Roaccutane

I was very upbeat on Thursday night after the appointment. I had been anticipating this appointment for weeks. However, in the day or so before that all important visit I began to have serious doubts. Call it a bad feeling, if you like. I was nervous more than keen. I worried. And I still don't know now whether these worries were unfounded or not.

I got what I wanted. On November 8th I will receive the prescription for Roaccutane, the med that could finally and permanently remove my acne. I dearly love what this med promises, I have longed for the results it will provide for around ten years. So why am I baulking?

It is not in my makeup to fear a med. Why should I fear a med? Surely if it's being prescribed then it should be safe. And if it's being prescribed then it's been legalised. And if it's been legalised then it's been subject to any number of trials to test it and work out its kinks. In a perfect world, Roaccutane would have no kinks, but this is not a perfect world and the med's track record is patchy -- with results! -- at best. Unfortunately, this med holds a long list of potential side effects which include

• Depression
• Tendonitis
• Arthritis
• Neurological symptoms
• Vision problems
• Joint pain
• Bone, tendon, and ligament calcification
• Hearing impairment
• Respiratory symptoms
• Rapid breakdown of muscle tissue
• Rashes
• And the list goes on (seriously...)

I've opted to list the ones that bother me the most, in no particular order. So, Roaccutane was originally developed as a chemotherapy medicine, due to it's design to find and destroy rapidly dividing cells (which cancers are comprised of). It is still used for cancer treatment, as well as for acne. Which I think is interesting. And I think that it's targeting of rapidly dividing cells makes the side effect list make sense, to varying degrees. It's also non-selective -- which I have very little doubt is it's major pitfall. If it were developed to target specific cells I can see it being a hell of a lot safer. But it has not been developed in that way and I'm not a scientist, I'm a seventeen year old girl with issues and a lot of time on her hands. Knowledge helps me feel more secure. Initially I was somewhat put off but I'm starting to calm down about it again.

It's really not that bad. In all seriousness it is unlikely that I'll experience many of the side effects on that list. And in reality there is only a minute chance that something irreversible will happen to me. If the chance were high it would not have been legalised. Obviously the depression element is my chief concern with this med. Now, I have done some legitimate research into this and there have been a number of studies done over the years. All of which have proved inconclusive as far as to whether or not Roaccutane is causal to depression. Obviously, there are reported cases and as such the producers have added a depression/suicide warning to the med's label but there is no clear connection. So, while I'm going to have to be monitored due to the pre-existence, it's no guarantee that it gets worse.

And that is something I will cling to.

Next up is the respiratory factor. That's an interesting one and the internet is non-specific on what exactly it can do to my respiratory system. It's thrown up respiratory tract infection, voice change and tightness in lungs. I don't know what any of this means for my pulmonary hypertension, but it should be an interesting question to ask. Now the final thing on the list of side effects that really stung me were the ones that concerned my joints. I'm a little bit shaky on this one. My joints aren't great as it is and I'd hate for them to deteriorate further as I don't think I could cop that. I've had to give up the exercise bike because of the intense pain it's causing the top of my tibia or fibula (can't be bothered distinguishing). Structural damage that's simply not worth exacerbating any further, I don't think. So yes, I would be absolutely horrified if any of my tendons, ligaments or bones calcified, and I would be horrified if I got to be on the receiving end of any more tendonitis. I would be in fact horrified if my joints caused me any more pain at all. I'm starting to think, as I type this, that it worries me more than the depression does. My ongoing difficulties with my joints are part of the reason my depression has continued to exist. Increasing these problems are essentially an invitation for the depression to resume a more stricter regime. 

I guess, categorically, you would call it the fault of the med. But you and I both know that the depression never ceased to exist. So the med alone hasn't invited it back into my mind. It's more or less a permanent resident. I simply have marginally better control of its influence, at the moment.

So that's me dealing with Roaccutane. Evidently, it's pretty scary stuff. But then, what med isn't? At the end of the day they're all volatile enough to permanently maim, if not kill you, if you're unlucky enough. Look what the pill did to me. No one expected that. But I'm still here, still here with limited options, and I'm now very prepared to take my chances with Roaccutane. You will not be able to sway me otherwise. 

The other interesting thing to come out of Thursday was that between the March and August exercise stress echoes, the pressure in my lungs actually increased slightly. Very slightly, I'm assured, but nonetheless increased. Now, while I can see why the cardio hid this from me, I'm not quite happy about it. I feel like I had a right to know. And of course, I do have a right to know and that's why I know now. The premise is that the pressure should have decreased from its March reading. When I ran that stress echo in March I was pill free. In August I was still pill free. So I don't know what the go is there, but I'm not happy and kind of stressed about it. I'm being told again and again and again not to worry until April. If it's still increasing in April, then I get to worry, which is just common sense. But naturally, I'm kind of worried now anyway. I, despite my pessimistic nature, thought that it would all go away just as it had at other times. Apparently not. I also thought it would be a much quicker process, as it usually is, but apparently not. And now that seed of just how bad it could be has been well and truly planted. I'm quite nervous about having to deal with this forever. Of course, I have acknowledge this concept of forever before, but I didn't quite think it would happen. Prepared for the worst, but not really, you know? I guess what I'm getting at here is that it's a little bit more real now that it's doing the opposite to what it should.

It's suddenly quite real. It all is. It's real and in my face. And outwardly I'm cool with this. You won't catch me cursing anyone or threatening to incinerate them quite as prolifically as you might here because on the outside I am long practiced in staying in control. 

And I have to be in control. That is pivotal.

- Sky