I’m 26 and my PsA is really messing with my feet. I’m down to tennis shoes and slippers, neither of which work for professional attire nor are they cute. Has anyone come across shoes that are cute, comfortable, and supportive? I know this seems like small beans but it kills me that I can’t wear cute shoes anymore…
I fear your disease may be accelerating on you. I had a wicked flair after the birth of my son. I was a nurse so I was all ready wearing orthopedic shoes most of the time. But I am concerned if your feet are so painful when you are young. I read your profile and I see you are not on a biologic. Is that because you just had your son? Are you intending to go back on a biologic? You may want to read another Mod's blog" Listen up by Seenie. She is dealing with destroyed feet right now. The pain and destruction of the small bones in the hands and feet is something to be avoided at all costs. We can get new knees and hips and even shoulders but those small bones! Yikes!
You might also want to gt the book recommended in the Book Review section at the top of the header. It will at least allow you to plan a bit.
Welcome to the board!
I’m not on anything at the moment. I live in rural Minnesota and there isn’t a rheumatologist near me. I’m going to see a doctor of internal medicine this week. I’m nursing right now and I don’t want to stop until my son is 6 months old. I’m not sure what will happen, but I will definitely loom into the resources you mentioned.
Hey, I heard my name! Yes, NewbieT, the blog is here –
http://discussion.livingwithpsoriaticarthritis.org/profiles/blogs/listen-up-take-notes
I don’t mean to scare you, but … OK, you do need to fear this disease.
Well I’m certainly scared.
I was scared too. Then I got mad. Do your reading and research, make well informed decisions. I hear you on nursing your baby. I nursed mine too. It is an important time but if you do decide to start some medications the doctors can help you decide what is safe and what is not. If, and that is a big if, you decide to go on meds and not nurse any more it will be ok. There are lots of babies raised on formula and are fine. I always wanted to wean mine to formula so I could get some help with the feedings but it never happened that way. My boy went from the breast to a cup at 8 months. He never liked the bottle. But when the mother's health is at risk and the decision is made to go to a bottle it is fine. Mothers and babies still bond and babies still grow like little weeds. Love IS all that really matters.
I travel over an hour to my Rheumatologist as I live in a rural state too. My Rheumatologist sees most of her patients every 6-12 months as there are few Rheumatologists here too. That is fine if the patient is stable. She has seen me every 3-4 months for the last 6 years as I have never been stable. I am one of the few whose over active immune system knocks the biologics out after about a year. I am on my sixth biologic, Stelara. I am almost an invalid when not on a biologic. I have had PsA for over 30 years perhaps since birth. I was not diagnosed until 2008 and I am a nurse and was around physicians all day. I was the one who realized what was happening and took myself to a Rheumatologist. It took two visits for her to be sure what I had was PsA. The Internal Physicians I worked with all day did not recognize it. Remember it is a rare disease and it is a great imitator. It really can appear to be a whole lot of other diseases.
Now for the more fun question you posed, shoes! I visit a site called Barking Dog Shoes. It is by a lady with RA and she reviews shoes and gives her thoughts. I usually purchase from Zappos and I like the brand Klogs USA the best. They are what my Rheumatologist suggests. They have a rigid anatomical foot bed like an orthotic covered in memory foam. They are wonderful on my achy feet.
Now that we have scared the heck out of you let us arm you with knowledge. Welcome to the group.
Thanks for welcoming me! I am certainly interested in knowledge 
something that concerns me about the different treatments is the higher risk for cancers. Breast cancer runs in my family and my mother had uterine cancer. Any insight?
When I was on methotrexate, I got every side effect listed. It was absolutely horrible. I stuck it out for a year, but I could never get a hold of my rheumatologist (Always got her nurse and then the we will call you back) I only talked to her twice in the year I was with her. I felt horrible so I dropped the meds and basically went back to dealing with it.
I’m hoping this internist can hook me up with another rheumatologist. I’m trying a different health system.
Thanks for the tip on the shoes! I’ll definitely check that out!
When I really took a look at the stats with cancer and biologics I found that the rates with most of the biologics was actually lower than the rates for general population. The one exception is teen age boys being treated for Crohn's with biologics. Their rate jumps dramatically. Unfortunately it throws the graphs off as they are all in the research together. And remember the ads on tv mention all the side effects that MIGHT happen. If we read the write up on Tylenol we might not take that either though it is a very safe drug in practice.
I hear you on the mtx. There are lots DMARDs to try. Mtx just happens to be cheap and works well for most patients. I would not rule it out entirely. In the hands of a better Rheumatologist who can ease out the ride you might be ok. But maybe not. There are many to choose from if that is the case.
The usual line up is a NASID (non-steroidal anti inflammatory) first. I have used them all but now switch between Celebrex 200 mg twice a day and Naproxyn (Aleve) 500 mg twice a day. You may notice I am on twice the recommended daily dose. My Rheumatologist has adjusted them to there as I have a lot of problems with swelling and my body tolerates it. Then they add a DMARD or Disease Modifying Anti Rheumatoid Drug which is mtx (methotrexare) or others. Then they add the biologics like Enbrel or Humira. Remember when researching this that only the biologics have been proven to halt joint destruction.
I take mtx with a biologic to try and stop my body from rejecting the biologic. My body still builds the antibodies but with mtx it takes about a year. Mtx also helps with the pain and swelling in my hands. Biologics work well on reducing pain and swelling on the "axis" or spine, hips etc but mtx is the king of reducing the symptoms in the hands and feet. The other DMARDS work similarly.
