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What now?

Well, I saw the consultant. I do have psoriatic arthritis.  This is not a surprise, my GP told me this in June after he’d x-rayed my right hand. The disease is mild but significant so he advised me to start treatment.

They’ve taken x-rays of my hands, feet and hips and more blood. The consultation took about 30 minutes, most of it asking me questions and taking notes on my history. He only asked me to walk a few steps and move my arms from side to side. He didn’t check the range of motion in my hips, knees or ankles.  I’m to go back and see him at Christmas time. I really hope I don’t get any worse between now and then!

In the meantime I’ve been prescribed some more anti-inflammatories and I have to decide if I want to take sulfasalazine now or have another child and then start taking it. He said I could take it while I was pregnant, if necessary. To be honest, I’m not sure it is necessary.  He said that the pain in my feet is definitely arthritic and that this disease has been going on for a long time. So if I’ve managed this far without drugs, another few months isn’t going to make a lot of difference in the grand scheme of things.  He did say that psoriatic arthritis was not a reason to not have children but I should expect the disease to flare (get worsse) after I’ve given birth.

If the pain in my feet is “characteristic” of psoriatic arthritis why was I not diagnosed when my feet started hurting 20 years ago?  Maybe because this is the first time I’ve seen a rheumatologist? (I’ve seen plenty, GP’s, orthopods, phsyiotherapists, podiatrists and other specialists over the years).

I wish they could treat the fatigue, I can live with the sore joints, but not having energy to do what you want to do is demoralising and frustrating. The consultant did say the fatigue is related to the inflammation (that hasn’t shown up in my CRP levels, go figure?) and that anti-inflammatories and painkillers won’t help with the tiredness but the sulfasalazine should. Lord I really hope it does. Maybe then I can get a bit of my old life back?

Overall I’m happy with the way the consultation went. I’m  somewhat resigned to the fact I’m going to have to accept a treatment with unpleasant side effects, for many months before I know if it works (or not). Not the best situation to be in, but by no means the worst.

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Psoriatic Arthritis, blood tests and x-rays.

Well my blood test results are back, everything looks normal, which is good. CRP (C reactive peptide), is a general marker of inflammation, which can rise when you have an inflammatory arthritis. My value is less than 10. Anything from 10-150 can indicate an arthritis flare (although that is not true for everyone, some people can have a severe flare that doesn’t show in their blood work). Sometimes inflammatory arthritis can cause an increase in your white blood cell count and again there is no sign of that. Some people with chronic diseases like rheumatoid and psoriatic arthritis can develop anemia and fortunately my haemoglobin (Hb.) is now back to normal. I think I will keep taking the spatone.

That’s all good news on the blood front, unfortunately the x-rays did show signs of psoriatic arthritis. It can take several years before psoriatic arthritis causes damage that can be seen on x-rays.  See the webpage from “Learning Radiology” 0r the University of Washington MSK Resident Projects for the technical details.

How do I feel about all this. I’m not sure? I’m glad my bloodwork looks normal (even if I feel crap.)  I’m glad I’m not anaemic but if I’m not, then there must be another reason why I’m feeling so exhausted. I’m a bit disappointed that they can already see changes on the x-rays but there’s not much I can do about that. Oh well. That’s life,I just need to get my head around it.

Categories: Psoriatic Arthritis Tags: , , , ,