Introduction Djohnsonjr

[Djohnsonjr]

Hello I am new to the club. My name is David.

I am a disabled veteran from the United States Army. I spent 10 years in the service with four different deployments to Iraq before getting out in 2010. I started showing signs of psoriasis in 2008 while still active duty. In the last 8 months or so after several tests, treatments, steroid ointments, and doctors visits they tell me I have psoriatic arthritis. I'm just now trying to research different techniques on managing the symptoms and will likely have a lot of questions. I plan on spending some time reading as much of the posts in this club as I can before asking my questions in order to keep from asking something that has already been answered. 

I thank you all ahead of time for your help and support and I look forward to chatting with you all in the future.

[jiml]

Hi again David I can   you again here in your own thread, this is a great group you have joined and I'm sure you will get a lot of different answers.
Do you think the trigger for starting you psoriasis could have been the stress from military duty? It's a possible trigger
Don't worry about asking questions that have already been asked as the membership keeps growing so the pool of knowledge also grows
Myself I think as you have been diagnosed with psa you will need to get a treatment that will slow the damage  to your joints,
I would think that is likely to be a biological treatment see Biological Treatments For Psoriasis  and there is a lot of information on those in the prescribed treatment section. I will leave you to read more on here and someone will always be pleased to answer any queries, although we are all the same as you psoriasis sufferers sharing our experiences ,and not medical professionals
Jim

[Fred]

Hello David   to Psoriasis Club.

First off don't worry about asking questions that may have already been asked. We encourage all our members to post as we are all different and what works for one may not work for another, so you post away. We may point you to relevant posts to your questions, but don't hesitate to ask questions.  

I agree and disagree with Jim. Yes you need to get some treatment for psoriatic arthritis, but I don't think a newly diagnosed psoriatic patient will get offered the Bio treatments. The usual way is to go onto the oral treatments first and if that fails or you can't handle the side effects Then you may be offered the Bio's, Bio's are usually the last thing to be offered.

Regards.

Fred.

[jiml]

Yes thanks Fred I have no experience of psoriatic arthritis and wasn't sure how treatment started, so thanks for enlightening me as well

[Fred]

Yes thanks Fred I have no experience of psoriatic arthritis and wasn't sure how treatment started, so thanks for enlightening me as well  

No problem Jim. They will mostly put people newly diagnosed with psoriatic arthritis on Methotrexate first, the Bio's are usually only offered to psoriasis and psoriatic patients after failure or intolerance to the oral treatments. Having said that, some still won't get offered the Bio's unless they are in a bad way.

I just thought I would mention it as I didn't want David building up his hopes only to find the treatment wasn't available to him, though I could be wrong as I'm not sure of the system in the USA or even if California is different in the way of protocol to say Texas.

Maybe Kat or Matari will know more about what is available to a newly diagnosed psoriatic patient.

[Kat]

Welcome David! You'll find a lot of information here and a lot of friendly people who are always willing to offer advice, give an opinion or just sympathize!

Fred mentioned that I might know a bit about what's available in the U.S. I can only tell you what my dermatologist's steps are in treating psoriasis. First, topical and UV treatment and then oral meds. He mentioned biologics but also said that those are after exhausting other treatments. That seems to be the standard just about everywhere from what I can tell, but of course individual patients may jump further ahead in treatment depending on the severity.

I do have a rheumatologist but I do not have psoriatic arthritis. During my last appointment with him my psoriasis was flaring a bit. He mentioned putting me on Methotrexate (he said most insurance companies will require it but not all will) and then going on Stelara. I mention this as my psoriasis wasn't as bad as the first time I saw a dermatologist who wanted to start out with topicals so different doctors will take different approaches.

Basically it will all depend on the doctor plus as you know insurance varies greatly here and that can also affect what a doctor would choose to start someone on.

What is REALLY great about this forum (among a lot of other great things!) is that you can get informed and that can help a great deal when working with a doctor if you should decide to go on a treatment. I know that should I need to get more aggressive on treatment again that I could go through my dermatologist (probably would put me back on Acitretin) or my rheumatologist who sounds like he would want to take a different approach.

[Djohnsonjr]

Thank you KAT. As far as insurance I think I'm pretty good on coverage being my disabled veteran status is at 100% I believe they cover any and all prescriptions a doctor would prescribes. I'm a bit weary about pills when reading the possible side effects and they can be worse then what they may treat.

[jiml]

Thank you KAT. As far as insurance I think I'm pretty good on coverage being my disabled veteran status is at 100% I believe they cover any and all prescriptions a doctor would prescribes. I'm a bit weary about pills when reading the possible side effects and they can be worse then what they may treat.

I have to agree with you David it does depend on the severity of the disease, and usually the dermatologist isn't going to prescribe something that is worse than the disease, that's why most is the treatments are for moderate to severe psoriasis.
But with proper monitoring the drugs are generally well tolerated and safe. But most require monitoring

[Fred]

I'm a bit weary about pills when reading the possible side effects and they can be worse then what they may treat.

Yes they can be worrying, but a lot of people do well on them.

But do keep in mind that once you have tried them and failed then you can move on to something else. If you refuse to try them it may be difficult to get something else, so even trying say methotrexate and being unable to tolerate the side effects may be enough.  

[Kat]

Thank you KAT. As far as insurance I think I'm pretty good on coverage being my disabled veteran status is at 100% I believe they cover any and all prescriptions a doctor would prescribes. I'm a bit weary about pills when reading the possible side effects and they can be worse then what they may treat.

First, I want to say thank you for your service. I know a little about the VA (husband was Navy for 16 years) but not very much when it comes down to what they cover. You should be able to get anything you need at no cost as you've said, but I'm not sure what protocol they may have (as far as trying out one thing first or not)

I understand your being cautious about pills! I'm the same way when it comes to meds, when you read the possible side effects and the warnings.... it's scary especially if you are already on other medications. I took Acitretin and when I read that I couldn't give blood until off of it for 3 years it made me wonder what exactly I am putting in my body (Acitretin can damage a fetus, hence the no giving blood) but I had reached the point of being miserable with psoriasis so I took it. I'm glad I did and as I cleared the dermatologist worked with me to reduce the dosage and even going off the meds. After my rheumatologist visit I've considered (if I ever need to) going a different direction due to the successes of some people here on other treatments. But we each have to consider our unique circumstances with other issues, immune systems, etc. to help make the best choices. The good part is that there are a lot of treatments available, but even topicals with steroids can have problems so it's just not an easy decision to make in my opinion. This forum helps, a good doctor helps and I hope you find the right treatment for you.

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