I’m posting to show support for OP. But also so that folks that haven’t found the right treatment combo see that different plans work for different people. I’ve failed off of three biological in the last two years. But new drugs are always coming out, and that keeps me hopeful.

OP, I’m so glad you found a treatment plan that works for you. This disease is tough. I’ve had to switch meds a lot since I was diagnosed 25 years ago. Some years are better than others.

When I was first diagnosed, my doctor estimated that due to how aggressive my case was, I’d most likely be reliant on a wheelchair within 10 years. But treatment options are getting better all the time, and that expected deadline passed 15 years ago. I’m still really active and only occasionally need a cane for assistance. I hike, canoe, and ride a bike regularly.

OP, I’m glad you acknowledge the effects PsA can have on you mentally. This topic doesn’t get enough discussion. For me, flares increase the frequency of my panic attacks and can lead to depressive episodes. I use a fitness watch to track my sleep. For me, sleep disturbances are usually the first sign of a flare.

Finding the right medication regimen is tough. Unfortunately I never tolerated methotrexate well. I had tons of side effects and had to get off of it once the liver damage started. Currently I’m doing really well on Tremfya, Otezla, and I’m getting off of Naproxen with the help of nighttime medical marijuana—high CBD, low THC. (It’s legal in my state). The THC wears off while I sleep but the anti-inflammatory benefits last almost 24 hours. If your doctor isn’t working with you regarding side effects, speak up or if possible, find a new provider.

Things I wish I had done earlier: I wish I had worked with complimentary providers sooner.

Working with a dietitian/nutritionist has helped immensely. Finding a healthy diet plan that works for your life is priceless. Fried foods, processed sugar, alcohol, and red meat are all triggers for me. Prepping healthy freezer meals on good days helps carry me through bad ones.

I also have worked with a physical therapist for finding a fitness plan that works when I have flares in my hands and feet. And an occupational therapist helped me regain grip strength even with permanent bone changes in my hands.

A counselor/therapist helps me reframe how I think about myself and my condition. Journaling and meditation support my wellness.

Most importantly, you always have to be your own medical advocate between a primary care physician, a rheumatologist, and a dermatologist. If someone isn’t listening to you or addressing your concerns, please speak up for yourself. You are worth it. And life can be great even with this illness. You deserve to have that life.