1 00:00:01,240 --> 00:00:05,800 Speaker 1: Welcome to Our Skin, a personal discovery podcast. I'm your host, 2 00:00:05,840 --> 00:00:08,320 Speaker 1: Holly Fry, and it is wonderful to have you here 3 00:00:08,360 --> 00:00:11,559 Speaker 1: with us. Connection is what this show is all about, 4 00:00:12,039 --> 00:00:15,680 Speaker 1: specifically connecting about things that we are sometimes afraid to 5 00:00:15,720 --> 00:00:18,520 Speaker 1: talk about. Today, we're going to be exploring the ups 6 00:00:18,520 --> 00:00:22,440 Speaker 1: and downs, past and present, personal and universal troubles we 7 00:00:22,520 --> 00:00:26,600 Speaker 1: have with our skin. Our skin is our most visible organ. 8 00:00:26,880 --> 00:00:29,800 Speaker 1: What happens on our skin affects the rest of our lives, 9 00:00:30,160 --> 00:00:33,960 Speaker 1: especially when dealing with a chronic condition. Getting diagnosed with 10 00:00:34,000 --> 00:00:37,480 Speaker 1: one of these, like psoriasis, can be overwhelming, but you're 11 00:00:37,520 --> 00:00:42,080 Speaker 1: not alone. Each episode features a personal story of resilience 12 00:00:42,200 --> 00:00:45,239 Speaker 1: and grace, but our personal stories are threads in a 13 00:00:45,320 --> 00:00:48,320 Speaker 1: larger tapestry, and there are lessons for us in the 14 00:00:48,400 --> 00:00:51,120 Speaker 1: history of how we treat our skin and the progress 15 00:00:51,159 --> 00:00:55,480 Speaker 1: we've made together. Caring for our skin is caring for ourselves. 16 00:00:55,880 --> 00:00:59,280 Speaker 1: Whether you're seeking inspiration for your own journey or curious 17 00:00:59,320 --> 00:01:03,320 Speaker 1: about the history of our skin, you'll find empathetic, transformative 18 00:01:03,360 --> 00:01:09,600 Speaker 1: conversations here on Our Skin. So today we are sitting 19 00:01:09,640 --> 00:01:15,000 Speaker 1: down with yet another incredibly inspiring guest, Joni Kazantsis. Joni 20 00:01:15,160 --> 00:01:18,000 Speaker 1: is not just a Sriasis advocate. She is also the 21 00:01:18,080 --> 00:01:21,160 Speaker 1: voice behind the just a Girl with Spots blog, which 22 00:01:21,200 --> 00:01:24,000 Speaker 1: is a resource and community hub where she shares her 23 00:01:24,040 --> 00:01:27,640 Speaker 1: personal journey living with siriasis and provides a space for 24 00:01:27,760 --> 00:01:32,959 Speaker 1: others facing similar challenges to find connection and information about sriasis. 25 00:01:33,520 --> 00:01:37,120 Speaker 1: When Joni was just fifteen, she woke up covered in red, 26 00:01:37,280 --> 00:01:41,720 Speaker 1: scaly spots. Looking back, they came out of nowhere. There 27 00:01:41,880 --> 00:01:45,760 Speaker 1: wasn't any big stressor or event that caused this initial flare, 28 00:01:46,400 --> 00:01:49,520 Speaker 1: and like many she faced the physical pain and frustration 29 00:01:49,760 --> 00:01:52,920 Speaker 1: of managing flare ups. But what really weighed on her 30 00:01:53,040 --> 00:01:57,240 Speaker 1: was the emotional toll. She remembers covering up her skin 31 00:01:57,360 --> 00:02:01,080 Speaker 1: to avoid stairs and comments, but her friends and classmates 32 00:02:01,120 --> 00:02:05,280 Speaker 1: were largely accepting. It was actually the reactions of adults 33 00:02:05,280 --> 00:02:08,000 Speaker 1: that stick in her mind now, like a very rude 34 00:02:08,040 --> 00:02:10,360 Speaker 1: woman at the beach who once asked Joni if she 35 00:02:11,080 --> 00:02:15,320 Speaker 1: was contagious, as if being a teenager isn't tough enough. 36 00:02:16,080 --> 00:02:19,440 Speaker 1: After years of struggling and navigating a medical system that 37 00:02:19,600 --> 00:02:23,520 Speaker 1: didn't always have clear answers, Jonie decided to take control 38 00:02:23,639 --> 00:02:26,840 Speaker 1: of her own narrative. She began writing Just a Girl 39 00:02:26,840 --> 00:02:29,200 Speaker 1: with Spots in twenty twelve as a way to share 40 00:02:29,240 --> 00:02:32,440 Speaker 1: her story, thinking she might reach a few people who 41 00:02:32,480 --> 00:02:37,040 Speaker 1: were going through similar experiences. That site has become a 42 00:02:37,160 --> 00:02:40,440 Speaker 1: hub of honest, raw and often humorist reflections on the 43 00:02:40,480 --> 00:02:44,280 Speaker 1: realities of living with psoriasis, everything from dealing with flare 44 00:02:44,320 --> 00:02:47,720 Speaker 1: ups in public to the anxiety of trying new treatments. 45 00:02:48,240 --> 00:02:51,240 Speaker 1: And this community became even more vital when Joni was 46 00:02:51,280 --> 00:02:55,280 Speaker 1: diagnosed with soriatic arthritis in twenty twenty at thirty eight 47 00:02:55,360 --> 00:02:58,440 Speaker 1: years old. Today, I am very pleased to say that 48 00:02:58,560 --> 00:03:02,320 Speaker 1: Joni joins us to share more about her journey, her advocacy, 49 00:03:02,400 --> 00:03:04,920 Speaker 1: and how just a girl with spots is helping others 50 00:03:05,000 --> 00:03:08,040 Speaker 1: feel less alone. So, Joni, thank you so much for 51 00:03:08,120 --> 00:03:09,120 Speaker 1: being here with us. 52 00:03:09,320 --> 00:03:12,600 Speaker 2: Hello, how are you? I'm so excited to be here 53 00:03:12,800 --> 00:03:15,840 Speaker 2: and really appreciate the opportunity to come on and tell 54 00:03:15,880 --> 00:03:18,400 Speaker 2: my story and a little bit about the experiences that 55 00:03:18,480 --> 00:03:21,240 Speaker 2: I've had growing up with psoriasis and then being later 56 00:03:21,280 --> 00:03:23,079 Speaker 2: diagnosed with soriatic arthritis. 57 00:03:24,000 --> 00:03:26,040 Speaker 1: I want you to take me back to what it 58 00:03:26,120 --> 00:03:29,800 Speaker 1: was like being fifteen and waking up covered in spots. 59 00:03:29,880 --> 00:03:34,000 Speaker 1: This seems like the teenager's nightmare. So what was that morning, Like, 60 00:03:34,360 --> 00:03:37,200 Speaker 1: how did your family react, what did you do? Tell 61 00:03:37,280 --> 00:03:39,000 Speaker 1: us how the whole thing played out? 62 00:03:39,360 --> 00:03:43,480 Speaker 2: I panicked. It felt like I had a million bug 63 00:03:43,520 --> 00:03:46,280 Speaker 2: bites on top of a bad sunburn. I always had 64 00:03:46,280 --> 00:03:48,800 Speaker 2: a lot of allergies growing up, so my family thought 65 00:03:48,840 --> 00:03:50,800 Speaker 2: it was something I ate, or potentially that I came 66 00:03:50,840 --> 00:03:53,880 Speaker 2: into contact with outside at a soccer game the day before. 