Tony, 50, has had psoriasis for a long time. He first realized it when he discovered an itchy bump on his scalp at the age of 19 or 20; however, looking back, he thinks that the bad dandruff he had in high school was probably the beginnings of psoriasis. For many years psoriasis wasn't that big of a deal for Tony. It was pretty much confined to his scalp and didn't get in the way of his active life. He married, had a son, Jim, who is now 13, and started his own business making high quality custom picture frames. Some of his work is currently hanging in the White House. In his spare time, he took on various construction projects, rebuilt old cars, and played the guitar.
When he was in his early 40's, Tony's psoriasis got progressively worse. His skin symptoms spread from his scalp to his arms and legs. Then he felt the first twinges of arthritis. "I was aching everywhere, and I thought--this can't be how a 42 year old is supposed to feel," he recalls. Within a year the arthritis became extremely severe. Tony felt like all of his bones were broken. He couldn't dress himself or hold a toothbrush. He couldn't shake hands. "Someone would give my hand a nice squeeze and it would literally drop me to my knees," he says. He could barely walk and getting around his hilly, stair-filled neighborhood was nearly impossible.
In addition to the pain, Tony suffered from overwhelming fatigue. It would take him 20 minutes to get out of bed in the morning and then two hours later he would fall asleep on the couch. He could only work about 4 hours a day and his business went into a downward spiral. He had to give up most of his hobbies--no guitar, no building projects, no football.
His family did the best they could to help him out. Jim would ferry things up and down stairs for him when he needed it. But, says his wife, Becky, it was hard to see him go through so much pain and frustration.
Tony tried numerous medications. In some cases, the side effects of treatment were worse than the disease. Methotrexate, a chemotherapy medication commonly used to treat psoriasis and psoriatic arthritis, gave him nausea so severely that he was confined to the couch for several days each time he took it. [Nausea, which can range from mild to severe, is a common side-effect of methotrexate, although for many people it is not a problem.]
He had discussed one of the biologic therapies with his doctor, but initially she discouraged him from trying it. At the time, it was very new and supplies were limited and hard to get. Also, it was, and still is, very expensive and many insurance companies are reluctant to cover it until patients have tried all other options. Four years ago, feeling like he was at the end of his rope and armed with excellent health insurance, Tony asked his doctor to prescribe it for him. She did, and soon, all that stood between Tony and the new therapy was a half-inch long needle. Patients need to inject themselves with the medication twice a week, and the first time it was tough for Tony. "I was sitting and staring at the needle for, like, two hours at the dinner table. Everyone else was watching TV," he says. Finally, he worked up the nerve to inject himself, and that was the beginning of a complete turnaround. Within three days 75% of his pain was gone, and within a month he felt fantastic. "I was blown away," he says. After the first time, the needle was no problem, either. Now, he even looks forward to the evenings when he injects his medication.
Tony’s happiness at getting his psoriasis under control has been clouded by concern for Jim, who developed psoriasis himself three years ago. So far he has patches on his legs that he treats with a topical ointment. “He handles it really well; he never really talks about it other than telling his mom or me that he is getting low on ointment. We are hoping that he doesn't develop the arthritis later on in his life, but time will tell,” says Tony.
Today, Tony’s medication is still working great, and he is back to all of his old activities. He plays guitar almost every day; he is restoring a 1958 Ford truck with Jim; and he coaches Jim’s youth football team. His business is running smoothly again. He feels enormously grateful for the biologics treatment that has helped him so much. “On March 31st of every year,” he says, “I call the companies that developed it and thank whoever answers the phone for saving my life.”
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