My joints sound like rice krispies, Snap, crackle and pop.
The aches and pains have kicked in. Knees, ankles, wrists are snapping, crackling and popping much more than they have before. Nothing debilitating, but I feel really sore and achy everyday as if I just did a really heavy workout, even though I'm working out very lightly.
I anticipated this side effect hitting me more than some other people since I am older and already have a little arthritis in some of my joints, so I've been taking Glucosamine and Chondroitin supplements since Week 1. I upped the amount when my Claravis dosage was upped.
My face has gotten clearer in the last week with fewer pimples, but since my period is due this week and that is when I usually break out really badly, I am waiting to see what happens this week.
I also have developed dark hyperpigmentation on both my cheeks which my doctor says is not caused by Accutane but has definitely got worse when I started taking it. The hyperpigmentation is more of a brown and red than just red because my skin is light olive in tone. The cause may be unrelated to the actual accutane but more a result of my stopping the Tretenoin cream and exfoliators (like salicylic acid) that I was using pre-Accutane. The Tretinoin cream and exfoliators might have been masking my natural tendency toward hyperpigmentation.
Why don't I listen to good advice?
The TMI begins --
As I've mentioned in previous posts, I have a nervous habbit of playing with my face -- picking, peeling off flaky skin, and sometimes just touching my face in a distracted fashion (similar to someone who twirls their hair while thinking or working or watching TV). So as a pimple is starting to heal, before I know it, I've pealed off the thin layer of healing skin and then the same pimple is either bleeding or sore.
I also have a worse related habit of spending time infront of a the mirror squeezing trying to get the junk out of my pores by squeezing until the solid junk comes out of the blackheads or the pus comes out of the deeper cysts. One of the reasons that I do this is because the cysts are often painful and they feel so much if I can get the pus out. I feel so much better and cleaner with that stuff out of my pores. (I know, I know. Ewww! even as I type this, I'm thinking ewww).
I don't have the problem as bad as some who will spend hours infront of the mirror with tweezers and other things digging at their face until they are full of open sores, but my picking habbit is bad enough for me to know it's a problem. I just can't seem to keep my hands off my face.
So even though I've read numerous posts from people on Accutane warning not to pick or peel because the skin is so thin, that even a little picking or squeezing will cause wounds. I've gone ahead and done this. My normal blackhead squeezing has caused the outer layer of skin on my part of the top of my nose to peel off as well as right below my nostrils, revealing the "not ready to be exposed" skin and leaving me with 2 big pinkish red sore patches.
I'm putting aquaphor on the spots to protect exposed pink layers and hoping against hope that my tendency to get brown hyperpigmentation on irritated spots on my face doesn't leave me with 2 dark nickel size brown areas on and under my nose.
I'll say it again. Why didn't I listen to good advice?
I counted my pimples on my face today and there are at least 12. The breakout started about 3 days ago and keeps coming. It looks just like my pre-accutane breakouts, but they aren't as quite as painful as they used to be. I got a taste of semi-clear skin for the first 3 weeks (I only had one, or two or three pimples at the same time), but now the acne is back. My period started and the acne came along with it on my chin, the sides of my nose and my forehead, just like it has been. I'm trying to tell myself that this happens on Accutane and this is probablly the IB or a pre-IB, but the nagging fear of "what if Accutane doesn't work at all for me, " keeps popping into my mind.
And since I have more pimples, I'm picking and squeezing much more which is disappointing me quite a bit since I'm trying to break that bad nervous habbit.
Ok, that feels better to get that off my chest.
Now on with the update...
Dr. Dermo upped me to 60 mg (20mg morning/40mg evening) and I start that dosage tomorrow. The lips are definitely drying and peeling and my skin is starting to look dry and flakey. I was a little surprised that Dr. Dermo said I'd be on Accutane for a total of 5-6 months (I was thinking I'd hit my cummulative does at 4-5 months instead). I'm going to keep track of my cummulative dose and if it gets up to the recommended dose and he wants me to continue, I'm going to need to hear some very good and provable reasons.
So many unknowns with this drug that I just have to stop worrying and have a little faith that it will work for me.
That's the last message I wanted to hear on my voicemail the week before my 1 month accutaine appointment. I fretted all night, worrying that my pancreas was going to explode due to abnormally high triglycerides or that my liver was shriveling up on a vitamin A overdose. (exaggeration aside, I was quite worried).
I finally reached Dr. Dermo's office the next afternoon after a round of phone tag and got the whole story. My bloodwork was fine (all those veggies and exercise paid off), but the iPledge paperwork was not. Somehow there was a mixup, and Dr. Dermo's assitant had entered me into the iPledge system the day before which meant that I had exactly 6 days to pickup my prescription and fill it or I'd be kicked out of the iPledge system for 19 days. That's 19 days without the pills.
Since my scheduled appointment wasn't for another week (it's really hard to get an appointment with Dr. Derm), the nurse agreed to ask the doctor to write me a prescription, and my nice mother-in-law picked the prescription up for me while I was working (the pharmacy won't accept faxed isotrentinoin prescriptions). When I got home from work that night and looked at the prescription, the dosage was exactly the same as I'd been on for the first 3 weeks.
Thanks to the wonderful acne.org members who are a wealth of great and useful info (you know who you all are), I knew that in the US, the dosage is typically raised to 1-1.5mg per kg of weight so my dosage should have been raised to about 60mg per day unless my bloodwork or sideaffects warrented a lower dose. When I called Dr. Dermo's office back, and explained the dosage descrepancy, she asked Dr. D himself and he agreed that normally he'd up my dose, but he wouldn't write me a higher prescription without seeing me first. I explained that my appointment wasn't even till next week and by then I'd be locked out of iPledge for almost 3 weeks because his assistant had mistakenly entered me 2 weeks early into the system.