67 00:03:54,520 --> 00:03:56,960 Speaker 2: My grandmother actually lived with us, and she had a 68 00:03:57,000 --> 00:04:01,120 Speaker 2: mild case of psoriasis, but based on how severe it was, 69 00:04:01,200 --> 00:04:03,400 Speaker 2: even she thought it was allergies because she had never 70 00:04:03,480 --> 00:04:05,320 Speaker 2: had more than a few spots on her arm at 71 00:04:05,360 --> 00:04:08,640 Speaker 2: a time. I first saw my pediatrician because I was 72 00:04:08,760 --> 00:04:13,440 Speaker 2: so young, and they recommended a dermatologist. My dermatologist who 73 00:04:13,440 --> 00:04:16,680 Speaker 2: I was able to get into pretty quickly officially diagnosed 74 00:04:16,720 --> 00:04:19,960 Speaker 2: me with guttade and plaxiasis on my first visit. But 75 00:04:20,200 --> 00:04:22,280 Speaker 2: I was a fifteen year old girl. I was already 76 00:04:22,279 --> 00:04:25,640 Speaker 2: self conscious about my appearance, so this honestly felt like 77 00:04:25,720 --> 00:04:28,479 Speaker 2: the worst possible thing that could ever be happening to me. 78 00:04:29,720 --> 00:04:32,720 Speaker 1: I imagine it feels like you went to sleep in one 79 00:04:32,760 --> 00:04:35,240 Speaker 1: body and woke up in another, Like how did you 80 00:04:35,320 --> 00:04:38,760 Speaker 1: even reconcile your identity? With yourself at that point. 81 00:04:39,680 --> 00:04:44,640 Speaker 2: It's a tough age to begin with it. Yeah, there's 82 00:04:44,680 --> 00:04:48,520 Speaker 2: so much going on in your mind that is about yourself. 83 00:04:48,800 --> 00:04:53,159 Speaker 2: You're very much focused on what other people think of you, 84 00:04:53,400 --> 00:04:56,440 Speaker 2: and now to be covered in these red spots, my 85 00:04:56,640 --> 00:05:00,159 Speaker 2: first inclination was just to hide and isolate myself. It 86 00:05:00,200 --> 00:05:03,400 Speaker 2: was just really hard to understand for me that this 87 00:05:03,560 --> 00:05:07,120 Speaker 2: was a chronic disease. I thought I had no experience 88 00:05:07,160 --> 00:05:09,359 Speaker 2: with it, that I would go to the doctor, he 89 00:05:09,360 --> 00:05:11,919 Speaker 2: would give me a pill or a prescription and I 90 00:05:11,920 --> 00:05:14,440 Speaker 2: would put it on and it would go away. He 91 00:05:14,560 --> 00:05:17,000 Speaker 2: started talking to my mom and me that you know, 92 00:05:17,200 --> 00:05:19,159 Speaker 2: if this doesn't work, we have Plan B, and if 93 00:05:19,200 --> 00:05:21,320 Speaker 2: that doesn't work, we have Plan C, and so on 94 00:05:21,360 --> 00:05:25,000 Speaker 2: and so on and so on. And it was really 95 00:05:25,320 --> 00:05:27,919 Speaker 2: challenging for me to understand that this was going to 96 00:05:27,960 --> 00:05:30,279 Speaker 2: be something that I would have to live with for 97 00:05:30,560 --> 00:05:34,480 Speaker 2: my entire life. And because I was so young, they 98 00:05:34,560 --> 00:05:37,600 Speaker 2: didn't really want to be very aggressive with the treatment, 99 00:05:37,720 --> 00:05:40,760 Speaker 2: so steroids wasn't an option. Biologics at that age wasn't 100 00:05:40,800 --> 00:05:43,200 Speaker 2: an option for me. So it was a lot of creams. 101 00:05:43,279 --> 00:05:46,919 Speaker 2: It was light therapy treatment and things that I could 102 00:05:46,960 --> 00:05:48,880 Speaker 2: do from a lifestyle perspective. 103 00:05:49,800 --> 00:05:53,920 Speaker 1: You have this somewhat unique experience in that you got 104 00:05:53,960 --> 00:05:57,839 Speaker 1: a whole new diagnosis much later in life to compare 105 00:05:57,839 --> 00:05:59,840 Speaker 1: and contrast with what it was like as a teen. 106 00:06:00,560 --> 00:06:03,400 Speaker 1: I'm curious how it felt to get that new diagnosis 107 00:06:03,400 --> 00:06:05,800 Speaker 1: at that point. You were thirty eight, you were a mom, 108 00:06:05,880 --> 00:06:09,440 Speaker 1: you had young kids, and then you're diagnosed to asiatic arthritis. 109 00:06:09,839 --> 00:06:11,960 Speaker 1: What was that like and did you think about it 110 00:06:12,040 --> 00:06:14,560 Speaker 1: at the time as a different experience from when you 111 00:06:14,600 --> 00:06:15,240 Speaker 1: were fifteen. 112 00:06:15,680 --> 00:06:19,000 Speaker 2: I definitely felt more control because I always knew that 113 00:06:19,000 --> 00:06:22,000 Speaker 2: it was a possibility that I could develop soiatic arthritis, 114 00:06:22,000 --> 00:06:24,280 Speaker 2: so I knew a lot about it. When I was 115 00:06:24,279 --> 00:06:27,240 Speaker 2: first diagnosed with psoriasis, I knew nothing about it. I 116 00:06:27,279 --> 00:06:29,320 Speaker 2: didn't even I hated the word. I didn't even like 117 00:06:29,360 --> 00:06:33,279 Speaker 2: to say the word. And it was pre Google. You 118 00:06:33,320 --> 00:06:36,279 Speaker 2: couldn't just look it up and find out anything about it. 119 00:06:36,480 --> 00:06:39,000 Speaker 2: I got pamphlets at the doctor's office, and I couldn't 120 00:06:39,000 --> 00:06:42,440 Speaker 2: pronounce half of the words in those pamphlets. So I 121 00:06:42,560 --> 00:06:45,200 Speaker 2: knew a lot more about it, and I felt more informed, 122 00:06:45,240 --> 00:06:48,200 Speaker 2: and I could find out information and different things that 123 00:06:48,279 --> 00:06:52,120 Speaker 2: I could do to be more proactive with it. But 124 00:06:52,200 --> 00:06:55,320 Speaker 2: there was still that panic attached to it, because there 125 00:06:55,400 --> 00:06:57,799 Speaker 2: was a lot more determination to get the right treatment 126 00:06:57,960 --> 00:07:01,599 Speaker 2: right away so that I could maintain lifestyle. I'm really 127 00:07:01,600 --> 00:07:03,760 Speaker 2: hands on with the girls. I've led both of their 128 00:07:03,760 --> 00:07:06,520 Speaker 2: Girl Scout troops, I coach lacrosse. I'm on the ground 129 00:07:06,600 --> 00:07:09,640 Speaker 2: with them on the gym floor, making signs and decorations 130 00:07:09,640 --> 00:07:12,040 Speaker 2: for cheer competitions, and those were the things that I 131 00:07:12,120 --> 00:07:14,520 Speaker 2: really wanted to make sure that I could still do. 132 00:07:15,160 --> 00:07:17,920 Speaker 2: I love to exercise, I lift weights four times a week, 133 00:07:17,960 --> 00:07:21,119 Speaker 2: I'm running, I'm going on bike rides, So being able 134 00:07:21,160 --> 00:07:24,640 Speaker 2: to maintain mobility was just critical for me. So there's 135 00:07:24,760 --> 00:07:26,680 Speaker 2: just days when I need to push through it. But 136 00:07:26,760 --> 00:07:28,760 Speaker 2: I also think it's important for the girls to see 137 00:07:28,760 --> 00:07:32,040 Speaker 2: me taking care of my body and myself, So there 138 00:07:32,120 --> 00:07:35,160 Speaker 2: was more of a balance. But I definitely felt more 139 00:07:35,200 --> 00:07:38,440 Speaker 2: in control with this diagnosis. I don't want it. Not 140 00:07:38,520 --> 00:07:40,200 Speaker 2: a club that I want to be part of, but 141 00:07:40,400 --> 00:07:45,000 Speaker 2: something that I felt I was more capable of managing 142 00:07:45,040 --> 00:07:45,720 Speaker 2: at this age. 143 00:07:46,280 --> 00:07:49,040 Speaker 1: Will you talk a little bit for our audience about 144 00:07:49,080 --> 00:07:53,120 Speaker 1: psoriasis versus soriatic arthritis. They're often related, but they are 145 00:07:53,160 --> 00:07:55,240 Speaker 1: not the same thing. So will you walk us through it. 146 00:07:55,520 --> 00:07:58,880 Speaker 2: Yeah, So both are autoimmune diseases, So essentially your immune 147 00:07:58,880 --> 00:08:02,480 Speaker 2: system is attacking your own body and that's causing inflammation 148 00:08:02,680 --> 00:08:06,960 Speaker 2: in your body. Pyiasis symptoms appear on the skin with 149 00:08:07,120 --> 00:08:11,280 Speaker 2: thick scaly patches, and then soriatic arthritis really affects the joints. 