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Living with Psoriatic Arthritis (PsA)

Am I Having a Flare?


#1

At given point MOST of us are concerned we are having a flare, but because PsA waxes and wanes even with treatment that’s not always the case. I recommend taking the following “quiz” several time over several Days:

Do you feel stiffness in your joints?

  • Sometimes (1pt) ____
  • Often (2pts) ____
  • Almost always (3 pts) ____

Do you feel pain in your joints?

  • Sometimes (1pt) ____
  • Often (2pts) ____
  • Almost always (3 pts) ____

Does joint pain make it hard for you to sleep?

  • Sometimes (1pt) ____
  • Often (2pts) ____
  • Almost always (3 pts) ____

Is it difficult to care for yourself?

  • Sometimes (1pt) ____
  • Often (2pts) ____
  • Almost always (3 pts) ____

Do you avoid favorite activities?

  • Sometimes (1pt) ____
  • Often (2pts) ____
  • Almost always (3 pts) ____

Do you feel tired or fatigued?

  • Sometimes (1pt) ____
  • Often (2pts) ____
  • Almost always (3 pts) ____

Does having PsA affect your well being?

  • Sometimes (1pt) ____
  • Often (2pts) ____
  • Almost always (3 pts) ____

Your Score: ____

Fewer than 5 points: It sounds like you symptoms are well controlled, but your doc may suggest additional treatments to avoid future joint treatments.

5 to 8 points: It sounds like PsA is a significant challenge in your everyday life. Be sure and share these concerns with your doc at your next appointment.

More than 8 points: Don’t delay! call your rheumie today and talk to him, it may be time to rethink your treatment.


Is this a flare up?
#2

16 points, i guess I need to have that talk…


#3

Oh great! 13 points. Thought that as I at least was functional I was good. Thanks, Lamb, LOL! Not a newbie and just saw the rheumy this week. We are giving it another 3 months then we will decide if we should make any changes.


#4

Thanks for this. Really good tool for assessing progress and response to treatment.
Score…17 :roll_eyes: I’m a newbie and on 4th week of Methotrexate. Hoping it kicks in soon and my score drops. :grinning:


#5

I’m embarrassed to say, my number is 4 or 5 if I don’t take my feet into consideration…I think my PsA is very controlled with Enbrel, but my feet and ankles are a mess…they raise the number to 10.

My pain is from damage—not much the doctor can do except surgery, and that could possibly make things worse! :roll_eyes:


#6

And thats why a survey like this is the beginning of a discussion… I understand the feet thing although my issue is in my back there is indeed arthritis there but not at all related to my PsA. Had something to do with falling out of an air plane and later parking my motorcycle on it’s side rather quickly. (Likely the cause of one of my recent joint replacements) I have to agree foot surgery is par with patela tear surgery and spinal fusions for a bad idea…,.


#7

Hmmmm…you’re lucky to be alive!
Do you think ankle surgery is pointless also?
My foot/ankle doctor told me they’ve come a long way with that and my ankles are “going”. If - or when - I do have ankle surgery, I don’t want to end up in more pain!


#8

Restoring function in Ortho surgery is the goal. No one should ever consider any kind of
ortho surgery simply to relive pain.

The reason spinal surgery and ankle surgery fails so frequently is because of the weight on the joints in the case of spinal surgery it is almost always c1, t 11, or l5 because these joints are the major stress points. Think of what your ankle carries…

Here is the problem spinal and ankle surgery. When bone is disturbed, it grows back, but it always grows a little extra sort of like God’s band-aid. You see it on Trees all the time (burls). You have created over the next week or months exactly the same problem the surgery was removing. No one has control of how that happens.

Joint replacements eliminate those issues but create a whole bunch of others… Now IF they couldn’t come up with a replacement ankle that works, maybe, buy we are a long ways from that.

Think of another joint in your body that moves like an ankle? Only a thumb comes close. The potential for increased pain is huge. When a doctor tells you “We have come a long ways.” That is code talk somwghat different than we think. it means “we have been doing a crappy job and now we are doing a less crappy job.”. Notice how your rheumy says "we have come a long ways with meds, instead of we have same great options?

Right now we are at about the same place we were with hips 30 - 40 years ago. The goal of the surgery was really not much more than to allow the patient to move from a wheelchair to the toilet. Recovery time was long because we casted the hip in those days to avoid the bone overgrowth.

The one thing I will say about foot and ankle surgery is of it is a DPM, no way in hell. Some are very good and have excellent training. Most do not…

There certainly some instances for surgery, I’m not saying that it’s not lake repairing patellar tears or spinal fusion to relieve pain which still happens despite clear evidence, neither of the two do anything. ( In fact there are growing numbers of insurance companies that won’t pay for either with out tons of paperwork or the surgery being done in a center of excellence.) But it’s darn close.