Stephanie, really sorry to hear you are in such agony. One of the things that hit me is have you ever been tested for gout? It is a simple uric acid blood test. I got it at the same time my Psoriatic arthritis started. It was excruciatingly painful in my feet and ankles. Not that I want to add to your misery and tests but it is easily treatable. I have not had a flare in a long time. On the ER question I would pass on that unless you just can’t go on. They don’t usually have rheumatologists available and sometimes no seems either. But you have to make you own call, I would just say if you do go try to get in first thing in the am, they are usually less busy! Good luck I hope you find some relief soon!

My blood work CRP level went from 60 down to 4.2

I was on humira for 10 years then my skin broke out but was still working for PsA. Then tried talz, dis not work. Then skirizi did not work. Now on enbrel 3 months working for both plaque psoraisis and PsA.

@A MyPsoriasisTeam Member. I'm wondering why they out younon another TNF-a blocker whennthe first one quit working. Enbrel and Humira/hyrimoz are all TNF-a blockers. Subtle differences but sme mechanism of action. They can have different drug interactions though and maybe the biosimilar hyrimoz is interacting badly with other medications you might be taking and causing a flare.

As for ER, I dont ever go just for a flare. I go for uncontrolled vomiting, pain level of 9/10, like for a kidney stone and I don't have any Phenergan or codeine around to get me through passing it. You can go in to the ER and come out with the flu or covid or worse. Its always a 6 hour minimum ordeal. Ugh. I ask myself what I want them to do for me and what they'll likely do for me. Extreme arthritis pain? They're likely to send me home and tell me to contact my Rheumi.

Good luck with the Neuro. I went through all those tests. There are many. It will likely require many appointments. I can't recall how many appointments for all those MS, MG, ALS, Parkinson's etc tests, but it took over a year of appointments and physical therapy recommendations which I did too. At the end of it all, the Neuro said that Psoriatic Spondylitis often does have a neurological component to it that causes MS/MG like symptoms.

My neurological symptoms improved when I addressed the sources of my triggers and improved the nutritional content of my diet.

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If you are unable to get your PCP to respond and your Rheumatologist doesn’t have anyone covering for him then I think you should go to the ER….even though most GPs don’t know a lot about these autoimmune disorders….maybe they can call In another specialist or at least look at bloodwork and symptoms and see what is going on. We have to be very cautious especially if inflammation or infection is involved somewhere in the body. Things can get out of control very quickly.. Better to be safe….