Double Diagnosis: Living with a PsA and RA Diagnosis

If I’ve said it once, I’ve said it a thousand times. Life is funny. There you are, going along day-to-day, tackling all the little challenges, and WHAM. You get smacked upside the head, double diagnosis.

If you’ve read any of my other articles, you know that I was originally diagnosed with psoriatic arthritis and have worked my way through several treatments with little success. Methotrexate, Arava, Remicade, Simponi Aria- just to make a few. It wasn’t until a recent doctor’s appointment that it became clear why…not only do I have psoriatic arthritis, I now officially also have rheumatoid arthritis. You read that correctly. I have RA AND PsA.

RA is certainly more well known than PsA in terms of autoimmune arthritis. RA is more common than PsA, but to have both is listed as “rare.” While there are quite a few similarities, there are certainly differences. This article, Psa vs RA: What’s the Difference by Psoriatic-Arthritis.com does an amazing job of explaining the similarities and differences of these diseases. I am working on wrapping my head around all the details of RA and am working on a more detailed article explaining it. Be sure to subscribe below to get updates on that.

So what does a double diagnosis actually mean in the grand scheme?

At first, as I’m sure you can image, I was very upset. I was angry and afraid. I had finally wrapped my head around what my future might look like with PsA, then to have RA added, it felt like quite a blow. After more thinking, and even more praying, I realized that the pain that I have been experiencing wasn’t different. The aches in my hands, wrists, back, feet, and legs were all still there, now they just had different names for the locations of the pain. It was all pain. Labeling certain ones RA pain and others PsA pain didn’t necessarily change how my body felt on a daily basis. I do find some comfort in that.

How is a double diagnosis treated?

This is the down-side and something that I’m still struggling with quite a bit. You see, when you have an autoimmune illness, like RA, with the correct medications working together, there is a chance to achieve remission. Meaning that disease progression is halted for 6 months or more. An article released by Rheumatology Network.com states the following:

 

“In rheumatoid arthritis (RA), studies suggest that sustained remission for some patients is indeed possible. But in psoriatic arthritis (PsA), this prospective study from Germany finds an “extraordinary high rate of recurrence” even among patients who reach and maintain drug-free remission.”

Beyond that, chances of achieving remission are much higher among males, and also higher among those with mild cases and early treatment. So, as much as I desperately want to get “better” it is clear that remission, is a ridiculously long shot, especially when you factor in the double diagnosis of PsA and RA.

When it comes to treatment, this is the biggest hurdle. When you have both PsA and RA, the possible options for medications is much smaller. There are a handful of medications that overlap in the treatment of both PsA and RA. Those are the ones we are focusing on trying first which is why I currently take Simponi Aria infusions with Arava and antiinflammatories. The majority of my pain relief these days comes from using CBD oil in vape form and by rubbing it directly on my aching joints. 

I wish I could leave you with some sort of inspiring words. I wish I could assure you that right now, in the darkness, I see the light. But I’m also a realist and believe that in my writing, I need to be honest with my readers as much as with myself. This has been hard for me. It is hard right now for me to accept that I will be spending the rest of my life trying to manage pain and fatigue. That the the chances of legitimately “feeling better” are slim. There is no cure and remission is highly unlikely. It isn’t like the flu or strep throat. There is no such thing as, “Take this medicine and you will feel better in a few weeks.”

When I am struggling to be the parent I want to be, the one that my kids deserve, sometimes it is so hard to set aside the pain and fatigue and remind myself that there are other ways. There are other ways to show my children that they are loved and cared for than running them to a thousand different activities or having a perfectly pristine home. For now, I will find strength in knowing that I am not alone, life may not be perfect, but it’s mine and I love it.

~Leanne
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