When Obstacles Get in the Way of Medication
Last updated: June 2018
I have had psoriasis for most of my life and have overcome many hurdles over the years. One obstacle I never thought I would struggle with, however, was any restriction on the medications I could take. I figured I would be able to try anything out there to help my psoriasis!
There are many ways in which we might be presented with restrictions on our psoriasis medications: generally, photosensitive sufferers cannot have light therapy, those with hepatitis cannot take Methotrexate, and those with chronic infections like tuberculosis are often denied any immunosuppressant medication. Of course, severe side effects to any medications are a clear cut reason to stop, but for many of us, certain medications are off the table right from the start.
What I do for a living
I work in the field of molecular diagnostics and am formally trained as a microbiologist. In my day job (as opposed to my alternate job of psoriasis warrior), I create assays that diagnose infectious diseases. Have a cold? I can tell you what virus you have! GI troubles? Yep, I can tell you that too. Because I work in the genomic sequencing department, if you send me a nasal swab I can also tell you what you ate for dinner. You’re envious, I can tell. One huge part of my job is working in a Biosafety Level II laboratory. That means I work with pathogens that have moderate to high individual risk. On a daily basis, I might be exposed to Norovirus, Giardia, Salmonella, Rotavirus, or Shigella (and that’s just from the poop samples!). I have always loved working with microbes, I even keep a number of giant microbe stuffies at my desk, but it didn’t occur to me that my work would come between me and the medications I needed.
A few years ago I returned from a trip to Nepal and went through the worst flare-up I had ever had. Miserable, I booked an emergency appointment with my Dermatologist. He took one look and declared it was time to start me on Methotrexate. As he sat writing my prescription, he went through his standard list of questions. He asked, “do you work in a healthcare setting where a compromised immune system may put you at risk?” I responded “actually, yes. I work with pathogens.” I should preface his response by indicating that my Derm has a terrible bedside manner. He told me “sorry, you’ll have to quit.” I left that appointment and cried all the way home. I loved my job. I was angry with my skin for getting in the way of the career I had worked so hard for.
Luckily for me, I admin a very large psoriasis group on Facebook and was well acquainted with all the different treatment options available to me. Topicals were out, and any systemic meds or biologics were out as well. That left phototherapy. My second stroke of luck was that there happened to be a phototherapy center a 15-minute walk from my work downtown. I did all the research and re-booked an appointment with my Derm. He asked if I had changed my mind about the Methotrexate, and that was when I handed him the info for the phototherapy center. He looked shocked. “I had no idea you worked near a phototherapy center. If I had known that I would have suggested this first.” He made all the arrangements, and less than 2 months later I was spending my lunch breaks walking to the hospital for my light treatments. A few months after that, I was clear for the first time since my diagnosis!
A lesson to be learned
In Canada where I live, phototherapy centers are very rare. It’s completely understandable that my Derm would assume that that treatment option was out, so it was up to me to be proactive and make a solution for myself. While we can always hope our doctors will point us in the right direction, don’t be afraid to do your own research. No one will ever care about your health more than you will. Websites and communities like these are great places to inform yourself, and I’m certainly not above printing off these resources and bringing them to my GP or Derm. The next time something gets in your way, remember this story… ask questions, know your options, be your own advocate.
Hope you are all having a terrific day! Please don’t send me your poop in the mail.
Does your psoriasis management change with the seasons?