I Don't Know

I honestly don't even know what's going on anymore, but psoriatic arthritis checks all the boxes.

I have had joint pain for a long time. It showed up first in my wrists probably 5 years ago or so. I didn't think much of it at first. Arthritis runs in my family and I pretty much just chalked it up to bad genes. I used braces and ibuprofen when I was tired of it or the pain made it difficult to do things. I had lots of other symptoms too, some of which I went to the doctor for (like unrelenting nausea which yielded gastritis and villus atrophy, but no real answers - and dizziness which was just recently diagnosed as POTS).

In 2017 I gave birth to a beautiful 9lbs baby boy and things just seemed to break down one by one... and this started the insanity that is my life.

A lot of things I experienced in his first year I chalked up to being postpartum, to sleep deprivation or my body adjusting to the changes to my life.

The first thing that popped up was a rash, swiftly followed by joint pain (my hips at first and then my hands). I wrote off the rash (doesn't everyone get dry skin postpartum???), but the joint pain built up so quickly that I nearly lost my mind. Having taken medical classes in college I knew this was a pretty typical way for Autoimmune to pop up. The hips I never even considered till recently... My son was quite large and the docs had to get him out via C-section so I figured my hips were just upset from all the changes in pregnancy and carrying a big baby. The wrists at first was just "oh, that pain came back", but when it surpassed the pain I had experienced previously to pregnancy I started to worry.

Since I had already seen a neurologist about the pain a year prior (with no answers), I asked my PCP to refer me to a rheumatologist who swiftly diagnosed me with seronegative RA (I've had a positive CRP and some osteopenia around my joints on x-rays, but RF, anti-ccp, and ANA were all strongly negative along with ESR (CRP is the only test I've had more than once out of these and it took a really nasty flare to bring it up out of the normal range (it was 15!)).

The doc prescribed me Plaquenil, which did nothing but make me nauseous, and then sulfasalazine... Which helped (I now have a week or so between flares and the pain is reduced - no more hot by the bus feeling but I still feel crummy some days and run mild fever whenever I flare).

Around the time I started the sulfa the rash stared to come back. It came with an awful flare and all the weird symptoms that seem to come and go in my life (nausea, GI troubles, dizziness, red hot painful swollen hands).

I sent my rheumatologist a message (he's probably sick of me by now I'm sure)... and he essentially sent me back a message saying this is probably why my antibiodies were negative because it's probably psoriatic arthritis rather than RA.

I looked into it... and it fits perfectly. It blew my mind because the rash isn't like clinical pictures (there's a spot on my ankle that's pretty close actually). You'd think I'd know by now that early in the disease process things don't always look like clinical pictures. Looking into the joint distribution and other symptoms and co-occurances a lightbulb went off in my head. I had never considered PsA because of my family history... but I've had "eczema" for years that comes and goes and this dry skin that just won't go away since my son was born (that on a flare goes completely erythemic (red, hot, burning) around flares of my joint symptoms... And some screwed up toenails (they're all flaking now but one is very thick, separated from the nail bed and bleeds like crazy whenever I clip it).

So, once more down the rabbit hole I go.

I feel completely caught off guard with all of this... But at least something's helping.