150 00:08:11,600 --> 00:08:13,960 Speaker 2: I get the arthritis in my hands and my toes, 151 00:08:14,040 --> 00:08:17,000 Speaker 2: which makes some days a little bit slower than others 152 00:08:17,040 --> 00:08:19,880 Speaker 2: and a little bit harder to do. But there's always 153 00:08:19,920 --> 00:08:22,600 Speaker 2: ways I find that I can kind of cheat a 154 00:08:22,680 --> 00:08:26,120 Speaker 2: little bit, and I find ways to adapt. You can 155 00:08:26,200 --> 00:08:29,880 Speaker 2: have psoriasis and never develop soriatic arthritis. You can also 156 00:08:30,280 --> 00:08:33,440 Speaker 2: have zordiatgarthritis and not have psoriasis. So there's really a 157 00:08:33,440 --> 00:08:36,199 Speaker 2: lot of aspects to it that are still a mystery. 158 00:08:36,760 --> 00:08:39,280 Speaker 2: There's no real way to know if you get diagnosed 159 00:08:39,280 --> 00:08:41,679 Speaker 2: with one, if later down the line you'll get diagnosed 160 00:08:41,720 --> 00:08:42,120 Speaker 2: with the other. 161 00:08:42,679 --> 00:08:44,800 Speaker 1: I know you've talked about from your point of view, 162 00:08:45,640 --> 00:08:48,560 Speaker 1: knowing that you had more information at hand when you 163 00:08:48,600 --> 00:08:51,320 Speaker 1: were an adult and you knew how to attack the problem. 164 00:08:51,600 --> 00:08:55,200 Speaker 1: But from the opposite side, how were the journeys different 165 00:08:55,200 --> 00:09:01,320 Speaker 1: in dealing with doctors, getting your diagnosis, getting treatments, figures doubt. 166 00:09:01,040 --> 00:09:03,959 Speaker 2: With my SERISIS diagnosis. I was a kid, so my 167 00:09:04,080 --> 00:09:08,120 Speaker 2: mom took me everywhere I went. She was really critical 168 00:09:08,320 --> 00:09:13,760 Speaker 2: in that treatment journey and was ultimately making those decisions. 169 00:09:13,920 --> 00:09:16,080 Speaker 2: I was always part of the conversation and we talked 170 00:09:16,120 --> 00:09:18,560 Speaker 2: about what would work and not work for me. But 171 00:09:19,000 --> 00:09:23,000 Speaker 2: she was very critical in research, again pre Google era, 172 00:09:23,120 --> 00:09:25,200 Speaker 2: so when she does research, she was taking herself to 173 00:09:25,240 --> 00:09:28,560 Speaker 2: the library and she was finding what else we could 174 00:09:28,600 --> 00:09:31,400 Speaker 2: be doing. So first it was a pediatrician and then 175 00:09:31,440 --> 00:09:35,240 Speaker 2: a dermatologist, and then treatment was really a challenge, I 176 00:09:35,320 --> 00:09:39,360 Speaker 2: think for us because of the age. Steroids was something 177 00:09:39,400 --> 00:09:41,520 Speaker 2: that my mom just didn't want me to be on, 178 00:09:41,800 --> 00:09:45,400 Speaker 2: especially being fifteen and in that space of growing up 179 00:09:45,440 --> 00:09:48,400 Speaker 2: and getting older, which honestly was really frustrated for me 180 00:09:48,480 --> 00:09:51,760 Speaker 2: because I just so desperately wanted to have clear skin, 181 00:09:51,920 --> 00:09:54,760 Speaker 2: and I didn't want to be patient and see if 182 00:09:54,800 --> 00:09:57,560 Speaker 2: things would work, and I wanted to be as aggressive 183 00:09:57,600 --> 00:10:01,680 Speaker 2: as possible. Thankfully, I did have a patient parent who 184 00:10:02,320 --> 00:10:07,520 Speaker 2: understood long term that that would be something that could 185 00:10:07,520 --> 00:10:09,360 Speaker 2: potentially have side effects. So it was a lot of 186 00:10:09,360 --> 00:10:12,840 Speaker 2: creams and ointments. They were very messy, very smelly, like 187 00:10:12,920 --> 00:10:18,240 Speaker 2: coal tar things. That stained things that just were not 188 00:10:18,360 --> 00:10:22,120 Speaker 2: pleasant to put on your skin, and I struggled mentally 189 00:10:22,240 --> 00:10:25,320 Speaker 2: understanding that a flair could last months or years, and 190 00:10:25,360 --> 00:10:27,920 Speaker 2: then wrapping my head around again that I would have 191 00:10:27,960 --> 00:10:30,800 Speaker 2: this disease for the rest of my life, where with 192 00:10:30,960 --> 00:10:34,160 Speaker 2: soriatic arthritis, I've already come to terms the fact that 193 00:10:34,200 --> 00:10:36,480 Speaker 2: I live with psoriasis is just part of my life now. 194 00:10:36,480 --> 00:10:39,320 Speaker 2: I grew up with it every major event in my 195 00:10:39,360 --> 00:10:43,719 Speaker 2: life so far. I've had psoriasis at my wedding, my graduations, 196 00:10:44,000 --> 00:10:48,119 Speaker 2: both of my kids being born, and so soriatic arthritis 197 00:10:48,200 --> 00:10:51,040 Speaker 2: was new for me, and especially being diagnosed in twenty 198 00:10:51,080 --> 00:10:53,320 Speaker 2: twenty when we all know what a great year that 199 00:10:53,559 --> 00:10:56,640 Speaker 2: was for everyone, So this just kind of felt like 200 00:10:56,760 --> 00:11:00,280 Speaker 2: a cherry on top of just a fantastic, fantasts a 201 00:11:00,360 --> 00:11:04,400 Speaker 2: year for everyone. I started to get spots coming back, 202 00:11:04,440 --> 00:11:07,000 Speaker 2: but also for the first time, I felt it in 203 00:11:07,080 --> 00:11:09,800 Speaker 2: my joints, and I knew right away what it was. 204 00:11:10,840 --> 00:11:14,080 Speaker 2: And so every doctor's appointment I have, he would ask 205 00:11:14,080 --> 00:11:16,400 Speaker 2: me any joint pain, any of this, and so this 206 00:11:16,559 --> 00:11:19,320 Speaker 2: was the first time that I was like, yep, I 207 00:11:19,360 --> 00:11:21,960 Speaker 2: have joint pain. My hands hurt in the morning, Like 208 00:11:22,080 --> 00:11:25,520 Speaker 2: what can we do, and how can we get something 209 00:11:25,600 --> 00:11:26,920 Speaker 2: new going right away? 210 00:11:27,840 --> 00:11:30,760 Speaker 1: How long did it take to settle into kind of 211 00:11:30,760 --> 00:11:33,599 Speaker 1: a regimen that controlled things. We've heard from all of 212 00:11:33,640 --> 00:11:38,000 Speaker 1: our guests that controlling psoriasis flares is about both medical 213 00:11:38,000 --> 00:11:41,560 Speaker 1: treatment and lifestyle changes. Was that the case for you? 214 00:11:41,640 --> 00:11:43,599 Speaker 1: And how long did it really take to get to 215 00:11:43,640 --> 00:11:46,400 Speaker 1: a point where you felt like either yoursriasis or your 216 00:11:46,640 --> 00:11:49,800 Speaker 1: criatic arthritis were under control as much as they could be. 217 00:11:50,320 --> 00:11:52,719 Speaker 2: It took a long time, I think, especially because of 218 00:11:52,760 --> 00:11:56,600 Speaker 2: the age and the less aggressive treatments, to find that 219 00:11:56,679 --> 00:12:00,080 Speaker 2: balance with medication and lifestyles. As time went on, I 220 00:12:00,120 --> 00:12:03,800 Speaker 2: started to understand what my triggers were. Stress I very 221 00:12:03,880 --> 00:12:06,280 Speaker 2: quickly realized was something that was a trigger for me. 222 00:12:07,040 --> 00:12:11,160 Speaker 2: My dermatile just was really knowledgeable about psoriasis. We talked 223 00:12:11,160 --> 00:12:15,000 Speaker 2: about lifestyle changes. It was smaller things. It was like 224 00:12:15,120 --> 00:12:17,520 Speaker 2: night shades could be a trigger, so you shouldn't neet those, 225 00:12:18,080 --> 00:12:21,280 Speaker 2: or sunlight is good for your psoriasis. I vividly remember 226 00:12:21,320 --> 00:12:23,680 Speaker 2: going home from that appointment after you said that, and 227 00:12:23,760 --> 00:12:26,640 Speaker 2: immediately got a towel and I went out to sunbathe. 