Stelara

Since I may be put on Stelara, I decided to do a little research. 

Stelara is categorized as an immunosuppressive drug used to treat plaque psoriasis and psoriatic arthritis. It has also been approved to help treat Chrohn's disease. - Which will benefit me on multiple levels. Not just the psoriasis, but since Humira also helps with Chrohn's and I have seen an improvement with my digestive issues of the past 24 years, this is possible to continue to help.

This drug is injected, using pre-filled syringes. The difference between Stelara and other biologics is the frequency of the injections. There is a first injection, another four weeks later, than every 12 weeks after that. - This makes me happier. I have had an adverse psychological issue when I have tried to get my injections ready. Now, with the fewer injections I will have to give myself, maybe I will not have that weird issue.

It can be used whether or not the patient is taking Methotrexate. (Which is good for me, since I do take Methotrexate.)

The concerns with Stelara are the same as with any other biologic or DMARD, the risk of infections (bacterial or fungal), contracting a virus, or being susceptible to various cancers, to include skin cancer. - Which means same concerns, different medicine.

All information I found was from the Stelara Information site

Progress

I looked up the diagnostic terms from the dermatologist's appointment notes, and I was mildly upset. I am not really going to go into it here, but it threw me for a huge loop, emotionally.

I have been religious in the use of the steroid solution and the prescription shampoo on my scalp. Three days total, and I can feel a difference. The itching is not as bad, and the inflammation has gone down. The plaques created by the psoriasis have been slowly coming off, however they bring locks of hair with them. I am glad I am not a vain person, because the sides of my head are going bald.

I had four vials of blood taken the other day so that I could get a TB test done before starting Stelara. I am not sure how long that test takes to be returned to the dermatologist. Depending on the results, which should be negative, I get to start Stelara.

Then, to make life more interesting, I suppose gravity decided to pull on me yesterday while I was walking into the garage from the house. There is the two inch step. Not sure exactly what happened, but I twisted my left ankle. I either stepped on something, misjudged where my foot was landing, and it straddled the step, or my ankle picked the wrong time to be weak. I iced and elevated it for six hours yesterday, and took an NSAID. Today, I have a brace on it, and have been keeping it elevated, when I can. The silver lining? I am so used to pain, that what would probably be high on a scale of 1-10, this is about a 3 while resting, but can get to a 5 when walking. My RD pain, when in a flare, is around an 8. 

All in all, it has been a week. Just waiting on lab results, and my appointment with my primary care physician next week.

Dermatologist 7-24-17

I went to my scheduled Dermatologist appointment yesterday. She was not happy with the way my scalp is nor the fact that Humira is not helping for the entire two weeks.

I have two prescriptions to pick up, one a shampoo and one a solution to be applied to my scalp. I also have to visit the lab and get blood work done so that I can start Stelara. 

Hubby and I are concerned because since I started Humira, my inflammation levels have been within normal limits. This has not happened in over a year. The Humira was working fine for the "arthritis" (whether it be rheumatoid or psoriatic) portion of all the diseases attacking my body.

I see her again in two weeks, hoping the shampoo and solution get my scalp under control, and hopefully I will be on Stelara by then.

Wish me luck.

Doctor Visit

Good morning. 

Be forewarned, this post may jump all over the place, thought wise, but I will try my best to get it organized before posting.

I saw my rheumatologist yesterday. It had been three months since my last visit. It has also been 4 months of Humira. Humira is working for my joint pain. Plus, I do not get a negative reaction at the injection site, like I did with Enbrel. One other surprising benefit, my lower GI issue, which I have had since the early 1990's. However, it only helps with my psoriasis, the reason for changing biologic, for roughly 4-5 days. That is a lot of time between injections to suffer with the inflammation and itching. My next two options are Otezla or Stelara - just to get my psoriasis back under control, hoping they will still benefit my Rheumatoid Disease.

We also discussed the edema in my legs, which has not improved since I mentioned it last year. My heart is palpitating again, a lot of times for no reason, or so it seems. 

Plan of attack? 

1. Go to the dermatologist and see what she wants to do. 
2. Try to get my recent stress under control, hoping to reduce inflammation.
3. See a GI doc because lower GI issues seemed to "fix" with Humira
4. See a cardiologist because of my edema and palpitations
5. Rest as much as possible, keep legs up
6. Reduce hand use because of swelling and pain

I am already working on the appointments. The rest and limited use of my hands, I need to figure out ways to do what I enjoy.

The one thing I do not like about my visits with my rheum doc, is how fast she has to handle patients. I think she has patients who are in for their follow-ups scheduled every 10 minutes. That gives her nurse time to do the vitals and her to do her assessment of the patient's condition. When she walks into the room, she doesn't sit, the computer stand raises and she types everything we discuss from there. While she does her exam, I ask questions. My time with her is precious, and half of the time, I forget my questions or concerns. Yesterday, however, I had notes. I asked as fast as I could because once she finished the physical exam of my joints, she was ready to leave. I know if she doesn't press the "chess timer" fast enough, there are repercussions. 

The other thing I do not like is having to go somewhere else to get my blood drawn. I wait no less than 20 minutes. They have 5-6 phlebotomists working in the lab, the problem comes when the computer system is running slow and the lab work orders are hung up in digital never-never land. There were 10 of us sitting in the waiting room for 15-20 minutes after the last lab was drawn, because the orders had not arrived. You could see the phlebotomists standing around and chatting.

There are two upsides to both of those downers. I can message my rheum doc and she will get back to me the same day, if not within an hour of the message, with answers and help. She is one who truly cares about her patients, but because of where she works, her one-on-one time is limited. That, to me, seems like the business is concerned more about the financial income rather than the patients' health or concerns.

The lab results, they come back the same day. I already have my results from yesterday. My kidneys and liver are functioning well. My sed-rate and c-reactive protein are within normal limits. Sed-rate is increasing, but this tells me Humira is working to keep the inflammation markers in check. Which explains the lack of joint pain, unless I have a quick flare.  

Anyway, that is the exciting events from yesterday's doctor visit.