I'm new, so forgive me please for already seeking encouragement...but I just saw my rheumatologist yesterday and he did a complete 180. At my last appt he said he wanted to start a biologic after I cleared blood work (which I did), and so I went to yesterday's appointment thinking we would choose between them -- and my pick was Enbrel. But instead, he talked about increasing my steroid use and continuing on my NSAID and Arava. When I asked him about the biologic route, he said, "Yes, well, I'm back peddling on that." I have mild cardiomyopathy, and a history of a few heart arrhythmias (including WPW). He's not willing to use biologics such as Enbrel and Humara with my heart condition. He is willing to look further into Stelara.
I've been trying to see if there is research on Stelara and patients with heart disease. Has anyone discovered information on this? And is Stelara now approved for PsA in the US? I'm seeing my cardiologist in a few weeks. Guess all this is in my best interest -- but right now, it's highly discouraging because I thought I was beginning to see the light of day...back to some sense of "normal." I feel like I'm back at square one.
A good consult with your cardiologist and Rheumy seems eminent. The Cardio Myopathy is very concerning but if you have WPW that can be a a reason. The body of research of these kinds of rhthyms and PsA being more than coincidence is growing. The same with Cardio Myopathy. I don't know how long it has been since you have had a GOOD echocardiogram but it is prolly not a bad idea. They concentrate on wall thickneses etc. Its is possible your PsA is causing some inflammation.
I say this only because not all Cardio Myopathy is congestive heart failure. it is sort of a blanket term. While your rheumy is certainly looking out for your best interests, the fact is the BIO's may actually HELP your heart problems (They did mine) Of course if stellara works, you have the best opf both worlds.
The other option is to have your cardiologist refer you to an electrophisiologist. The WPW while generally more of a nuisance than anything can be taken care of. While he has you in the lab they can really get a handle on the Cardio Myopathy as to what it is.
This is only my experience. I am fortunate in that my community is home of the International Heart Institute which happens not only to be a Top 50 heart hospital (FWIW) but has an incredible record with Heart Failure. My whole diagnoses path started because of "heart problems" As an ex-mechanic I wasn't realy fond of rheumatiology, thinking they were pretty much drug pushers (before the Bils they were) Because of my History of heart failure, the Rheumys were loathe to start me on the Bio's. A note from the cardiologist (who happens to be a whiskey collector and a fellow member of the keats club and wrote the note after a meeting) got me started. My annual echo 8 mos later was perfectly clean. AND I got to stop the heart meds. The Echo 6 years later is still clean.
I've been thinking more and more that these things just HAVE to be related. I mean, it's all in the SAME BODY. I've had two cardiac ablations -- one to correct the WPW and one to correct another arrhythmia that was causing my heart rate to drop significantly while at the same time creating thousands of extra beats a day (I already have an electrophysiologist). I get yearly heart echoes (EF went from a 29% to a 50% with meds). I'm guessing they'll do the more sophisticated echo before clearing me, but I'm also hopeful that I'll get to go down the biologic med path -- and that it will lead to improvement in all areas.
My rheumatologist said I was a "test case" for him in many ways. Guess I'll have to get used to that.
tntlamb said:
A good consult with your cardiologist and Rheumy seems eminent. The Cardio Myopathy is very concerning but if you have WPW that can be a a reason. The body of research of these kinds of rhthyms and PsA being more than coincidence is growing. The same with Cardio Myopathy. I don't know how long it has been since you have had a GOOD echocardiogram but it is prolly not a bad idea. They concentrate on wall thickneses etc. Its is possible your PsA is causing some inflammation.
I say this only because not all Cardio Myopathy is congestive heart failure. it is sort of a blanket term. While your rheumy is certainly looking out for your best interests, the fact is the BIO's may actually HELP your heart problems (They did mine) Of course if stellara works, you have the best opf both worlds.
The other option is to have your cardiologist refer you to an electrophisiologist. The WPW while generally more of a nuisance than anything can be taken care of. While he has you in the lab they can really get a handle on the Cardio Myopathy as to what it is.
This is only my experience. I am fortunate in that my community is home of the International Heart Institute which happens not only to be a Top 50 heart hospital (FWIW) but has an incredible record with Heart Failure. My whole diagnoses path started because of "heart problems" As an ex-mechanic I wasn't realy fond of rheumatiology, thinking they were pretty much drug pushers (before the Bils they were) Because of my History of heart failure, the Rheumys were loathe to start me on the Bio's. A note from the cardiologist (who happens to be a whiskey collector and a fellow member of the keats club and wrote the note after a meeting) got me started. My annual echo 8 mos later was perfectly clean. AND I got to stop the heart meds. The Echo 6 years later is still clean.