228 00:12:27,000 --> 00:12:29,120 Speaker 2: I also learned that day that you still need to 229 00:12:29,160 --> 00:12:32,120 Speaker 2: wear sunscreen even though the sun is good for psoriasis, 230 00:12:32,240 --> 00:12:36,320 Speaker 2: because a sunburn is actually much much, much worse. So 231 00:12:36,480 --> 00:12:42,160 Speaker 2: lived experiences in what works and what doesn't work lifestyle 232 00:12:42,520 --> 00:12:46,359 Speaker 2: to me now, when I think about my treatment, lifestyle 233 00:12:46,440 --> 00:12:47,120 Speaker 2: is a part of that. 234 00:12:47,920 --> 00:12:52,080 Speaker 1: Tell me about starting just a girl with spots and 235 00:12:52,120 --> 00:12:54,680 Speaker 1: then sharing what hadn't hadn't worked for you, What was 236 00:12:54,720 --> 00:12:57,200 Speaker 1: going on? What was it like to just start sharing 237 00:12:57,240 --> 00:12:59,360 Speaker 1: your entire journey so publicly? 238 00:13:00,120 --> 00:13:04,480 Speaker 2: Scary? I mean really scary. When I was first diagnosed, 239 00:13:04,520 --> 00:13:07,160 Speaker 2: I wouldn't be in a picture, I wouldn't say the word. 240 00:13:08,120 --> 00:13:10,840 Speaker 2: And I came home from a doctor's appointment. I was 241 00:13:10,880 --> 00:13:13,040 Speaker 2: living in New York City at the time with my 242 00:13:13,559 --> 00:13:17,280 Speaker 2: boyfriend now husband. I was really frustrated because when I 243 00:13:17,280 --> 00:13:20,240 Speaker 2: first called, they said he had experience with psoriasis. I 244 00:13:20,280 --> 00:13:22,959 Speaker 2: walked in, I sat in the office and there was 245 00:13:23,000 --> 00:13:26,440 Speaker 2: a video playing of him on a TV show talking 246 00:13:26,480 --> 00:13:29,040 Speaker 2: about his anti aging regimen and how you can come 247 00:13:29,080 --> 00:13:33,600 Speaker 2: into his office and get like your hands treated for aging. 248 00:13:33,640 --> 00:13:36,560 Speaker 2: And I was like, well, this isn't really what I'm 249 00:13:36,600 --> 00:13:39,640 Speaker 2: here for. So I started the blog because I really 250 00:13:39,679 --> 00:13:42,080 Speaker 2: wanted to be the resource that I needed when I 251 00:13:42,160 --> 00:13:45,480 Speaker 2: was first diagnosed. There's so much to know about living 252 00:13:45,520 --> 00:13:49,160 Speaker 2: with psoriasis that you really only get to understand if 253 00:13:49,160 --> 00:13:52,240 Speaker 2: you're living with it. So this was firsthand experience. There's 254 00:13:52,280 --> 00:13:54,480 Speaker 2: a lot of child and error, and if you're being 255 00:13:54,520 --> 00:13:59,000 Speaker 2: diagnosed initially, it is so much of a mental overload 256 00:13:59,240 --> 00:14:02,240 Speaker 2: to try to retain all of that information in one 257 00:14:02,400 --> 00:14:06,600 Speaker 2: probably fifteen minute if you're lucky, doctor's appointment. So the 258 00:14:06,679 --> 00:14:09,520 Speaker 2: goal really is to be able to provide resources and 259 00:14:09,559 --> 00:14:12,640 Speaker 2: support to others who are living with psoriasis. There's like 260 00:14:12,720 --> 00:14:17,320 Speaker 2: lifestyle tips on there, learnings, advice, just personal experiences, funny 261 00:14:17,360 --> 00:14:20,400 Speaker 2: jokes about living with it. And it's really just because 262 00:14:20,440 --> 00:14:23,560 Speaker 2: I don't want anyone who's living with psoriasis to feel 263 00:14:23,560 --> 00:14:26,360 Speaker 2: alone in their journey, no matter if they're newly diagnosed 264 00:14:26,480 --> 00:14:28,600 Speaker 2: or been living with it for years. 265 00:14:29,160 --> 00:14:34,120 Speaker 1: Clearly you have always had support through your family, but 266 00:14:34,240 --> 00:14:36,840 Speaker 1: can you talk a little bit about the importance of 267 00:14:37,040 --> 00:14:41,040 Speaker 1: building community to your experience and how much has reaching 268 00:14:41,040 --> 00:14:43,840 Speaker 1: out to connect with others who know what you're going 269 00:14:43,880 --> 00:14:48,280 Speaker 1: through changed your day to day probably as much as theirs. 270 00:14:48,720 --> 00:14:51,280 Speaker 2: When I was growing up, I had a lot of support, 271 00:14:51,360 --> 00:14:55,480 Speaker 2: but I also felt emotionally isolated because of it. I 272 00:14:55,560 --> 00:15:00,120 Speaker 2: didn't really feel comfortable talking to anybody about it, and 273 00:15:00,160 --> 00:15:02,680 Speaker 2: I had a lot of trouble describing just how it 274 00:15:02,800 --> 00:15:05,960 Speaker 2: felt because people think, oh, it's just dry skin or 275 00:15:06,040 --> 00:15:08,720 Speaker 2: it's itchy, but it was so much more than that, 276 00:15:08,800 --> 00:15:11,200 Speaker 2: and I couldn't really put it into words about what 277 00:15:11,320 --> 00:15:14,240 Speaker 2: it was. So when I first started meeting others in 278 00:15:14,280 --> 00:15:17,000 Speaker 2: the crisis community, and that was actually thanks to my mom, 279 00:15:17,040 --> 00:15:20,360 Speaker 2: who found us a in person meeting of the Natural 280 00:15:20,400 --> 00:15:24,160 Speaker 2: Psoriasis Foundation, I met other people who actually had psoriasis. 281 00:15:24,680 --> 00:15:26,920 Speaker 2: It just felt like I had found this missing piece 282 00:15:26,960 --> 00:15:29,800 Speaker 2: of the puzzle. So there's just so much relief in 283 00:15:29,920 --> 00:15:33,320 Speaker 2: talking to people who just get it. They understand. I 284 00:15:33,400 --> 00:15:36,080 Speaker 2: didn't feel alone. There's people that you could just vent to. 285 00:15:36,320 --> 00:15:41,920 Speaker 2: They understand the struggles of medications, putting things on the stains, 286 00:15:42,040 --> 00:15:46,680 Speaker 2: the flakes. I didn't learn anything in eighth grade or 287 00:15:46,720 --> 00:15:49,280 Speaker 2: whatever grade. I was maybe ninth grade science because that 288 00:15:49,360 --> 00:15:51,320 Speaker 2: was the year I was diagnosed with psoriasis, and I 289 00:15:51,520 --> 00:15:54,720 Speaker 2: had patches in my hair and flakes everywhere, and the 290 00:15:54,840 --> 00:15:59,280 Speaker 2: desks in science class were black, and so I spent 291 00:15:59,440 --> 00:16:03,880 Speaker 2: the entire period it's just making sure that nothing would 292 00:16:03,960 --> 00:16:07,040 Speaker 2: fall on the desk. So I can't tell you anything. 293 00:16:07,120 --> 00:16:09,000 Speaker 2: I think it was Earth's science that year. I know 294 00:16:09,120 --> 00:16:13,160 Speaker 2: nothing about it, and that is solely because of my poriasis. 