My Psoriasis Is Flaring Which Has My Psoriatic Arthritis Flaring

By Vickie Wilkerson

3 min read

Last year was a terrible year for me and this year hasn’t been much better. It started with the passing of my mom and ended with an assault by a family member. That assault left me with a broken knee. I started 2023 in a wheelchair because I could not put weight on that leg at all. That was doctor’s orders. All these months later, I am finally able to walk, but my knee is still not right and will probably never be right. I have been told that I will need a total knee replacement, but I am trying hard to push it out as far as I can. I can’t see coming all this way from non-weight bearing to walking just to turn around for that. It has already been such a struggle both mentally and physically.

How was my psoriasis flare triggered?

I am not of the mindset yet to face the new obstacle, but I know I can’t wait long either. It has all been so disheartening to say the least. Cue last week, I found out I had to go to court over the assault, just two days before the day I was supposed to be there. Those two days were spent with my mind whirling, my anxiety at an all-new high, and I was dealing with my fear of what I would have to face. Sitting in that courtroom took its toll on me both mentally and physically. Because of the added stress it put my psoriasis into a flare. The irritation of the flare had caused my psoriatic arthritis to flare as well.

Can my psoriatic arthritis flare at the same time?

Can both conditions flare at the same time? I have never had it happen before but there is always a first. I know how tense I was that day. That was definitely not good on the psoriatic arthritis. It is not like you can get up in a courtroom and move around so it was hours of sitting which is never good on me in the first place. There was no doubt in my mind that the psoriasis would flare. I already anticipated that it was coming. What I did not have in mind is that the psoriatic arthritis could flare right along with it.

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Why did I have a terrible night's sleep?

How bad is it? Just for an example I spent one of the most miserable nights I have had in a long-time, last night. My ankle which is covered in psoriasis throbbed and was so painful that even the sheets touching it made it hurt. I tried to find a position to lay in that would ease that pain, but was met with pain from my hips, back and knees. Those are the areas my psoriatic arthritis affects. It seems that no matter what I did, I was in misery all night. I think I finally managed to snooze a bit when I put a pillow between my legs which seemed to help both situations. I hope I go a long time before ever experiencing that kind of discomfort again.

How am I feeling?

I feel beat up, beat down and all over tense. It feels like my body has been put in a vice and someone cranked on the handle until it squeezed me into a blob. I thought I knew pain before. Somewhere in the back of my mind, I thought I had felt all the psoriatic arthritis pain at once before. However, last night has me rethinking that. As much as I want to wait on that knee replacement I don’t know if I can now if I have too many more nights like that.

