While true that we all need good medical care for the management of PsA, there is more to it than just that. Disease management, for any autoimmune disease, involves lifestyle changes that are wide ranging and far reaching. First and foremost among these changes is cessation of alcohol and tobacco use. According to the World Health Organization, "There is no safe amount (of alcohol) that does not affect health." So that occasional glass of wine, or that "couple of beers" on the weekend while mowing your lawn? Nope. And if you are still smoking, are you absolutely nucking futs? We all know the dangers of smoking. And I would include smoking cannabis with this statement. Lighting anything on fire, and then inhaling the smoke isn't safe. So if you drink, if you smoke, you are undoing everything your doctors are trying to do for you. If you wish to fight this thing with both hands tied behind your back, that's your business. But don't ask others who are helping you to do so as well.