A Singular Journey: Psoriatic Arthritis Without Psoriasis

In the days of yore, a malady such as psoriatic arthritis would have been a source of much bewilderment amongst the healers and the wise. It is a condition most vexing, where the sinews and joints find themselves besieged by an unseen inflammation, oftentimes in league with the ailment known as psoriasis. Yet, thou art a rarity, a singular occurrence where the skin remains untouched by the flaking scourge that commonly accompanies this affliction.

Thy mother’s pride is well placed, for thou art indeed a curiosity in the eyes of the medical guild. Should the skin’s rebellion arise in the morrow’s unknown breadth, then this ailment’s capricious nature will confirm its evident unpredictability. But for now, rejoice in thy unblemished flesh, even as the joints may protest in silent agony.

The humours within thee have conspired in an unusual fashion, leading to this peculiar presentation of symptoms. It is as if the stars have charted a course unique unto thee, separating thy experience from the common folk’s tales of woe.

In mine own ponderings, I have oft reflected upon the capriciousness of such conditions. They are like the wind that changes direction without forewarning, leaving us to but chase after the understanding of its whims.

Thou art tasked with navigating this journey with the wisdom of the ancients and the knowledge of the moderns, blending the two to find solace and remedy. In this quest, may the apothecaries offer thee potions to ease thy suffering, and may the learned physicians provide counsel to illuminate thy path.

For now, let us not dwell on the morrow’s uncertainties but focus on the present’s blessings. Thy condition, though burdensome, has not marred thy countenance with its full might, and in that, there is a sliver of fortune to be cradled.

Take heart, brave soul, for thou art not alone in this plight. Many have trodden this path before thee, and many shall follow. Each step is a stride towards understanding, and with each passing day, the pages of healing grow ever more robust.

In the grand scheme of the cosmos, thy tale is but a whisper, yet it is a whisper that carries the weight of human experience. It is a reminder that within the fragile vessels we inhabit, there lies a strength untold, capable of enduring and prevailing against the trials set before us.

So, carry forth, with head held high and spirits undeterred, for thou art a living testament to the resilience of the human form and the enduring quest for wellness and vitality. May the morn greet thee with less pain, and the eve find thee in repose, comforted by the progress of the ages and the hope of the morrow.

In the far-off days of yesteryear, the malady now known as psoriatic arthritis was a formidable foe to those afflicted. This ailment, marked by the red dragon of inflammation, would besiege the body’s bastions, the joints, with relentless fervour. The hands and feet, those diligent labourers of the human form, were oft laid low by its wrath, their vigour diminished, their movements encumbered by the cruel grasp of stiffness and throbbing agony. Yet, this adversary did not halt its conquest at these extremities; nay, it ventured forth to lay siege upon the larger citadels of the corporeal realm—the hips, knees, and the very pillar of life, the spine.

The sinews, those sturdy cables anchoring muscle to bone, found themselves ensnared in the inflammatory onslaught, rendering such regions as the heels, elbows, and the sacred expanse of the lower back, realms of discomfort. Verily, the essence of this affliction lay in an internal tempest, a maelstrom of the body’s own making, where the flesh doth turn upon itself, a civil war within the confines of one’s own skin.

In my contemplations, I have observed the humours in disarray, a discordance betwixt blood and bile that gives rise to such corporeal strife. The treatments, as diverse as the stars in the firmament, seek to quell the inner turmoil, to restore harmony within the humoral concert. Herbs of potent virtue, minerals hewn from the earth’s bosom, and the healing hands of the physician—all are summoned in the quest to pacify the belligerent humours.

Yet, let us not be ensnared by the delusion that our current understanding is the pinnacle of wisdom. For as the heavens continue their eternal march, so too does the knowledge of medicine advance, an ever-unfolding scroll revealing new secrets and strategies to combat the maladies that plague humanity. Thus, we stand as sentinels on the threshold of discovery, ever vigilant, ever seeking the keys to unlock the mysteries of ailments such as psoriatic arthritis, that we may one day banish them to the annals of history.

In the waning days of November 2024, under the watchful eye of the waning moon, I chanced upon a curious affliction befalling my dexterous digit. A swelling most peculiar, as if a humoral imbalance had taken hold, yet I dismissed it with a nonchalant thought, attributing it to the boisterous escapades amidst the woodland with my faithful hounds. The woods, a place of verdant mystery, where one’s limbs might dance with the unseen elements of nature’s own making.

