Have you ever just felt so desperate for something that you jump into a decision, without thinking it through completely or weighing the possible repercussions of your decision?
It had been five years since my last flare up of guttate psoriasis. Following the first signs of another outbreak, I had begun the same treatment regime that brought me remission the first time around: that was, phototherapy three times per week along with two topical corticosteroids applied to the psoriasis plaques twice daily.
(As an aside, the dermatologist that I was seeing in Charlottesville told me to go to a tanning salon instead of a formal light therapy studio “to save money and time” and looking back, I wonder if this decision prolonged my current flare up.)
Initially, my spots were fading rapidly, but then seemingly overnight, they returned, larger and more pronounced than ever.
Apparently, this was just “the nature of the beast.” In a frenzy, I called my new dermatologist to schedule an appointment as soon as possible. I was so desperate that I forgot about my first appointment with him, when I left with a bad feeling in my gut. He was too aggressive in his examination for my liking, looked me over for a grand total of five minutes, and charged my insurance plan $150.
Before this point, I had only tried treatments that would fight guttate psoriasis on the outside, by targeting the rash itself. These treatments were getting more and more impractical as the psoriasis spread around my body, and because my outbreak now qualified as “severe,” for my second appointment, I had already decided that I needed to try a treatment that would fight my disease on the inside, by targeting my overactive immune system. I wanted to combat it quickly and effectively, and I felt like the next step up to my previous treatment regime was to use some kind of immunosuppressant.
My dermatologist agreed with me and prescribed Methotrexate, a chemotherapy agent that is also used to treat cancer, ectopic pregnancies, and severe Crohn’s disease. My mother weighed her skepticism down on me, but my dermatologist assured me that my guttate psoriasis would disappear in three weeks’ time and would likely not reappear again for the rest of my life. It sounded perfect. The side effects? I couldn’t drink alcohol, would experience minor hair loss, and would have to get my blood drawn every ten days when I was taking the medication. It didn’t sound like anything I couldn’t handle, and the ten-dollar copay on the 24 pills I needed was next to nothing.
I was to take six small Methotrexate pills one day per week for three weeks. I was so optimistic and so reassured, but week after week passed without any significant change to my skin. By my last round of pills, my optimism had faded, and to make matters worse, I had contracted another case of strep throat. (In my case, strep throat triggers a guttate psoriasis flare up.)
When all was said and done, my skin was worse than it was before I started taking the Methotrexate, and I had racked up medical bills to the tune of $1,000 or so from the blood work and dermatologist appointments I needed to keep on the medication.
I had a follow up appointment scheduled with my doctor after the Methotrexate course was completed, which I cancelled. I don’t know what he would have said about my experience, or what he would have prescribed me next, but I have since found a new dermatologist, who I trust, and who has since told me that Methotrexate was not a good drug for me.
The moral of this story is how important it is to trust your gut, especially with new doctors and new medications.
Get a second opinion, do your own research, and approach everything with a healthy dose of skepticism.
In the long run, it is better to be patient and wait for a more secure treatment plan, then to rush into something that may end up doing more harm than good.
Disclaimer: Methotrexate did not work for me, but that doesn’t mean that it won’t work for everyone.