Kat's journey with laser therapy (XTRAC)

[jiml]

Just a couple if things for you to read before you go to methotrexate for the psoriatic arthritis

Methotrexate not working for Synovitis in psoriatic arthritis
MTX senseless with PsA

[Kat]

We discussed Skyrizi and Ilumya, but they are not yet recommended for psoriatic arthritis.

The rheumatologist gave me a simple explanation (which I always appreciate) He told me to think of it as a river with branches. At the end of one branch is skin psoriasis and the end of another is psoriatic arthritis. Where do you build the dam? Some biologics target one or the other, and sometimes it helps both but a TNF inhibitor works "further back" as in before the river branches. One of the reasons it has more warnings. Somehow, I understood the meaning. But then I once had a hematologist using people getting on and off of a bus to explain what was going on with my blood levels once, I really am a bit of a dunce when it comes to medical science!

I pretty much already have my mind made up on methotrexate.

After Acitretin cleared up the psoriasis on my body, I've been left with scalp psoriasis. I thought I could manage it on my own until I flared two years ago. When I'm all itchy which is most of the time, and looking at the scaling on my shoulders, I think I need to find something that works for me. Sometimes it eases up and I think that it's not too much worse than a bad case of dandruff, but admittedly those times have been slim. Also, I've been fortunate to be here and know that psoriatic arthritis isn't something I want to have get worse as so many of you share what you've gone through with it. So I know I shouldn't ignore things until they get worse.

HOWEVER, I also feel lucky at times as I do not have it to the extent that so many people struggle with. And that makes me question sometimes the risk vs gain. If I had it worse (so to speak) then the risks is worth it.

So some days I think it's worth it, and others days not so much.

To me it seems something should have already worked! I'm a tad bit disappointed honestly. But that doesn't get me anywhere.

It's just a wait and see what I find out from my other doctors, then moving forward from there. It will all work out.

[Fred]

   

The rheumatologist gave me a simple explanation (which I always appreciate)  He told me to think of it as a river with branches.  At the end of one branch is skin psoriasis and the end of another is psoriatic arthritis.  Where do you build the dam?  Some biologics target one or the other, and sometimes it helps both but a TNF inhibitor works "further back" as in before the river branches. 

That's a good way of putting it.

[Turnedlight]

That’s a good analogy - so I take it it’s a safer treatment the near the dam is to the end of the river?
And does the methotrexate dam sit just next to where the water springs out of the ground?

[Fred]

That’s a good analogy - so I take it it’s a safer treatment the near the dam is to the end of the river?
And does the methotrexate dam sit just next to where the water springs out of the ground?   

Are any treatments safe ?

[Kat]

Well according to most of the warning labels....

I'd have to say no. Nothing is safe.

But, some are safer than others. However, even that only matters if one has the bad misfortune to be who the warning labels are written about.

[Kat]

Well, this will not be a surprise,

I went for treatment this morning. I had some "sore" places from the previous treatment, sore as in I had some seeping and then scabbing in a couple of spots, itching and scaling in others. This was my 14th visit and I had 12 treatments (after burn there was no treatment, nor was there one today)

We decided it isn't helping. I told her that I felt that it was a bit better early on but lately I have felt that perhaps it was making it worse so we agreed to stop. She agreed that the last couple of treatments things have looked worse instead of better.

I have a prescription for Taclonex to use as needed. Hopefully that gets me to the first of the year when I have a dermatology and rheumatology appointment to decide what to do next.

So my laser therapy journey has ended. I do think for mild psoriasis in some people it could be beneficial. Although even good results are usually short term, if it works it could well be worth it.

[jiml]

That's a shame Kat I had hoped you would get some relief from it and we would learn of another successful treatment .....but sadly it hasn't worked for you and its a long drive each time for something that is having a detrimental effect.
I hope the Taclonex does the trick while waiting for your appointments

[Kat]

That's a shame Kat I had hoped you would get some relief from it and we would learn of another successful treatment .....but sadly it hasn't worked for you and its a long drive each time for something that is having a detrimental effect.
I hope the Taclonex does the trick while waiting for your appointments

Thanks Jim.  I've had good results with Taclonex, but I refuse to use it often.  It really got that bad flare from two years ago under control while I was waiting to get approved for Stelara.  I just recently discovered that Taclonex is Enstilar.  Taclonex is oily and Enstilar is the foam if I understand it correctly.

But with steroid creams, ointments etc, long term usage isn't ideal so I will use sparingly.  As long as I can maintain at least where I am for now, I'll manage till the first of the year.  However, should things take a turn for the worse then I'd have to increase the Taclonex usage and call for an earlier appointment but I don't expect that to happen.

Edit to add: Had the laser therapy worked, I might have made the drive as it has less side effects and warnings than a lot of other treatments. I do think it's worth trying and could be an option for others. And if it was only a short drive, it would have definitely been something to think about (had it worked of course!) as it's very quick to have done. So although I didn't get good results, I think I'd still recommend it for people who are interested to try. I just seem to have an extremely stubborn scalp!

[Fred]

I'm not surprised, it has been mentioned a couple of times on here but no one has ever reported back with a good result. But at least you tried it and have reported back and we now have first hand experience we can point others to.

Unfortunately it's one of those treatments that will never give lasting results. But that is just my opinion and we all have to try things till we find what works for us.

Good luck at your next appointment Kat, at least you have some time have read up on your next option.