Ian, hello and welcome.
We're all volunteers here, and we really do welcome the opportunity to share experiences, ideas and alternative points of view with people. We don't sell anything. We're not paid by a drug company or anyone else to be here. Unlike JulesG and Sybil, I am Canadian, and my experiences with PsA have been somewhat different from theirs, but more on that later.
First off, just to get the party started, I'm going to take issue with the idea that you've been slapped with a life sentence of Sulfasalazine (or medications in general). The situation is, in fact, that you've been given a life sentence with Psoriatic Arthritis. You didn't ask for it or earn in, it's not your fault, but it is yours to keep. It's a difficult realization, and one with which all of us here have had to come to terms. Some of us even manage to do that, more or less, on a good day.
You may be interested in the fact that I took not a single arthritis medication for the first twenty or so years of my disease. (Yes, I'm way past my best before date. :-) I struggled but I managed. I was tired and depressed, and my knees hurt, but I pushed on. Within a few of years, I had two knee replacements, and I recovered well. I carried on, bearing my aches and pains, until one day my feet hurt so badly that an x-ray revealed erosions in almost every mid-foot joint. And that's when the doctors, twenty years after my miscellaneous complaints started, diagnosed Psoriatic Arthritis. Up until then, I had never had the option of taking medication, you see, because I didn't know that I had the disease. But I will tell you that at that point, I WANTED treatment to prevent more damage, and the more aggressive the treatment, the happier I would have been. My conservative rheumatologist, though, gave me sulfasalazine, as well as all the other DMARDs in succession, and when I got to leflunomide, she considered that to be good enough. It took more foot damage and the loss of both my hip joints for someone to realize that my disease was severe, and to get me onto a biologic medication. That was three years ago. I now feel healthier and better than I have in the last fifteen years or so. Unfortunately, I now travel on a mobility scooter because ten minutes or so is the limit for walking or standing on my severely (and inoperably) damaged feet. Food for thought?
The other interesting comment that stood out for me was "Since the diagnosis for Psa the black dog has been back " Your diagnosis, as depressing as that is, may, in reality, not be the only reason for your depression: there is more and more evidence for believing that there is a connection between PsA and depression. In fact, for me, one of the best effects of my treatment has been a vast improvement in my depression.
Unfortunately, most doctors don't have the time, and many don't have the skills, to engage patients in an exploratory discussion on percentage risk in their disease and likely success rates of various treatments. Think of it this way: as a professional person in the financial sector, if a client were to ask you whether they should insure their house, what would you say? Would you trot out the percentage risk figures for fire, water damage and theft? Engage them in a detailed conversation about what their insurance policy is going to cost, relative to the consumer goods that they are going to have to forego in order to pay for it? Bring out pictures of charred skeletons of houses? No, more likely you'd say something like " I really don't think you want to take a risk like that."
That said, you have us! We have great information in our Newbies' Guide, and loads of people to talk to. You might also like to do a search for questions that interest you, using the search feature at the top right of your screen. I would also highly recommend this book, which many of us regard to be the PsA patients' "bible".
OK, wine. You mentioned it, I'm on a roll, may as well go for it. When I could see my retirement from education on the horizon, I decided that I would need something interesting, active and skilled to do after teaching, and it would definitely have to be something involving plenty of contact with people. I threw caution to the wind, went to college and did a sommelier diploma. I was going to dabble in restaurant service, wine education and perhaps get involved in wine tourism. I was just getting my "Spanish Wines and Sherry Tapas Night" act together when I was diagnosed. That put paid to my sommelier career: instead, I chose methotrexate, which was one of the hardest choices I've had to make in my entire life. Now my retirement "job" is being a volunteer here at Ben's Friends. It's not what I planned, it's not what I wanted, but it's making the best of what I got. And I will add that I am not the only person here who has had PsA put paid to their career.
On the bright side, it may not seem like it now, but you've been very fortunate to have been diagnosed as quickly as you were, before there was major damage. Nothing about the PsA sentence is easy. But as they say, a door slams and a window opens. It's all in how you look at it. (Oh sure, I sound brave this evening, but I do have my days!)
That's more than enough for now. We're glad that you joined us, Ian, and I hope after the earful we've given you that you still are as well.