Inflamation Questions

A MAJOR side effect of mtx you should limit exposure to sunlight. When I first went on it, my doc didn't tell me about the side effects and I seriously burned on a camping trip. I had never experienced that kind of sunburn pain before; it was miserable. My new doc immediately inform me of the sun issues and recommended purchasing a few articles of sunscreen clothing availble at most outdoor retailers. It makes all the difference. I am unable to use sunscreens as my skin is highly sensitive to the chemicals in them and breaks out.

I hope this helps and you shall never experience a burn due to medications.

AnneMarie

Michelle said:

My Rheumy is being as pro-active as she can. My numbers were right for PsA but some other tests were not conclusive to the standard, however she has me on 15mg of Predisone, 3 METHX, 1 Naproxin and vicodine as needed. The pain is manageable until about 2 PM and then the pain level is not controlled. Since I work I only take half of Vicodine at 2 PM and 2 full at 8 PM. This of course is not ideal, but until my insurance will OK HUMERA this is the game we play. The METHX makes me so tired that I am ready for bed at 8PM but never make it to bed until 11 PM. I seem more sensitive to sunlight, is anyone else experiencing that? I am told I am more emotional, does anyone have that side effect also?

I know, although I never had any problems with it. My sister would get really sick with MTX. She has RA. In my case, they did 4 biopsies to corroborate the diagnosis of LLS with the skin rash. My Derm was ready to throw the Lupus diagnosis when I reminded him it could be a side effect. It is.

Thanks Anne Marie, that information was very helpful! I am more paranoid that most people bc my husband died of malignant melanoma from a severe sunburn he got when he was 10 years old. We're having a massive heat wave in Seattle (very unlike us too) and I am doing my best to stay out of the sun. Thx for the tip on clothing.

Michelle

anne marie said:

A MAJOR side effect of mtx you should limit exposure to sunlight. When I first went on it, my doc didn't tell me about the side effects and I seriously burned on a camping trip. I had never experienced that kind of sunburn pain before; it was miserable. My new doc immediately inform me of the sun issues and recommended purchasing a few articles of sunscreen clothing availble at most outdoor retailers. It makes all the difference. I am unable to use sunscreens as my skin is highly sensitive to the chemicals in them and breaks out.

I hope this helps and you shall never experience a burn due to medications.

AnneMarie

Michelle said:

My Rheumy is being as pro-active as she can. My numbers were right for PsA but some other tests were not conclusive to the standard, however she has me on 15mg of Predisone, 3 METHX, 1 Naproxin and vicodine as needed. The pain is manageable until about 2 PM and then the pain level is not controlled. Since I work I only take half of Vicodine at 2 PM and 2 full at 8 PM. This of course is not ideal, but until my insurance will OK HUMERA this is the game we play. The METHX makes me so tired that I am ready for bed at 8PM but never make it to bed until 11 PM. I seem more sensitive to sunlight, is anyone else experiencing that? I am told I am more emotional, does anyone have that side effect also?

Zipsor is an anti-inflammatory I believe. I have had a rough day today though. I think it’s the weather. My hips, knees and ankles have been really sore and I have been exhausted despite sleeping 11 hours last night and a 4 hour nap.

I know. Me 2. I'd like to think it's the weather 2.

I’ve never heard of a DNA test for PsA. Did you go for a lab for this or did your Rheumy do it in his office? I was just at my Rheumy’s office - still in pain even in MTX and Humira. Also, I was just put on Lyrica for Neuropathy by my Neurologist.
He told me to stop both the MTX an Humira for now! I’m pretty nervous about that but will wait and see.



Gelita said:

The first thing my Rheumy did was get a DNA testing. There is a marker there that let them know if it is PsA. As you check out the different types of PsA in the website address below, notice that of five types, only one include the "sausage toe/finger". Many docs have said that before they had all these blood tests, doctos relied only on sight to diagnose.

http://www.psoriasis.org/psoriatic-arthritis/types

Michelle the Pednisone can cause all sorts of mental problems and emotions and should start to taper off once your off of it. I've deleted about 10 close friends and family from facebook because they ticked me off and it wasn't till I got on too a lady at the store that was being rude to my husband that I realized I was a bit cranky ( now my husbands has a not so nice term for it! lol)

My inflammation markers were extremely high even after being on NSAIDS for the past 3 years! my middle and ring finger on my right hand are huge and severely damaged from sausage fingers that everyone passed off of as just a little trigger finger. Astym will help with range of motion if anyone is seeing a physical therapist.

