Diagnosed with psoriatic arthritis today - terrified about starting methotrexate

[GingerFish]

I was diagnosed with PsA today. The diagnosis itself wasn't a shock as I've had sausage toes and fingers for a few months and it impacted my walking, bad shoulder and elbow pain to the point I couldn't lift or bend my arm and I have had psoriasis since I was a kid. I am 29 now and for the last 6 years, my psoriasis has been constant whereas when I was a kid, it would go away for a while or calm down at least.

My podiatrist referred me urgently to the rheumatologist and I had my first appt today. I was lucky to wait less than a month for an appt. I was sent for methoxtrexate screening blood work and also a chest x ray and was told if all those come back fine, my GP will call me within a few days/a week to discuss starting methotrexate. Methotrexate was the only med I was really offered today. She said instantly that biologics aren't recommended for my mental health history (I have BPD, OCD, CPTSD and have had psychotic episodes in the past, albeit very rarely) and biologics can make those conditions worse, or so I think. I can't remember the exact reason she gave, I had so much to take in at the appt today. My MH troubles mostly stem from trauma and anxiety based conditions. I have anxiety about everything but especially about death and my health. My dad died suddenly 5 months ago and all my conditions, mental and physical have just nose dived since. I have anxiety about taking meds. For years I wouldn't even take paracetamol because I was scared of side effects. Now I can take them and Naproxen (what I have been treated my joint pain with so far) fine.

You can imagine the anxiety I have about starting a medication as serious as methotrexate then! Even have anxiety about all the blood work and scans I have had done. I always think I am going to get a call out the blue saying they have found a tumour or something bad. Again, this is no doubt fuelled by losing my dad recently and also 3 other loved ones suddenly dying in the last 2 years. I am trying my best to not over Google or read into side effects and I have my next CPN appt coming up soon so will discuss with my nurse more ways to try and calm and control my health anxieties because I know I need to at least give this medicine a try especially if I want to be able to walk. The pain in my foot is horrendous at times. It makes me feel sick and it throbs.

Just looking for any advice or a shoulder to cry on. Its been a lot to take in and part of me was in denial even when the ultrasound showed the arthritis a month ago and I was in denial that I would have to take serious meds for arthritis and kept telling myself maybe I could be ok with just painkillers despite seeing family members crippled with arthritis. Just feels like it has been one thing after another tbh.

[BlueIris]

Not sure what to say, but sending love and positive vibes.

[panic_down_under]

My dad died suddenly 5 months ago

My condolences on your loss, Yasmin

Methotrexate was the only med I was really offered today. She said instantly that biologics aren't recommended for my mental health history (I have BPD, OCD, CPTSD and have had psychotic episodes in the past, albeit very rarely) and biologics can make those conditions worse, or so I think

The underlying physical brain problem which expresses as anxiety and/or depression is arguable caused by a type of auto-immune response and some of the biologics work by boosting the immune system which may exacerbate the brain dysfunction (this is also why colds, flu and other infectious diseases can cause anxiety disorders and depression to flare as the immune system ramps up). It is now common for antidepressants to be prescribed to patients being treated with these biologics.

I am trying my best to not over Google or read into side effects

A very good idea! While methotrexate can trigger some serious side-effects much of what is online relates to the treatment of cancer at high doses. While there are no guarantees there is a good chance that they will be milder, possibly absent, at the doses you're likely to be prescribed. If side-effects do become an issue talk to your GP about taking it in injectable form as this can bypass some side-effects triggers.

On a more positive note there is evidence methotrexate may ease Covid symptoms, however, it may also reduce the effectiveness of Covid mRNA vaccines if taken on the day of the vaccination so talk to your GP if you're due for a shot.

[Youssef sekkoum]

Psoriatic arthritis is a chronic diseasecharacterized by episodes of exacerbation, and other episodes of reduced severity, and which affects approximately 0.1% of adults, has become a preoccupation of many with psoriatic arthritis treatment.


Arthritis in psoriasis appears in 5% - 7% of patients who suffer from skin psoriasis, which affects about 2% of people. Age 50 - 55.



Skin disease appears in 70% of patients many years before the onset of arthritis, and skin and joint disease begins at the same time in 15% of patients, in the remaining cases, arthritis appears before psoriasis, and arthritis usually appears gradually, but sometimes it is Very severe onset of inflammation.



Often times, dermatitis and arthritis do not get worse at the same time, but in patients whose psoriasis and arthritis started at the same time, exacerbations of the disease occur at the same time.



Psoriatic arthritis can occur in many forms, and psoriatic arthritis affects only one or several joints in two-thirds of patients.



Arthritis appears only in the distal joints of the fingers, in a special group of patients who have injuries to the nails.



In this article, follow up on psoriatic arthritis treatment, its types and diagnosis

https://heltnow.blogspot.com/2022/04...ment-2022.html