Two years ago, I was in almost constant pain. My hands hurt so much I couldn't open jars. I remember lying in bed, just wondering how to prepare to roll over. I had suspected for a long time that I might have psoriatic arthritis. I already had psoriasis, and with the pain I was experiencing, it seemed likely. But I hadn’t jumped through the hoops to get a diagnosis because, as we all know, the medical world requires seeing many different doctors to get any kind of diagnosis.
About 20 years ago, a dermatologist had suggested I might consider biologic treatment. He thought I could be showing early signs of psoriatic arthritis, but I definitely had psoriasis. At the time, there weren’t many biologic options available, and I didn’t want to go that route. I had young kids, and I knew biologics meant being immunosuppressed.
However, two years ago, the pain became too much, and I decided to start the process of getting a diagnosis. I was right. I had to see a lot of doctors, jump through many hoops, and finally, the rheumatologist diagnosed me with psoriatic arthritis.
The doctor told me to get all the vaccines I could because immunosuppression would increase my risk of infections. I’ve always been a healthy person, but I followed her advice, preparing for typical infections like COVID-19 or the flu. I received all my vaccines, started on a biologic drug, and prepared to give myself injections every two weeks. Initially, everything went fine, but I wasn’t prepared for some rare side effects that aren’t commonly discussed.
The biologic I was prescribed can cause a rise in seasonal allergies for people who are susceptible. It is not generally understood why, but I was one of the lucky few. My allergies became extreme. Fresh vegetables that had never caused reactions before suddenly triggered allergic responses due to cross-reactivity with my known allergens. Still, despite the allergic reactions, I felt better in general.
Then, in the summer, something unexpected happened. I developed a strep infection on my face—erysipelas—which was likely from a strep bacterium. I don’t know how I got it, but perhaps it was from paddleboarding and falling into the local reservoir. Or maybe from working in my garden. My face was bright red and I felt awful. I have a public facing job and don't like looking like I am on fire. Erysipelas is a known but unexpected side effect of being immunosuppressed.
Living in a first-world country, I don’t usually think much about these kinds of infections because we have vaccines, clean environments, and good healthcare. But being immunosuppressed changes everything. It’s not just about getting more colds—it’s about being vulnerable to infections that we don’t often consider. I had to take antibiotics for months to treat the infection, and during that time, I had to stop my biologic treatment.
Right now, I’m not in pain, though I expect it will return eventually. I’ve started wondering if living with some manageable pain might be a better option than the unpredictability and severity of these side effects.
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