Thank you everyone so much. After so many years of trying to find out what is wrong with me and enduring so much pain and humiliation the medical profession has dished out, it is beyond relief to have all this information. I am deeply grateful for the information and support.

DNA is just a blood test. Did your doc explain why stopping the meds?

westee said:

I've never heard of a DNA test for PsA. Did you go for a lab for this or did your Rheumy do it in his office? I was just at my Rheumy's office - still in pain even in MTX and Humira. Also, I was just put on Lyrica for Neuropathy by my Neurologist.
He told me to stop both the MTX an Humira for now! I'm pretty nervous about that but will wait and see.





Gelita said:

The first thing my Rheumy did was get a DNA testing. There is a marker there that let them know if it is PsA. As you check out the different types of PsA in the website address below, notice that of five types, only one include the "sausage toe/finger". Many docs have said that before they had all these blood tests, doctos relied only on sight to diagnose.

http://www.psoriasis.org/psoriatic-arthritis/types

"sausage" fingers/toes are the hallmark of psoriatic arthritis; when i first saw my rheumatologist, i was diagnosed with RA (even though i had severe psoriasis, and my dermatologist had referred me b/c she thought i had PSa) -- my RA factor was positive, and i had some swollen joints, but really the pain was more of an issue. however, a few months later i went into the office with a very red, swollen toe, and my rheumatologist was so excited, because this was a positive sign of PSa -- so from then on my diagnosis was both RA and PSa. now, several years later, i always (darn!!) have swollen inflammed fingers and toes; i guess PSa is very tricky to diagnose, and the "sausage" fibger/toes are one sure way of distinguishing it from other inflamatory processes.

My Dr did not say why he was stopping my meds, just that he was not happy with my progress. A question I should have asked was what now but I go back in six weeks so I guess I will find out then.



Gelita said:

DNA is just a blood test. Did your doc explain why stopping the meds?

westee said:

I've never heard of a DNA test for PsA. Did you go for a lab for this or did your Rheumy do it in his office? I was just at my Rheumy's office - still in pain even in MTX and Humira. Also, I was just put on Lyrica for Neuropathy by my Neurologist.
He told me to stop both the MTX an Humira for now! I'm pretty nervous about that but will wait and see.





Gelita said:

The first thing my Rheumy did was get a DNA testing. There is a marker there that let them know if it is PsA. As you check out the different types of PsA in the website address below, notice that of five types, only one include the "sausage toe/finger". Many docs have said that before they had all these blood tests, doctos relied only on sight to diagnose.

http://www.psoriasis.org/psoriatic-arthritis/types

Thanks Shutterfly for the response. My Rhuemy has promised I won't be on them forever, thank heavens. I feel like my weekends are "recovery time" to prepare me to hold everything together so I can work the remaining 5 days. I sleep as much as I can on Saturday and Sunday, but then end up feeling like I have no life.

Shutterbug said:

Michelle the Pednisone can cause all sorts of mental problems and emotions and should start to taper off once your off of it. I've deleted about 10 close friends and family from facebook because they ticked me off and it wasn't till I got on too a lady at the store that was being rude to my husband that I realized I was a bit cranky ( now my husbands has a not so nice term for it! lol)

My inflammation markers were extremely high even after being on NSAIDS for the past 3 years! my middle and ring finger on my right hand are huge and severely damaged from sausage fingers that everyone passed off of as just a little trigger finger. Astym will help with range of motion if anyone is seeing a physical therapist.

I have some pain, swelling and bruising in my fingers at times but have never gotten the classic sausage fingers. I know PsA is difficult to diagnose, but my first Rheumy told me I didn't have PsA because my Psoriasis isn't directly on the joints that I had problems with. Type A that I am I had already done all of the research when my primary doctor had mentioned PsA, and nowhere does it say anything about this being a requirement (at least not that I could find) I'm not sure where she got her degree, but when I could do better on WebMD than going to her - I switched and found an amazing Rheumatologist. She had the nerve to have her office call me after 2 months when I didn't go back and I was very up-front about my reasons for never going to her again....and her lack of knowledge was just one of the reasons!

I used to hate Wednesdays. Mondays and Tuesdays-the weekend's rest helped me. Thursdays and Fridays-the weekend was near. Wednesdays were the days I used to take off to make it through.

