Lori and I joined a Christian conference for graduate students in the beautiful Santa Cruz mountains. We found this prayer chapel during one of our walks. The trip marked our first weekend on leave from the church.

Happy New Year! I know it is almost mid-February, but it’s my first PsoHoward entry of the year. I’ve been quite busy preparing for a personal leave that started this month. Now that I will be on four-month break I hope to come back to writing regularly.

Today I’ll start with treatment updates.

Skyrizi Still Somewhat Working

I started taking Skyrizi for psoriasis on May 31, 2019. I now have over 36 weeks and about nine months of experience with it. Since my last update and fourth dose on December 8^th, I can report mixed results. 

I know it’s still working as the severity of my psoriasis is less than without treatment. My hands and feet, upper back and chest, and parts of my legs and arms are mostly clear of psoriasis. In places I do have psoriasis there are smaller plaques that are more pinkish than red. I do wish I had less psoriasis overall, but Skyrizi is definitely doing some good. 

Possible Reasons My Skin is More Inflamed

However, if I compare my skin’s response to earlier days with Skyrizi I am not doing as well now as I was then. Before declaring Skyrizi is not working well, I believe my skin inflammation can calm by addressing some seasonal and lifestyle issues:

Winter and Phototherapy

In winter my skin conditions tend to worsen. My eczema especially reacts to colder temperatures and drier air due to indoor heating. Phototherapy effectively keeps eczema under better control but seems to make my psoriasis worse at higher doses. I’m finding difficulty finding that dose that helps eczema and doesn’t worsen psoriasis.

When spring arrives, my skin conditions should improve. I might need to rely less on artificial light therapy as well.

Stress, Stress, and More Stress

As I alluded to earlier, it’s been a stressful time for me at work in preparing for my personal leave. Of course, I continued to manage other areas of my life such as my younger daughter’s transition to college and my older daughter’s medication transitions. No doubt I experienced psoriasis flares due to the high levels of stress.

I will have more to say about caring for my health and this leave in an upcoming Everyday Health The Itch to Beat Psoriasis column so stay tuned. But with stress as a psoriasis trigger, reducing stress can only help.

---

Follow my Skyrizi journey!

Starting Skyrizi for Psoriasis Week 0

Skyrizi Week 3: Three Questions Waiting to Be Answered

Skyrizi Week 6: Anxiously Awaiting Results

Skyrizi Week 16: The Verdict?

---

Poor Diet

The result of worsening skin amidst an intense stressful lifestyle? I ate poorly, often grabbing fast and junk food on the run. I can’t say for certain what I eat that causes psoriasis flares. But I can say that when I eat junk my body feels like junk. I definitely looked forward to my break when I could take the time to prepare meals and eat more healthfully.

Lack of Sleep

Getting quality sleep is an ongoing issue for me. But during recent times I found myself working late, affecting my bedtime. I also started to worry about things that I normally could let go, affecting my ability to rest. For example, when my gutters leaked water during rainstorms, I would stay up wondering if they would break, if a damaged roof caused water overflow, or if water would pool and damage the house’s foundation. 

Getting better sleep is a good possibility as I learn to let go of things in less stressful times.

Where is My Next Dose of Skyrizi Coming From?

With the new calendar year 2020 my health insurance provider changed pharmacy benefit managers. I mainly felt the impact in working with a new specialty pharmacy since I can continue to go to my local CVS or Costco for non-specialty medications. 

My new specialty pharmacy, Optum, gave me quite the runaround when I called to see if and when I could receive my next Skyrizi shipment. I literally talked to eight different people over a one-hour phone call before reaching the one person who could help me. Unfortunately, she said my Skyrizi prescription and prior authorization did not transfer to their system. I would need to talk to my dermatologist to get those.

Resigned to my fate, I began the process of messaging my dermatologist. Then, unexpectantly, someone from the clinic called offering me my Skyrizi through the clinic’s specialty pharmacy. I could work directly with her locally. Since she works in the same office as my dermatologist, I could enjoy a streamlined and centralized processing of Skyrizi. I told her yes, yes, yes, I want her to manage my Skyrizi prescription.

She called me today to let me know everything is in order and the medication will be delivered on Friday. Yes, yes, yes!