Focus On The Fight | Psoriatic Arthritis

Welcome to Focus On The Fight, a series of interviews that will be posted weekly, focusing on a blogger/advocate, their health and their advocacy work.

This week we meet Vickie, and we will highlight: Psoriatic Arthritis (PA)

Before we dive into the heavy stuff, please tell us all a little about yourself outside of your health! About your family or your hobbies !!

I am married with two grown sons and a five year old grandson. My favorite hobbies are reading and fishing.

What Chronic Illness (es) have you been diagnosed with? Which one will you focus on today?

I have psoriasis and psoriatic arthritis.

Let’s take just a second to look at Psoriatic Arthritis before we jump into Vickie’s Interview.

What is Psoriatic Arthritis?

According to The Mayo Clinic psoriatic arthritis is a form of arthritis that may affect some of those who have psoriasis. Psoriasis is a condition that causes red patches of skin that are topped with silvery scales. Most people with psoriatic arthritis will develop psoriasis first and will later be diagnosed with psoriatic arthritis. That being said the joint problems can sometimes begin prior to skin lesions appear. At this time there is no cure for this condition, so like many other incurable conditions the focus is set on symptom management and trying to prevent damage to the joints. Without any treatment psoriatic arthritis can become disabling.

What are the symptoms of Psoriatic Arthritis?

Joint pain, stiffness and swelling are the main symptoms with this condition report. The pain, stiffness and swelling can affect any part of your body, including but not limited to, your fingertips and spine. These symptoms can range from relatively mild to severe. Just like with psoriasis, psoriatic arthritis disease flares may alternate with periods of remission.

Psoriatic arthritis can impact the joints on only side or both sides of your body. The signs and symptoms of this condition often resemble those of rheumatoid arthritis. Both conditions can cause joints all over the body to become painful, swollen and warm to the touch.

Psoriatic arthritis is likely to also cause:

  • Swollen fingers and toes - Psoriatic arthritis can cause a painful, sausage-like swelling of your fingers and toes. You may also develop swelling and deformities in your hands and feet before having significant joint symptoms.

  • Foot pain - Psoriatic arthritis can also cause pain at the points where tendons and ligaments attach to your bones — especially at the back of your heel (Achilles tendinitis) or in the sole of your foot (plantar fasciitis).

  • Lower back pain - Some people develop a condition called spondylitis as a result of psoriatic arthritis. Spondylitis mainly causes inflammation of the joints between the vertebrae of your spine and in the joints between your spine and pelvis (sacroiliitis).

How is Psoriatic Arthritis diagnosed?

It is important to note that no single test can confirm the diagnosis of this condition. But some tests can rule out other causes of joint pain, such as rheumatoid arthritis or gout.

  • Physical Exam- In order to properly diagnose this condition one must have a thorough physical exam by a qualified provider. During this exam the provider will be looking at your joints for signs of swelling or tenderness, your fingernails for pitting, flaking and other abnormalities, and they may press on the soles of your feet and around your heels to find tender areas.

  • X-rays -Having plain x-rays done can help pinpoint changes in the joint that occur in PA but not in other arthritic conditions.

  • MRI - This kind of testing can be done to check for problems with the tendons and ligaments in your feet and lower back.

  • Lab Testing - Lab Testing may be done to check for certain factors that can be found in the blood with PA.

    • Rheumatoid Factor (RF) - This is an antibody that’s often present in the blood in people with rheumatoid arthritis. However it is not usually seen in the blood of those with PA, so this may be done to rule out or distinguish certain conditions.

    • Joint Fluid Test - This is done using a needle to remove small samples of fluid from the affected joints, often the knee. If uric acid  crystals are found in the joint fluid it may indicate that you have gout rather than PA.

How is Psoriatic Arthritis treated?

There is no cure for psoriatic arthritis, so any treatment plan focuses on controlling inflammation levels in your affected joints to prevent joint pain.  

  • NSAIDS -Nonsteroidal anti-inflammatory drugs (NSAIDs) can relieve pain and reduce inflammation. Over-the-counter NSAIDs include ibuprofen (Advil, Motrin IB, others) and naproxen sodium (Aleve). Stronger NSAIDs are available by prescription. Side effects may include stomach irritation, heart problems, and liver and kidney damage.

