Day 14, Month 1

We are in Tucson, AZ, which is obviously a dry climate. I think I might finally be detecting some dryness, but it could also be the desert. My skin looks really good however, which is great. For the past year and 1/2 I have been treated with minocycline, which worked really well, but can't be used forever. When I tried weening off it, the acne came right back. They put me back on minocycline for the month long waiting period be fore starting this, which cleared up my skin. I think coming into this with clear skin helped. I'm glad the breakout from last week is over. When I was using the minocycline, which I knew was going to be temporary, I really appreciated everyday my skin was clear, and still do now.

Hopefully my lack of dry and peeling side effects is due to all my diligent moisterizing, and not a lack of effectiveness. I have been using a fragrance free thick cream from Trader Joes, and Aquaphor on my lips and in my nostrils everyday, since before I started. I also drink tons of water. But the feeling that the medicine is working now, has me feeling optimistic.

Day 9, Month 1

I still don't have any side effects. And of course I hope that I never get a depression side effect, but I did associate the expected dryness with the medicine working. I am breaking out a little, and taking that as a good sign, but if I don't get other side effects, like dryness by the time this month is over, I will ask the doctor for the higher dose of 40mg twice a day. I'm not doing all this birth control stuff and not drinking, to get anything less then the best results possible.

Although, I have had a couple glasses of wine over the holidays, but very little.

Day 3

I feel tired, and have been sleeping really well, that is all I want to do. I feel a little moody, but I don't think the fatigue or moodiness can solely be blamed on the accutane, but also on the cold, the ice, and my very own laziness.

I've read about back aches, so I think I'll try to do yoga for that, and the fatigue and laziness.

Day 3

I feel tired, and have been sleeping really well, that is all I want to do. I feel a little moody, but I don't think the fatigue or moodiness can solely be blamed on the accutane, but also on the cold, the ice, and my very own laziness.

Day 2

I feel very tired and some what disconnected, but I think that has nothing to do with accutane and everything to do with the semester being over. I think I need to be more busy, and exercise more. Its just been so cold and snowy. All I want to do is sleep.

I am beginning to feel relief. There was so much effort and worry about getting the medicine, but now that I have it, and know everything will work just fine the next times, I am beginning to feel relaxed, and looking forward. Although all the processes seem so over whelming, that has a lot to do with my personality, not being able to switch gears very well. I am really optimistic about the out come of this treatment.

However, I forgot mention another very important restriction.

NO DRINKING! for the whole 5 months! The reports on the internet vary, but basically, accutane is bad for the liver and so is alcohol, so you don't want to give your body a double dose of work!

Keeping this journal feels really helpful.

Day 1: I am sure I am making this up.

I am sure this is psychosomatic, but I feel itchy, just a little, on my stomach. I am pretty sensitive in general, so I might be perceiving a change.

Day 1

So after eating, I took the first one. I take two a day, 20mg each. They came with even more information, that I must admit, I didn't read. I normally read everything that comes with any prescription, but this has become so much! The amount of information is over whelming and redundant. Here is my check list for the first month.

Stay moisturized: The doctor made fun of male patients for waiting until their lips are bleeding before they start moisturizing. This includes skin moisturizing as well as nose, eyes, and everything else.

Drink tons of water.

Don't get pregnant.

Look out for depression.

Don't drive at night: "sudden loss of night vision may occur"

No contact sports: skin may tear, bones may break.

SUNBLOCK!

During the first few weeks my skin may get worse, before it gets better.

Ok I think that's it. After the whole month of waiting, all the birth control anxieties, and everything involved, taking the first pill is full of psychosomatic responses, before it has even been digested.

All I can say, is it is easier to get crack, heroin, morphine, Oxycontin, or a wide variety of drugs that are addictive and make you feel good. It takes an extreme amount of dedication for a woman to want to, and then to take this drug. And my commentary is that this is all because of abortion and our country's obsession with it. I have seen my responsibility for not getting pregnant as simply, I don't want to have an abortion. I think having an abortion would be painful and awful. But no where in ALL the literature did I read, that abortion would be expected if pregnancy occurred. I asked my doctor if abortion was always an option and they said yes, and that it is what they would recommend it, if all else failed. So in my opinion all this work and waiting for accutane is about abortion.

