Helpfull Advice Needed for 7th Oct 2003

[Guest guest]

Hi to everyone

I am a 26 yr old male from the uk and have been suffering from

psoriatic arthritis for about 3 yrs. The psoriasis and arthritis

seemed to manifest itself at the same time so i was quite lucky to be

diagnosed correctly (i hope!) at an early stage. The rhumy started me

on sulphasalazine (6 a day) which didnt work and then onto

methotrexate (7.5mg - 10mg a week) which when i saw him a month ago

he decided also wasnt working. The arthritis is quite limited so far

(touch wood!) but has deformed my left index finger and has damaged

my right shoulder to such an extent that the rhumy now says i will

need a shoulder operation as for about 2 yrs now i have had no use in

the right arm which has hung by my side despite lenghty treatment

from my physio. The other joints effected are both my ankles, left

thigh, lower back, neck and toes. The joints occasionaly swell up but

generally seem to ache and pain most days with no let up. The

psoriasis is only being treated with creams which seem no use at all

because i am now breaking out all over the place which is seriously

getting me down.

sorry for going on but i am really writing this email for some

advice. I am due to see the rhumy on the 7th oct 2003 and need to be

armed with questions and suggestions for him. I was wondering if any

of you out there have any ideas on what i should be asking/demanding

from him.

The rhumy has given me 4 new treatments to look at but due to my very

high blood pressure (170/95) he said 2 of the treatments wouldnt be

possible due to the increase of blood pressure they cause. He wants a

decision on the 7th oct when i see him so i am asking for your help

on suggestions of what is best or is there any alternatives. I did

suggest biologics (enbrel) but he said that they would be dangerous

because they are not tried and tested over long periods (10 yrs +)

and he also said people have died while on these biologics. He really

wanted me to stay on the methotrexate but at a higher dose cause he

reckons methotrexate is one of the best drugs out there but i said no

because of the serious side effects plus all the nausea and upsets

they were causing me.

The 4 treatments he suggested are:-

1. Azathioprine (Imuran) - rhumy recommends this one

2. Leflunomide (Arava) - rhumy said no due to increases

blood pressure

3. Neoral (Cyclosporin A) - rhumy said no due to increases

blood pressure

4. Gold injections

Any suggestions would be really appreciated or any other relevant

advice.

I would also appreciate any suggestions on combating the psoriasis

because i feel this is getting me more down than the actual arthritis

and i just cant seen to get a hold on it as i say the creams (e45,

dovonex, dovobet, elocon, daktacort etc) none of them are doing

anything. Is there a drug?, tablet? that can be taken.

Sorry for going on for so long but i dont know where to turn to so i

will say a big thankyou to anyone that responds and hope that all of

u have better luck at managing your conditions than i have so far.

good health and happiness to everyone

thankyou

.