I hoped I'd never be back here....

[Scamble]

Greetings all. I used to post here some years ago (on the other board) in the eternal search for a treatment for my relatively mild Plaque P.

I tried UV, Steroids, Vit D analogues, weird vitamin combinations and eventually completely cleared myself with Exorex. I still use it today for the odd little spot that appears.

Over the past 6 months my P has been coming back - not badly, but after a period of severe stress last year (I run my own business, you work out the rest) things started getting worse. I also developed Inverse P around my bum and groin, but have managed to get rid of that with HC cream.

Anyhoo, this brings me onto why I am here. I went to the doctor some weeks ago after wondering around in a Fog the whole time. I put this down to exhaustion and stress. I also got a new prescription for Terbinafine to treat my fungal nail infection that I have been fighting, unsuccessfully, for 7 years now. I am aware that I have had nail P once or twice, just a few pits that come and go. All of a sudden, things started falling into place. This wasn't a nail infection at all (or if it was, there was another underlying problem) - it was nail P. I now have it in both big toes, both thumbs and one middle finger. I have always put down the tenderness and swelling of two of my toes to problems with the infection......

all sounding familiar?

Anyhow, without wishing to self-diagnose, could this all be linked? Even though my nail P is not that bad and I only have the swelling and tenderness in two toes, could this be the cause of my brain fog an exhaustion? I note that most of the diagnosis pages about PA on the net talk about exhaustion and fog. I also have chronic lower back pain (I have had all my life) but of late it has been much worse.

I have hypnopomic hallucinations at night which mean my sleep is very bad and I spend the whole day feeling like I am in a dream - it waxes and wains and so far the doctors have found nothing wrong with me.

I am not asking you guys to diagnose me - that's not your job and, well, I am pretty convinced anyway. What I need to know is whether I can deal with this? Whether I will come out of it? whether I can do something to clear my head.

I'm certainly not bad enough (I wouldn't have thought) to start swallowing MTX - my mother was taking it when she died (for Sjogrens syndrome) and had had serious problems on it.

Help - I'm really scared. I'm only 37 and have a new baby (no. 3) on the way and am terrified my life will never be the same again....

[niceman]

Hi Scamble.  Without wanting to state the obvious it sounds like you need to see a rheumy.  Coping and getting through it is one thing, but if you do have PA you need to get in the system.  If you haven't already, try and get a referral from your GP.  If you do have PA and it becomes aggressive then you will need treatment as I am sure you will know.  Don't hang about, get it checked out!

[Scamble]

Cheers for the advice.

I'm back to see the GP next week, so will see where we go. To be honest, I can manage any discomfort at the moment (if indeed there is a PsA problem) - it's the fog I'm really struggling with....

[niceman]

Can't help you on the fog I'm afraid, it's not something I've suffered with.  Don't underestimate your discomfort though - although it is not too bad now, things can change quickly.  I'd still consider getting a referral to a rheumy if I were you, not to get onto MTX or anything but just to see about a diagnosis.  Swollen and painful digits are a big indicator so don't play it down, even if you are not too troubled with pain at the moment.  Good luck anyhow (especially with no. 3!)

[smose]

I used to get extremly fatigued which I wouldn't have described as a fog until recently when it seems to have lifted lifted and I can only describe myself as feeling more "alive" than I have done for the last few years.

I don't have P but have had odd joint problems on and off since my teens. In the spring of 2008 I got a small lump on my foot which was very painful hot and swollen, this happened twice and I saw the gp who refered me to podiatry. Then in the september my fingers started to swell and become painful - one at a time with no real pattern. Then my shoulders became excrutiating so I visited the Gp again - he asked if I had had this before to which I said no but my fingers and foot have been painful. He refferred me but the last three years have been hell - fluctuating but never completly free from pain.

I left work in the summer and have a much quieter pace of life so I have put the lack of fatigue down to that but I am also now on MTX, Leflunomide and last month started anti tnfs so it is entirely possible it is actually the fact that thigs are beginning to get under control.

I guess where I am going with this is that you really do need to get yourself seen and then make an informed decision about your treatment. Recent research does show that catching things early helps stop the progression and although I can understand your aprehension about MTX all I can say is without the 10 plus drugs a day I take I wouldn't have a life at all so i would rather risk shortening it than live in hell.

[moanalot]

Hi, I can only echo what others have said, get a referral to a Rheumy and get those joints check out.

[SallyD]

Hi Scamble,
I agree with the others, get a referral to the Rheumy, its supposed to be better to get treatment in the early stages.
I struggle with fatigue "cognitive Fog" I feel detached from myself... and it can be hard to adjust to normal everyday living....
Good luck...S x   

[newshaz]

I agree with the others, get referred to roomy via GP. I understand your hesitancy with no 3. on the way.  I went to gp when I was 43, my youngest was 8 and my oldest 18, with three others in the middle.

[Scampi]

Go and try to get a referral.  As for not wanting treatment as you 'can cope' - research has shown that early treatment has the best outcome, so the best chance of putting the thing into complete remission.  Don't right off early treatment until you have fully discussed the options with a rheumy.

[Gav74]

Same as everyone else.

Hello Scampi, btw.
I haven't had particularly bad P, but like you I'm only 39. Fit and healthy and in my prime, now scared that I'm on a slippery slope to decrepitude. Which is why, even though I have either very mild, or very early PA, I kicked up a fuss and demanded early treatment to avoid any potential worsening. I know it's scary, but if you think you have it, then push for treatment and push hard. My father has it and he's had to give up his career as an electrician because his fingers were so badly damaged by it. I used that as my argument; I said that I wanted treatment now, before it gets that bad.
Also, if you're worried about MTX, there are other alternatives that you can try too.
Best of luck.