Correct Diagnosis?

[Guest guest]

I've been diagnosed (by three doctors, all on the first visit) with

PA. I have a few small patches of psoriasis and and xrays indicate

inflamation in most of my joints. When I was told by the first doc

that approximately 15% of the population with psoriasis also has PA I

began to think about it since they all want me to take Methotrexate.

Bottom line - I have psoriasis (it comes and goes, but it's never very

bad) and I have arthritis. Do I necessarily have PA or is it possible

to have regular old arthritus and just happen to have psoriasis too?

Thanks. mozz

[Editor's Note: The odds are overwhelming that you have PA. There is not such

thing as " regular old arthritis " . If you had osteoarthritis, it would be very

evident from xrays and other tests. Chances are if you have psoriasis, your

arthritis is PA. PA is a subset of rheumatoid arthritis. The symptoms are very

similar and the treatments are virtually the same. Kathy F.]

[Guest guest]

Hi Mozz! Glad your psoriasis isn't to bad, but sorry to hear you

have arthritis.

Many with PA go for years, seeing countless doctors, receiving

multiple

diagnoses, before PA is identified as the culprit causing their

symptoms and recieve helpful advice and treatment. Your P may be

mild, not much more than an inconvenience,

but your arthritis must be somewhat advanced. To have three

different doctors diagnose you with PA on your first visit is rare.

The diagnosis may be daunting to you, given all the implications

such a disease carries. In any context the phrase " just old

arthritis " , to me, has a harmless connotation. From all that I've

learned since being diagnosed, there isn't such a thing. Arthritis

is arthritis. The difference between the various types has to do

with the pattern of damage, joints affected, and which components of

the joint are damaged. The point is they all cause damage.

It's true that the damage to one person's joints may be more, or

less, severe than someone with the same type or other

type, but that could change at any time. No one can predict when

their arthritis will go into remission or progress further. MTX

is one of the drugs that can help prevent that.

DMARDS like MTX have demonstrated

scientifically that they actually modify the disease, which I

understand to mean that they actually hold back the progression of

the disease. To what degree varies from person to person. If you go

on MTX

you may never know how bad you might get without it, on the hand, if

you don't there is the possibility that you could get much worse.

I always encourage people who are afraid of MTX, not to be. While

the side effects are nothing to take lightly, the risk of developing

some of the more serious ones, like liver damage, can be minimized

if your blood levels are checked regularly. I'd want my doctor to

run tests every four weeks for the first few months. You can go

longer between labs the longer you're on it and your labs come back

normal, but wouln't go more than three months. If in one of your

labs

your liver enzymes are elevated, you

can go off the medicine. I'm under the impression that they in all

likelihood will fall back into normal range.

You didn't say what type of symptoms you're having if any. I assume

you're experiencing some degree of pain or limitation otherwise you

wouldn't have gone to the doctor. At it's best MTX can significantly

decrease your discomfort. Heck! Some people actually go into

remission. Then you could go off it. But even if you can't, it's

well worth the risk to try it and see if it can get the relief we

all seek from this disease.

I've been on it since April. It's changed my life. I'm not in

remission and have steady discomfort. But for the first time in many

years I actually felt better, even GOOD, around about the third full

month. And stayed that way. I feel better today than I had at

anytime before I started MTX. My quality of life has increased

significantly. I won't change meds unless it stops

working or I do develop a serious side effect.

I've had a serious case of hepatitis twice in my life. Even with

that history I haven't shown any irregularities in my labs. And I've

never experienced any side effects from the drug, but I know there

are others in this group that have, like fatigue. One way to try and

prevent those from affecting you is to take folic acid with the MTX.

If you can't tolerate MTX for any reason, I'd say try another, and

keep trying until you find one that you can take and gives you

relief.

I just now saw Kathy's footnote at end of your message and agree

that odds are you have PA. Like you, my P is very mild. My arthritis

isn't. I'm grateful to be on MTX and would have started earlier had

I been diagnosed sooner.

Hope this helps!

Michele

Dallas

>

> I've been diagnosed (by three doctors, all on the first visit) with

> PA. I have a few small patches of psoriasis and and xrays indicate

> inflamation in most of my joints. When I was told by the first doc

> that approximately 15% of the population with psoriasis also has

PA I

> began to think about it since they all want me to take

Methotrexate.

> Bottom line - I have psoriasis (it comes and goes, but it's never

very

> bad) and I have arthritis. Do I necessarily have PA or is it

possible

> to have regular old arthritus and just happen to have psoriasis

too?

> Thanks. mozz

>

>

> [Editor's Note: The odds are overwhelming that you have PA.

There is not such thing as " regular old arthritis " . If you had

osteoarthritis, it would be very evident from xrays and other

tests. Chances are if you have psoriasis, your arthritis is PA. PA

is a subset of rheumatoid arthritis. The symptoms are very similar

and the treatments are virtually the same. Kathy F.]

>