Psoriatic Arthritis: How do you manage PA and flares?

Posted by lemdjm @lemdjm, Feb 27, 2017

I am a 74 year old female who has had psoriasis for over 40 years. The psoriasis was present on my scalp and ears in flares from time to time. I never experienced joint swelling and joint pain until recently. About one month ago I experienced an abrupt onset of severe joint swelling in my hands wrists, feet, and neck with severe pain. At first I suspected that it might have been related to my oncology medication, Arimedex that I began taking approximately 4 months before my sudden joint problems began. Testing ruled out Rheumatoid Arthritis and Lupus. My oncologist did not think that the joint issues could be related to the Arimedex, however, he recommended that I suspend taking the cancer medication for 4 weeks while I was given oral Prednisone for 23 days (referred to as Pulse and taper). I am on day 22 of the Prednisone and the joint swelling and pain is no longer present. My oncologist wants me to resume the Arimedex, however, I am afraid that the severe joint pain will return. I am hopeful that additional diagnostic testing will determine the underlying cause of my joint swelling. If anyone reading this has had similar problems or any information related to my situation I would be interested in your comments. Thank you.
lemdjm

Interested in more discussions like this? Go to the Autoimmune Diseases Support Group.

Welcome @lemdjm.
Please allow me to introduce you to fellow Connect members @marylou705 @jewel8888 @jerseygirl926 @julz @boxermomma and @slbeall, all of who have spoken about psoriatic arthritis. Hopefully they will have some thoughts about managing joint pain.

Joint pain and stiffness are known side effects of Arimidex (anastrozole) an aromatase inhibitor used for treating some types of breast cancer. You can read side effects in this drug info from Mayo Clinic http://mayocl.in/2m5bKo9. You may also wish to post a message in the Connect Breast Cancer group to this discussion about anastrozole:
- Concerned about the side effects of anastrozole http://mayocl.in/2d4tiKL

I can imagine that you're concerned about starting anastrozole again. Anastrozole is one of 3 aromatase inhibitors. Each has a different set of side effects. Perhaps a different drug would be better for you. Have you talked to your oncologist about taking exemestane (Aromasin) or letrozole (Femara)?

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I after more than 25 years was diagnosed finally with psoriatic arthritis. It started out as me having rash on face and ER doctor said it it was classic book lupus and sent me to an internal med at the clinic I was in. She said on no (without any testing) it was just fibromyalgia. I just kept getting worse and she just increased pain meds, that did not help and refused to send me to a rhemotologist ( sorry about spelling). She sent me to a neologist that did MRI of head and said everything was normal, even though I had a large Tumor in my nasal cavity, he said nothing about it.
Finally she retired and new PC sent me to rhemotologist and I spent six hours in her office and within two weeks was given the diagnosis of PSA with lupus tendonsies. Was put on methotrexate but had to stop because it was causing liver issues. Finally got approved for Otezla and am on started pack. Can't take humeral or the similar stuff because of skin cancer. All delayed treatment has caused me to have chronic iritis in both eyes and might go blind. Can't do anything that I loved to do even cook a holiday meal, I used to make totally homemade Rubens for my husband's b-day because his b-day is on Saint Patties day. I have now also developed an adrenal Tumor and adrenal indofitionsy, plus have heart issues and am only fifty. My husband helps me as much as he can but he has back and neck issues that the VA won't help him with (he is ex-navy). Plus I still have issues that have not been diagnosed. It seems that if you are not rich nobody cares.

I feel for you and hope you are with a team of doctors that will work together and that you trust. We just moved to east TX because we lost our jobs running a ranch because of our medical problems even though they knew about it nine years ago when they hired us and this is all we could afford. It needs a lot of work that we can't do or afford but brought us closer to Houston where we are hoping to get better medical càre. A new pair of glasses only last me about a month and a half and insurance only covers one pair a year. They just put me on a cane, wear braces on both wrists and have to use hearing aids.

