Psoriatic Arthritis, Light bulb moment 💡 or not?

[Flora_Fauna]

Hi

I have suffered with plaque Psoriasis since the age of 12 (onset = Trauma related due to being hit by a car at that age & fracturing my pelvis ) (im now 50 years old)

My skin Psoriasis has very fortunately been under control for over a year now, since finding out I was vitD deficient & treatment for that seems to have helped it immensely.

My granddad suffered with Psoriasis, I think (was too young to remember) he also had Psoriatic arthritis? & major heart disease that took his life.

Over the last few years I have suffered with various joint pain issues mainly in hips/lower back/ knees.

Sometimes swollen red toes, swollen top of finger joints.

Feet & ankle pain & swelling (this doesn't happen to both feet at the same time)

Mouth sore patches & boil type lesions on tongue, mouth ulcers,etc

Eye problems / vascular (all these symptoms can be because I have another autoimmune 'Behçets Disease' that presents in flare ups this way, especially the mouth & eye issues)

Over the last 8 weeks I have had terrible inside left knee pain that's restricting my walking , sitting etc & hip & Lower back pain, restricting bending, extreme fatigue.

Mouth issues (geographical tongue & ulcers)

My finger nails have had horizontal ridges for years , however lately the ridges are very prominent & restict nail growth by constantly splitting.

I have always put these symptoms down to my Behçets Disease, but now after some self research I'm thinking Psoriatic Arthritis?💡

I have recently undergone a very traumatic Endoscopy & last week a lletz/loop procedure for precancerous cells removal, that I'm still recovering from (causing lots of stress/worry & upset lately)

The Psoriasis plaque on my very painful knee has also come back!

Maybe these procedures have caused a bad flare?

I havent had chance to speak to my Dr's about my bad pain as yet , due to far too much going on in regards to those other procedures & results. So thought I'd hop on here & hopefully, kindly get some insight from the Psoriasis community? ♡

Thank you for reading me & any advice or insight would be very welcomed as always 😊

[Greenmil3]

I’m not able to say if it’s PsA or not but I had a similar situation and was putting it down to my cerebral APS oh the joy of autoimmune diseases. Wasn’t till I got cross referred to another Rheumatologist that it was diagnosed and put onto methotrexate. This has helped but getting my follow up soon so hoping a dose increase will help some more. I hope you get this sorted and sorry I can’t be more helpful

[Flora_Fauna in reply to Greenmil3]

Thank you for your reply, its very much appreciated Ditto to the joys of Autoimmune & all their cross over glory! I mean how many autoimmune's are too much autoimmune's hey?.... the cross referral to a different Rhumatoligist I think maybe my key too, as my Behçets team of professionals treat all my symptoms as just that.

'Colchicine' I call it my wonder drug as its got me through the years this far without having to take anything else too invasive, I have researched Colchicine use in PSA & it seems to have positive effects (it deals with inflammatory responses & helps to dampen down the bodies reaction to those responses , restricting the effects of the bodies cells attacking each other during flare ups) It is a toxic medication , however is less invasive as the group of meds Methotrexate falls under , yet still packs an adequate punch. You can also self alter the dose in keeping with the strength of your flare ups , I take it twice a day as a rule , however I increase to 3/4 times if flaring is particularly troublesome, until flare up subsides to a more copable level (usually takes flare up down to 2 days , instead of the usual 8+ )

Maybe you could mention Colchicine as an optional/additional route to look into if the Methotrexate is not being kind to you or isnt working as well with your other medications?

With me there is also that fear of introducing new medications to further depend upon or having to cope with the additional stinky side effects ontop! (body kinda says "Oh no she's doing that Guinea Pig thing again" )

Hopefully you will find your happy medication medium & the pain management soon 🍀

Thank you again for your insight & response , I will definitely be pestering my GP for a different Rhumatoligist referral ASAP.

[Greenmil3 in reply to Flora_Fauna]

flora

Thanks I’m on so many meds to manage pain and all my other symptoms so heh ho but I will see what my next appointment comes out with!

[Batty1]

Psoriatic arthritis is a monster and your list of ongoing issues absolutely sounds like PSA and if you don’t get a proper diagnosis and treatment the damage is permanent.

Psoriatic arthritis suffer for 7 years now after multiple misdiagnosis and I pay for this everyday…. My PSA attacks come on fast and furious.

Thyroid disease is common with PSA and so many more …. Joy

[Flora_Fauna]

Hi Batty1 Thank you for your reply, your insights are much appreciated..I'm sorry to hear you suffer from many, multiple crappy autoimmune's

The last thing you mentioned about Thyroid disease has further light bulb'ed me 💡 I had a brief Dr's appointment to discuss swallowing issues,( like a cotton ball stuck in throat) choking alot more on cereals or sometimes even fluff in the air? Cough, puffy throat in clavicle area etc.. I also at the time mentioned my debilitating knee pain & fatigue. The Dr unfortunately was very flippant & said "let's get this throat sorted now as that's what you've booked your appointment for & its the most important" (sent me for a Endoscopy at hosp, very traumatic experience!) (found a hatial hernia & gastritis ) after I was hurried out of his office he sent me, via txt, a medical exercise plan for arthritis of the knee?!! In which was also pointless as I can hardly manoeuvre it into any kind of position due to pain.