I wish the literature had all the statistics associated with the various form of birth control. They gave me that information in high school. I feel like the scare tactics of the ipledge program have made me more distant from making accurate and informed decisions, rather then the other way around.

I got it.

I have it. It came with another book of information. I need to eat to take it.

It comes in a ton of packaging. Inside those two boxes are more boxes with blister packs containing 10 pills, all with a picture of a pregnant woman in the international "no" circle.

This pharmacist is really nice.

This pharmacist is really nice. He says he doesn't like my insurance. He says i'll get out of here. He is patient.
-Renee

Im at the pharmacy &

Im at the pharmacy & of course there is an insurance problem. I am prone to such little panics...
-Renee

Tomorrow

Tomorrow, I will begin the accutane acquisition. Last week on Thursday I had my blood drawn to confirm that I am still not pregnant, and that my liver works, and I could have gotten my prescription on Friday, but the ipledge program would not let the doctor prescribe it to me until the 15th. Why? I am not really sure.

So tomorrow I will wake up, meditate, and begin my calls. First I will call the wonderful nurse Georgia, who as soon she can, will log onto the ipledge website for the doctor and indicate that I am not pregnant, that my liver works, and that I am using an IUD and condoms. She will then call Walgreens and place my prescription. I then have to log onto the ipledge website and take a quiz about, I'm sure, mostly birth control. My answers concerning what I am using must match what the doctor said I am using, other wise I fail. And failing this process can mean I am locked out from getting accutane for 30 days! So no pressure. Then I will walk to Walgreens to pick up my prescription, and hopefully there will be no problems with my insurance coverage.

On a positive note. I will only have to this 5 times, once a month for five months.

Starting Monday

I will start taking Accutane on Monday.

But the challenges began a month ago when I had to join the FDA mandated ipledge program, in which I pledge not to get pregnant. Accutane causes serious birth defects. So being a woman of child bearing capabilities I must pledge to use TWO forms of birth control, for one month before I even begin accutane, meaning one hormonal and one barrier. I've been married to my lovely husband Michael for almost four years, and using a condom has been challenging for both of us. Hopefully it will result in more creativity and humor, but currently it feels frustrating. What is additionally frustrating is that even though I was given a book to read on how to use and choose two forms of birth control, it did not truly inform me of any drug interaction between accutane and hormonal contraception. I feel like this program is a scare tactic, when I would prefer being informed.

Accutane also threatens its users with depression, of which I am no stranger. After practicing sitting meditation for nearly three years, I have felt confident of my abilities to thwart off depression with great ease. This confidence resulted in me not meditating everyday, which has resulted in a resurgence of impatience, irritability, and anger. In preparation for this treatment, I have once again been meditating everyday, and I am meeting regularly with my meditation instructor at The Shambhala Mediation Center. I will use the discipline of meditation to keep a watchful eye on my mood.

So before the accutance has even started, I feel as though I am in a battle and I am preparing for more. What I took as good news from my doctor is that all of the bad symptoms will happen in the first month. So I feel like if I can handle the first month, I will be able to handle all five!

Accutane works in many ways, and while I'm on it my skin, nose, eyes, everything will be very dry. I have started collecting a kit of lubrications, but I should be more prepared. I should have travel and domestic versions of all the moisturizers I'll need.

At my last appointment, where they took my blood, my doctor greeted me by asking if I was ready to have acne free skin? She said I shouldn't do anything to my skin that wouldn't be done to a new born baby. I am getting new skin! For so many years, I though my acne would clear up. I thought I am too old to have this, so it will go away. I thought and heard from others that it wasn't that bad, but it was. It was really bad. Last year when I started on antibiotics and my skin became clear, I could tell people treated me differently, even Michael. And now, if this is successful, I will have clear skin. Not for the five months of treatment, but for all time after.