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@djfd

I after more than 25 years was diagnosed finally with psoriatic arthritis. It started out as me having rash on face and ER doctor said it it was classic book lupus and sent me to an internal med at the clinic I was in. She said on no (without any testing) it was just fibromyalgia. I just kept getting worse and she just increased pain meds, that did not help and refused to send me to a rhemotologist ( sorry about spelling). She sent me to a neologist that did MRI of head and said everything was normal, even though I had a large Tumor in my nasal cavity, he said nothing about it.
Finally she retired and new PC sent me to rhemotologist and I spent six hours in her office and within two weeks was given the diagnosis of PSA with lupus tendonsies. Was put on methotrexate but had to stop because it was causing liver issues. Finally got approved for Otezla and am on started pack. Can't take humeral or the similar stuff because of skin cancer. All delayed treatment has caused me to have chronic iritis in both eyes and might go blind. Can't do anything that I loved to do even cook a holiday meal, I used to make totally homemade Rubens for my husband's b-day because his b-day is on Saint Patties day. I have now also developed an adrenal Tumor and adrenal indofitionsy, plus have heart issues and am only fifty. My husband helps me as much as he can but he has back and neck issues that the VA won't help him with (he is ex-navy). Plus I still have issues that have not been diagnosed. It seems that if you are not rich nobody cares.

I feel for you and hope you are with a team of doctors that will work together and that you trust. We just moved to east TX because we lost our jobs running a ranch because of our medical problems even though they knew about it nine years ago when they hired us and this is all we could afford. It needs a lot of work that we can't do or afford but brought us closer to Houston where we are hoping to get better medical càre. A new pair of glasses only last me about a month and a half and insurance only covers one pair a year. They just put me on a cane, wear braces on both wrists and have to use hearing aids.

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Sorry to hear of your struggle. It took more than 10 years to get a Dx. I am taking Cymzia, Tramadol and Meloxicam with Prednisone for flare ups. I also have developed Heart Disease, Sjogrens and IBS as a consequence. I also have cataracts and hearing loss, all as consequences to the PsA. My manual dexterity is shot. You could get some tips from an Occupational Therapist about assistive devices. I also do water aerobics twice weekly. Good luck and don't give up.

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@lemdjm. That's a late onset for PsA but it's a sneaky disease. PRednisone definitely helps but you can't stay on it for too long without side effects such as osteoporosis. I take a biologic but you have to play around with the dose to get the effects, or change to another one. I'm on my third. There are also pain Meds that are not addictive. Good luck.

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@marylou705

@lemdjm. That's a late onset for PsA but it's a sneaky disease. PRednisone definitely helps but you can't stay on it for too long without side effects such as osteoporosis. I take a biologic but you have to play around with the dose to get the effects, or change to another one. I'm on my third. There are also pain Meds that are not addictive. Good luck.

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Thank you so much for taking your time to provide the helpful information. lemdjm-

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@djfd

I after more than 25 years was diagnosed finally with psoriatic arthritis. It started out as me having rash on face and ER doctor said it it was classic book lupus and sent me to an internal med at the clinic I was in. She said on no (without any testing) it was just fibromyalgia. I just kept getting worse and she just increased pain meds, that did not help and refused to send me to a rhemotologist ( sorry about spelling). She sent me to a neologist that did MRI of head and said everything was normal, even though I had a large Tumor in my nasal cavity, he said nothing about it.
Finally she retired and new PC sent me to rhemotologist and I spent six hours in her office and within two weeks was given the diagnosis of PSA with lupus tendonsies. Was put on methotrexate but had to stop because it was causing liver issues. Finally got approved for Otezla and am on started pack. Can't take humeral or the similar stuff because of skin cancer. All delayed treatment has caused me to have chronic iritis in both eyes and might go blind. Can't do anything that I loved to do even cook a holiday meal, I used to make totally homemade Rubens for my husband's b-day because his b-day is on Saint Patties day. I have now also developed an adrenal Tumor and adrenal indofitionsy, plus have heart issues and am only fifty. My husband helps me as much as he can but he has back and neck issues that the VA won't help him with (he is ex-navy). Plus I still have issues that have not been diagnosed. It seems that if you are not rich nobody cares.

I feel for you and hope you are with a team of doctors that will work together and that you trust. We just moved to east TX because we lost our jobs running a ranch because of our medical problems even though they knew about it nine years ago when they hired us and this is all we could afford. It needs a lot of work that we can't do or afford but brought us closer to Houston where we are hoping to get better medical càre. A new pair of glasses only last me about a month and a half and insurance only covers one pair a year. They just put me on a cane, wear braces on both wrists and have to use hearing aids.