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AlisaLavine Member
I'm sorry that you are dealing with all this chaos. I do hope things in your life settle down so that you can breathe and heal. I've never had psoriasis anyplace than on my scalp and behind my ears so I don't relate personally to what you experience. But my mom has terrible psoriasis and I know how awful it was for her when she had flares before she started on a biologic almost a year ago. First time she's had clear skin since she was 9. I do understand the horrible nights though. My PsA seems to have started in my back after an "abrupt stop from height" accident. I have been sleeping with a pillow between my legs for a good 25 years or so. With my fibromyalgia on top of my back and now ankles, knees and toes, I can't take the pressure of one leg on top of the other. I regularly have sleepless nights where I can't get comfortable for anything. Even a wrinkle under my ear on my pillow case feels like Mt. Everest! I've learned the hard way that when I'm that uncomfortable it's time to get up and get into my recliner with a heating pad, coffee, a muscle relaxer and a pain pill. I also get my Kindle so I can read and distract myself. While this might keep me up for 2-3 hours, the routine is calming and I inevitably end up getting sleepy and crawl back initio bed feeling much more relaxed. I hope the flare is settling down! 🤗🥰
1. Diane T Moderator & Contributor
 Hello <inline-mention username="Vickie Wilkerson" user-id="3316344"/> , I'm hoping things have calmed down for you and you are doing better now. Just take things one day at a time. As you know, we have a great community here, so you don't have to do this alone. Are you sleeping any better now?
Vickie Wilkerson Moderator & Contributor
<inline-mention username="AlisaLavine" user-id="6222588"/> thank you for responding. I am the same way. If I am in so much pain I can't sleep I get up and go to my recliner. My husband has to get up super early to go to work so I don't want to keep him from sleeping. I also use my kindle so that I can play a game which usually makes me tired enough after a bit that I can go to sleep. Thankfully yes the flare has started to settled down which I am grateful for. I had to chuckle a bit when you stated about your pillow feeling like Mt. Everest. I have never thought of it in that way but I definitely understand what you are saying. Vickie W., Team Member
Mary Lynn Member
 Vickie, you wrote a great description -"beat up and beat down". Physical pain and emotional pain and stress are a wicked mix. I hope you can sleep better tonight. I can understand not wanting a knee replacement after being non weight bearing for so long. If you do go ahead, I think that you'll be up on moving on your knee very soon. PT will have you putting weight on it and hopefully pain free weight in a short time. Wishing you all good things!
Mylander63 Member
Vicki, I can definitely say that your plate is over filled at this time. Sounds like the court and family issues have been delt with temporarily. As far as the assault, please check you should have victim's rights and should have counseling made available for you. If not please talk to your physicians and ask for help due to the stress that you are going through. It might help with your flares that you are having. Also discuss with your physicians on all your options for your knee. If you already have to have PT, having a knee replacement might be better for you in the long run. Also talk to your rheumatologist and hopefully they can tell you what might be the best options for you. I will be thinking and praying for you and that 2024 will be a lot better for you. Renee
1. Vickie Wilkerson Moderator & Contributor
 <inline-mention username="Mylander63" user-id="4728206"/> thank you Renee. It has been a lot. I appreciate your post. I have not thought about checking to see if counseling is available. I will definitely check on that. I do have a Victim's Advocate so I will be emailing her. I appreciate your prayers. Vickie W., Team Member
ralphcook Member
I don't pretend to be a medical expert, nor do I wish to provide any medical advice but every little bit of what I am about to say is based on my own experiences and as there have been so many over almost 35 years I will necessarily not be able to say much in detail but I am willing to answer in detail and truthfully to the best of my knowledge any questions that anyone may have. 1) I was diagnosed with PSA when I was 35 years old 2) I was 64 years old in September of this year 3) with the exception of one important episode of my life, I am right now experiencing the worst symptoms of PSA, this began two months after I had Covid for the first time in March 2020 and has got progressively worse with each further infection (I have had Covid at least three times and possibly four or five times) the reason for my uncertainty is that I have been properly ill so rarely in my life that I can only measure my state of health by comparison with the health of others. My partner has definitely had Covid three times and my immune system has simply killed the virus before it could do any noticeable harm. Around the time my partner is ill with Covid, I tend to have early symptoms (runny nose or headaches etc. but they only last a few hours, I know it sounds daft but by the time the virus is well-enough established to cause symptoms (this takes about ten days) my immune system is fully geared up and the virus is wiped out. A strong immune system is a feature of PSA in some people. Mine is especially strong. 3) Unfortunately destroying the immune system is insufficient for my immune system, it sets off an inflammatory storm, a Cytokine Storm which rampages through my body. These events occur when the immune system produces too many inflammatory signals. These storms can cause be very serious and in some cases can lead to organ failure and death. Symptoms of cytokine storm can include confusion, shortness of breath, lethargy, and more. 4) I have never felt as vulnerable as I do now with a host of conditions afflicting me that I did not exhibit before March 2020. 5) I feel the only reason I am still alive is the same one that saw me survive that one other serious PSA related crisis in 2013 when I had a heart attack in the August and an aortic dissection in the December. My surgeon told me that I owed my life to whatever "miracle" it was that kept my arteries so clear of cholesterol. He looked so crestfallen when I told him that was probably my vegan diet. Aged 54 I had been vegan (for moral reasons - I dispute our supposed right to abuse, kill and eat animals) since I was 19 years old. My diet cannot prevent me getting infections, my diet cannot stop my immune system over-reacting long after it has done its job protecting me from infections but my diet has I believe given my body the ability to fight long after my friends have gone to their graves (three have died of Covid) 