  • Disease-modifying antirheumatic drugs - These drugs can slow the progression of psoriatic arthritis and save the joints and other tissues from permanent damage. Common DMARDs include methotrexate (Trexall), leflunomide (Arava), and sulfasalazine (Azulfidine). Side effects vary but may include liver damage, bone marrow suppression and severe lung infections.

  • Immunosuppressants - These medications act to tame your immune system, which is out of control in psoriatic arthritis. Examples include azathioprine (Imuran, Azasan) and cyclosporine (Gengraf, Neoral, Sandimmune). These medications can increase your susceptibility to infection.

  • TNF - alpha inhibitors - Tumor necrosis factor-alpha (TNF-alpha) is an inflammatory substance produced by your body. TNF-alpha inhibitors can help reduce pain, morning stiffness, and tender or swollen joints. Examples include etanercept (Enbrel), infliximab (Remicade), adalimumab (Humira), golimumab (Simponi) and certolizumab (Cimzia). Potential side effects include nausea, diarrhea, hair loss and an increased risk of serious infections.

  • Newer Medications - Some newly developed medications for plaque psoriasis can also reduce the signs and symptoms of psoriatic arthritis. Examples include apremilast (Otezla), ustekinumab (Stelara) and secukinumab (Cosentyx).

Now Let’s Jump Into The Interview.

Please share briefly what led you to the decision to become a blogger who focuses on chronic illness and also patient advocate if that applies to you.

I started to blog as a means to help people learn about psoriasis. I advocate to give voice to the voiceless, as well as to tell my story so that people get a better understanding of what it is like dealing with psoriasis.

Diagnosing a Chronic Illness can sadly be a VERY long process! For you, how long did it take for an official diagnosis? And did you have to act your own advocate to get a doctor to take what was going on in your life seriously and look for a diagnosis?

I was lucky in that my primary care doctor knew what psoriasis was so that's what I diagnosed myself with. He sent me to a dermatologist who confirmed it. As for my psoriatic arthritis that is still trying to be determined for sure. That dermatologist said yes psoriatic arthritis while rheumatologist says no it's osteoarthritis.

Chronic illness is just that, chronic. Please share with us how your illness (es) impacts your daily life!

I still have active plaques on my legs even after 16 years. That always puts my self-consciousness into reality. The psoriatic arthritis makes it hard to do every day like washing dishes because of the pain in my back.

Being chronically ill can take a toll on all kinds of relationships. Have you noticed this in your life? If so, how has your health impacted the relationships in your life?

I left my husband and I would give him a divorce and let him out because I did not know where the psoriasis was going and how bad it would get. Lucky for him  I have stuck it out and are still together.

Sadly, living with chronic illness can be life changing. Have you found that your life has changed significantly over the years of living with your condition? If so, in what ways has it changed?

It has changed my life in that I can not do the things I did not like but I also do not let it define the person that I am. I keep pushing forward.

All diseases have different kinds of flare ups, and every one will exhibit different signs of flare ups. For you what signs do you know to watch when a flare is coming your way?

For me being stressed is a big flare up coming my way. Although I try not to stress that is impossible in most cases.

What do you do to treat your flares? Or to make your bad days better?

Since I have not been clear in sixteen years the only thing I can do to make my bad days better is to get lost in a book or listen to music.

Being diagnosed with a chronic illness can be very overwhelming. If you could give one piece of advice to someone who is going through the diagnosis process, or is newly diagnosed, what would it be?

Find you a support team whether it be family, friends or through the agency that deals with your condition like the National Psoriasis Foundation.

Living with a chronic condition is hard, it just is! Especially because for the most part there are no outward symptoms that can be seen by others. If you could share one thing with the public about living with a chronic illness what would you want them to know?

If you could be in my body you would feel what I feel. Just because I do not look sick on the outside you are not seeing the pain I deal with everyday.

Where You Can Find Vickie





If you would like more information on psoriatic arthritis you can check out the National Psoriasis Foundation.

With Love,