My husband is Air Force, and we currently live in Japan. To say that my healthcare options are limited is an understatement. While my husband was deployed Dec 2010-Jun 2011, I went home to stay with my mom. I was encouraged to see a doctor for my joint problems, and was diagnosed with PsA by a rheum. I do not have Psoriasis, but we found out later that my father does.
When I returned to the military hospital in Japan, the first thing the doc asked was, "Where's your Psoriasis?" Once I saw a different doctor, I found out that no one here in Japan has the authority to put me on a DMRD, the next treatment plan after Sulfasalazine and Plaquinil. That requires a Rheum.
The nearest (English speaking) Rheum is in Hawaii, and he doesn't believe my diagnosis, as I don't have Psoriasis! Does anyone have any ideas?
Do you have copies of documentation from your visits with the rheum who diagnosed you? I would start with that.
You may also want to print out some information/facts about PsA (like it can be present without P) and other information about PsA and provide that to your primary doctor. Think of it as an educational experience (for them). I think many doctors react this way because they're not familiar with PsA....but since many doctors have a God complex, they can't come out and admit to their lack of knowledge on anything. You may have to educate them a bit.
Since there isn't anyone at the bases in Japan authorized to prescribe DMARDs, you may have to request that they send you to Hawaii; unless they're willing to accept the original diagnosis. While there, you should be able to come up with some sort of plan to address your needs with the rheum and your doctor. If they don't send you, but accept your other rheum's diagnosis, you should be able to come up with a plan with your doctor (after you arm him/her with the right information).
Where in Japan are you (I was stationed in Misawa for 4 years in the mid-to-late 90's, beautiful area!).
Here are some links that might help you in your info gathering:
I do live in Misawa. I did miss The Earthquake (always the next question). My 50'' TV survived, the cups on top of my fridge did not. (Usually the third)
I know that I need to do something. At 27, my fingers are already misaligned, and I hurt all over. Left the military in Aug 2010 because working in a warehouse and doing military-grade workouts became impossible. I would crash when I got home, and spent the weekend in bed. Never knew why, the military said it was all mental. I had to push through it. I was diagnosed in Apr 2011.
The last BAD flare that I had, I couldn't open my left hand without outside force. The X-ray technician had to physically move my fingers to get the pictures they wanted. My rings, which are normally a little loose, were leaving grooves in my skin. I was lucky to not have to cut them off. (Cut my WEDDING rings off? Heck no!) I loved the next comment: you need to take an anti-inflammatory when you get home. (On top of the pharmacy-grade one I'm already taking daily? The one that I have to take with Nexium to keep me from getting another ulcer?) I turn into a nightmare for the Doctors, as my military job was medical supplies. My specialty was Pharmacy supplies. You could say I know my drugs.
The doctors are trying to keep me off of MTX, as I am childbearing age. I hated sulfasalazate, and plaquinil did nothing for me. They want me to try Humera(sp?) first. Not because it fits better, but because they have a military contract. Ugh. Has anyone tried Humera for PsA? I know Enbril is the only one certified, so I'm worried.