Less Is Not More: Psoriasis Treatment
Last updated: January 2021
My husband and I are trying to start a family. During routine testing, I found out that I would need to have a D&C. I reached out to each specialist for my psoriasis, psoriatic arthritis, and Crohn’s disease for guidance about surgery and treatment delays.
While I waited for responses to come back, I grew curious to see what responses people got online.
The decision to delay biologic treatment
One thing that struck me, in particular, was how many people on a biologic wanted to come off once their skin cleared. I totally understand not wanting to be on medications or treatments of any kind. I stink at consistently taking my morning vitamins, let alone morning and night-time meds that have to be timed. My biologic treatment for psoriasis is just one more thing to manage.
However, I don’t use this biologic to only manage psoriasis. This biologic helps manage my psoriatic arthritis and Crohn’s disease, as well. For the first time in 20-plus years of having these chronic conditions, I am finally in remission. Even my scalp psoriasis cooperates and it was one of my biggest issues since childhood.
So, when the specialists began replying that they wanted to delay treatment for 1-2 weeks post-surgery. I was legitimately scared.
Fear of what is to come
This was not the kind of scared that a type-A personality has when they miss something scheduled. It was the kind of scared that someone whose skin isn’t painfully blistered, peeling, itching for the first time in decades feels. This fear stemmed from knowing I was purposefully withholding the medication that cleared my blistered underarms, scalp, and inverse psoriasis down below.
But, I also wanted to heal. I didn’t want to delay healing or become susceptible to infection. So, I followed the doctor’s orders.
While going over the calendar for the week of my surgery, I saw my injection was due the day before the procedure. This was such a bummer. One of the medications I had to take prior to the surgery was an antibiotic. It is one I’ve used for skin infections in the past, so I was hopeful that it would help keep things status quo.
Out of control symptoms
The first few days after surgery were a blur. I wasn’t getting out of bed much, so my joints were not happy. A familiar itch and burn tingled throughout my skin and scalp. By the time I had enough energy to wash my hair in the shower, I felt a familiar ridge in my scalp.
I am on a 6-week dosing regimen and grew unsure if I would be able to make it to week 8 before injecting. Here is the crazy thing. During some hours of the day, my psoriasis, psoriatic arthritis, and Crohn’s disease symptoms felt out of control. I would negotiate with myself to get through the day and inject the following morning.
By the late-afternoon or evening, I wasn’t feeling so bad and would forget about my bargains. That is until the following day where I would find myself making bargains all over again.
My body was ready for treatment
I almost made it to the 14-day mark, but my scalp was developing plaques, my underarms were blistered and it hurt to walk. Eating at that point was growing difficult. Everything was making me feel sick. I didn’t feel like I was in a full-blown flare by any means. I felt like my body was ready for treatment.
Something else I’ve noticed close to injection time in the past is that my fatigue heightens about a week before injection time. The best I can describe it is feeling like you need a nap from your last nap.
I wish I could say that I felt right as rain, after getting my shot. It took about two more injection cycles, as well as a 7-day course of antibiotics also used to treat skin and GI infections, before I was able to achieve relief.
The impact of a two week delay
At the time of writing this, I’m due for my shot in 9 days. Right now, I’m pretty sure I can make it to that mark without an issue arising. To say that it’s been a bit of a struggle to get back to feeling well after that almost-two-week delay is an understatement. In the future, I most likely will push for a smaller window or no delay at all.
The bottom line is that "less is not more" for me, especially where my biologic treatment schedule is concerned.
Did you ever have to delay treatment? Tell us how that worked out!
Does your psoriasis management change with the seasons?