It’s Not ‘Just a Flare’ This Time

I've been lucky to see some great results with my biologic for seven years. I have had flares from time to time, but overall, it has worked well in managing both my psoriasis and psoriatic arthritis.

Trust me, I never took this for granted, but I admit, there were times when I didn't think about my PsA pain daily. I didn't have to - my symptoms were mild and controlled for so long. I was one of the lucky ones who found a medication that worked for years. After having COVID-19, all of this changed.

Psoriatic arthritis & COVID-19

When life looked a lot different before 2020, it took many years of trial and error to find this treatment. It was a frustrating, time-consuming, and painful process. My doctors and I worked together to keep trying, and it finally paid off.

With this treatment, I could get out of bed easily each day. I could grip the steering wheel and drive to where I needed to go. I could lift laundry baskets of dirty clothes and walk up and down the stairs to the washing machine. I could function at work, photo editing even the most intricate digital images.

I could attend kickboxing classes and throw multiple roundhouse kicks on the heavy bags. The activities I could do far outnumbered those that gave me trouble. Again, I was one of the lucky ones.

How this virus impacted my PsA treatment plan

Understanding that it's not uncommon for me to flare after an illness or infection, I've had to come to terms that this flare never really went away. I don't want to give the impression that I can't move and that pain is constantly high, but it certainly is not the same as before getting this dreaded virus.

I have to rest more often, take more NSAIDs, and limit how much I would pack into each day. I was dealing with it and not complaining, but I knew my arthritis was on its way back with a vengeance. It wasn't there yet, but it was coming.

Taking advice from my rheumatologist...

My rheumatologist confirmed my active arthritis at my recent doctor visit and even added an osteoarthritis diagnosis. He explained that osteoarthritis (OA) is just as painful as psoriatic arthritis (PsA), but unlike PsA, my biologic will not improve OA. Getting both of these under control again will take some patience.

So, now what? My doctor had a few options...

• Take steroids to help get me over this hump. Steroids are not my friend. I get very jumpy, and I feel like the rest of the world moves in slow motion. I just want to cry because I don't feel like I am in control of my own body.
• Change my NSAIDs. He explained that switching meds within the same class of medication can sometimes bring good results.
• Change my biologic. Even my dermatologist has been putting the bug in my ear about perhaps giving a new biologic a chance. Great new medications have come on the market in the past seven years.

Switching NSAIDs seemed like the best option. He said to give the new medication a week to see if I improved. That seemed like a time frame I could live with. Reluctantly, I also agreed to try steroids, but in a smaller dose, to hopefully limit the side effects. We'll see how that goes!

It's just scary to try something new. There may be a few months of waiting to see if the new medication will work or what side effects might show up. Or the big one, will insurance cover it? If I haven't improved enough in two months, we will make the switch.

My psoriatic arthritis medication plan, moving forward.

While we wait for the medications to do their job, I will work to control what I can: eat healthier, exercise more with low-impact activities, drink more water, get rest when my body demands it, and ask for help from friends and family when I need it.

All of these are easier said than done. I'm not naïve. I know this will be difficult, but even if I try and fail, at least I'm trying. My aunt gave me a shirt a few years ago. On the front: "Underestimate me. That'll be fun."

I think this is my mantra for the next few months. Giving up is not an option.