Going back to the Thyroid disease , I have just researched that it can cause swallowing difficulties etc? plus my weight gain has been really significant over the last 3 years without me overeating & diet not really changing much from prior to the weight gain suppose I have been less mobile due to joint pain,fatigue etc over those 3 years tho? I'm now thinking after you mentioned it, that I tick alot of boxes for Hypothyroidism too

I have alot of anxiety ( nothing new there over the last few years either) about going back to GP's with all these new (to them) issues with me, I feel like I will be labelled the biggest hypochondriac in the surgery!

I have already had alot of that disbelief, after I was diagnosed (after over a year of tests) with my Behçets Disease at the age of 40 (which also I've had since I was alot, lot, younger) I get the "Oh really, but you look so well" or the eye rolls to the ceiling kind of looks! at work & sadly sometimes with friends So to announce more autoimmune conditions to them gives me even more anxiety.

I honestly feel like I'm falling apart, I've got sooo many symptoms going on that I'm desperately trying to get this old banger (me) kick started again with its next MOT!.

(Ps my HRT is working wonders Thankgoodness, been on that for 1 year last week, so I can't blame symptoms of Menopause )

I definitely need this possible PsA looked into ASAP like as you mentioned it does appear to be a monster

Appologies for this longggg reply, I can't help it ,its because I know you understand me & can sympathise, so it all comes out 😳

Thank you for taking your time out to read me , I do really appreciate it

[rmros in reply to Flora_Fauna]

I'm glad I read your reply - I've been getting swallowing issues lately too, and frequent heartburn/acid reflux that I was putting down to my advancing age and probably perimenopause. I never linked the two or considered thyroid as a potential cause.

I have asthma and always used to gargle after using the twice-daily steroid inhaler. Lately I haven't been able to do this without gagging and nearly throwing up. I might have to investigate further.

[Flora_Fauna in reply to rmros]

Yesss rmros 💡 I originally had that exact presumption in regards to Acid Reflux/ Gerd ( I also suffer with the same) however my Endoscopy results found no acid damage to my esophagus? to be causing the choking/ swallowing issues we both have.. during some brief research (after Batty1's appriciated reply ) I found numerous arrow pointing evidence towards Hypothyroidism... one extract read.. 'When the thyroid gland becomes significantly enlarged, the goiter can begin to compress the esophagus (and other nearby structures, such as the trachea), leading to dysphagia, as well as breathing difficulties in some cases' (I also have breathing difficulties & asthma & have Brown steroid too, yep that sometimes makes me cough whilst taking 🙄)

There's many more info extracts in regards to Hypothyroidism & the something stuck in your throat symptoms, just obviously worded medically

I'm like Thankgoodness for this forum & the replies hey ♡

I'm due back to GPs to further discuss results of Endoscopy, so I shall use that time as my excuse to impose my findings & thoughts whilst in there ,(relieving some of my anxiety in regards to broaching the subject) hopefully this will lead to a Thyroid test?! & answers.

[Batty1 in reply to Flora_Fauna]

Swallowing issues is how I was first diagnosed with tumors on my thyroid but was told nothing to see here benign lumps and off I went bouncing through my life choking on just about everything I ate and then the panic attacks started happening they were absolutely horrendous they would hit out of the blue for absolutely zero reason lots of times they hit while I was driving and force me to pull off the side of road feeling like I was dying (yes that bad) eventually my eye started popping out of socket and my weight started to climb … crazy experience and finally my eye doctor is the one to actually tell me you definitely have thyroid related issues…. Sent to Endocrinology department they did fine needle biopsy and I had cancer (nightmare begins) Thyroidectomy to follow and 2 weeks later my arthritis (normal OA type) went crazy saw 3 Rheumatologist and all of them told me I was too active and needed to take breaks (idiots) . (ME) to rheumatologist If my pain is just me doing too much then why do I have to show up to your office and hour and 1/2 before my appointment just to make sure I can make it in to see you on time …(Doctor) What do you mean? I can’t pickup my legs to walk I drag myself across the ground and stand still every 2 mins… Him oh thats not good you just need to take breaks …. I was devastated and it took me another hour or so to walk back to my car …. I eventually went out on my own to search for Rheumatologist that could help me from (John Hopkins University) when you make appointments to see these doctors you must send them all your health records and lucky for me the Rheumatologist that took me on as a patient specializes in Psoriatic Arthritis and does research if it wasn’t for her I would have been wheelchair bound.

