Fatigue, Psoriatic Arthritis, and Biologics: Oh My!
I live in a perpetual state of tired. Can you relate? I’m so tired of being tired. Fatigue is commonly associated with psoriatic arthritis. It’s also a common side effect with PsA treatments.
Unfortunately, there’s not enough time in the day to be this tired when stuff needs to get done. Below is my experience with Crohn’s and psoriatic arthritis fatigue. Thankfully, I now know how to recognize it, slow down to rest, and when to speak to my doctor about it.
The chronic illness lifestyle
Back in 2012, my chronic illnesses all flared up at the same time. In the year leading up to this flare-up, I was doing all the things we are told are right. I changed my diet and went to the gym daily. Some days, I went twice; once in the morning for cardio and again in the evening for a class or weight training.
I was working as a contractor and paying for my own health insurance. It cost more than my car payment. The plan was expensive due to my pre-existing conditions and the deductible was almost $17,000. I hoped by doing the diet and gym program that it would keep me out of the doctor’s office.
Sometime during that year, I found myself dragging around lunchtime. Rather than going to lunch with co-workers, I either drove home and took a 30-minute nap or took the entire hour sleeping in my car. Other co-workers did the same, so I didn’t feel like something was terribly off when that started.
Is it more than psoriatic arthritis?
Due to sometimes going to the gym twice daily, I easily excused scaling back on the gym sessions. I also reasoned away how what should have been a 15-minute nap after work easily became 120-minute naps after work.
My diet was taking a hit as well because I was too tired to cook fresh foods and began to rely on takeout. The takeout wasn’t always healthy and I attributed the fatigue to that factor.
My joints were achy and stiff, sometimes they burned. My skin grew itchy and inflamed, but I didn’t have psoriasis plaques that stood out. However, my scalp psoriasis, at the time, was terrible. Because of misdiagnosis with cradle cap as a teen, I thought it was just another Jaime issue. Each issue was a warning flag and I kept missing them.
When the fatigue sets in
I know now that when all of these issues began to creep in, silent inflammation was ramping up in my system. Aside from napping because I needed the rest, I should have called my doctor to discuss these changes and ask for labs.
To be crystal clear, I was a chronic illness newbie. I was under the impression that diet and fitness would fix all the things. At the time, I was on zero medications for inflammation associated with psoriatic arthritis, psoriasis, or Crohn’s disease. I didn’t have great doctors when I was diagnosed in 2005.
They left me under the impression that my life would be harder than others and that was that. Symptoms began in early childhood and I became debilitated by age 30. That is 20-plus-years of inflammation running amuck in my system before it became too much to handle. It took almost another year before biologics were started, due to insurance approval issues.
When biologics met fatigue
After starting on a biologic, my symptoms improved and endurance increased a little, but the damage was done. I’ve never fully recovered. The days following treatment are always wrought with fatigue. I plan my to-do list and travels around treatments, making sure that I have a few days of rest post-treatment. Also, I plan downtime in the days leading up to treatments.
I’m now 7-years-into using biologics managing PsA, Pso, and IBD, and still feel fatigued coming as the next treatment day nears. During a span of several-weeks-worth of fatigue, along with other symptoms, my specialists deemed it time to test if an increase was needed. It was. I now pay closer attention to out-of-ordinary fatigue.
Managing those symptoms
Not to say that I don’t have fatigue days throughout the six weeks that fall between injections. There are days where my limbs feel too heavy to move and everything hurts or I need a nap after brushing my teeth. If fatigue continually reoccurs, I let my doctors know. In the meantime, I try to listen to my body as much as possible and rest on those days.
I recognize how very lucky I am to have an understanding and supportive household when these days occur. Not everyone has this privilege. Regardless, if your psoriatic arthritis symptoms or fatigue are increasing, please contact your healthcare provider.
Do you have a sleep disorder (eg. insomnia, sleep apnea, RLS) in addition to your PsA?