Psoriatic arthritis may have caused Deanna Norris to give up a career she loves. But mentoring others with psoriatic arthritis is this Florida woman's new passion.
Living with psoriatic arthritis hasn’t been easy for Deanna Norris. The former realtor from Tampa, Fla., was diagnosed at age 46. Her first symptoms involved what is commonly known as sausage digits — dactylitis — affecting toes on her right foot, she said, and she also had some soreness in the hands. Now, four years later, the disease affects most of her joints and impacts her ability to work and do everyday tasks.
About 7.5 million people in the United States have psoriasis, andabout 30 percent will develop psoriatic arthritis, said Yousaf Ali, MD, interim chief of rheumatology and an associate professor of medicine at Mount Sinai School of Medicine in New York City. Psoriatic arthritis has many symptoms, most notably swelling, stiffness, and pain in the joints, he said. Usually people experience the skin condition first, and then psoriatic arthritis develops later. For Deanna, however, psoriasis and psoriatic arthritis were diagnosed at virtually the same time.
Deanna’s Psoriatic Arthritis Diagnosis
Like it does for many with psoriatic arthritis, getting a diagnosis took a while for Deanna. “I initially went to my general practitioner, who ordered blood tests for RA [rheumatoid arthritis] and gout. Both were negative, so he told me to take ibuprofen for pain and swelling. Then he sent me on my way, telling me I was just getting older,” she recalled. After a dactylitis flare nearly ruined a trip to Las Vegas, however, Deanna went searching for more answers — and relief. More blood tests and X-rays taken by a podiatrist showed nothing, but the doctor suspected arthritis and referred her to a rheumatologist, an arthritis specialist. “While this was going on, I developed a rash on my hands and fingers — mostly blisters that would break open and then heal over very thickly,” Deanna recalled. “The skin would crack. It was painful.”
At the rheumatologist’s office, Deanna was examined head to toe, underwent another battery of blood tests and X-rays, and was diagnosed with arthritis, though not psoriatic arthritis. She started treatment, but kept breaking out in rashes, which were treated by her primary doctor. When she mentioned the rashes to her rheumatologist, she said, “he again examined me, paying specific attention to my fingernails.” Nail changes, such as separation from the nail bed or pitting, are common in people with psoriatic arthritis.
After the exam, the doctor decided she had psoriatic arthritis.
Getting the Right Psoriatic Arthritis Management Plan
Dr. Ali said psoriatic arthritis management includes physical therapy, lifestyle changes like weight loss, and non-impact exercise. Another psoriatic arthritis management component is drug therapy, which might include:
“Many patients are scared of the potential side effects of biologic medications, but a 3-month trial can often be life-altering,” Ali said. “And, in my opinion, the benefit far exceeds the risk in a majority of patients.”
Because of another health condition, Deanna cannot take biologics. However, methotrexate has cleared up the psoriasis and provides fairly good control over her psoriatic arthritis. She takes an NSAID, too.
At this point, Deanna has symptoms in almost all her joints, especially on her right side. “I also have sacroiliac joint involvement [a pelvic joint], as well as degenerative disk disease and scoliosis,” she said.
Her condition has taken a toll. Though Deanna loved being a realtor, she found that her health made it impossible to continue at it. She explored other avenues of work, but her psoriatic arthritis has made sitting for long periods painful and made typing difficult, and has resulted in her having to miss too many days of work. “I no longer work, and, in fact, will be applying for Social Security Disability Insurance in the near future,” she said.
Sometimes even household chores are challenging. Breaking big jobs into smaller ones, though, helps her manage better. “I always listen to my body,” she added, “and when it says rest, I rest.”
Sharing Psoriatic Arthritis Patient Tips
Deanna now volunteers with the National Psoriasis Foundation, mentoring people newly diagnosed — a role she finds very satisfying. “I wish there had been someone to talk to when I was first diagnosed,” she said, “to reassure me that life would go on, that a psoriatic arthritis diagnosis wasn’t a sentence to life in a wheelchair or being totally dependent on others.”
Deanna believes it’s important for anyone with psoriatic arthritis to get educated about the disease and treatments. A good place to start is the National Psoriasis Foundation Web site. She also stresses the importance of being your own health advocate.
“You only get one body and one life,” Deanna said, “and it’s your responsibility to protect it. Above all, I always tell ‘newbies’ that they should have hope because there are so many good treatments available and one will work for them.”