Psoriatic arthritis is no joke when your having a flare it can drop you were your standing as if someone pushed you down…. I flared so bad just last week my lower back, butt cheeks, entire upper legs and clear to my knees hurt so bad I couldn’t even walk, sit or stand calling ambulance did cross my mind because I was home alone for the week.

You should venture over to the thyroid group and stalk around and look at information lots of people do their own thyroid test.

[Flora_Fauna in reply to Batty1]

Aaahh Batty1 you really are a Warrior on a different level! ♡ truly awful battles you've had to try & overcome & by the sounds of it still battling! 💐Sounds like there was a reason that day , why that Dr hadn't a clue, was just ticking boxes & his total lack of personlised care towards you..just imagine if you'd have had to carry on being under his care on paper! Thankgoodness he pushed you to seek out alternative, authentic caring help/support hey!. The Rhumatoligist at John Hopkins sounds amazing!

I totally get you with the panic attacks, 'scary' is an understatement! I have suffered a few , the ones where your lips actually turn blue I have naturally low blood pressure which drops & causes my heart to work overtime creating vaso vascular syncope. I can only imagine even more terrifying whilst you are driving!

I will definitely have a mooch on the Thyroid group (Thank you) , a bit of bedtime reading

I really hope your recent flare up subsides on the pain front very quickly for you

I'm really grateful of you alerting me to the absoulute seriousness of PsA ⚠️ its some scary poop!! Definitely given me the urgency push to call my Dr's in the morning & get the ball rolling.

Thank you,

Keep Warrior'ing on 💐

[rmros]

Hello. Well obviously I can't say one way or the other but your story sure points to PsA in my view.

Mine tends to be very symmetrical, which isn't meant to be the norm with PsA, but so many of the symptoms you mention I can relate to.

I believe nail psoriasis is a greater risk factor for developing PsA than skin psoriasis. I never knowingly had skin psoriasis, I went straight for the joint symptoms but a rheumatologist examined my nails and spotted I have pitting, which helped finally steer towards my diagnosis.

There is also a much stronger familial link with psoriasis and PsA than with conditions like rheumatoid arthritis. Family history scores a point on the diagnostic criteria.

Best practice says doctors should be asking psorisis patients about any joint problems at an annual review - but it's not an ideal world I know. I would take some notes and talk openly about your thoughts with your doctor.

I hope your recovery from the unpleasant procedures is quick and full - you've got a lot on your plate so can understand putting this off but the sooner you get seen the less chance you have of lasting damage.

[Flora_Fauna in reply to rmros]

Hello by the way too aahh Thank you for the 'hoping I make a speedy recovery' from those crappy procedures quickly 🌱 very much appreciated 🌷 they've put me in a horrible painful flare (of Behçets & now goodness knows what other type of flare included) & I'm feeling very sorry for myself...I cant fathom why the Dr's haven't even, ever, suggested PsA to me??

They are fully aware of my skin Psoriasis, I have a repeated prescription for my Exorel lotion & occasional steroid based creams!!

I think they just think oh yep this is her Behçets Disease, (even though most Drs haven't a clue about it) & like admittedly I have been putting it down to Behçets myself (it's easier for them to use that tho hey)

I'm definitely going to go armed with PsA & Hypothyroidism insights & use the line "well I'm going to make this an easy appointment for you today" " I need a Thyroid blood test & an urgent referral to a Rhumatoligist (that's not one of my usual Behçets Rhumys) in regards to PsA, thank you "

Thank you for your replies , really appreciate your insights & ailments sharings

I'll update on here after my appointments if I get any further on my quest 🤞🏻

[Greenmil3]

Flora just been reading the rest of your posts and other answers I’m having a camera down my throat due to swallowing anything else than very sauce based food difficult. The barium meal I had showed nodules on my spine which when I researched is yet another possible issue with PsA just thought I would mention. Will let you know what final diagnosis is.

[Flora_Fauna in reply to Greenmil3]

Thank you Greenmil3 sorry to hear about your swallowing issues, they sound really debilitating! The connection all these symptoms have sound really bizarre hey! goodluck with the Endoscopy 🍀 I hope they manage to get to the bottom of the cause & your food choice can eventually be back to being exactly that Barium meal is actually next on my list of procedures, it was due to happen next Tues, however I can't face another procedure at the moment , but when it does it will be interesting to see if it picks anything up in regards to PsA (would never have thought about that, so thank you again for the insight )

Yes please do keep us updated.

Really appreciate your replies

[Kristian89]

D vitamin, look up thiamine (b1) and mithocondria. I suggest research thiamine sublingual or injection. You need cofactors as well. Psoriasis can be caused by strep pyogenes. K12 probiotics can kill the strep pyogenes. Quercetin with every meal can also boost your small intestine health. To process sugars you need a lot of thiamine, our diets are heavy with sugar.