It started with eczema, a fairly common chronic skin condition. That was the diagnosis that registered nurse Terri Eggeman received in the late 1990s. But in early 2008 her skin lesions started to change, plus there were more of them and her medication seemed to be ineffective. She headed to the dermatologist who was treating her eczema, and a biopsy revealed that Eggeman now had psoriasis.
“I didn’t really know what psoriasis was, so I had to look it up on the Internet,” says Eggeman, who learned that it’s an autoimmune disease in which overactive T cells (a type of white blood cell) cause skin cells to grow at an abnormally rapid rate. These cells rise to the surface of the skin, where they appear as thick, red, scaly patches.
When Eggeman mentioned to her dermatologist that she also had chronic lower back pain, she was quickly referred to a rheumatologist, who confirmed, in the spring of 2008, that she had psoriatic arthritis—a relatively unheard of type of arthritis, but one that’s more common than most people realize. Eggeman went back to the Internet and learned that about 30 percent of individuals with psoriasis go on to develop the arthritic component. She had become one of them.
According to the National Psoriasis Foundation, approximately 2.25 million Americans have psoriatic arthritis effects. This inflammatory autoimmune disease commonly affects joints in the fingers and toes, as well as the wrists, knees, ankles and, surprisingly, the lower back, which is the area in which Eggeman feels the most pain when she has a flare-up of her condition. The symptoms of psoriatic arthritis are very similar to other types of arthritis, with the twist that psoriasis goes along with it.
Eggeman is now on a pretty intense regime of medications. At first, she tried taking only Celebrex, a popular anti-inflammatory medication, but it just wasn’t effective enough on its own. These days, she takes Celebrex every day and methotrexate once a week, and every two weeks she gives herself an injection of HUMIRA. Both methotrexate and HUMIRA help to reduce joint pain, stiffness and swelling, as well as minimize the psoriasis.
“Overall, my joints do really well most of the time, but it’s a disease that flares,” says Eggeman, explaining that she kept on working right through her diagnosis and the rocky time when she began taking methotrexate. “When I started on the methotrexate, I felt tired and nauseated, so I sat down with my charge nurse and explained what I was going through. The people I work with were wonderful and they would help pick up the slack if I was having a down day.”
Eggeman works 30 to 35 hours per week in the Post-Anesthesia Care Unit (PACU) at the Pediatric Surgery Center in Tampa, Fla., where she has been employed tor the past six years. “Now that I’m stable on the medication, I don’t have very many of those down days anymore,” she says. But for those times when her back or joints hurt—she spends a great deal of time on her feet, so her hips and knees do bother her occasionally—she reaches into her cart at her PACU station, where she keeps a small arsenal of heat wraps. “When I feel pain, I just grab one of them and wrap it around the area that aches.”
Eggeman has also incorporated some complementary therapies into her treatment regime. She gets a deep tissue massage every six to eight weeks and attends an exercise class for people with arthritis. In January she started tai chi. “I love it!” she says. “It’s a wonderful, quieting and relaxing moving meditation, and it’s helping with my flexibility and core strength.”
She has also come to understand that when she eats junk food, has a few donuts at work or skips a meal, she can have a flare-up. “It really does make a difference when I eat healthy—fruits, vegetables, lean proteins and lots of water,” she admits. “I’m not perfect, but I do try.”
Eggeman starts her day by taking a hot shower to get rid of any stiffness that has built up from being in bed all night. “I have a hot shower, drink a lot of fluid and just start moving.”
She devotes some of her spare time to being a mentor with the National Psoriasis Foundation. “I felt so lost and out of control when I was diagnosed with this disease,” she explains. “I coped by finding out as much as I possibly could. I went to a national conference and learned about this new one-on-one mentoring program for newly diagnosed patients. I did the training about a year and a half ago, and I’ve mentored about 20 people since then. I find this very satisfying because I understand perfectly what they’re going through.” Eggeman adds that about half of these 20 people were diagnosed with psoriasis only, and the other half with psoriatic arthritis.
As far as her nursing career goes, Eggeman says, “I’ve been a nurse for 33 years, and as long as I feel as good as I do, I’ll keep doing it. I like where I work and I love the people I work with.”
In addition to nursing and volunteering, Eggeman enjoys traveling with her husband and spending time with her three grown sons, one of whom is currently in medical school. She leads a rich life, and having this somewhat obscure form of arthritis hasn’t slowed her down. In many ways it has opened new doors for her and made her a much stronger person.