Coordinating Care for Multiple Conditions

by Diane Talbert

I have had psoriasis since the age of 5 and developed psoriatic arthritis at the age of 25. People have not understood how bad my disease has been over the years or the need to coordinating care for multiple conditions. Psoriasis affects 2% of the world population, so to be sure, they have other health issues too.


I remember years ago a doctor telling me that because of my psoriasis I was experiencing a “domino effect”. I didn’t understand what that meant at the time, but once new diseases started appearing, I knew exactly what it meant. I have:

  • Psoriasis
  • Psoriatic arthritis
  • Diabetes
  • Fibromyalgia
  • High blood pressure
  • High cholesterol
  • Obesity and Anxiety

The diseases on this list are considered “co-morbidities”. That is when multiple diseases are present at the same time. It doesn’t mean they are necessarily related, but in many cases they are, or, they might be. You can have high blood pressure and psoriasis without them being related at all. However, researchers recently found a relationship between psoriasis and high blood pressure. They state that the more severe one’s psoriasis, the greater the chance of having high blood pressure. So, they could be related.

I manage each of my diseases differently. A medication I’m taking for one might interfere with another, so I have to monitor carefully. It means seeing different kinds of doctors and making sure they share what they learn between them.


This is why coordinating care is so important. Having a primary care doctor is essential to creating a holistic picture of your overall health. Seeing a rheumatologist for psoriasis makes sense, but that rheumatologist might not connect the dots to, say, high blood pressure, or anxiety. Your primary care doctor plays a unique role in this way. He or she is the home base for all your tests and conditions and specialist reports. That means they are also the key provider to speak with should you need to make changes to your medical record. Make sure you keep your primary care doctor in the loop.


Some days dealing with my diseases gets the best of me. My high blood pressure and high cholesterol might not affect my everyday living, but having psoriatic arthritis can affect my joints, fingers and toes. Psoriasis plays a role on the immune system which can be overactive.  Having fibromyalgia just makes you hurt all over.

A lot of people live with comorbidities, even those with rare diseases. So for all of us who don’t look sick on the surface, don’t assume we’re okay. We’re not. Be compassionate and show some understanding for the struggles you can’t see but are still there. You may never understand what it is like to live this way – I hope you never will know.


We have to learn how to take care of our bodies; be your own best advocate. Ignorance is not bliss when it comes to our health. Our lifestyle choices play a big part in our health. Coordinating care between your health, nutrition and lifestyle changes could make a huge difference for the entirety of your health.

No matter how complex your health gets, its important to remember that your diseases are not who you are. My diseases don’t define me, even on my worst days. They are just a part of me. I get to decide how big a part.

Diane Talbert is a blogger, patient advocate and speaker for psoriasis and psoriatic arthritis. She has been an advocate for this disease for over a decade now. Diane has run support groups in the Maryland, DC and Virginia area, is a volunteer for several organizations and vows to help find a cure for psoriasis and psoriatic arthritis and stop the stigma associated with it. She loves being a wife, mother and grandmother.

Diane Talbert

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