe sometimes both day and night. Plus I'm on meds for another illness which makes my psoriatic arthritis worse