Jump to this post

Thank you again for your compassionate response to my call for help.lemdjm

REPLY
@djfd

I after more than 25 years was diagnosed finally with psoriatic arthritis. It started out as me having rash on face and ER doctor said it it was classic book lupus and sent me to an internal med at the clinic I was in. She said on no (without any testing) it was just fibromyalgia. I just kept getting worse and she just increased pain meds, that did not help and refused to send me to a rhemotologist ( sorry about spelling). She sent me to a neologist that did MRI of head and said everything was normal, even though I had a large Tumor in my nasal cavity, he said nothing about it.
Finally she retired and new PC sent me to rhemotologist and I spent six hours in her office and within two weeks was given the diagnosis of PSA with lupus tendonsies. Was put on methotrexate but had to stop because it was causing liver issues. Finally got approved for Otezla and am on started pack. Can't take humeral or the similar stuff because of skin cancer. All delayed treatment has caused me to have chronic iritis in both eyes and might go blind. Can't do anything that I loved to do even cook a holiday meal, I used to make totally homemade Rubens for my husband's b-day because his b-day is on Saint Patties day. I have now also developed an adrenal Tumor and adrenal indofitionsy, plus have heart issues and am only fifty. My husband helps me as much as he can but he has back and neck issues that the VA won't help him with (he is ex-navy). Plus I still have issues that have not been diagnosed. It seems that if you are not rich nobody cares.

I feel for you and hope you are with a team of doctors that will work together and that you trust. We just moved to east TX because we lost our jobs running a ranch because of our medical problems even though they knew about it nine years ago when they hired us and this is all we could afford. It needs a lot of work that we can't do or afford but brought us closer to Houston where we are hoping to get better medical càre. A new pair of glasses only last me about a month and a half and insurance only covers one pair a year. They just put me on a cane, wear braces on both wrists and have to use hearing aids.

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I appreciate the helpful information that you sent. Thank you so much for taking your time to offer assitance.lemdjm

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@colleenyoung

Welcome @lemdjm.
Please allow me to introduce you to fellow Connect members @marylou705 @jewel8888 @jerseygirl926 @julz @boxermomma and @slbeall, all of who have spoken about psoriatic arthritis. Hopefully they will have some thoughts about managing joint pain.

Joint pain and stiffness are known side effects of Arimidex (anastrozole) an aromatase inhibitor used for treating some types of breast cancer. You can read side effects in this drug info from Mayo Clinic http://mayocl.in/2m5bKo9. You may also wish to post a message in the Connect Breast Cancer group to this discussion about anastrozole:
- Concerned about the side effects of anastrozole http://mayocl.in/2d4tiKL

I can imagine that you're concerned about starting anastrozole again. Anastrozole is one of 3 aromatase inhibitors. Each has a different set of side effects. Perhaps a different drug would be better for you. Have you talked to your oncologist about taking exemestane (Aromasin) or letrozole (Femara)?

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Thank you for your response to my concerns. I appreciate your helpful information and suggestions. I will be seeing my oncologist again in 2 days and you have provided useful input that will be of assistance when I discuss my options.lemdjm

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@colleenyoung

Welcome @lemdjm.
Please allow me to introduce you to fellow Connect members @marylou705 @jewel8888 @jerseygirl926 @julz @boxermomma and @slbeall, all of who have spoken about psoriatic arthritis. Hopefully they will have some thoughts about managing joint pain.

Joint pain and stiffness are known side effects of Arimidex (anastrozole) an aromatase inhibitor used for treating some types of breast cancer. You can read side effects in this drug info from Mayo Clinic http://mayocl.in/2m5bKo9. You may also wish to post a message in the Connect Breast Cancer group to this discussion about anastrozole:
- Concerned about the side effects of anastrozole http://mayocl.in/2d4tiKL

I can imagine that you're concerned about starting anastrozole again. Anastrozole is one of 3 aromatase inhibitors. Each has a different set of side effects. Perhaps a different drug would be better for you. Have you talked to your oncologist about taking exemestane (Aromasin) or letrozole (Femara)?

Jump to this post

Good luck at your appointment

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Hi! I've had PsA for many years, I am now 70. Been on Methotrexate, Azulfadine, & then finally Enbrel. Developed BOOP (lung disease), then MAI, so I needed to come off biologics. Went on Otezla that worked for a little over 2 years, then it stopped working! I'm in tremendous pain, and using prescription strength Advil. Ive been placed on meds for the MAI ( 3 antibiotics, 3X a week for 12 to 18 months) & hopefully, after 3 months, I can go back in n the biologics. Does anyone else have a similar situation? Thank you.

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