As the Yuletide season embraced the land in its frosty grasp, the swelling lingered, stubborn as the ancient oaks. Thus, post the festivities of Christendom’s grand celebration, I sought the counsel of my learned Galen, a physician of no small repute. After sundry consultations, the presence of gout was banished, and I found myself journeying to the hallowed halls of Kings Mill Hospital, there to keep an appointment with the sages of Rheumatology.

March brought with it the vernal equinox and a revelation most startling. Psoriasis, that capricious malady of the flesh, was named as the culprit of my woes. Upon reflection, the pieces of this medical conundrum fell into place with a clarity that bespoke of the Fates’ intricate design. Allergies manifold have I contended with, from the humble aspirin to the deceptively sweet cherry, from the bane of gluten to the enigmatic peanut butter, and the seasonal tyranny of hay-fever, each thread conspiring to craft an intricate pattern of immune system insurrection within me.

The days preceding my pilgrimage to the clinic were fraught with dolour and discomfort, my hands rendered as useless as a marionette without its master’s guiding strings. The simplest of tasks, like grasping the kettle’s girth, became a Herculean trial. The night brought no respite, only the sharp bite of pain and the incessant pricking of pins and needles, as if a host of invisible sprites were at play. The common apothecary’s remedies offered naught but fleeting solace, and even the potent draughts of co-codamol and dihydrocodeine failed to quell the relentless tide.

A diagnosis emerged from the ether – an occluded nerve, ensnared within the sinews of my arm, a prisoner of my own flesh causing the pins and needles. A missive was dispatched, seeking the expertise of those versed in the healing arts, and now I abide, with the patience of Job, for the appointed hour of my next consultation. In this interlude, I ponder the mysteries of the body, that wondrous labyrinth where the spirits of health and malady engage in their eternal dance.

In the year of our discourse, two thousand and twenty-four, I didst embark upon a regimen of the draught Prednisolone, administered in decrements over the span of three weeks, commencing with a dose of fifteen milligrams and concluding with five. Thereupon, I didst begin a course of Methotrexate, measured also at fifteen milligrams. The potion of Prednisolone proved most efficacious, for anon the agony abated, the tumescence waned, and ere a week had passed, I wielded my hands with their wonted dexterity and slumbered with less disturbance.

Yet, as the taper of Prednisolone reached its end and the Methotrexate took the helm, the maladies that had been vanquished commenced their insidious return. Within the fortnight, tasks as mundane as the hoisting of a kettle became herculean labours again, my digits seemed no more than bratwursts, and I found myself engaged in a veritable joust with the apothecary for a script of dihydrocodeine, fifteen milligrams in strength.

As the leaves turned and May of two thousand and twenty-five unfurled, I undertook a second peregrination through the realm of steroids, this time in concert with the Methotrexate. The steroids, true to their nature, didst perform their healing sorcery. In the month of June, having secured the coveted dihydrocodeine prescription, I managed the day’s trials with a medley of common analgesics and, to court Morpheus’ favour, a single tablet of dihydrocodeine ere I surrendered to night’s embrace. Yet, the agonies of swelling and pain, ever loyal in their attendance, shifted their cruel caresses with each dawn, leaving me to wonder which torment the morrow might bring.

In the waning days of June, whilst in discourse with my learned healer of joints and sinews, I did voice a grievous increase in the torments of my dexter manus. Upon consultation with the sage overseeing my care, a regimen of potent humours, in the form of a six-week decrement of steroidal elixirs, was prescribed. Thus, with a satchel brimming with an array of medicinal draughts, I ventured forth with my companion Magaret to the sun-kissed shores of Malta, an isle of resplendent beauty amidst the cerulean embrace of the Mediterranean.

Upon my return to the hearth of my dwelling in July, a colloquy in person with my curative counsel yielded the verdict that the alchemical compound Methotrexate had not wrought the desired alleviation of my afflictions. In its stead, I was enjoined to partake of Leflunomide at a measure of ten milligrams. Alas, this new potion didst provoke a tempest within my sanguine rivers and brought upon me spells of vertigo most curious. ‘Twas akin to the gentle descent of a sky chariot, preparing to embrace the terra firma once more, a sensation not of malaise but of constraint upon my customary vigour.

As the leaves began their autumnal turn, another parley with the custodians of my rheumatic woes led to the cessation of Leflunomide. And now, as I inscribe these words, I abide in anticipation of the forthcoming chapter in my quest for solace, perchance to be found in the heralded realm of biologics. Yet, the path remains shrouded in the mists of futurity, with nary a denouement to be penned yet.

FALL SEVEN TIMES, STAND UP EIGHT

Japanese proverb