It's Not You, It's Me: Breaking Up with Biologics

Living with psoriatic arthritis comes with it a million difficult decisions. They range from seemingly simple decisions, “Does my body need to rest today, or should I be up and moving?” to increasing difficult ones, “Should I try to file for disability?” Not the least of which are decisions about medications. When should I try biologics? Which one might be the best for me? Is it time to try something different?

The decision is ours to make

While your rheumatologist can provide information and guidance, when it comes down to it, the decision ultimately is ours to make. More importantly, the consequences (good or bad) of those decisions are ours to live with. We are the ones facing an uncertain future, mounting medical bills, and the very real possibility of serious side effects.

I know quite a few people who swear by their biologics. Their biologic medications allow them to feel better than ever and have given them their lives back. It’s priceless really. It’s not a perfect system, but certainly a far cry from where we were, even 5 years ago. But what happens if you don’t find yourself among the lucky few? You try one, then another, then another, hoping that the next formula will be the one that works for you.

All of these decisions, choices, and “trying” can really take a toll on a person.

Sometimes, through no fault of my own, I just need to take a little break.

I need to take a break from the endless cycle of shots

Planning, scheduling, and working life around appointments for shots or infusions can take its own toll on me. Checking the calendar to make plans and try to schedule outings for “just the right time” to increase the likelihood that I will feel good enough to go. I have to avoid doing things the week before medication because chances are, the effects (however minimal) will wear off before my next dose.

I need a break from fighting with insurance and paying deductibles

Even with “good” insurance, there are always the questions, “Will I be approved for this medication?” Or, “How much is this going to cost?” Even with insurance, the cost of biologics packs a big punch, just from the sheer nature of the type of medicine that it is. Checking statements, talking to the doctor’s office, and calling the insurance company all take time, effort, and mostly worry.

I need a break from managing the emotional toll that a new medication brings

A person can only be hopeful, just to be let down so many times. Each time brings with it a fresh wave of more questions. “How long should I try this?” And, “At what point should I move on?” Or, “Is this the best it will get, or is there something out there that might work better with less side effects?” Emotions swirl around each of these decisions. Disappointment. Anxiety. Worry.

Being okay with the consequences

I know there might be consequences for my choice. I know that the war inside my body will still be raging on and there might be irreparable damage done. Yes, there are risks involved with this decision. But there are risks with every single decision we make while trying to manage our psoriatic arthritis. This is likely a temporary choice because this battle is a lifelong one.

In time, I may literally come crawling back. But for now at least, biologics, we need a break. Please understand, it’s not you, it’s me.