Subject: Re: Hosp appt today - suspected PA !!
Hiya Christine It seems there's a PA epidemic at the moment!!! Welcome to my club anyway, it's a fairly exclusive one. (I've had PA for 21 years now, since the age of 9) I think early diagnosis can help prevent the disease from progressing too quickly if the rheumy puts you on some disease modifying drugs fairly soon. It sounds like you've been lucky to get a goodun. We are given anti inflamatories and pain killers to help with the symptoms only whereas disease modifiers (DMARDs / Disease modifying anti rhematic drugs) work on the cause of the problem which is your immune system. My rheumy did explain years ago when I was very young what causes the problem so I hope I remember rightly (it's fairly layman but helped me to understand)... People suffering from psoriasis and PA have malfunctioning immune systems. The immune system is like a chain reaction and there is one particular bit of it that isn't working properly and makes the body believe we have damage / infection in an area where there is none (ie the skin or a joint). I think there are two types of disease modifiers, one that lets the bodies immune system go through the whole process but stops the bit that then defends the area (i.e. the skin or the joint) and another that interupts one of the links of the immune system chain. If you are prescribed these types of medication it can stop the production of fluid etc which causes the inflamation and pain. I think it is the inflamation that can make the bones and cartilidge wear down which causes even more pain and possible need for joint replacement although this is really not very common in PA sufferers. I hope this helps. I may have explained it all wrong but the tall and the short of it is that the sooner the disease modifying treatment starts the longer you can hold off the progression of the disease! Examples of this type of medication are sulfasalazine, methotrexate, cyclosporine, gold injections and quite a few others but my mind's gone blank. If you have not had any success with two or more of these types of meds then they can look at putting you on biologics called "anti-tnf"s which is a really new type of drug (I think less than 10 years old) such as etanercept (enbrel), remicade, humira and infliximab. It can take a bit to get your head around everything but everyone on here's dead helpful if you need any advice and support. Lou x
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