295 00:16:13,560 --> 00:16:15,400 Speaker 1: Like I don't know what the mantle and the crust are. 296 00:16:15,400 --> 00:16:17,200 Speaker 1: I know other stuff going on. 297 00:16:17,280 --> 00:16:19,840 Speaker 2: There were no faith, That's all I was concerned about. 298 00:16:20,360 --> 00:16:22,960 Speaker 1: Joni, thank you so much for talking with me about 299 00:16:22,960 --> 00:16:25,400 Speaker 1: all of this and sharing more of your story. We 300 00:16:25,480 --> 00:16:28,920 Speaker 1: will have more questions for you to come, but after 301 00:16:28,960 --> 00:16:31,440 Speaker 1: this break, we're going to talk about what a difference 302 00:16:31,680 --> 00:16:34,840 Speaker 1: hundreds of years of history makes. Our look back at 303 00:16:34,880 --> 00:16:37,200 Speaker 1: the history of how we treat our skin and the 304 00:16:37,240 --> 00:16:40,280 Speaker 1: conditions that affect it has shown us throughout this season 305 00:16:40,280 --> 00:16:43,840 Speaker 1: that there were some really rough times for soriasis patients 306 00:16:43,840 --> 00:16:47,760 Speaker 1: of all stripes over the years. Injecting arsenic comes to mind, 307 00:16:48,680 --> 00:16:52,160 Speaker 1: super gross. But we are in a pretty exciting age 308 00:16:52,200 --> 00:16:55,440 Speaker 1: of new treatments for autoimmune conditions, and chief among them 309 00:16:55,520 --> 00:16:58,040 Speaker 1: is biologics. So we're going to talk more about that 310 00:16:58,480 --> 00:17:19,639 Speaker 1: right after the break. Welcome back to our Skin. We 311 00:17:19,880 --> 00:17:23,320 Speaker 1: have covered a lot of ground, so for some context 312 00:17:23,400 --> 00:17:26,399 Speaker 1: on just what a remarkable moment this is in the 313 00:17:26,440 --> 00:17:31,320 Speaker 1: treatment of priasis and other autoimmune conditions, let's review Briefly, 314 00:17:32,080 --> 00:17:36,840 Speaker 1: For centuries, piasis was simply considered a skin condition, something 315 00:17:36,840 --> 00:17:39,800 Speaker 1: that caused red, scaly patches on the skin. This is 316 00:17:39,800 --> 00:17:44,320 Speaker 1: something Joni referenced earlier. The first accurate clinical description of 317 00:17:44,320 --> 00:17:47,399 Speaker 1: psoriasis as we know was offered by doctor Robert Willin 318 00:17:47,560 --> 00:17:51,800 Speaker 1: in eighteen oh eight. Willin, often called the founder of dermatology, 319 00:17:51,920 --> 00:17:55,840 Speaker 1: was the first to distinguish psoriasis from other skin diseases, 320 00:17:55,880 --> 00:18:00,879 Speaker 1: although his understanding of its underlying causes was a little off, 321 00:18:00,960 --> 00:18:03,719 Speaker 1: and our understanding of it was going to take some time. 322 00:18:04,480 --> 00:18:08,120 Speaker 1: Fast forward to the nineteen fifties, when treatment with ultraviolet 323 00:18:08,200 --> 00:18:13,360 Speaker 1: light and cordico steroids began to emerge. These were significant breakthroughs, 324 00:18:13,520 --> 00:18:16,600 Speaker 1: but they were based on the idea, again that syriasis 325 00:18:16,760 --> 00:18:20,040 Speaker 1: was purely a problem of the skin. So, Joni, you 326 00:18:20,280 --> 00:18:24,120 Speaker 1: have written about thinking soriasis was just a skin thing, 327 00:18:24,160 --> 00:18:26,520 Speaker 1: and we talked about that a little earlier. When did 328 00:18:26,560 --> 00:18:28,439 Speaker 1: you learn that it was an autoimmune condition? 329 00:18:29,640 --> 00:18:32,080 Speaker 2: I would have to say that it was probably like 330 00:18:32,440 --> 00:18:35,320 Speaker 2: at least five to ten years into my diagnosis that 331 00:18:35,520 --> 00:18:39,040 Speaker 2: I really understood. It's when I started doing my own 332 00:18:39,080 --> 00:18:39,800 Speaker 2: research on it. 333 00:18:40,280 --> 00:18:43,320 Speaker 1: So in the two thousands, pretty recently, it actually wasn't 334 00:18:43,440 --> 00:18:46,639 Speaker 1: until nineteen sixty three that a pivotal shift occurred in 335 00:18:46,680 --> 00:18:50,480 Speaker 1: our understanding of soriasis and soiatic arthritis. 336 00:18:51,000 --> 00:18:51,320 Speaker 2: EJ. 337 00:18:51,520 --> 00:18:55,679 Speaker 1: Van Scott published a groundbreaking paper revealing that pyriasis was 338 00:18:55,720 --> 00:19:00,440 Speaker 1: not just a skin condition, but an autoimmune disorder disease 339 00:19:00,480 --> 00:19:04,520 Speaker 1: in which the immune system mistakenly attacks the body's own tissues, 340 00:19:05,119 --> 00:19:09,639 Speaker 1: and this realization had profound implications for treatment, opening the 341 00:19:09,680 --> 00:19:13,120 Speaker 1: door to therapies that targeted the immune system rather than 342 00:19:13,240 --> 00:19:18,480 Speaker 1: just the skin. Understanding psoriasis as an autoimmune disease is 343 00:19:18,520 --> 00:19:20,879 Speaker 1: a game changer, and it was then It meant that 344 00:19:20,920 --> 00:19:24,280 Speaker 1: treatments could now be developed to target the underlying immune 345 00:19:24,320 --> 00:19:28,760 Speaker 1: processes driving the disease, rather than just addressing the symptoms. 346 00:19:29,480 --> 00:19:32,520 Speaker 1: This shift in perspective paid the way for more effective 347 00:19:32,560 --> 00:19:36,080 Speaker 1: and targeted therapies, including the development of something I know 348 00:19:36,160 --> 00:19:40,320 Speaker 1: Joni knows a lot about, which is biologics. Before biologics, 349 00:19:40,320 --> 00:19:44,719 Speaker 1: the primary systemic treatments for psoriasis were small molecule drugs 350 00:19:44,760 --> 00:19:48,240 Speaker 1: like methatrexate. Introduced in the late nineteen forties as a 351 00:19:48,320 --> 00:19:52,159 Speaker 1: cancer treatment, metatrex eate became the first choice for treating 352 00:19:52,160 --> 00:19:56,800 Speaker 1: severe psoriasis by the nineteen seventies. While it was somewhat effective, 353 00:19:56,960 --> 00:20:01,080 Speaker 1: Metatrex eight came with significant risks, including more than ten 354 00:20:01,240 --> 00:20:05,040 Speaker 1: black box warnings from the FDA, some of which involved 355 00:20:05,320 --> 00:20:09,040 Speaker 1: the risk of death. So this obviously was far from ideal, 356 00:20:09,200 --> 00:20:12,880 Speaker 1: especially for a disease that, while chronic, is not typically 357 00:20:12,920 --> 00:20:16,520 Speaker 1: life threatening. Joni, did you have any experiences with your 358 00:20:16,600 --> 00:20:19,720 Speaker 1: treatments that had major side effects, maybe worse than the 359 00:20:19,720 --> 00:20:20,880 Speaker 1: psoriasis itself. 360 00:20:21,480 --> 00:20:23,960 Speaker 2: I was on not a biologic, but an oral medication 361 00:20:24,160 --> 00:20:26,879 Speaker 2: that I was on for only a week because the 362 00:20:26,920 --> 00:20:30,960 Speaker 2: stomach issues were just it was not good. 363 00:20:31,280 --> 00:20:34,080 Speaker 1: So now your skin hurts and your digestive system is 364 00:20:34,080 --> 00:20:37,879 Speaker 1: also a mess, just what everybody wants, hot mess. So 365 00:20:38,320 --> 00:20:41,720 Speaker 1: enter biologics. That's a class of drugs that represented a 366 00:20:41,840 --> 00:20:46,160 Speaker 1: seismic shift in the treatment of autoimmune diseases like psoriasis. 