Got it in one!
To answer your questions, I think the simple answer is that the stronger meds can be very good. Before PsA I would occasionally take a Nurofen, that was it - very wary of drugs! Because PsA is a progressive and destructive disease, most of us here advocate the most aggressive treatment possible i.e. the biologics such as Enbrel and Humira. I think the biologics are the only treatment proven to slow joint damage. Not everybody gets a great result from them, but many do. And although that word ‘aggressive’ sounds scary, it would seem that it is the disease that gets the aggression, not the whole body. Many of us find that the biologics cause few if any side effects.
In the UK there are treatment protocols, basically starting with anti-inflammatories and then progressing to ‘traditional DMARDs’ - the most commonly used one is Methotrexate. Then, if you’ve tried 2 traditional DMARDs and still have 3 or more swollen joints, the next step is a biologic drug. It varies a little but that’s the outline. Oral or injected steroids are often used to give temporary relief, too.
I had a wonderful rheumy whose bearing suggested that he considered himself a vastly superior being. Turned out it was just his way, he helped me so much that I came to consider him a superior being lol! There is arrogance, there is what I can only describe as indifference encouraged by sheer lack of funds, but I’ve learned not to judge doctors by their manner but by what they actually do.
I could go on forever, damn it, I will! Exercise … well, you will probably meet our wonderful tntlamb soon. An expert on all things PsA plus other stuff such as … fishing, I think, all sorts of things! I think it’s him who first compared managing PsA to a 3-legged stool: meds, exercise, nutrition. Seeing as exercise has long been recommended for just about anything, it’s easy to overlook just how effective it can be in managing this particular disease. But it really, really helps. Regular exercise would even seem to reduce fatigue. Apart from the fact that it (probably) doesn’t slow joint damage, exercise probably does more to tackle my PsA symptoms than the biologic does. And in fact it may help prevent joint damage because strong muscles and tendons support the joints and limit what PsA can do to them. It can also help with the feeling that you have suddenly turned into your grandmother.
Okay, I had better shut up. It’d be interesting to know which hospital you attend and so on, if you want to say anything negative then best to send me a personal message so we don’t get sued! Oh, and I was diagnosed in 2012 during a massive flare. However it looks like I may have had it since I was a teenager, though at what my rheumy calls ‘background level’. As I am 62, that is a long time!
You have done well to get a diagnosis, I see that there was … hum … a bit of a delay!! It’s not a great thing to happen, but so often that diagnosis heralds much better days. The tricky phase is the one you’re in at the moment: aware now of what you’re dealing with, but waiting for more effective treatment. And, incidentally, while the wait can be soooo worth it, most of the drugs are slow acting. You know, there is a good chance that you will get to grips with PsA, there really is. Very glad you’ve joined us.