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Fits and Restarts

Though he is early on in his journey with psoriasis, Austin Tolchin has experienced access to care issues, step therapy-related challenges, and difficult flare ups. Fortunately, things are looking up for this young man.

Austin Tolchin thought the flaking and itching on his scalp was dandruff. He tried a number of shampoos with no relief and no improvement. But he was able to put the problem out of his mind for the most part, with plenty of other distractions in his life. Tolchin works at a fast-paced job in finance in the Washington, D.C., area, where the native of Miami, Florida, had landed while getting his master’s degree in finance at Georgetown University.

“I started developing an itchy scalp. I'd be at work, itching and seeing all these flakes all over me,” he recalls. “I'm like, ‘What is going on here?’ It was weird.”

These first signs of what turned out to be psoriasis showed up around 2018. Tolchin did not immediately connect the lesion that soon developed on his leg with the scalp symptoms he was experiencing. It was not until lesions spread to several other parts of his body that he sought out a dermatologist and got the right diagnosis.

With the COVID-19 pandemic in full swing by then, and because he grew up in Florida and was newer to Washington, D.C., Tolchin saw a Florida-based dermatologist via video – also known as telehealth, a practice many have become familiar with as a result of the pandemic. The dermatologist got him started on a biologic treatment. Tolchin was concerned, however, because his dermatologist said his insurance would likely not cover the biologic unless he had tried and failed several other treatments first. This is known as step therapy, which the National Psoriasis Foundation (NPF) works to address through state and federal advocacy efforts.

Because of the pandemic, Tolchin and his dermatologist also worried about the impact of other systemic treatments on his immune system. So he settled on trying out the biologic samples from what he referred to as a “starter pack” from his dermatologist. The biologic worked. Although flares came and went, the treatment helped him gain some control, and the body surface area coverage of the lesions lessened.

“I was pretty clear for a couple months,” Tolchin says. “But insurance still hadn’t covered [the biologic] for me, so I ran out.” That’s when things went from bad to worse for Tolchin. Florida began reopening, so the hospital at which his dermatologist worked went to in-person appointments or in-state telehealth appointments only, leaving him without access to his health care provider.

As you might guess, the psoriasis flared. Tolchin found himself with new obstacles to overcome, and life was not going to slow down to allow him to catch up. This was about the time that Tolchin first heard of the Team NPF Cycle event in Culpeper, Va., last fall.

“I was super excited about it,” he says. “A lot of people that I was close with, I had not been able to see in a long time. They had no idea that I was going through this, so I kind of just put it out there, and I asked for some support and fundraising for NPF and got some tremendous support. I was shocked and really grateful for it.”

Tolchin raised more than $2,200 that will go toward new treatment options, continued patient support, and a cure. At the event, Tolchin met Chris Williams, a multi-time Team NPF Cycle participant and an NPF staff member. Williams helped Tolchin feel connected, and the NPF staff member followed up and later assisted Tolchin in finding a dermatologist in his area so he could recommit to managing his psoriatic disease.

On top of all that, Tolchin also had a good time at the cycling event, riding 56 miles with new friends and spending time with buddies who had come to support him. “I've been into cycling for a while,” he says. “I was the perfect match for this kind of fundraising event.”

Tolchin plans to deepen his connection to NPF through membership and continued fundraising involvement. Most importantly, he began seeing the dermatologist NPF helped him find, and he hopes he is on his way to an effective treatment that his insurance will cover. “I'm optimistic,” he says. “And now I have all these new resources that I have access to, and I am getting more involved with NPF as well.”

If you are looking for additional ways to connect with others like you who understand what living with psoriasis is like, but you do not want to pedal, run, or walk, you can find community, tips, and free tools on the app and website of Twill Care for Psoriasis, an official partner of NPF.

Pedaling with Purpose

Michelle Racicot used her passion for mountain biking to support those with psoriatic disease.

Read Michelle's story

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