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Just Diagnosed with PA
from Rachel

Hi, Ed.  Remember me? When you last heard from me I was en route to marriage.  (Sent you mail which you titled, Needs Improvement: Wedding Imminent).  Well the wedding and honeymoon passed wonderfully, as has the first year of marriage.  I was very sorry to hear of your battle with testicular cancer. 

Anyway, am writing now because I was just (today) diagnosed with psoriatic arthritis. Big sigh.  Have had P since I was 19, and now, on the eve of my 30th birthday I have PA.  Here are my questions (which I hope you can answer).

1) My PA is still pretty mild so Rheumatologist prescribed Naprosyn, took x-rays of all my joints practically and am meeting with her again in three weeks to discuss sulfamazide (am I even close on the name?)  Does that sound like a reasonable course of action?

2) Are there any "homeopathic" treatments for PA that you know of to work?

3) What's the deal on exercise with PA?  Can I still work out?  Should I be lifting weights?  What about Yoga?  (I was a bit stunned and forgot to ask the rheum.)

Thanks, Ed.  Your work is very appreciated.  –Rachel


Ed’s Response:  Good to hear from you, Rachel!  And, as I predicted, your P in no way hampered your wedding or your honeymoon!

Regarding your questions, remember that anything I or others say here is anecdotal and not to be interpreted as medical advice.  Hopefully you’ll use our discussion to jump start the more important dialogue with your doctors.

Naprosyn is one of an arsenal of NSAIDs prescribed for a variety of pains, most commonly osteoarthritis and other joint/muscle complaints.  The warnings associated with all nonsteroidal anti-inflammatory drugs apply: over-use can lead to ulcers or internal bleeding.  None of my resources recognize “sulfamazide” and I suspect you may be thinking “sulfasalazine,” which is an anti-inflammatory often prescribed for ulcerative colitis, a disease that may be related to P and PA.  There are lots of “sulfa-” drugs and I’m not sufficiently versed to second guess what your rheumy has in mind, here.

PA is often treated like osteo- or rheumatoid arthritis, so I would be surprised if there weren’t a homeopathic approach to treatment.  I’m sure there are plenty of naturopathic approaches, too.  One of the once-naturopathic approaches that has lately gained pretty wide acceptance in the conventional medical community is the use of glucosamine and/or chondroitin to arrest and/or replace joint damage associated with the arthritises.  I with my PA, and my wife with her osteoarthritis have both been told to take these natural supplements and we do.

“The deal” with exercise and PA is a pretty one-on-one subject between you and your rheumatologist.  I began exercising (aerobic) somewhat late in life on the recommendation of my cardiologist to combat overweight, elevated cholesterol and general “unfitness.”  It started on low-impact gym equipment then, years later, I took up mountain biking (modestly) and rollerblading.  I was rollerblading 4-5 miles a day, 4-5 days a week in the early-mid 1990s when my PA kicked in for real. 

No doctor whom I’ve consulted has been willing to tell me to curtail all exercise to favor the arthritic joints.  In fact, I’ve been encouraged to continue exercising so long as it does not increase joint pain.  My PA waxes and wanes like the rest of my P and, when it’s at its worst, significant exercise is simply not possible.  When it’s not, and I do exercise, am I helping or hindering the problem?  I really don’t know.  It may be a trade off.  I may be accelerating damage done by my PA as the price for helping other aspects of my health. 

I’m sure one of the reasons your rheumy has x-rayed all your joints is to help assess the level of damage.  Your own exercise plan may evolve from that assessment.

Yoga, I’m told, is a good idea no matter what ails you.  I don’t have any first-hand knowledge of this but I was married once to a practitioner who said she would only increase her time spent doing yoga as she grew older and acquired age-related ailments.

Hopefully other FlakeHQers will have more to say on these subjects, Rachel.  In the meantime, I’m sorry about your PA diagnosis, but be assured you’re in good company and because you are pursuing information about this condition aggressively — and knowledge is power — I imagine you’ll have an easier time of it than lots of folks.

Do stay in touch.  -Ed

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