367 00:20:46,840 --> 00:20:49,800 Speaker 1: But what exactly are biologics and how do they differ 368 00:20:49,880 --> 00:20:52,520 Speaker 1: from the treatments that came before them. So, in very 369 00:20:52,520 --> 00:20:56,960 Speaker 1: simple terms, biologics are large, complex molecules that are derived 370 00:20:56,960 --> 00:21:01,400 Speaker 1: from living cells, unlike small molluc drugs, which are chemically 371 00:21:01,440 --> 00:21:05,560 Speaker 1: synthesized and can be taken orally biologics are typically proteins 372 00:21:05,600 --> 00:21:08,240 Speaker 1: that need to be injected because they would be broken 373 00:21:08,280 --> 00:21:10,840 Speaker 1: down in the digestive system if you take them orally. 374 00:21:11,600 --> 00:21:14,199 Speaker 1: This difference in how they're made and administered, though, is 375 00:21:14,400 --> 00:21:18,680 Speaker 1: just the beginning. Small molecule drugs like methatrex eight work 376 00:21:18,760 --> 00:21:21,960 Speaker 1: by broadly suppressing the immune system, and that can of 377 00:21:22,000 --> 00:21:25,760 Speaker 1: course lead to significant side effects and an increased risk 378 00:21:25,840 --> 00:21:28,840 Speaker 1: of all sorts of infections as the immune system's operation 379 00:21:29,080 --> 00:21:33,720 Speaker 1: is hampered. In contrast, biologics are designed to target specific 380 00:21:33,800 --> 00:21:37,320 Speaker 1: parts of the immune system. This targeted approach means they 381 00:21:37,320 --> 00:21:40,320 Speaker 1: can be more effective with fewer side effects, making them 382 00:21:40,320 --> 00:21:45,840 Speaker 1: a game changer in the treatment of autoimmune diseases. I imagine, though, Joni, 383 00:21:46,080 --> 00:21:50,200 Speaker 1: because biologics are so focused, sometimes you have to try 384 00:21:50,800 --> 00:21:52,480 Speaker 1: different ones to see which is going. 385 00:21:52,440 --> 00:21:56,560 Speaker 2: To work exactly. I've been on a few throughout the years, 386 00:21:56,720 --> 00:21:59,840 Speaker 2: and there's some that you tried, they don't work right away, 387 00:22:00,119 --> 00:22:03,080 Speaker 2: you have to change within a few months. There's a 388 00:22:03,119 --> 00:22:05,520 Speaker 2: few that I've been on that I've been on for years. 389 00:22:05,920 --> 00:22:09,160 Speaker 1: Bodies are fascinating. Now let's get into the nitty gritty 390 00:22:09,200 --> 00:22:13,240 Speaker 1: of biologics, specifically, the different types of biologic agents used 391 00:22:13,240 --> 00:22:18,280 Speaker 1: to treatsoriasis, so first up TNF alpha inhibitors. The approval 392 00:22:18,359 --> 00:22:21,439 Speaker 1: of the first TNF alpha inhibitor in two thousand and 393 00:22:21,520 --> 00:22:25,800 Speaker 1: three mark the beginning of the biologic era in syriasis treatment. 394 00:22:26,520 --> 00:22:29,960 Speaker 1: The first biologics to be approved for cyiasis targeted a 395 00:22:30,040 --> 00:22:35,200 Speaker 1: molecule called tumor necrosis factor alpha or TNF alpha, which 396 00:22:35,240 --> 00:22:39,439 Speaker 1: plays a key role in inflammation. By blocking TNF alpha, 397 00:22:39,480 --> 00:22:43,280 Speaker 1: these drugs can reduce the inflammation that drives psoriasis and 398 00:22:43,400 --> 00:22:48,520 Speaker 1: joint pain caused by soiatic arthritis. Next IL twelve and 399 00:22:48,640 --> 00:22:53,199 Speaker 1: twenty three inhibitors. As our understanding of cyiasis improved, so 400 00:22:53,400 --> 00:22:57,760 Speaker 1: did the specificity of biologics. The next generation of biologics 401 00:22:57,800 --> 00:23:01,000 Speaker 1: targeted interluke in twelve and interlace uk and twenty three 402 00:23:01,160 --> 00:23:06,160 Speaker 1: cytokines involved in the immune response. By inhibiting these molecules, 403 00:23:06,200 --> 00:23:10,400 Speaker 1: these biologics could more effectively reduce the symptoms of psoriasis, 404 00:23:11,200 --> 00:23:15,560 Speaker 1: and the next advance was IL seventeen inhibitors. Further research 405 00:23:15,600 --> 00:23:20,080 Speaker 1: revealed that INTERLUCN seventeen or IL seventeen plays a crucial 406 00:23:20,200 --> 00:23:23,880 Speaker 1: role in how psoriasis affects our skin and joints. How 407 00:23:23,960 --> 00:23:27,560 Speaker 1: those characteristic symptoms show up on and in our bodies. 408 00:23:28,400 --> 00:23:32,080 Speaker 1: Biologics targeting IL seventeen have proven to be highly effective 409 00:23:32,160 --> 00:23:36,679 Speaker 1: in achieving clear or almost clear skin, a significant advancement 410 00:23:36,760 --> 00:23:40,240 Speaker 1: in treatment, and then, most recently, we have IL twenty 411 00:23:40,280 --> 00:23:44,960 Speaker 1: three inhibitors. These biologics focus on the INTERLUCN twenty three molecule, 412 00:23:44,960 --> 00:23:48,680 Speaker 1: which is another key player in the immune response. These 413 00:23:48,760 --> 00:23:52,680 Speaker 1: drugs offer even more targeted treatment options, providing new hope 414 00:23:52,680 --> 00:23:57,240 Speaker 1: for patients who may not have responded to earlier therapies. However, 415 00:23:57,400 --> 00:24:01,040 Speaker 1: biologics do still have some side effect. Although their targeted 416 00:24:01,119 --> 00:24:03,879 Speaker 1: nature is definitely a step up from many of the 417 00:24:03,920 --> 00:24:07,040 Speaker 1: places where we've been, people still have to watch out 418 00:24:07,040 --> 00:24:09,639 Speaker 1: for things that you might imagine when your immune system 419 00:24:09,680 --> 00:24:14,080 Speaker 1: gets suppressed, like increased risk of infections. So obviously it 420 00:24:14,160 --> 00:24:17,320 Speaker 1: is very important to talk thoroughly with your doctor before 421 00:24:17,359 --> 00:24:21,800 Speaker 1: and during treatment so that adjustments can be made if needed. Joni, 422 00:24:21,840 --> 00:24:25,080 Speaker 1: could you do something of a compare and contrast for 423 00:24:25,880 --> 00:24:27,959 Speaker 1: what you have been doing in terms of tweaking and 424 00:24:28,000 --> 00:24:30,480 Speaker 1: having these conversations with your doctor and how they have 425 00:24:30,520 --> 00:24:34,479 Speaker 1: played out versus years ago when you were much younger 426 00:24:34,520 --> 00:24:38,000 Speaker 1: and having a pre biologic effort to try to control 427 00:24:38,000 --> 00:24:38,920 Speaker 1: your psoriasis. 