Living with Psoriatic Arthritis
About the time I turned 35, my joints started to ache to a point where I couldn’t move. It prompted me to go to the doctor, something I rarely do, and then only if I’m deathly ill.
It did not take long for a rheumatologist to diagnose me with psoriatic arthritis (PA). It is a rare and aggressive form of arthritis usually found in people with a skin condition called psoriasis, of which I had no symptoms. Nonetheless, I had developed PA, in the prime of my life, and as I had always been an active and healthy person, I was not prepared to deal with a debilitating disease.
Once you’ve been diagnosed with PA, it is a matter of working with your doctor to find the right treatment. Up to the point where I was finally referred to a rheumatologist, I had tried everything available or recommended by anybody to alleviate the pain, from Emu oil to glucosamine sulfate. Let me tell you, none of it worked. Don’t just take other people’s advice, seek help from a physician if you suspect you have arthritis.
What works?
Working with my doctor over a period of a couple of years, we finally settled on a weekly regimen of methotrexate, an inexpensive but effective drug, that counteracts the effects of PA, pretty much stopping it in its tracks. Make no mistake, this is a nasty drug that has caused me more than one nauseating headache. But once I got the dosage at a point where I could tolerate it, the effects of PA all but disappeared.
Methotrexate is really hard on the liver however, and you have to have blood tests once in a while (formerly every three months, now twice a year.) Also, being so hard on the liver, you must limit your alcohol intake to two drinks per week (not a problem for me except on holidays,) and consult your doctor if you take other medication you suspect may cause liver damage.
The best over-the-counter treatment is Ibuprofen. It is a non-steroidal anti-inflammation drug that alleviates the swelling that causes the pain in the joints. No other over-the-counter medication works as well for me. For daily maintenance, that is my main pain relief. I take it under doctor’s advisement, because Ibuprofen too can have adverse effects on the stomach and liver.
When the PA was at its early height of activity, I took prednisone (an adrenocortical steroid.) I understand now why athletes get hooked on this stuff. Not only did it alleviate the symptoms of PA, but I felt like I was 18 years old again. Needless to say, the doctor was leery of prescribing this to me, and I’ve only actually taken it for about three weeks over five years. But man, was it good at the time.
Exercise may seem counterintuitive, but it is a major part of my ongoing treatment. I suppose the benefits of exercise for general health can’t be overstated, but for sufferers of PA, the main benefit is continued flexibility of the joints. Another side effect is building up a tolerance to unavoidable pain associated with PA. I don’t work out per se, but stretch, do push-ups and walk two miles to work almost every day.
Joint ointments that contain capsaicin (chemical derived from hot peppers) work best in this category of pain relievers. Just don’t rub your eyes after applying it (it burns.) I use this rarely and usually in the winter when the cold causes me more discomfort.
Omega-3 fatty acids (food supplements, fish) have had some long-term positive effects. This is not a treatment, but rather a dietary supplement that promotes joint health.
Warm water and a warm environment also help to immediately alleviate discomfort.
As another pain reliever, my wife kindly massages my hands and fingers if I ask nicely.
What doesn’t work?
If I didn’t mention it above, I probably tried it and it didn’t work. Emu oil, peanut oil, glucosamine sulfate, Tylenol, aspirin, Celebrex, among others, had no effect on the symptoms of PA. I’ve tried more stuff than I can remember, usually on well meaning advice, but to no avail.
Daily life with PA.
Now that I have a routine treatment, I hardly notice that I have PA. I just take a few drugs (methotrexate weekly, Ibuprofen as needed, vitamins,) that don’t really interfere with my daily life. There will always be discomfort with PA and occasionally I can predict the weather by how I’m feeling on a particular day.
Next, I’m going to try acupuncture to alleviate occasional discomfort in my hands. I’ll let you know how it turns out.
If you suspect you have PA, the best thing you can do is see a doctor. With treatments available these days, you can lead a long, normal and active life.
