Goodness me, -lee, you have been having a really rough time of it 🙁 It is incredibly tough to deal with these symptoms that have an impact on every area of life. I am so sorry that you are having to deal with all of this and with no solid answers. Did your rheumatologist mention anything about PsA at your most recent visit?
I noticed in your status update that your rheumatologist has prescribed Humira. I really hope that this makes a difference for you. To answer your question, it's not unheard of for people to go straight to a biologic (although some people do have to go through other medications first). Has there been any news from your insurance yet?
I am sending you some very gentle virtual hugs. Please remember that we're here if you ever need support or just a place to vent. -Catherine, Community Moderator