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A Profile of Severe Psoriasis
Hello, Ed. It's been awhile since I wrote. I thought I would give you a brief history and an update.
1990-2003 — Small patches here and there kept under control with clobetasol [a topical corticosteroid] and Dovonex [a vitamin D3 derivative] rotation.
2003 — After siding the house, I noticed P on my palms where I had held the hammer and siding. It slowly took over both palms with the corticosteroids having not much effect. Am still working as a machinist.
2004 — Tried Enbrel — cleared whole body very nicely — except my palms! Since it didn't work for my hands I stopped after 4 months.
2005-2006 — Used clobetasol frequently. Ignored feet. During this time I experimented with Kalawalla, diet, weight loss, fish oil, other natural anti-inflammatory food supplements, all to no avail.
2006 — (Known as one of the worst years of my life) I tried Raptiva. I thought this was “my” med that finally worked. I saw some improvement to palms. Still working at my job. Then all hell came against me. New boss, new coworker, sister-in-law and her son moved in, my father died, marital problems ... stress is ratcheted up 10 fold. Small lesions start to appear all over my torso and legs. Feet get worse. After about a year my derm says I’m “failing” Raptiva and takes me off.
2007 — In January I picked up a nasty MRSA infection in my hand. That summer I got several more infections in my hand, side, then on lower back. Operations and antibiotics. Surgeon can't believe I continue to work at my job with hands like mine. In August I couldn't take the new boss, painful hands and feet and MRSA any more and quit my job of 15 years! This meant getting on my wife’s insurance and switching derms. Switching derms turned out to be a great thing. My old derm was a great guy whom I could easily talk to — a new experience for me — but he could only take me so far. The New derm is actually a PA who previously worked at the Mayo clinic — very aggressive. Wet dressings twice a day cleared everything but my stubborn palms and soles. In December I got seriously depressed. My family doc prescribed Lexapro [anti- depression and anxiety medication] which helped in a big way.
2008 — Earlier this year I tried methotrexate, 8 pills once per week. It cleared my feet nicely, and my hands half way. Unfortunately it made me feel half sick all the time and sapped my energy so I stop taking them. My Derm then got me approved for Remicade but the cost was too high and the wife doesn't like the risks. PUVA treatments would be too expensive.
From August 2007 through February 2008, between MRSA, P, and depression I went to the doctors more times than I can count. (You know you’re there too often when the receptionists all recognize you and call you by your first name.)
Things have turned around for me lately.
I have been taking clindamycin for 5 months now for the MRSA and haven't had an outbreak since, and my depression is under control now. I am currently back on Enbrel to keep my body clear and I am using Clobex lotion and sunlight for my hands and feet. I'm seeing some improvement. My Derm is currently working on Humira for me. I hope it works for me. It's my next “great hope” so to speak. I just believe that eventually something will work.
On a side note, I was quickly approved for SSDI [Social Security Disability Insurance] this spring (a miracle in itself). What a major blessing. After quitting my job, we feared losing our house, but the SSDI payment just covers our house payment. Now I am “mister mom” to our 6 year old. I’m doing the school thing, housework; the whole nine yards. I've gone from being a “jack of all trades” and “do it yourselfer” to a “hire everything done” person. My hands just won't allow me to do what I've always done. Dollar bills have become my new hand tools. I am currently working with voc rehab to train me for a work from home computer job.
I see you had a bout with MRSA, too. I am glad the Humira is working for you.
Thanks for all you do, -Steve W.
Ed’s Response: Nice to hear from you again, Steve, though wish you had a bundle of better news. I’m glad you took the time to share the personal chronology. Many of us won’t ever have it as bad, but I think it’s important for all of us to know it can be this bad. Psoriasis can be a lot worse than a few itchy skin sores.
I hope Humira works as well for you as it has for me. -Ed
Previous correspondence from Steve W.: