Three month visit yesterday with the rh, and we talked about my exact diagnosis.  I am seronegative, and the initial diagnosis of RA was based on symptoms.  A bit later, it was 'undifferentiated auto-immune disease'.  Now, it's PsA.  My increasingly chunky sausage-fingers are the deciding factor, apparently.

The Stelara seems to be helping, but one more finger has joined the ranks of the sausage links in the last few months.  We're going to consider switching to a different med next time, in early March, if anything else changes before then.  Overall, though, I don't feel fatigued or 'foggy', and I haven't had any side effects from the mtx and Stelara.  Yesterday's appointment went well, and in general I'm happy with the management plan.

What's weirdly fascinating to me is that I find myself a little rattled by the change in diagnosis.  I had accepted my identity as "RA" and it is almost unnerving to re-identify..........and that's just weird, really, when you examine it logically.

I think part of it is that for the general publiuc, PSA is associated with skin issues, and I have zero skin involvement.  I understand that psoriatic arthritis does not always affect the skin.  But that's the general perception.  On the few instances when I have used the term with a new acquaintance, I find myself doing an awful lot of explaining.  I'm happy to be an ambassador and do my part to help people understand more.  But it gets tiring, especially with people aho are positive that they know more than I do, since they saw, you know, an episode of "Ellen" about it, or read an article in a magazine at their dentist's office.

I think I'm going to be "PSA" in my own head, and "undifferentiated auto-immune disease" publicly.  I realize I don't need to make anything public at all, but I often find myself in a position where I can be of some service to others by being honest about my situation, so it does come up.  In early Feb, I'll be speaking at a statewide farming conference.  I addressed the group when I was just starting as a farmer at 40, and again at 50 when things were really starting to crank up.  My original plan was to speak again at the age of sixty, and I'm imagined it as a fairly triumphal moment; I'd planned to have expanded the farm, perhaps bough some adjacent acreage, hired some employees, and so on.

When I was hit by the freight train which is RA/PSA/Whatever, I thought I might cancel the plan to speak at the 2020 conference, because all that planned upscaling didn't happen.  But now I've decided I actually do have something valid to say.  I've just changed the title.  ("I'm Not Dead Yet! - what happens when Plan A takes a hit.")  

It won't be about ME, other than enough information so that attendees understand my bona fides when it comes to having Plan A turned upside down.  But I've realized that what I'll say that day will be more important than my original plan of speaking about farm expansion.  Farm bankruptcies are soaring, farmer suicides are at an all time high.  Farmers are notorious for ignoring chronic health issues, and often have terrible or non-existent retirement plans.  There is much to discuss.

But, I do have to be comfortable in my own head about 'who I am', medically speaking.  

On those occasions when you choose to discuss your diagnosis publicaly, what terms do you use (especially anyone who's in that middle area with both some RA and PSA symptoms)?