New here also

[TeacherMary]

[COLOR=Red] Hi all,
I am new here and have a very mild case of both P and PA. I was reading Lulu's post and the early part of her story sounds like me. I have patches on my elbows that mostly look like dark patches and some flaking. Thick skin on the knees, mild itchiness on my scalp and think toenails. Ocassionally I have flairups of guttate psoriasis, usually following strep throat or some real stress. I have been doing better with the stress, when I notice a few spots starting I find something to relax me and it usually goes away. I used to use Tegrin on my elbows but you can't buy it anymore here and none of the other tar based work. I am not in pain unless I catch the skin on my elbows on my sweatshirt etc. Also I am a preschool teacher and had a student last year who liked to rub my arm and always caught the elbow. Thats when I asked for a referral. My Dr sent me to a derm who's staff apparently think he knows everything. They told me I was lucky to see him. He came in and was covered in big white flakey patches. When I told him why i was there, he told me I didn't have p because I didn't have it like his. He asked how long I thought I have had p. I told him as long as I can remember, my mom, my grandma, my auints, my sister and my daughter also have it. He told me it was just thick skin. He suggested a cream and told me to come back if it got worse (weird, I was hoping to prevent that).
I have some mild pa as well. Usually flairs up with weather changes and too much walking, or other on my feet activity. Also I am overweight and if I add any additional weight it acts up.
I also got a referral to a rhuemy who said I was not in enough pain and since I didn't have bad enough P, then I probably didn't have PA either. Just keep taking ibuprofen and come back when it gets worse. Ah the joy of HMOs.Oh yeah, he had the office move my appointment from the end of the day to lunch because he wanted to go home early. I was his last appt, when I walked out, the whole office and he did as well.
I know I am not in constant pain but I was hoping for some ideas from these medical professionals on how to handle these flair ups. Two years ago I was in a car accident, head on, that I saw coming so I am thinking I tensed. My hand has been so sore, and difficult to move the fore finger. But that also was not bad enough. He offered me a cortisone shot. So I decided I would come here and see if there are any others who are mildly afflicted and maybe have found some better ideas.
Mary

[SandraJean]

Hi Mary,

Welcome to the boards, but I'm sorry to hear the problems you are having. It sounds like you might want to get to a different dermatologist first, to try to get a second opinion. Even a mild psoriasis can be very upsetting and needs to be dx correctly and given meds that will halp it. The fact that you might also have psoriatic arthitis is another reason for a second opnion, although pa is very difficult to dx at first. Ir's like a process of emilamation, but treatment in the beginning can help further down the road.

I have an HMO too, and can understand the difficultlies of it at times, but if you can ask your primary doctor for a second referrel---they'll probably do that okay. Also there are listing of Doctors on the National Psoriasis Foundatoins front pages, where you can click into finding a doctor and in your area. I would try that first and see if one of the Doctors take your HMO.

Hopefully more people will be on and give more advise. Usually the boards are slower over a weekend.

Take care and let us know how you make out.

Sandy

[ouchyk]

Hi Teacher,

I'm with Sandy, INSIST on a referal to another derm and rheumatologist. Have the derm do a biopsy to confirm what it is you have.

When you get to the rheumatologist bring this with you, or at least read it to brush up on things;

http://www.psoriasis.org/about/psa/diagnosis.php

http://www.psoriasis.org/forum/showthread.php?p=74786&highlight=favorite#post74786

I met a girl from Boston at CHD, she has very mild PA that remits and she only treats it when it decides to show up. She takes an otc nsaid. Some people are mild enough that they are able to do that. She was not heavy at all but I can understand that any extra added weight might stress your joints.

By the way, I have VERY mild psoriasis, so do a lot of other people who post here who have PA. So I don't understand your rheumatologists comments.

Hope this helps,
Karen

[tmartha]

Welcome, Mary - this is a great place to get info and support - glad you're here!

And I'm just echoing Sandy and Karen - try different docs. My p isn't too bad (still, I want it treated!) but my pa is moderate - treating it aggressively early on is very important. Because it will keep progressing, otherwise. When I found an NSAIS that helped the pain, my rheumy told me that it's a medication that helps the pain but doesn't do anything to stop the disease - so it's actually masking the disease. And then a couple months later it moved into my back (pain not masked).

Best of luck - keep us posted!
Tani

[vshorter]

Hi Mary,

I would definitely look into getting different doctors. Very rarely do I ever have any P anywhere, but in just 2 1/2 years my PA has become debilatating. I am now disabled and have just ordered an electric wheelchair while we continue to search for that elusive medication cocktail. :rolleyes:

My point is - one is not a marker for the progression or severity of the other. A good rheumatologist can get you the treatment to prevent permernant destruction that simple OTC pain killers (NSAIDS, Advil, etc) may be masking, like Tani pointed out.

The link to thread Karen posted is very good for going to a new rhuemy. You may need to go to a new derm first and INSIST on a biopsy to get a definite dx of P before going to a rhuemy, but don't wait too long if you're having pain and stiffness.

Good luck and let us know how you are doing.
Vicki

[TeacherMary]

Thanks for all the info. Sorry I did not get back here sooner, I had some computer probs. I printed up the info you suggested and will ask my dr for more referrals. So far when I do that I am sent hours away, I hate that. So you guys are telling me that with proper treatment I can prevent my pa from getting worse? The rhuem I went to said there was nothing I could do, it'll get worse and I just have to live with it(although he said it wasn't pa but oa on the basis that my toes and fingers were not swollen). Have any of you found any otc creams that make the mild patches any better?
Thanks again
Mary

[vshorter]

Mary,

It's such a shame that we have to educate our doctors or go months or even years trying to find a good doctor in order to get the treatment we need. I hope you looked at the links that Karen had given in an earlier post. If you can't get a new Rhuemy - try to educate this one and insist on some of the tests that Jesselou refers to in her post (on the 2nd link).

PA does not ALWAYS affect the fingers and toes. There are different types. I have never had swollen toes/fingers or the "saugage" digits, yet I am now disabled due to my PA. I have a severe case that affects my LARGE joints - hips, knees, shoulders, ankles, etc.

If you truly believe you have PA, please try to get the treatment you deserve EARLY so you can stop the disease progression and prevent permanent damage. Please let us know how you get along.

Good Luck :)
Vicki

[janelee]

Well Good Grief!! A SMART and GOOD rheumy would be aggresive with treatment. In my opinion....treating it sooner rather than later could prevent more damage to the joints. These folks here have great advice......and will turn you in the right direction.

[tmartha]

Good grief is right! Your rheumy, Teacher, makes a good case for second opinions. "There's no hope, lady, go home and be miserable the rest of your life..." Man! I get so mad about docs sometimes....Glad you got your computer problems taken care of and you checked back in! Best of luck - we're rooting for you!
Tani
p.s. My toes and fingers not affected either - feet, ankles, hips, shoulders. PA has many manifestations.