1. CathyD Moderator
 <inline-mention username="ralphcook" user-id="3306790"/>, thank you so much for taking the time to share your experiences here. I'm sincerely saddened to read of the loss of your friends. These past few years have really been horrendous, and in so many ways. I wish you weren't having to deal with so much health-wise. I really feel for you and can empathise to an extent - infections are a huge trigger for my psoriatic disease and the thought of getting sick absolutely terrifies me now. In the past, it's sometimes taken years for me to recover from a cold. It's awful. Alongside your vegan diet, is there anything that's helping you manage your symptoms? Thank you again for sharing here, Ralph. We appreciate you. Wishing you the very best, -Catherine, Community Moderator 
2. Vickie Wilkerson Moderator & Contributor
 <inline-mention username="ralphcook" user-id="3306790"/> thank you for responding. I am sorry about the loss of your friends. Thats hard to deal with and then add the psoriatic arthritis on top of that it's a wonder you have not been in a constant flare. What has got you feeling the most vulnerable now? It sounds like you have been through so much I was kind of surprised by that. Vickie W., Team Member
ralphcook Member
ralph cook
ralphcook Member
Thank you Catherine, apart from my diet which I am quite certain is inflammation reducing and of course virtually devoid of cholesterol and that material in meat which apparently our immune systems regard as an alien invader, the only thing that I think may contribute to my condition being less nasty than those of other people I know who have psoriatic arthritis (my sister for instance has a similar condition) is my temperament. I wouldn't say I was particularly a calm person I do get quite ratty when things don't go the way I want them too but it never lasts more than ten minutes and whatever it is and whatever has happened, I drown my irritation or annoyance with my sense of humour and positivity. Most of the time if something really annoys or worries me, I simply forget about it. My friends cannot understand for instance how relaxed I am about the fact that I have now to complete a third application for divorce from my wife (we remain good friends and the divorce is now mutually agreeable, she still helps me and we like each other too, but we both have partners and feel its time, after 17 years of separation, to end our marriage) because of the ridiculous rules the system has invented. I see many of your members openly revealing their mental state in this forum, explicitly connecting their physical misery with mental anguish. I fully understand this but I think those linkages can take you on a downward spiral from which it is difficult to escape. Before 2020, if I felt depressed, I'd grab my binoculars, hop in the car and drive to a place where I could watch wild birds for an hour or two. Finally, I have some hobbies that are central to my existence, I am writing a book and I collect ancient and modern coins, old stamps from around the world, antique porcelain teapots and antique pocket watches. I really don't have time to be ill!!
1. CathyD Moderator
 <inline-mention username="ralphcook" user-id="3306790"/>, I can totally see how temperament could play a role, especially as stress can be such a big trigger for many of us. I really admire people who are able to feel whatever they need to feel and then let it go. It's definitely a testament to your temperament that you're relaxed about this divorce business - how frustrating that you're both ready and in agreement and it's still so much hassle! I'm glad to hear that it's not stressing you out too much. Your hobbies sound so interesting, Ralph! I wish I was passionate enough about something to collect it. Were these always your hobbies or did you take them up after you got PsA? I used to have quite a few hobbies, mostly related some form of being active, which I was then unable to do because of my health. I don't know if I have any hobbies now, which makes me a bit sad! I do enjoy playing video games... maybe that counts 😅 Warmly, -Catherine, Community Moderator
ralphcook Member
Hobbies keep me sane. My primary hobbies are bird watching, studying wildlife, reading, writing and arithmatic (OK, I lied about the last one, I hate maths). My partner and I own a 3 acres ancient woodland and I used to enjoy maintaining that but unfortunately it has been neglected for the last four years since I caught Covid. Bird watching is now restricted to watching our garden birds feeding at our "feed station" and animal study to monitoring the hedgehogs that we feed in our conservatory (they nest beneath its floor and go in an out through the permanently open sliding doors. My collections date back to when I was a child although they are much more valuable and eclectic than they were then. My fossil collection has expanded significantly and I own 2,000 Roman coils and roughly 800 medieval European coins. Teapots are a new passion that I would never have envisaged myself collecting only 10 years ago. I own five or six very early teapots that are quite valuable and several hundreds that are just pleasing to the eye. As I say, collecting keeps me sane and very poor, whoever is lucky enough to receive them in my Will could be wealthy if they sell them diligently and wisely.
1. CathyD Moderator
 <inline-mention username="ralphcook" user-id="3306790"/>, I so enjoyed hearing more about your hobbies. It certainly sounds like they're keeping you occupied! How wonderful that some of them started in your childhood. I would never have thought to collect teapots but that's such a cool idea. I imagine there's a huge variety of different styles/shapes. Your comment reminded me actually that I enjoy bird watching too. Mainly just from the window, but I did manage to get away for a few days last week and saw a bird I'd never seen before at the beach - a turnstone (I'm over in the UK and not sure where else in the world these little birds inhabit)! It was such a sweet thing. Nature is so good for the soul. Thank you so much for sharing, Ralph. You've inspired me to try to find something that I enjoy doing/collecting again! If you're interested, there's an array of community views on hobbies and PsA in the following article: <a href='https://psoriatic-arthritis.com/living/hobbies' target='_blank'>https://psoriatic-arthritis.com/living/hobbies</a> Warmest wishes, -Catherine, Community Moderator