428 00:24:39,400 --> 00:24:42,359 Speaker 2: It's honestly made a world of a difference. The biologic 429 00:24:42,440 --> 00:24:45,560 Speaker 2: that I'm on I take every eight weeks, So every 430 00:24:45,600 --> 00:24:47,919 Speaker 2: eight weeks I take a shot at home. It takes 431 00:24:48,040 --> 00:24:50,879 Speaker 2: two minutes to get all the materials out and do 432 00:24:51,000 --> 00:24:53,159 Speaker 2: the shot. Well, when I was on topicals, you're applying 433 00:24:53,160 --> 00:24:55,880 Speaker 2: those twice a day, and I was covered from head 434 00:24:55,920 --> 00:24:59,040 Speaker 2: to toe, so it would take a very long time. 435 00:24:59,280 --> 00:25:00,960 Speaker 2: It would take up to a hour to put this 436 00:25:01,119 --> 00:25:06,000 Speaker 2: medication on. So it feels from a time perspective, and 437 00:25:06,119 --> 00:25:09,600 Speaker 2: just mentally, there was so much fatigue about doing that 438 00:25:09,800 --> 00:25:12,760 Speaker 2: all the time. And now I just have to I 439 00:25:12,800 --> 00:25:14,919 Speaker 2: put a reminder on the calendar and I take my 440 00:25:14,960 --> 00:25:16,480 Speaker 2: shot and I'm done. 441 00:25:17,320 --> 00:25:20,159 Speaker 1: This seems like much much easier to integrate into your 442 00:25:20,200 --> 00:25:21,040 Speaker 1: day to day life. 443 00:25:21,200 --> 00:25:23,560 Speaker 2: Absolutely, because it's it's not even day to day. 444 00:25:24,480 --> 00:25:26,760 Speaker 1: For those of you listening, you may be wondering where 445 00:25:26,760 --> 00:25:29,880 Speaker 1: do we go from here? Clinically, and today we stand 446 00:25:29,920 --> 00:25:32,960 Speaker 1: at the forefront of the second breakthrough in systemic treatments 447 00:25:33,000 --> 00:25:36,680 Speaker 1: for psoriasis. With the development of biologics and with these 448 00:25:36,800 --> 00:25:41,679 Speaker 1: highly targeted and effective therapies, the goalposts have shifted now, 449 00:25:41,840 --> 00:25:44,720 Speaker 1: achieving a ninety percent or for some people, even a 450 00:25:44,760 --> 00:25:48,480 Speaker 1: one hundred percent reduction in symptoms is a realistic goal 451 00:25:48,520 --> 00:25:52,200 Speaker 1: in clinical trials. But the story does not end there. 452 00:25:52,760 --> 00:25:57,119 Speaker 1: The future of soriasi's treatment lies in further refining these therapies, 453 00:25:57,560 --> 00:26:00,719 Speaker 1: conducting head to head trials of different bio logics, and 454 00:26:00,880 --> 00:26:05,840 Speaker 1: continuing to improve patient outcomes. While newer biologics have set 455 00:26:05,840 --> 00:26:08,800 Speaker 1: the bar very high, it's important to remember that older 456 00:26:08,840 --> 00:26:12,320 Speaker 1: biologics still have their place. For example, one of the 457 00:26:12,400 --> 00:26:16,240 Speaker 1: earliest biologics approved by the FDA twenty years ago has 458 00:26:16,280 --> 00:26:19,359 Speaker 1: one of the best safety profiles for older patients, so 459 00:26:19,920 --> 00:26:24,119 Speaker 1: it remains a valid and valuable option. As we continue 460 00:26:24,160 --> 00:26:27,320 Speaker 1: to learn more about the immune system and refine these therapies, 461 00:26:27,359 --> 00:26:30,919 Speaker 1: the future looks very bright for patients with psoriasis, and 462 00:26:31,400 --> 00:26:34,479 Speaker 1: who knows, the next big breakthrough could be just around 463 00:26:34,480 --> 00:26:37,600 Speaker 1: the corner. Joni, and talking through all of this history, 464 00:26:37,640 --> 00:26:39,840 Speaker 1: the obvious point here is that we have come so 465 00:26:40,040 --> 00:26:44,240 Speaker 1: far already. I feel like you are the textbook case 466 00:26:44,280 --> 00:26:47,119 Speaker 1: of someone who has seen it all and tried it all, 467 00:26:47,280 --> 00:26:49,480 Speaker 1: and it sounds like you feel like you've come a 468 00:26:49,480 --> 00:26:52,440 Speaker 1: long way in terms of treating and managing your psoriasis. 469 00:26:52,840 --> 00:26:56,480 Speaker 2: Absolutely, I think that not only physically with the medications 470 00:26:56,480 --> 00:26:59,640 Speaker 2: that I'm on, but mentally, I know how to manage it. 471 00:27:00,080 --> 00:27:03,160 Speaker 2: I understand that it's not just a physical disease, and 472 00:27:03,680 --> 00:27:08,199 Speaker 2: it's important to recognize that having the mental support and 473 00:27:08,280 --> 00:27:13,240 Speaker 2: the physical support, and that holistic treatment that includes a 474 00:27:13,280 --> 00:27:16,159 Speaker 2: biologic which also includes the lifestyle. So there's just so 475 00:27:16,280 --> 00:27:19,520 Speaker 2: much more that I know and have learned throughout my 476 00:27:19,680 --> 00:27:22,760 Speaker 2: journey with this that I want to keep sharing with 477 00:27:22,760 --> 00:27:25,080 Speaker 2: people that are newly diagnosed, because it is it's just 478 00:27:25,119 --> 00:27:29,639 Speaker 2: so much when you're first diagnosed to learn everything. 479 00:27:30,119 --> 00:27:34,200 Speaker 1: Thankfully, treatment now is much more effective than the days 480 00:27:34,200 --> 00:27:37,040 Speaker 1: when people were rubbing arsenic on a psoriasis flare up, 481 00:27:37,200 --> 00:27:40,200 Speaker 1: but even so it can still be daunting. If someone 482 00:27:40,280 --> 00:27:42,439 Speaker 1: has been a little bit reluctant to open up to 483 00:27:42,520 --> 00:27:45,840 Speaker 1: their doctor and to really explore what treatments are available 484 00:27:45,880 --> 00:27:48,120 Speaker 1: to them, now is really the time to do it. 485 00:27:48,560 --> 00:27:50,880 Speaker 1: Do you have any pointers for people though, who might 486 00:27:50,920 --> 00:27:53,920 Speaker 1: be struggling to get what they need from their medical team, 487 00:27:54,040 --> 00:27:56,159 Speaker 1: like how to go into an appointment and feel like 488 00:27:56,200 --> 00:27:58,680 Speaker 1: you're going to get your message across and come out 489 00:27:58,720 --> 00:27:59,920 Speaker 1: with some real action item. 490 00:28:00,600 --> 00:28:03,359 Speaker 2: I always spend some time prepping for my doctor's appointments, 491 00:28:03,400 --> 00:28:06,280 Speaker 2: writing down any questions I have. I look at even 492 00:28:06,320 --> 00:28:09,119 Speaker 2: what's new in the market, what's a newer medication. Is 493 00:28:09,119 --> 00:28:11,239 Speaker 2: that something that could work better for me or not. 494 00:28:11,840 --> 00:28:14,359 Speaker 2: I keep track just in a notes app on my phone, 495 00:28:14,520 --> 00:28:17,520 Speaker 2: of any symptoms I'm having, when they happen, how long 496 00:28:17,560 --> 00:28:21,000 Speaker 2: they're happening for. I think keeping track of what your 497 00:28:21,040 --> 00:28:24,119 Speaker 2: symptoms are and going into a doctor's office prepared with 498 00:28:24,160 --> 00:28:28,240 Speaker 2: any questions it makes it easier to just say I 499 00:28:28,280 --> 00:28:31,320 Speaker 2: have some questions and go through your list, because you 500 00:28:31,520 --> 00:28:34,639 Speaker 2: barely have a chance in those doctor's appointments to ask 501 00:28:34,760 --> 00:28:38,160 Speaker 2: anything or they're barely there with you. So just being 502 00:28:38,200 --> 00:28:40,880 Speaker 2: strong about saying no, I have a couple more questions 503 00:28:41,360 --> 00:28:44,080 Speaker 2: and advocating for yourself is really important to get the 504 00:28:44,120 --> 00:28:46,320 Speaker 2: treatment that you want to be on and that makes 505 00:28:46,320 --> 00:28:47,160 Speaker 2: the most sense for you. 506 00:28:48,160 --> 00:28:50,640 Speaker 1: I know some people also go through that problem where 507 00:28:50,680 --> 00:28:52,800 Speaker 1: they will walk into a doctor's office with