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

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@fransav

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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@peach414144 You have said nothing wrong as far as I can tell. I was just trying to explain you may have been misundetstood and to not take it personally. I am of the mind set to just let it go. Be yourself and stay upbeat!

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@asf1234

Mine won't let me suffer...I'm just so tired of trying things that don't work via injection. The back injections didn't work but I did have about 10 neck injections on Tuesday and it's REALLY helping. I'm in NYC so I have an endless supply of doctors here. I wish you did too! @djfd

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Welcome to Connect, @asf1234,

Thank you so much for sharing your insights. It's so true that getting the right healthcare provider, doctor, someone you can "call your own" is such a significant decision. And often, as so many Connect members have shared, we have to look for treatments beyond medication.

@asf1234, may I ask what other autoimmune issues you face?

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i (80 year old woman) have the joint swelling of the knee and both feet and one finger. also have psoriatic arthritis and also rheumatoid arthritis. seems when the swelling and pain goes away after about three months i might get a month with no swelling and pain, then it starts all over again. i am not taking medication for this because i have stage 3 kidney disease. ohh! forgot, i take a weekly injection of 10 mgs of methotrexate and have been taking this for about seven years. it has helped with the rheumatoid arthritis. i have just been diagnosed with the psa in 2016. it is a horror. to me it is worse than toe rheumatoid arthritis. the existing medications seem to be harmful to body parts or create other problems. imagine the poor children that have these diseases and suffer with them. i do honor he doctors who devout their lives to their patients. (just want you to know that your suffering is acknowledged by the rest of us and wish to have it stopped.

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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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i was not wanting anyone to move to another country. i was just using an example of health care in other countries. i myself cannot afford to move there as well. and i do feel for you for one reason i am going blind as well with glaucoma and macular degeneration. sorry if i upset you. good luck.

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@peach414144

i (80 year old woman) have the joint swelling of the knee and both feet and one finger. also have psoriatic arthritis and also rheumatoid arthritis. seems when the swelling and pain goes away after about three months i might get a month with no swelling and pain, then it starts all over again. i am not taking medication for this because i have stage 3 kidney disease. ohh! forgot, i take a weekly injection of 10 mgs of methotrexate and have been taking this for about seven years. it has helped with the rheumatoid arthritis. i have just been diagnosed with the psa in 2016. it is a horror. to me it is worse than toe rheumatoid arthritis. the existing medications seem to be harmful to body parts or create other problems. imagine the poor children that have these diseases and suffer with them. i do honor he doctors who devout their lives to their patients. (just want you to know that your suffering is acknowledged by the rest of us and wish to have it stopped.

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I do understand your issues of can't do this and can't do that because of something else. I have used a cane some since I was in high school after an operation on one knee at age 13. That is now my good leg. Nine years ago I tore my meniscus/tore medial and lateral ligaments and have to do daily physical therapy just to be able to walk. I have Type II Diabetes so have food/eating issues, but back in 2003 I suddenly became allergic to Aspirin and all other NSAIDs so cannot take over-the-counter pain/anti-inflammation meds. except for Tylenol which is only useful for mild pain. This allergy thing includes not being able to take or use any minty flavorings, ginger, grapes/raisins and certain artificial preservatives. So I used to take Tramadol daily, but never exceeding the prescription limits. But that leads to dehydration which contributes to constipation and dry mouth which is a problem for Diabetes. My leg issues are complicated by a history of broken ankle/complete break of same leg-shin bone. At age 72 there is dryness by aging. These various issues limit mobility which interfers with Diabetes and all of my arthritises. The Psoriatic Arth. often causes some depression as does Diabetes as does chronic pain as does not being able to do as much as I used to due to aging and all the various things listed above. Now I am more limited in hand grip and finger use even though my medications help. BTW - with my ability to get more involved with my own physical therapy I have been able to essentially eliminate the use of Tramadol and thus reduce frequency and severity of depression.

We each have to find our own paths to distractions and find more ways to increase our independence and reduction of pain. Forums like these, suggestions from members and also the Arthritis organization magazine, etc. all help - if nothing else they help by giving us new ideas or spark a creative twist that works for some of us. I now limit flying time to about 4 hrs. as it is torture to be in a little jail cell of a seat for a longer period of time. My wife and her adult kids have had to modify vacations accordingly. Our vacations after this year will have to be modified more. In part I look at life as - the price we pay in still living in to advancing age is the various medical and quality of life limitations. Beats the alternative.

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I am 51 and just since May have had broken ankle, foot, and elbow that I had to go into emergency surgery. I will be having two knuckles replaced very soon, if they still can since one has dropped close to thumb. I also have to use cane, it was supposed to help me stop falling, doesn't seem to be working. I to have a lot of allergies including aspirin and Motrin. My new rhemotologist is sending me to an allergist to de-sentisize me from those so that I can take an anti-inflammatory.

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you are correct. one thing opposes another. and distraction is the key word. i watch a huge amount of tv including many movies on tv (will not go to a movie house so as not to contract anything,) this is to get lost in the story and then to put myself into the character i put myself to be. sounds like to much, but it does me good. i am glad i was a swimmer. think it helped saved the ligaments and tendons. swimming is a safer exercise than most. just a few helpful hints from an old lady.

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@djfd

I am 51 and just since May have had broken ankle, foot, and elbow that I had to go into emergency surgery. I will be having two knuckles replaced very soon, if they still can since one has dropped close to thumb. I also have to use cane, it was supposed to help me stop falling, doesn't seem to be working. I to have a lot of allergies including aspirin and Motrin. My new rhemotologist is sending me to an allergist to de-sentisize me from those so that I can take an anti-inflammatory.

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@djfd You are so young to have so much going on! Instead if a cane, have you tried a walker? I use one when I am really bad and my mom has one. They both have seats and make walking so much easier and safer. I am keeping you in my prayers.

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@peach414144

you are correct. one thing opposes another. and distraction is the key word. i watch a huge amount of tv including many movies on tv (will not go to a movie house so as not to contract anything,) this is to get lost in the story and then to put myself into the character i put myself to be. sounds like to much, but it does me good. i am glad i was a swimmer. think it helped saved the ligaments and tendons. swimming is a safer exercise than most. just a few helpful hints from an old lady.

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Marylou8 here.  I'm an old lady too!

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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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I have had PsA for many years. I think it started while I was in South America and I got strep throat. I've been bopping along since then with various biologicals and Tramadol. But in the last couple of months or so, I've been floored by widespread pain and exhaustion. My Rheumatologist is great and he is trying me on Humira as of last Wednesday. He gave me a short Rx for Norco, but I don't think I can take it. It sends me to sleep but then I'm awake with nightmares! Last night I dreamt I became a shoplifter!! I'm wondering if I am having a flare of PsA. It's being so joyful as keeps us going, in the Scottish idiom of my late Mother!

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