Health Boards
Tue-19-11-2019, 03:11 AM
Thanks Jim and KatT 
@KatT - The way he explained it is that although all the biologics have some of the same warnings such as increased infections, the TNF inhibitors do have the most warnings adding heart failure and cancers to the list. He basically agreed with the dermatologist that as far as biologics go, he would recommend a TNF inhibitor as the next logical choice (since I've tried Stelara, Cosentyx and Taltz already) He did say that if I wanted to not go that route we could look at other options, one basically being that if the dermatologist finds something that works for the skin, depending on what it is, he could prescribe methotrexate for the psoriatic arthritis. I'm not really into trying that either (I know MTX has worked well for some, but I have read the experiences and thoughts of others here over the past few years and can't say it's something I want to try) So I told him I'd talk to my heart doctor and pulmonologist and see what they think about Humira. If they think I'm a higher risk than the average person on a TNF inhibitor, then I'll decline as I won't think it's worth the chance.
I'm not in a super bad place right now. My ears are doing fairly well, the scalp about the same as usual and those are my problem areas. I'm honestly beginning to think my scalp will never be totally clear. I got close while on Acitretin. However the dermatologist doesn't really want to go "backwards" to that (yes I know, she means the treatment is backwards in her opinion as she favors biologics. It was my first dermatologist in the same office that had me on the Acitretin... long story) Plus, the Acitretin although cheaper than the biologics overall, cost me MORE out of pocket than the biologics! If I recall it was $200 to $300 per month out of pocket which isn't something I want to do long term. One of the reasons I asked to go off of it once I felt things were manageable, however there were other reasons as well.
Anyway, hopefully the laser therapy is helping more than I think. At least I'm in an "okay but not great" place but I know from experience it can take a quick turn downhill fast so that's one reason I don't just rule out anything that might be helping. So for now, I'll keep up the laser therapy while I'm checking into Humira as an option. Once the new year and new insurance rolls around, decisions will need to be made.
@KatT - The way he explained it is that although all the biologics have some of the same warnings such as increased infections, the TNF inhibitors do have the most warnings adding heart failure and cancers to the list. He basically agreed with the dermatologist that as far as biologics go, he would recommend a TNF inhibitor as the next logical choice (since I've tried Stelara, Cosentyx and Taltz already) He did say that if I wanted to not go that route we could look at other options, one basically being that if the dermatologist finds something that works for the skin, depending on what it is, he could prescribe methotrexate for the psoriatic arthritis. I'm not really into trying that either (I know MTX has worked well for some, but I have read the experiences and thoughts of others here over the past few years and can't say it's something I want to try) So I told him I'd talk to my heart doctor and pulmonologist and see what they think about Humira. If they think I'm a higher risk than the average person on a TNF inhibitor, then I'll decline as I won't think it's worth the chance.
I'm not in a super bad place right now. My ears are doing fairly well, the scalp about the same as usual and those are my problem areas. I'm honestly beginning to think my scalp will never be totally clear. I got close while on Acitretin. However the dermatologist doesn't really want to go "backwards" to that (yes I know, she means the treatment is backwards in her opinion as she favors biologics. It was my first dermatologist in the same office that had me on the Acitretin... long story) Plus, the Acitretin although cheaper than the biologics overall, cost me MORE out of pocket than the biologics! If I recall it was $200 to $300 per month out of pocket which isn't something I want to do long term. One of the reasons I asked to go off of it once I felt things were manageable, however there were other reasons as well.
Anyway, hopefully the laser therapy is helping more than I think. At least I'm in an "okay but not great" place but I know from experience it can take a quick turn downhill fast so that's one reason I don't just rule out anything that might be helping. So for now, I'll keep up the laser therapy while I'm checking into Humira as an option. Once the new year and new insurance rolls around, decisions will need to be made.