a very 508 00:28:52,840 --> 00:28:55,800 Speaker 1: obvious problem, and when they say what's wrong, they're like, 509 00:28:55,880 --> 00:28:57,680 Speaker 1: nothing much, Really, I'm pretty much fine. 510 00:28:57,760 --> 00:29:01,480 Speaker 2: Yeah, And I think with sariasis too, you wait sometimes 511 00:29:01,480 --> 00:29:04,320 Speaker 2: so long for those appointments so when you finally have 512 00:29:04,520 --> 00:29:07,120 Speaker 2: the chance to sit with the doctor and talk through it, 513 00:29:07,320 --> 00:29:10,920 Speaker 2: having all of that information readily available is so important 514 00:29:11,280 --> 00:29:14,480 Speaker 2: because sometimes your next appointment won't be for next three 515 00:29:14,520 --> 00:29:17,360 Speaker 2: to six months based on the way their calendars fill out. 516 00:29:18,280 --> 00:29:21,280 Speaker 2: And also it's okay to change doctors. I think there's 517 00:29:21,400 --> 00:29:26,560 Speaker 2: dermatologists out there that are really comfortable and really knowledgeable 518 00:29:26,560 --> 00:29:29,360 Speaker 2: about psoriasis, and then there's others that really don't know 519 00:29:29,400 --> 00:29:33,120 Speaker 2: that much about it, and it's important to find someone 520 00:29:33,160 --> 00:29:36,560 Speaker 2: that you can talk to and trust and understand your 521 00:29:36,600 --> 00:29:37,400 Speaker 2: actual disease. 522 00:29:38,080 --> 00:29:41,520 Speaker 1: And it's not there to dage your hands exactly. 523 00:29:41,600 --> 00:29:44,480 Speaker 2: I mean that it's a great thing for some people, right. 524 00:29:44,440 --> 00:29:46,840 Speaker 1: Nothing wrong with deaging your hands, but it's not the 525 00:29:46,880 --> 00:29:50,840 Speaker 1: same thing that a psoriasis patient needs. What suggestions do 526 00:29:50,920 --> 00:29:54,080 Speaker 1: you have for people who maybe don't have an autoimmune 527 00:29:54,120 --> 00:29:57,720 Speaker 1: condition themselves, but they love someone who does, there's someone 528 00:29:57,720 --> 00:29:59,640 Speaker 1: in their family or their friends circle with one. What 529 00:29:59,680 --> 00:30:00,560 Speaker 1: can they do you to help? 530 00:30:01,040 --> 00:30:04,040 Speaker 2: I think just being there to support them and learning 531 00:30:04,080 --> 00:30:06,120 Speaker 2: as much as you can about it so that you 532 00:30:06,240 --> 00:30:08,400 Speaker 2: can have an idea of really what they're going through 533 00:30:08,400 --> 00:30:11,400 Speaker 2: on a day to day basis is really important, and 534 00:30:11,440 --> 00:30:14,880 Speaker 2: it makes them feel seen and that they don't have 535 00:30:14,960 --> 00:30:17,640 Speaker 2: to feel bad about canceling plans with you if they're 536 00:30:17,680 --> 00:30:20,480 Speaker 2: not feeling good. And maybe it's just being open to 537 00:30:20,560 --> 00:30:22,960 Speaker 2: suggestions about you know, oh, if you don't want to 538 00:30:23,000 --> 00:30:25,360 Speaker 2: go out, let's stay in and watch a movie. Let's 539 00:30:25,360 --> 00:30:28,920 Speaker 2: put some comfy clothes on. Getting dressed is always a 540 00:30:28,960 --> 00:30:31,160 Speaker 2: really big challenge when you have a flair because you're 541 00:30:31,280 --> 00:30:35,160 Speaker 2: just not comfortable pretty much in anything, and so just 542 00:30:35,240 --> 00:30:39,080 Speaker 2: being really supportive and understanding that sometimes things can change, 543 00:30:39,120 --> 00:30:42,000 Speaker 2: and they can change pretty quickly, and that you're just 544 00:30:42,040 --> 00:30:43,680 Speaker 2: there to help them mentally. 545 00:30:44,400 --> 00:30:48,240 Speaker 1: Last, but not least, if you could send one message 546 00:30:48,280 --> 00:30:51,240 Speaker 1: to our listeners who might be grappling with their own diagnoses, 547 00:30:51,280 --> 00:30:51,920 Speaker 1: what would that be. 548 00:30:52,840 --> 00:30:56,280 Speaker 2: You're not alone. There's a lot of people out in 549 00:30:56,320 --> 00:30:58,720 Speaker 2: the world who want to talk to you about their SHRIIASUS. 550 00:30:58,760 --> 00:31:02,200 Speaker 2: Anybody can email me, send me a direct message. I'm 551 00:31:02,280 --> 00:31:06,120 Speaker 2: happy to talk through any kind of advice or questions 552 00:31:06,240 --> 00:31:08,040 Speaker 2: or just if you want to say I want to 553 00:31:08,120 --> 00:31:11,200 Speaker 2: vent about psoriasis. There's somebody that is going to be 554 00:31:11,280 --> 00:31:14,000 Speaker 2: willing to listen to you. So you're not doing this alone. 555 00:31:14,760 --> 00:31:18,320 Speaker 1: And again, your site is just a girl with spots. 556 00:31:19,040 --> 00:31:20,800 Speaker 1: What's the best way for people to get in touch 557 00:31:20,840 --> 00:31:21,080 Speaker 1: with you. 558 00:31:21,440 --> 00:31:24,320 Speaker 2: I'm on Instagram at just a Girl a spot, so 559 00:31:24,840 --> 00:31:27,600 Speaker 2: I'm pretty easy to be found, and like I said, 560 00:31:27,600 --> 00:31:30,440 Speaker 2: I love talking about it, sharing my journey and just 561 00:31:30,600 --> 00:31:32,680 Speaker 2: being there to help others who are going through this 562 00:31:32,720 --> 00:31:33,120 Speaker 2: as well. 563 00:31:33,680 --> 00:31:36,280 Speaker 1: Thank you so much for being here with us, Jonie, 564 00:31:36,640 --> 00:31:38,800 Speaker 1: and I want to make sure I thank our listeners 565 00:31:39,120 --> 00:31:42,080 Speaker 1: for coming on the journey of season one of Our Skin. 566 00:31:42,680 --> 00:31:46,400 Speaker 1: From pine tar to arsenic to modern biologics. The evolution 567 00:31:46,560 --> 00:31:49,720 Speaker 1: of the treatment of psoriasis owes much to the doctors 568 00:31:49,840 --> 00:31:54,040 Speaker 1: and crucially to patients throughout time who just wouldn't stop 569 00:31:54,080 --> 00:31:58,880 Speaker 1: asking questions about this condition. Striving to understand how psoriasis 570 00:31:58,960 --> 00:32:03,280 Speaker 1: works has unlocked incredible advances in minimizing its impact on 571 00:32:03,360 --> 00:32:07,560 Speaker 1: people's lives, and the future is really bright. As we're 572 00:32:07,560 --> 00:32:10,560 Speaker 1: wrapping season one, I have an ask for you. If 573 00:32:10,560 --> 00:32:13,040 Speaker 1: you like the show, please consider leaving us a review. 574 00:32:13,280 --> 00:32:16,000 Speaker 1: It really helps others to discover the podcast, and as 575 00:32:16,040 --> 00:32:19,920 Speaker 1: we know, it's all about community. Until next time, take 576 00:32:19,920 --> 00:32:27,760 Speaker 1: care of yourself and your skin and each other. Our 577 00:32:27,840 --> 00:32:31,640 Speaker 1: Skin is hosted by myself Holly Frye and executive produced 578 00:32:31,680 --> 00:32:35,240 Speaker 1: and engineered by Ryan Martz. Our senior producer and writer 579 00:32:35,480 --> 00:32:38,640 Speaker 1: is Meredith Barnes. If you enjoy the show, share it 580 00:32:38,680 --> 00:32:41,680 Speaker 1: with your friends. You can also listen and follow on 581 00:32:41,720 --> 00:32:46,200 Speaker 1: the iHeartRadio app, Apple Podcasts, or wherever you get your podcasts.