To make a short story long -- they realized it was their mistake, squeezed me in between the last 2 appointments of the day, gave me a preg test, asked me if I was practicing safe sex and gave me a prescription for 60mg per day and I was good to go. They explained that from now on they are going to have only one person enter the info into IPledge to avoid mistakes and confusion and apologized for the mixup. Alls well that ends well.
I have a confession to make.I love dietcoke. It's one of my few vices (at least one that I'm willing to admit). I can drink a 2 liter a day easily. So since starting accutane and knowing how important it is to keep my self as hydrated as possible, I've made a pact with myself. If I want a glass of diet coke, I have to drink a full glass of water before each diet coke. That way I am assured to keep enough pure water in my system to help ease the side effects of the pills. My hubby doesn't think I'm drinking any less diet coke, but he does know I'm drinking a heck of a lot more water than I ever did before so that's a start.
Side effects seem to be about the same. Dry lips and slightly more achy joints and tendons and a little back pain (feels like I strained my lower back a bit). Some pimples, but nothing like before I started the pills and they are all quite close to the surface and not painful like my pre-pill acne thank goodness. I'm trying to psychologoically prepare myself for the initial breakup that I know will happen when the Doc ups the dose in 2 more weeks since it hasn't happened yet.
I'm also not doing as well as I should at keeping my hands off my face. I'm still subconciously touching and picking/pealing at the few pimples that I currently have. It's annoying neurotic habit that's hard to break and I often don't know I'm doing it. I'm trying hard to stop once I realize what I'm doing so hopefully I'll get out the habit and that will be that -- they say it takes 2 weeks to break any habbit.
Has anyone but me noticed how hypersensitive they've become to every little change in their face or body since starting accutane?
It's like I've become completely hypersensitive to every single thing about myself.
I find myself looking at scratches and cuts that I never noticed before and thinking, "Wow, they aren't healing as fast since I've been on accutane;" when the truth is, they are probably healing at the same rate but I never paid as much attention to them before. Or getting a back twing or a knee pain and thinking, "Wow, the joint and back pain has started already!" when really they are probably the normal random pains of a Mom with 2 young boys.
It's almost as if I've read too much about Isotretinoin pills and I'm anticipating every symptom. Is it just me or is anyone else overly monitoring themselves?
Finished my first week on Claravis (20mg -- 2x-a-day). The second day I was on it, I came down with a bad sinus infection. Seems like this has happened to other people too during week one. Maybe my body is using its energy to get back into balance after being assaulted by Claravis and didn't have the energy to fight the sinus virus. Either way, I'm feeling miserable.
I have changed my facial products (see below) and now I'm wearing both moisturizer and sunscreen. This makes me nervous because I've never been able to wear any moisturizer or sunscreen without breaking out alot so this will probably cause more pimples.
Things I've noticed during the first week:
The skin on my face started to act differently. I still have a bunch of pimples, but they started to heal right away and aren't as painful so it's alot easier to leave my face alone and not mess with it.
The pimples that I do have, and am still getting, seem closer to the surface and look like they might actually heal themselves. Usually my pimples never go away for weeks even months at a time and are deeper.
My lips are starting to get chapped and peel a little (I never have chapped lips ever)
My face looks redder with more pores showing and it looks like I have more brown hyperpigmentation on both sides of my face that I didn't have about a week ago.
My nose, throat and eyes are dry and itchy (probably more from the sinus infection)
CeraVe AM moisturizer/sunscreen for face in morning
Lubriderm Lotion With Suncreen for my body
Aquaphor for lips
Lyspol for lips (yuck -- hate waxy stuff on my lips)
Jojoba Oil + Hyaluronic Acid at night (sounds harsh, but really a very gentle moisturizing ingredient) for face
Multivit Vitamins Without A (to keep me from getting sick - haha)
Glucosamine and Chondroitin (for us older people who already have some joint pain)
I'm sure we all agree that any program that attempts to stop potential birth deffects is a great and necessary thing. However, I don't think they had me in mind when they designed the IPledge program. Even the dermatology assistants were confused and insisted that I needed to go on birth control pills along with an additional secondary birth control method, before they would hand over the Claravis prescription.
When I reminded them that my tubes were tied, they didn't quite know how that fit into the whole IPledge rules. This started quite a debate around the dr.'s office regarding whether birth control pills were necessary. Finally, I pulled out the bright yellow, caution-sign-like booklet and had them reread Page 15; and they finally agreed to enter me into the IPledge system as long as I signed something that said I would use condoms or abstinence along with having my tubes tied.
If that wasn't comical enough, I wish I had videotaped me trying to explain to my confused husband how him having to wear condoms was all about my acne.
Let me introduce myself, I am a 45 year-old Mom of 2 wonderful boys whose had acne off and on for 20 years. I've tried everything to get rid of it and over the years the acne has gotten worse, not better. Almost all of it is on my face, but lately it's started to show up on my chest. I am sick and tired of having painful acne, especially at my age.
My determatologist mentioned Accutane several times over the last couple of years, but I resisted because I was scared to try it (all the sensationalized articles on the web about it had clouded my judgement) and I kept thinking -- maybe I'll finally outgrow acne.
Then one day I realized that at 45, I wasn't going to outgrow it without some big help. That's when I made up my mind to start taking Accutane.
I have to tell you that this website is great. I learned so many things from all of the forums and logs and blogs about acne in general and Accutane.
I wanted to start this blog because there are not alot of older "more seasoned" people who have gone through the Accutane therapy and I was hoping my experiences might help some others who are going through or thinking about going through the same thing.
Wish me luck.