Michelle said:

Thanks Shutterfly for the response. My Rhuemy has promised I won't be on them forever, thank heavens. I feel like my weekends are "recovery time" to prepare me to hold everything together so I can work the remaining 5 days. I sleep as much as I can on Saturday and Sunday, but then end up feeling like I have no life.

Shutterbug said:

Michelle the Pednisone can cause all sorts of mental problems and emotions and should start to taper off once your off of it. I've deleted about 10 close friends and family from facebook because they ticked me off and it wasn't till I got on too a lady at the store that was being rude to my husband that I realized I was a bit cranky ( now my husbands has a not so nice term for it! lol)

My inflammation markers were extremely high even after being on NSAIDS for the past 3 years! my middle and ring finger on my right hand are huge and severely damaged from sausage fingers that everyone passed off of as just a little trigger finger. Astym will help with range of motion if anyone is seeing a physical therapist.

I asked my rheumy and family doctor and sausage fingers like increased Sed rate are indicators of the disease but do not mean you don't have PsA in their absence.

What ho??? No one ever told me that taking NSAIDS would mess up the SED rate test!!! I used to eat them like candy but had to stop, thanks to my NSAID-sponsored ulcer (thank you, Advil.) I'm not sure if I was taking them immediately before the test but there's a good possibility I was. And I also didn't know that PsA doesn't cause some of the proteins they're testing for. So then, that test might have been completely useless? Arrrrrgh!! I'm arrrrrghing due to the elbow patch I still have, and also some nice new pain on my big toe. And redness. Double arrrrrgh!

I do need to keep coming here. Your posts are invaluable, Lamb. I honestly think I should be paying you, instead of some of my doctors. Even if you aren't one. Which doesn't bother me.



tntlamb said:

Many of the blood tests are for RA and are looking for a particular set of proteins (CRP being one of them)

The "shot gun test" is called SED Rate. here they assume that the proteins produced by inflamation will latch onto red bleed cells making them sink to the bottom of test tube fairly quickly.

Great theory but PsA doesn't cause some of the more specific Proteins tested for. The others that are more general and can be present with PsA even if they do latch on may not be found.... You see if you are taking blood thinners, the sed rate is effected. Now I don't know ANYONE with PsA taking NSAIDS which of course work by thinning the blood, but if they were the SED Rate would be a waste of time......

That's why sausage fingers are so helpful along with funny nails, range of motion etc etc. There are no blood tests listed in the Dx criteria for PsA.

How long should you be off nsaids before having bloodwork done? Does It elevate or lower sed rate? Do nsaids affect the blood test for inflammation( forgot what its called)?

wow -- you were definitely right to switch docs -- never have i heard that the psoriasis needs to be on affected joint for it to be diagnosed as PSa; as a matter of fact, some people can actually get PSa without ever manifesting the skin disease!! my hands/fingers are definitely the worst of my joints currently, and i never have psoriasis on my hands!!

Alexa35 said:

I have some pain, swelling and bruising in my fingers at times but have never gotten the classic sausage fingers. I know PsA is difficult to diagnose, but my first Rheumy told me I didn't have PsA because my Psoriasis isn't directly on the joints that I had problems with. Type A that I am I had already done all of the research when my primary doctor had mentioned PsA, and nowhere does it say anything about this being a requirement (at least not that I could find) I'm not sure where she got her degree, but when I could do better on WebMD than going to her - I switched and found an amazing Rheumatologist. She had the nerve to have her office call me after 2 months when I didn't go back and I was very up-front about my reasons for never going to her again....and her lack of knowledge was just one of the reasons!

I have never exhibited the classic ‘sausage’ fingers. Absence of this symptom is hardly a reason for dismissing PsA as a diagnosis as it only occurs in a fraction of patients with PsA. The arthritis foundation lists 5 types of PsA each with distinct symptoms sets. Psoriasis need not be present at the affected joints. For example, I have spondylitis but no psoriasis on my back or neck. In fact, in some people PsA is present before or without active psoriasis.

As far as testing, my understanding is that there is no specific blood test for PsA. Rather, general inflammation indicators are looked at in conjunction with other symptoms. My rheumy immediately found reduced range of motion & loss of strength as key indicators despite the lack of obvious swelling. This was accomplished with a quick physical exam.

I would find another doctor.

Yes, I cry all the time. It is hard for m to understand how a skin condition can cause all these problems!