PsA Flares: When to Ask Questions and Seek Help

Living with PsA can feel like each day brings a new set of questions. How does your PsA feel? Have you ever experienced a big change in your arthritic pain? Do you know when you should talk to your medical team? Are you having an arthritic flare? Do you know which medical team member you need to speak with?

Is it a flare?

Many of these questions are currently on my mind. Lately, when I first wake up, I notice so much stiffness in my joints. Sometimes, I feel like my toes will not bend. Then, my left knee had a sharp pain when I stepped down to begin my day.

After that, I notice my waddle. My left hip feels tender to the touch. This continues for about 30 minutes.

When the day starts to go on, I notice that movements like walking up and down steps are not just uncomfortable but immensely painful. Another feeling is that more of my joints are being involved. Sometimes, when I need to sit down in my car to drive, I discover an intense pain in my lower spine, hip, and knee.

Insurance and specialist referrals

First, I think I need to look at, all the changes that are happening. Second, who should I discuss this with? Do I tell my primary doctor or do I seek out advice from my Rheumatologist? What is the actual protocol for these questions?

Some insurance companies require the primary payer to give authorization to see a specialty physician. As I think more about the problem I notice that I might want to start with my insurance first.

Now, I've decided that I need to call my insurance provider. Whenever I reach out to the Medicaid office, I mark down the name, date, time, and whom I speak with. That way, there is a complete record I can refer back to later on.

After a moment, I explain what I am trying to find out, and the attendant tells me that I do need a referral. It seems that I need to speak to my primary care doctor first. Once I learned this, I thanked the attendant for the information and ended my call.

Doctor office preparation

After I dialed up the primary, I explained that I would like to see the physician to get a referral. The secretary helps me make an appointment right away. Next I prepare for my appointment, which is usually the following day. This is when I write down my questions to ask tomorrow.

When it is time for my appointment, the list of questions comes out so that I can address my concerns. My doctor is glad to see me and addresses my concerns.

There is a referral made out. We discuss that we know my arthritis will worsen by nature.

My doctor agrees that the Rheumatologist needs to handle the situation. He looked me over, and we discussed the next appointment I should make with him. As I leave I feel satisfied with my care.

First, I called my Rheumatologist's office and said that I had a referral to see him. Second, the secretary told me that he had phoned ahead and said he was sending me on for arthritis changes.

We will make an appointment two days from now. As we hang up I know that I have made the right choices.

Discussing next steps

2 days pass, and I am waiting in the office for my Rheumatologist. Again, I have my list of questions.

When the doctor came in, he told me he had read the notes from my primary school. He wants to look at me physically.

Next he checks my walking. He tells me he sees changes and wants to send me for X-rays. I agree with his testing. We discuss our concerns and if this is a case of psoriatic advancement.

He tells me that he feels I am advancing in disease. Next, he told me about his potential ideas for medications.

My doctor always includes me in decision-making. He explained he had information for me about the medicine to look over. He believes this is a flare of arthritis.

New findings and a care plan

With my thoughts in place and all my questions answered, I went on to the X-rays. Finally, I am happy with my plan of care.

By the way, my doctor found new evidence of arthritic changes and is referring me to an orthopedic surgeon. Not only do I have PsA, but I have a dislocated left knee cap.  

Have you had any changes that advanced your PsA? Do you know what to do?