"Work through the pain."

David Tostrud
Chapter 1
Pins and Needles

I've lived with psoriasis for more than 20 years, but to be honest, for the longest time it just wasn't all that big a deal for me. The one place I routinely had problem was on my hands, and for years -- I'm 46 now -- I didn't even know I had psoriasis. Whenever I had a flare-up I'd rationalize it, thinking to myself, "Well, I've been working outside, whacking weeds, mowing the lawn, whatever. I guess this problem with my skin is just blisters or something."

Around 2009, after being a stay-at-home dad for 10 years, I got a part-time job at the middle school where I now work full-time. I was supervising in the cafeteria at lunchtime, and I noticed that when I stood up after sitting for a while my feet were tingling. A kind of pins-and-needles feeling -- until the day I woke up and couldn't get out of bed and couldn't stand on my feet without intense pain. And weirdly, one of my fingers started looking kind of bent and broken, even though I couldn't recall hurting it in any way. Eventually I did go to a rheumatologist who took x-rays, and after showing me the calcium deposits on my fingers and the wrist of the affected hand, he told me I had psoriatic arthritis.

Chapter 2
Thank You, Finger

For years before the diagnosis of psoriatic arthritis, I did have occasional pain, but I ignored it. I'm a piano player, and my wrists would sometimes get sore, or I'd work out, doing pushups or lifting weights, and I just thought that I was putting a little extra strain on my body, that I wasn't that young anymore, and it was no wonder my wrists were sore and my feet were hurting. But when I got that diagnosis, I thought, "Wait a minute. Who gets arthritis in their late 30s?"

But the funny part about all of this -- or what's funny to me now -- is that if that bent finger didn't get bad enough for me to finally go see the doctor and get that x-ray, I probably would have lived with it for another few years and not given it another thought. Or at least I would have tried not to give it another thought. I'm not big on going to the doctor. I mean, if I can help it I only go to the doctor if I have a compound fracture or something. You know, if a bone is sticking out of me or I'm near death. I don't head to the doctor because I have some aches and pains. I guess I get that attitude from my dad. You know, "Ah, you're all right. Just rub some dirt on it, and get back to work."

Chapter 3
No Time for Pity

I was prescribed Methotrexate for a while, but personally I found that it didn't really help all that much. It was when I modified my diet -- trying to be as gluten-free as possible, for example -- and combined that with exercise that I started noticing a real change in the arthritic pain. I'm a fitness coach, and I've learned that sometimes you just have to work through the pain, or find ways around it. If one style of push-up doesn't work because it's simply too agonizing on your wrists, you look for another. But the fact is that some degree of pain inevitable. What's essential is not starting from a place where you feel that you can't do something because of that pain.

So many of us have people in our lives who say stuff like, "Oh, I'm so sorry that you can't go outside and exercise," or "How terrible it must be for you, not being able to go for a run." Well, you know what? I would rather be someone who responds to that sort of pity by treating it as a challenge. I want to show people -- and I want to show myself -- that despite this chronic illness, I can live a healthy, full, active life. And I do.