Flares compared to Chronic - Question

Mich54, I have the same issue. I have been on Embrel for 9 weeks. I thought I was feeling better about week 4, but now fatigue has set in. I have never been one to just lay in the bed or take naps. I have been needing a nap the last several days. It's 10:36am and I just don't have the drive to get up. I just want to roll over and stay in the bed.

I see my Dr on the 24th. Hopefully, this is temporary. Also like you, I have constant pain in my feet, hands, fingers and shoulders. I wonder if this is a flare? Or has embrel caused what now appears to be chronic fatigue.

I hope you have great results with your Humira.

Hi and , this is a great point. When Doctors talk about flares, they usually mean a period of time where symptoms are worse or more severe. That certainly doesn't mean that the rest of the time symptoms are manageable, unfortunately, it just means that flares are when you've moved from your baseline. Does that make a little more sense?
Best wishes to you both,
-Victoria, Community Moderator

MJk2011 and VickiN....... Ok so my thing is I feel I am constantly in a flair then. I guess, basically, everyone is different. I read the articles on it. I guess I am questioning if others have stiffness/soreness all the time? That is my issue. I have it all the time. It never goes away. I have had some times when something will flair....ie, my wrist swelled, my finger, my ankle.... or just times when one part might hurt extra for some days at a time. But as for the day to day living, It never goes away. I wake up very stiff.... I can move a little easier after a while, but if I sit for a while, I am definitely more stiff. Or if I overexert myself (shopping, cleaning, etc.) I feel more stiff and more fatigued. I am constantly fatigued anyway. I have to pace myself and traveling is hard because it just takes so much out of me and you can't pace yourself so well when you travel. I just started Humira (actually yesterday was my 2nd injection). I feel no difference yet and I am depressed thinking nothing is ever going to help me. I have been dealing with this for 30 years, with it continually getting worse and worse. (I didn't get a true diagnosis until just maybe 6/8 months ago.....I have gone all these years with no one seeming to put the puzzle together, until I finally did it myself.) I even had pushed for parathyroid surgery in 2010 thinking that could be my problem. Crazy..... all these years, and no one helped me. I think I even ended up with a heart blockage in 2007 because of this. I am just feeling depressed that maybe this isn't going to help me either.

Hello ! I had that same question for a looooong time. I wasn't sure what my "new" life with PsA was or what the "best" I could expect was. Everyone talked about "flares" but never really said exactly what it was. Which is guess is part of the problem. There isn't really a clear cut answer or definition of a flare. Sure we can look at blood work and see elevated levels of CRP and stuff like that, but that isn't definitive either. You could look at swelling, but that isn't ALWAYS an indicator either. The list goes on and on of "possible" signs of a flare. But the truth of the matter (in my experience) is that it isn't a clear "flare" vs. "not flare" life.
I've come to compare it with like a dimmer switch on a light. There are some days when the light (aka inflammation) is turned all the way up. Fatigue runs high, joint pain and stiffness doesn't ease at all no matter what I do. When the light is dimmed, my symptoms are easier to manage and I can go about my day with extreme fatigue or pain. Then there are all sorts of ranges in the middle.
Medicine works a funny way with the dimmer switch. The way I've decided if it is "helping" is that the majority of my days the inflammation dimmer is turned low. Sure there are some higher days that sneak in there, but the majority is bearable. It has taken me 5 different medicines to find one that give me more low inflammation days than high. Because of that, I am quite certain that I was pretty much in a flare (of one level or another) for years before diagnosis and during my initial treatments.
Unfortunately, (to answer you questions about waking up stiff and day to day life) I'm still stiff in the morning, I'm still stiff at night, and occassionaly throughout the day. However, (and my Dr uses this for an indicator as well) I know meds are working based on how long it takes for the stiffness to ease. Is it under a half hour? Then it is probably good. Does it take over an hour? Not so good.
Does that make any sense at all? Again, this is just my experience and how I've come to understand and live with it everyday. I'm wishing you many low dimmer days and feeling hopeful that Humira will bring you some relief! Please hang in there the best you can and know that being a big depressed living with this is totally normal and don't be afraid to talk to your dr about it. Apparently many anti-depressants also carry pain relieving properties (which I never knew about until I spoke with my dr) even at very small doses.
Please let me know how you are doing these days!
-Leanne, Community Moderator