My Rheumatologist says she keeps her patients on all three for the most part. She says it is a complicated disease and usually needs a three pronged approach.
The book recommended under book reviews goes into all of this. It's name is The Facts:Psoriatic Arthritis.
I have been debating going to get a second opinion at Dartmouth Hitchcock in NH which is about 2 hours from here. I like my Rheumatologist but at times I do sense her frustrations in treating me. I share your frustrations with rural accability to physicians.
Don't plan on weaning just yet. I had to start medications when my son was just 1 year old, and he kept nursing for a very long time. In fact, I weaned him when I had waited long enough to start one of the "stronger" DMARDs. But plaquenil is somewhat compatible with nursing, as are many NSAIDs. I have a friend who uses Humira, and was on it while pregnant and breastfeeding. As a matter of fact, biologics may well be the safest medication while breastfeeding. Think about it, they need to be injected because the stomach would break down the proteins. Even if any was in breastmilk, the baby's stomach would break it down.
I would greatly encourage you to work with you doctor on this, but you should not need to wean. You can also contact your local La Leche League leader through the LLLI.com website. There are a few LLL leaders on this site, including myself.
On the topic, methotrexate and leflunomide are not compatible with pregnancy or breastfeeding.
Newbie_Teach said:
I'm not on anything at the moment. I live in rural Minnesota and there isn't a rheumatologist near me. I'm going to see a doctor of internal medicine this week. I'm nursing right now and I don't want to stop until my son is 6 months old. I'm not sure what will happen, but I will definitely loom into the resources you mentioned.
Back to the immediate question about SHOES! (OMG I used to love nice shoes!) Klogs USA are great, with a nice cushy insole. Very soothing. You might also want to look at Dansko clogs. They are very cool looking, come in cute colours and have a rocker sole to take some of the strain off your feet. I was never able to wear them because of my high instep, but I wanted to!
I can certainly recommend Zappo’s – they are my shoe retailer of choice when I’m in the US. Free shipping both ways is nice.
Just throwing this out there. Have you tried crocks? Not a lot of support but very comfortable when standing for long periods
Oh, and don't forget that you might need to get orthotic inserts for your shoes. See if your insurance covers custom orthotics. I can't even tell you what a lifesaver these are. Whenever mine are away to be adjusted, I am in a lot worse shape than I am with them.
And for just hanging around the house, as long as my feet are in okay shape, I'm a big crocs fan. My husband hates them, but both my 7yr old and I love them.
I wear Dansko shoes and clogs. I also love Clark’s and Aerosoles. BORN has some beautiful shoes. I even have a pair of HEELS from them that I absolutely love.
Better disease control, will open up the shoe world for you, at least a little bit. I was wearing ballet slippers for a while since they were the only thing I could get on my feet. I got them in different colors and natural color, black, and light pink. That was what I wore to work for the longest time. But now that I have better disease control, I am able to wear a variety of shoes. I do make sure to buy nice shoes that have a good support and I don’t waste my time on cheap shoes anymore. My feet are very thankful and so are my legs.
Man this is rough…it wasn’t too long ago that I was playing basketball and running cross country for college and modeling in 6 inch heels…now I’m having to consider orthotics 
I know it’s for the best but I’m having a hard time coming to terms with this disease.
Hey Newbie_Teach,
I hear you. It's such a dramatic change, isn't it? I LOVE wearing heels. But right now my big toes are doing this weird cracking, popping, locking thing (maybe a new dance move for the toes--pop and lock). So heels are out for a while. I went to DSW yesterday and stocked up on flat sandals. I have luck with Clark's and BOC (Born) as they tend to be leather, supportive and offer good foot-beds. I'm traveling to the east coast and overseas in the next two weeks and anticipate a LOT of walking. I have purchased some comfortable and relatively cute flat, closed toe, leather and mesh Clark's for walking around the city. J41 (Jambu's cheaper off brand) has some really cute, comfy and a little sporty-looking styles, too.
Shoes. Love 'em. Learning to love flats is not an easy path but my feet thank me. Learning to live with PsA is a daily practice of acceptance and tolerance. You can do everything you have always done. Just not as much of it or as often. At least not until your meds are working right. I still wear heels. But just for an occasion. You will still play basketball but you may need to work up to it. I started playing racquetball this month. In December I could barely walk. As I said, it's a daily practice of acceptance and tolerance.
For now though (to misquote Christopher Walken), you have a fever, and the only cure is...SHOES!
janeatiu said:
For now though (to misquote Christopher Walken), you have a fever, and the only cure is...SHOES!
I love my SAS Freetime shoes! You can look online for them. I buy mine at The Shoebox here in CA. They are pricey but well worth it. I could not walk far or for too long before I found these! They are very light and comfortable, insoles mold to you feet! Good luck finding the right shoes. I was 21 when I had to start wearing these.
Shoes: I LOVE my Birkenstocks in the Spring/Summer/Fall and my Bearpaw wool boots in the Winter. They are the only shoes I've found that don't kill my feet.
Breastfeeding: Most biologics are to large molecularly to pass through breastmilk, so don't pose a problem. Methotrexate, however, is a no-no while pregnant/breastfeeding.
What line of work are you in? I work in a Hospital so I am on my feet 12 hours a day and have found the Alegria brand is fabulous. I still have pain in my feet, but no where as bad as it was with my running shoes with orthotics.
I’m a teacher, so I am also on my feet a lot. There is a place nearby that does custom shoes. I’m thinking I’ll check them out.
I also started Humira today so hopefully my shoe options will open up within the next few months