The very first indication I had that something was wrong, and this is not uncommon with psoriasis, was a rash on my scalp when I was 12 years old. After that, I developed joint pain but I did not associate the two -- the skin problems and the pain in my ankles, wrists, and knees -- for quite a long time. In fact, it wasn't until I was 22 in my 20s that the connection between psoriasis and this quite severe joint pain was made plain. And even then, it was not exactly a relief to know that my psoriasis was to blame for my joint pain, because at that time I was on state Medicaid and the program did not cover treatment for psoriatic skin disease. So I had a diagnosis, but I couldn't afford treatment.
On top of all that, my dermatologist at the time basically told me that the medications available for my joint pain were toxic to my organs. Some choice, right? I was potentially looking at liver or kidney failure, or permanently aching joints. I figured I'd take the aching joints.
Psoriasis can be quite insidious, but one of the hardest things to get used to is that people who have no experience with the disease tend to be shocked when they hear that it's the reason you can't, say, walk up stairs. My skin is mostly covered during the day, of course, so while I do have quite a few skin lesions, they're largely invisible. For me the big problem is the joint pain. When people see me hobbling around, wearing a wrist brace, or having a hard time on the stairs, they invariably ask, "Oh, did you injure yourself?" I tell them what I have, and their next reaction is, "Wow. But you're too young to have arthritis!" That's often their introduction to psoriasis as more than a rash. a chronic, autoimmune disorder.
Being a doctor, of course, and being quite a vocal advocate about this illness, people who ask about my condition get a lot of information from me -- whether they really want it or not.
I practice naturopathic primary care medicine, and I love treating everyone in the family. But I do have a special little sweet spot for autoimmune disorders. Personally, for my own condition -- with both psoriasis and psoriatic arthritis -- I have a multi-pronged approach. I start with my diet - autoimmune paleo. I have different things that I do for stress management. I get acupuncture and massage regularly. I take some specifically chosen and well researched nutritional supplements. I use hydrotherapy. And I do use biologic medication, so I see a rheumatologist, as well as my naturopathic doctor. I'm trying to use the best of all worlds, so that I can minimize the amount of medication I am putting in my body. I want to not only reduce the side effects of medications, but also maximize how long they will work.
That's an aspect of medication that is often lost on people. When you get into some of the stronger medications, your body gradually adjusts and you kind of graduate out of that medication, and then there's nowhere else to go. So a balanced approach, with a variety of treatments, really is the best way forward for most people.
Anyone with a chronic condition, and especially chronic pain, is going to feel overwhelmed at some point, and quite frequently, when trying to deal with it. If someone is feeling like they might be headed toward depression, it's critical to get mental health support as well as physical support. You cannot treat only the physical symptoms and ignore the very real, very important mind-body connection.
I would also urge people who really like alternative medicine and who feel conventional medicine is the enemy to rethink their stance. You can't be so afraid of medication that you don't give yourself the care that you need. Sometimes we really need a band-aid. So go ahead. Get that pharmaceutical band-aid, stop the process, and then go see a natural health practitioner. Preferably a licensed naturopathic doctor, because we're trained physicians who understand medications, nutrition, supplements, and herbs and their interactions with each other.
Get your healthcare team on board and work on healing whatever that band-aid has covered up. Don't be so afraid of the band-aid that you end up doing more damage to yourself in the long run.
For my part, I would not wish this condition on my worst enemy. But it is a part of my life and I have to deal with it. And honestly, I believe it has made me a better, more empathetic doctor.