Psoriatic Arthritis in Teen

My daughter has suffered from Psorisis for years then last summer (AUG 2007) she woke to severe knee pain and was very tired and weak. I thought that she hurt herself but she did not recall any injury. Later that same day she was still unablr to walk so I took her th the E.R. where we were told she sprained her knee somehow.  The pain and swelling persisted and I took her to the Pediatrician who thought she might have arthritis. We saw a sports doctor first just to rule-out any knee injury. That doctor removed a lot of fluid from her knee 25cc's and had it sent for testing. The test only showed a high wbc that he said was consistent with arthritis. She then had some labs drawn which showed her sed-rate elevated at 78 she was also anemic.  We were scheduled with the rhumatologist for a February appointment. (It took4 months to see the only pediatric rhumatologist around here).

She saw the rhuematologist who said it was Psoriatic Arthritis and prescribed naprxen whic did not help then feldene which helped a little and now she will start taking methotrexate injections every week.

My daughter is going through severe depression and is unable to attend school on somedays due to severe fatigue. She is on the 504 Plan and is in all honors classes but is so tired. She wants to work part-time for extra money like her friends but is so tired all the time. Her skin is flared so she is withdrawn from people. Can she quailfy for SSI?  My youngest child receives it since he is autistic. I am not sure if she will or not.  Any input would help.

[purkat]

Psoriatic Arthritis is a form of spondyloarthritis. Did the Rheumatologist do any other blood tests? I cannot see how he could make a diagnosis without doing further tests, as there are other forms of Arthritis that affect children/teenagers.
I suffer from Psoriatic Arthritis and it affects my pelvis, back and knees. I have tried quite a few different anti-inflammitory drugs and I find that Mobic works the best for me.
I know you said that there is only one Paed Rheumatolgosit in your area, but is there a possibility of getting a second opinion?

[simisuresh]

How is your daughter now? How is she feeling after taking methotrexate? I do really feel bad for your daughter. I suffer from spondyloarthritis and know how difficult it is to manage the pain and fatigue. I wish she will get the right treatment  in time. Don't worry the research is on and surely very soon your daughter will be out of all these pain.

[MomsIan]

I see it's been a few years since you posted. I hope she's doing better, but if not here's some advice. I'm 50 and have had psoriatic arthritis since I was a teen, although wasn't diagnosed until I was in my late twenties. Methodrexate is a cancer treatment drug used to surpress the immune system and because psoriatic arthritis is autoimmune it's frequently prescribed. When I was on it I was extremely ill for days at a time and my work suffered terribly. Talk to her rheumatologist about an injectible like enbrel or humira. I've been on both and they don't make you nearly as tired and they're also used to treat the skin condition very successfully. I haven't had placque in years. There's no reason for your child to suffer like this. If your rheumatologist is unable to secure insurance authorization then take her to a dermatologist. For some reason they have an easier time getting it through.

[jactt]

My son 17years old was just diagnosed with psoriatic arthritis after several years of suffering. He is totally withdrawn suffering from all of the symptoms including depression at this time. Unfortunately extremely frightened of needles, ulcer from nsaids, refuses counseling for depression. Schools online, college? Work from home? Disability? Any advice in any or all areas greatly welcomed!

[carolanivey]

As he is still underage, if you believe he needs counseling you can legally make him go. He will dig in his heels but trust me, he will thank you for it later. Sometimes you have to be the "bad cop" to do what you think is best.

He will probably start with many of the same medications that I have taken for RA, many of which are taken orally. Unfortunately, the newest, most effective drugs are injectible, but having said that, the FDA has just approved an oral version of these same drugs, known as "biologics". Also, many of the injecibles are given via a "pen", in which you never see any needle, just feel the little prick to the skin.

There are many online support groups for teens with PsA; it might be a great place to start if he is reluctant to go out in public. Facebook has a number of open and closed support groups for PsA sufferers.

A medical social worker can help you find support groups and counseling services. Because blood tests are so very, very important, it is essential that he get treatment for his needle phobia. See if you can find a lab with phlebotomists who specialize in drawing blood from frightened patients of all ages. Done correctly, it doesn't have to hurt at all.

Please let me know if I can answer any more questions.