My name is Jeff and I was diagnosed with PsA about 8 months ago. I am 42 and a firefighter. I started with psoriasis about 8-9 years ago. It would come and go. Occasionally I will get hurt on the job and have to get looked at. Every xray I had came up with arthritis! I was having more pain in my joints, especially my back, hands, feet and knees. I had two trigger finger issues, one requiring surgery. After about 5 years of problems, including a grade 4 chondromalacia patella (hole in the cartilage under my kneecap) my ortho finally referred my to a rheumatologist. She has been treating me ever since. I am on Enbrel and Lodine right now, but I am still having problems with my feet and back. I am starting to have a hard time at work, and it is very upsetting. I love my job and want to stay at it for at least 10 more years. I am looking for info on treatments. What has worked, and what hasn't. Hoping to get help from people with the same issues as myself. Thank you for your time!
Welcome to the group Jeff! It's good that your orthopedist got wise and sent you to a rheumatologist. It sounds like you are being treated appropriately. Remember, it takes some time for the meds to start working, and not every medication will work for every person.
One thing to consider . . . custom orthotics for your feet may be of help in supporting your feet and easing your foot pain.
Stoney said:
Welcome to the group Jeff! It's good that your orthopedist got wise and sent you to a rheumatologist. It sounds like you are being treated appropriately. Remember, it takes some time for the meds to start working, and not every medication will work for every person.
One thing to consider . . . custom orthotics for your feet may be of help in supporting your feet and easing your foot pain.
Thanks for the words of encouragement. I've been on Enbrel for about 6 months now. How long does it take? I tried orthotics and hated them. They lifted my feet up about 5/8 of an inch and I felt like I was falling out of the shoes
Welcome, Jeff. If after a few more months the Enbrel doesn't work, you might try a combination of Methotrexate and Enbrel. The combination was more effective for me (though there is no guarantee you will have the same efficacy from any medicine as anyone else). There are some other biologic possibilities (Humira, Remicaide, Stelara) and a lot of other oral meds. Unfortunately, it is hit or miss until you find something or a combination of somethings that will work for you. The most effective treatment for me has been a combination of MTX (Methotrexate), Remicaide (with a high dose of IV steroids and benedryl as premeds), folic acid, and an NSAID (for me it was diclofenac). I'm not currently on that treatment (which is a whole other story), but hope to get back on it soon. I haven't been on Lodine. I've also done a bit of rehab on the symptoms as they appeared.
This group has been the best thing I've done yet for my PsA. The wisdom, kindness, and understanding here have gone a long ways towards helping me come to terms with my altered circumstances. Again, welcome, and good luck!
I agree with timberwolf, this group has been the best of every source of info and compassion for me. I told my doctor about it and mentioned a moderator by name and she new him professionally and said I was in the very best of support groups. Welcome ....know your gonna feel right at home here. Thanks for your service big guy:)
Hi Jeff and welcome!
If there's one thing you learn here it's that you'll never stop learning here. We all respond so differently to the illness and the treatments that it's a big unrelenting game with many moving parts. Just when you think one thing is going well then something will happen to change the status quo and then you're on the hunt for another treatment or way to ease your aches and pains.
One piece of advice--given how complex and relentless and difficult our illness is to treat--try as best you can to get all the other parts of your life in a simple and stable routine. If you can eat right, not stress too much (although I'm not sure how that works when you're a firefighter), and generally have a well-ordered life outside of your illness, then the illness becomes the target for your energies and efforts. It can be much easier this way to pinpoint a potential trigger for an increase in your symptoms--if all other things tend to remain the same in your life. I hope this makes sense.
See you around the site!
Thanks for all the words of encouragment. I appreciate the advice. My next appt. is in December and I think I will have to discuss other options. I heard that methotrexate and mess with your liver?
Hi Jeff, welcome to the forum 
Yes MTX can “mess with your liver” but then so can many things…alcohol, other drugs etc
But whereas we can abuse our bodies without any idea what is happening to our insides, your docs will make sure you have regular blood work to make sure your organs are not being damaged by any medications you maybe prescribed.
I’ve been on MTX, first tablets and now 25mg subcut injections, since July '11 and my liver shows no signs of any problems…as has been said we are all so different and react differently to meds. My local Occupational Therapy department have been a god send to me, helping me stay in work, with tailor made exercise and splints they made there and then for me.
Good luck
Welcome, Jeff!
PT and OT can be a huge help in maintaining function. As Has already been mentioned; simplifying your life, making sure that you have a healthy diet, and regular exercise are essential to this as well.
Finding the right NSAID is also incredibly helpful. The rule of thumb for the biologic drugs is three months. As in, if you aren’t seeing the results that are expected from that drug after three months of it, it may be time to try something different. That can include adding another medication in, like a DMARD (methotrexate or Sulfasalazine) or a new biologic drug altogether.
I am so glad you found this group. There are times that it had been a support that no one else could provide. You are certainly in good company!
Grumpy