How I've managed 40 years with PsA

I'm 68 years old and was diagnosed in 1983. Basic skin problem with swollen joints. Started with anti-inflammatories, Methotrexate, steroids, etc. Managed with exercise, good eating habits, and low stress (avoidance sometimes not available---then flare-ups). Drank alcohol 4-5 times a week but would cut down if swollen.

Fast forward to 2000. Started on Embrel and EUREKA---swollen joints went away. Skin partially cleared but started doing PUVA or UVB (purchased a light) with moderate results. For next 21 years Embrel, Humira, or Remicade (worked the best but got allergic reaction) kept me in check.

Starting in 2021 when both wife and I were off private insurance and Enbrel stopped subsidizing due to income cap, I stopped taking everything due to net cost---you guessed it---joints went bonkers and I had hard time moving around. Once on the biologics, then they have you by the shorthairs and not much you can do about it!

Since Enbrel and other Biologics are 'tier 5' under Medicare part D, the net cost is prohibitably expensive. Thus, my Rheumy suggested Simponi Aria Infusions which are covered under Medicare Part B at 80%. The other 20% is taken care of through a Medigap plan. So I went from paying out of pocket thousands a year to almost nothing.

The Simponi works great until about a week before next infusion (6/year) and I cut down the alcohol and load up on Ibuprofen to get through until the next time I go in for the Magic Sauce!

I hope this summary helps others with similar issues.