Hi,
I'm struggling with the management of my psoriasis and the impact of this on TTC Sorry if this is long.
I was diagnosed at 20 with a strong family history of Ps and PsA. Since then I've burned through the various pathways. I tried topical for 6 months, then light therapy, which cleared during treatment but was then back within a month, far more serious than it had been before and I ended up as an inpatient having dithranol. I left hospital on ciclosporin. Since then I've had methotrexate, stelara, humira, cosentyx and tremfya. Nothing seems to work long term and I'm losing hope. It's always the same story - it works for four months and then starts a slow slide into a flare.
Never during a consultation has a consultant or anyone eve asked me about my mental health. (It's dreadful and on my notes probably). Depression, anxiety...I was also very unlucky to have just started training for a very stressful profession when I was diagnosed.
I am getting married and we want to TTC. Only when I specifically mentioned it, a year before the planned start date for TTC, did they say anything about the bombshell that there is only 1 treatment that they think is safe for pregnancy and it has a six month wash out date. Fine. Swap me please!
This drags on for over six months. Finally they have agreed to swap my meds. Here's the thing - with a six week washout period beforehand, just in time to clash with my wedding which they've known about (I specifically discussed looking less of a monster well in advance). This is also clashing with building work so not the least stressful time to do this! 
I don't know whether I'm being unreasonable but I'm so disappointed in my consultant. Had they bothered to ask or even question vaguely close to the subject of fertility I would have mentioned it but I thought a year in advance would be enough time. I'm going to look dreadful on my wedding day (I reach 90% coverage with the majority on my face, ears, arms and inverted pso). I have days where I can't walk as my knees are agony, my hips pop out of joint and my fingers swell.
Has anyone else been a similar position or got advice? I feel so miserable and frustrated.