Psoriatic arthritis

Hi I'm just wondering if there are any others out there who are pregnant or have been pregnant with psoriatic arthritis? I've had psoriatic arthritis for about 10 years now (started when I was 19) and as this is my first bub I'm just wondering what others experience was during and after pregnancy.

My arthritis went into remission when I fell pg which I've read is quite common, however the last week or so I've been waking up with really stiff knuckles. Usually my arthritis effects all of my joints but so far only my knuckles have began to feel stiff again. I'm praying this isn't the start of my arthritis rearing it's ugly head. Has anyone else experienced this?

Also I've read that after the birth the arthritis can return with a vengeance. How long after birth did your arthritis re-appear and were you able to take any meds while breastfeeding? I had to stop my meds when I fell pg (I was on anti-inflammatories as no other meds helped with the pain and the only safe ones to use while pg made me really sick). I'm just worried that I'll be in so much pain after the birth that I can't enjoy my new bub. Also I find that my arthritis gets so much worse when I don't have enough sleep, so I'm imagining that being a sleep deprived new mum is not going to help things.

Would love to hear any of your stories. Sorry for the long post!

Hi Claire. I don't have psoriatic arthritis, but I do have psoriasis though, so I can sympathise with you on that at least. I hope someone can give you some answers.

Thanks Sherie. Out of curiosity did your psoriasis get better or worse during and after pregnancy?

Hi Claire
I have psoriatic arthritis.. During pregnancy and for a few months after birth I had no problems however after about 4 months I found it to be worse than before pregnancy and even more so the past 3 months..

It always cleared up really well with minimal treatment when I was pg, because your body is in a naturally induced immunosuppressed state (to allow the baby to grow). But within a few weeks of giving birth it always came back again - but never worse than what it was previously. After my 4th baby it was back within days of his birth and with a vengeance too. I've just started taking Methotraxate (immunosupressant) to treat it that way because I've also had a rather nasty flare up from an infection.

HI claire, I am currently 16 weeks preg with No 2. Have had psoriatic arthritis for the past 16 years, am now 32. First pregnancy no problems. went into remission straight away. then a few days after giving birth could feel tightening in my knees it was the start of it coming back. managed to go 6 weeks without meds then stopped breastfeeding and went back on methetrexate. this time different story. stopped meds 3 months before getting pregnant. had been on methetrexate and arava. arava wash out was horrible. over those three months I was in so much pain with my knees. had to have cortisone injections. got pregnant pretty quickly but the arthritis has been flaring up on and off since then. have had cortisone injections which lasted a week. some days haven't been able to walk. on top of that horrendous morning sickness which is just starting to subside. I have lost 6kg since I got pregnant. have been picking up every virus/bug that has been going around. this is definitely my last pregnancy. I had to take 2 weeks off work I was that sick. Roll on May 2009!

but first pregnancy was great. I can't really say that the arthritis came back worse after the baby was born but it is definitely worse now but i gave birth in 2005.

I hope this is of some help. I am planning not breastfeeding this time round and starting meds straight away. no use breastfeeding if I can't get out of bed to look after the baby. I think my arthritis will be like this my whold pregnancy. if it was going to go into remission it would have a couple of weeks ago. fingers crossed I am wrong.

take care
Richelle

Hi Richelle! I hope you don't mind me popping in... I don't have psoriatic arthritis, but I do have a weird serum-negative rheumatoid arthritis that nobody has yet been able to put a name to. I did want to give you some hope, though. First time I was pregnant I'd pretty much gone into remission by 6 weeks, sadly I lost the baby just before 9 weeks... This time, it was MUCH later before I had any signs of remission at all. It was more like 17-18 weeks before I felt comfortable reducing my prednisone dosage at all, but now at nearly 32 weeks, I've halved the dosage of my salazopyrin and I'm only still on the prednsione (5mg, half of what I started with) because my rheumy told me not to bother and that I'd have to take more around the time I give birth anyway. Not sure what the deal with that is, but I did want to let you know that just because you haven't gone into remission yet, doesn't necessarily mean you won't. I really hope things improve for you soon...

BW

Hi Richelle,

Thanks for your reply. I guess you've confirmed what I was dreading. I really want to be able to breastfeed for atleast 6 months but know I probably won't be able to last that long without medication. I guess I just have to wait and see :crossfingers:

I really feel for you - having to copy with morning sickness is bad enough, let alone dealing with PA on top of it. I really hope you go into remission with this bub and that you don't get any more bugs/flus.

Ouchies on the psoriatic arthritis. I like Trillian, also have psoriasis. It pretty much cleared up with my DD, except for one tiny spot on my scalp, and with DS it cleared up, but I still had some spots on my scalp and some little ones on my elbows.

I have recently bought some MooGoo with MSM, to try on my elbows, and it seems to be working pretty good. The plaques aren't as dry and scaly, and don't seem to be multiplying as quickly. had one spot on the back of my hand that has pretty much disappeared.

Hope all goes well and it doesn't make an appearance for quite a while :)

Nic

Greetings!

I am pregnant with my first (13 weeks right now), and I am also experiencing some flaring of my PsA. Knock wood... my skin is pretty good, though.

