How do you know

How do you know when your at the point of being the best you can be? I’ve been to see my DR today and we are going to give the Metho & Enbrel another 8 weeks.If I still don’t have further improvement then I think we are going to try Orencia Infusions. I have been on various treatments the last 18 months with no real improvement especially in my hands & wrists. Do you just keep trying different meds and hope that somewhere out there is the one which works for you. I have to say since being on meds I have no psoriasis what so ever and for that I am grateful its just the pain & swelling that’s proving to be difficult.

IF you are getting P control, I wouldn't be too quick to jump ship. Your Doctor is the final authority obviously BUT it oftern takes a pretty good high dose tape of Predi to get going followed up by the right NSAID. Even then there may be some specific areas that require extra attention (hands being common) For me its my shoulders.

You also need to discuss with him the possibility of the pain and swelling coming from damage NOT inflamation. It may also be from something that is not PsA such as OA.....

The bare minimum for *me* is to have about 3/4 good days and 1/4 bad days (bad days area basically doing nothing more than rest and recover). Last summer I had more bad days than good and I knew it was time to ditch my meds and try something else because I couldn't live that way. There are SO many meds out there, and they don't work the same for each person. It is a lot of trial and error. And then combos of meds (even MORE to try!).

Don't give up. There are so many meds out there that might help you! 18mo without much improvement is really tough though. For what it's worth, Enbrel and Simponi did the best for me, while Remicade, Rituxan, and Humira did nothing. That's a lot of meds, a lot of time waiting, but once you hit on one that helps you will *know*

I asked her for some of that Voltaran cream yesterday,when she gave me it she said ‘it might help your cervical pain but I don’t think it’s going to help your hands.’ For her to say that before I even tried it kind of sucked. She doesn’t think I have OA but she’s mentioned RA a few times. My mother was diagnosed with RA when she was in her 30s,I’m 43. I’ll keep plodding onward,I just want my hands to stop hurting so much.