Inside the Visit: Psoriatic Arthritis
Reviewed by Poonam Sachdev on February 16, 2022
Video Transcript
[MUSIC PLAYING]
INTERVIEWER: Hey, Dolores.
SUBJECT: Hello.
INTERVIEWER: How are you?
SUBJECT: Doing great.
INTERVIEWER: Great. Thank you for being here. Today we're going to talk about psoriatic arthritis. Dolores is also a health care professional. She has a doctorate in nursing.
But today, she's going to be sharing with us her personal experience as someone who actually has psoriatic arthritis. In the beginning, did you start off with skin involvement or joint pain?
Dolores: Skin involvement. That was my first symptoms.
Speaker: Did you notice joints symptoms before you were actually diagnosed?
Dolores: I certainly did, but I didn't associate it with the psoriasis. So with the progression, it went from I couldn't turn keys to turn the car, or to open my front door. Then I became at work having excruciating neck pain from looking down at the keyboard. And during the time while being treated by the dermatologist, she referred me to a rheumatologist.
And I was shocked. I wasn't thinking about going to a rheumatologist. And do people with psoriasis, do they develop psoriatic arthritis? Is it common?
Speaker: Well, actually, this is the most common sequence that people develop psoriatic arthritis. Usually, the skin disease comes first, usually in about 70% of people. And the other point is the amount of skin involvement doesn't correlate with the arthritis. You can have just very minimal skin involvement and didn't have very significant arthritis.
[MUSIC PLAYING] So there are many treatments available now. And they're very effective. So we started you on an injectable TNF alpha inhibitor. We've been through two or three. And we're now on one that's been working well for, what, two years?
Dolores: Two years.
Speaker: Two years.
Dolores: Mm-hmm. Each one of them did well, but I would start having more flares on the medications. And eventually, have to change.
Speaker: Speaking of flares, how do you handle flares? How do you control flares?
Dolores: One of the big lessons is to say no to some activities, especially when I'm feeling very tired already. Let myself rest. Come home and use hot wax on my hands when they're hurting.
Speaker: That's an old treatment.
Dolores: I keep multiple heating pads during a flare. Mornings are nightmares. Next is getting in the shower and standing in the shower, and letting that hot water hit the areas that are most painful.
Speaker: And how does stress affect you?
Dolores: I know that when I'm going through periods of increased stress that I'll probably have a flare. And when I have a flare, then it increases my stress. Now I've learned to recognize it. And say, OK, start doing things that you enjoy. And I have to really do a lot of things to keep myself positive.
Dolores: Aside from pharmacologic therapy, there may be some other things to consider. There now is information on anti-inflammatory diets. The most common one that we talk about is the Mediterranean diet. Incorporating more fish in your diet, olive oil, fruits and vegetables, nuts and berries, beans, and whole grains.
Sleep is very important. You can try to have good sleep habits. Mild exercise can also be quite helpful. So since we've been at this, yours has remained few joints here and there.
Dolores: Do you progress between them, or do you typically stay in one of the stages?
Speaker: Typically, you would stay. And that's probably the most common one we see is the one that's a few joints that are scattered here and there. You've had improvement in terms of severity just based on the treatment.
Dolores: Yes, definitely. I feel better. I can do more things than I was able to do before. As life changes and I move toward getting older and retirement, it's not as bleak as I thought it would be. So I'm glad there are options out there for me.
Speaker: Very good.
SUBJECT: Hello.
INTERVIEWER: How are you?
SUBJECT: Doing great.
INTERVIEWER: Great. Thank you for being here. Today we're going to talk about psoriatic arthritis. Dolores is also a health care professional. She has a doctorate in nursing.
But today, she's going to be sharing with us her personal experience as someone who actually has psoriatic arthritis. In the beginning, did you start off with skin involvement or joint pain?
Dolores: Skin involvement. That was my first symptoms.
Speaker: Did you notice joints symptoms before you were actually diagnosed?
Dolores: I certainly did, but I didn't associate it with the psoriasis. So with the progression, it went from I couldn't turn keys to turn the car, or to open my front door. Then I became at work having excruciating neck pain from looking down at the keyboard. And during the time while being treated by the dermatologist, she referred me to a rheumatologist.
And I was shocked. I wasn't thinking about going to a rheumatologist. And do people with psoriasis, do they develop psoriatic arthritis? Is it common?
Speaker: Well, actually, this is the most common sequence that people develop psoriatic arthritis. Usually, the skin disease comes first, usually in about 70% of people. And the other point is the amount of skin involvement doesn't correlate with the arthritis. You can have just very minimal skin involvement and didn't have very significant arthritis.
[MUSIC PLAYING] So there are many treatments available now. And they're very effective. So we started you on an injectable TNF alpha inhibitor. We've been through two or three. And we're now on one that's been working well for, what, two years?
Dolores: Two years.
Speaker: Two years.
Dolores: Mm-hmm. Each one of them did well, but I would start having more flares on the medications. And eventually, have to change.
Speaker: Speaking of flares, how do you handle flares? How do you control flares?
Dolores: One of the big lessons is to say no to some activities, especially when I'm feeling very tired already. Let myself rest. Come home and use hot wax on my hands when they're hurting.
Speaker: That's an old treatment.
Dolores: I keep multiple heating pads during a flare. Mornings are nightmares. Next is getting in the shower and standing in the shower, and letting that hot water hit the areas that are most painful.
Speaker: And how does stress affect you?
Dolores: I know that when I'm going through periods of increased stress that I'll probably have a flare. And when I have a flare, then it increases my stress. Now I've learned to recognize it. And say, OK, start doing things that you enjoy. And I have to really do a lot of things to keep myself positive.
Dolores: Aside from pharmacologic therapy, there may be some other things to consider. There now is information on anti-inflammatory diets. The most common one that we talk about is the Mediterranean diet. Incorporating more fish in your diet, olive oil, fruits and vegetables, nuts and berries, beans, and whole grains.
Sleep is very important. You can try to have good sleep habits. Mild exercise can also be quite helpful. So since we've been at this, yours has remained few joints here and there.
Dolores: Do you progress between them, or do you typically stay in one of the stages?
Speaker: Typically, you would stay. And that's probably the most common one we see is the one that's a few joints that are scattered here and there. You've had improvement in terms of severity just based on the treatment.
Dolores: Yes, definitely. I feel better. I can do more things than I was able to do before. As life changes and I move toward getting older and retirement, it's not as bleak as I thought it would be. So I'm glad there are options out there for me.
Speaker: Very good.