I try to relax the joints and easily stretch or move them often. Walking a little bit actually helps to avoid too much of tightening up. I also, pretty regularly, wear a sport support on my knee. It really helps keep my knee in place. The ankle support is alright. I got them at the pharmacy. I actually find that basic point and flex stretches work well for the ankle... at least temporarily.

I was on Enbrel. My rheumy has been recommending either Cortisone or Prednisone (sp?) if I really get in tough shape now that I am pregnant. I am trying to avoid both as long as I can!

I agree with the other posts about feeding. My plan is to breast-feed for a month (if I can make it and longer if that is at all possible!), then go to formula so I can go back on Enbrel. I have also heard that PsA gets rough after birth.

Has anyone tried acupuncture for the inflamed areas while pregnant instead of taking meds????

I found that acupuncture would give me some relief during a flare - but it wasn't particularly long-lasting. It would certainly take the edge off, though!

However, I do wonder if my experiences with RA can translate to PA, because mine got better during pregnancy.

AMT, if you get to the point where you have to make the choice, try the prednisone before you go for cortisone injections. I was on prednisone for my entire pregnancy - never more than 10mg, and only 5mg for the second half... I'm assured that it's completely safe for the baby, it's just pretty rough on you if you end up needing a higher dose. Congratulations on your pregnancy, too.

The sad news... I only lasted with breast feeding for two weeks, and that was only dribbles. We had problems with supply as well as my RA flaring quite severely... I'm heavily dosed up on my regular meds and I'm just not comfortable exposing Samuel to them even when he was only getting dribbles of breast milk. I suspect that when my rheumy returns from holidays (mid-Feb, ugh!) that I'll have to start on methotrexate. :(

BW

Hi AMT and welcome! I think that you have to take the best course of action for your situation. If it flares up really bad afterwards, then as much as you know breastmilk is the best source of nutrition for baby, it's not much good if Mum can hardly move or pick baby up because of her arthritis, so you have to take a holistic approach and look at the entire picture.

BW, if you do have to go on MTX, then you would have to have given up breastfeeding anyway - it will have adverse affects on bubs and you can't BF while taking it. But I really hope that it works well for you and you don't get any side effects from it. I imagine you would be taking a much higher dose for your arthritis than I am taking for my p.

Hi,

Sorry to butt in here.. I am not a sufferer of psoriatic arthritis..

My 5y.o DD however is on Methotrexate for Juvenile Idiopathic Arthritis. I really am hoping she goes into remission before she reaches adulthood. She was diagnosed over 12mths ago & it affects her right knee.
I of course cannot give her the medication, due to being pregnant & depending if I breastfeed this little one, I'll have to continue to avoid it..

I guess the point of me crashing this thread is to be able to talk to someone who has had experience with methotrexate or even find someone else whom has a child on the medication..

Hi Mon, I don't personally know of any children on it, but there is a site I go to for p and PsA sufferers and I know some of them have children on MTX. If you like I can give you the link.

Trillian, I knew I'd have to give up BF if methotrexate came on to the scene... In fact, that's about the only thing I know about it! I've been flat out refusing to discuss it as an option with my rheumy until we finally got IVF to work so now the only thing I can remember is that it's taken weekly instead of daily. I have no idea about side effects or anything else - I simply can't remember! Of course, it's much more important that Samuel have a functional mother than be breast fed... If you can call the current limping about on high doses of pain killers functional.

BW

Yep, it's only a weekly dose and you need monthly blood tests to check liver function etc as it can wreak havoc on your liver, but I've been fine. Its not nice to read the info you'll find on it, but like with anything you have to weigh up the risks v benefit. And you deserve to be fully functioning too, not just for his sake (but that's important too) but for your own, I can't imagine how you're feeling atm.

AMT I just thought I'd let you know that my bubs is almost 6 weeks old and I am still managing without any meds apart from voltaren. My PA is creeping back in but so far it is manageable - fingers crossed I can keep going for a few more months. I guess the difference with us is that my PA went into remission as soon as I fell pregnant. But here's hoping for you that yours does the same.

By the way, congrats on your pregnancy!

:

---

Hi Mon, I don't personally know of any children on it, but there is a site I go to for p and PsA sufferers and I know some of them have children on MTX. If you like I can give you the link.

---

That would be absolutely fantastic if you could please :D :dance:

Hi,

Im 21 and have psoriatic arthritis and planning to start a family, am currently taking diclofenac but would like to know if this is still safe to use during pregnancy as i am afraid i will be unable to cope without them.

Any info would be a great help

Thanks
Leigh

From the drug information on diclofenac...

:

---

FDA pregnancy category C. This medication may be harmful to an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant during treatment. Taking diclofenac during the last 3 months of pregnancy may harm the unborn baby. Do not take diclofenac during pregnancy unless your doctor has told you to. Diclofenac can pass into breast milk and may harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby. Do not give this medicine to a child without the advice of a doctor.

---

Being a category C drug, there's no way I'd risk taking it. Before you start trying for a baby, I'd suggest you really need to chat to your doctor and find some other alternative. It may mean prednisone - a steroid rather than an NSAID, but there are safer drug options during pregnancy.

BW