Christmas Haiku

On Christmas morning,

I still get excited, Ah!

A Buddhist failing.

May everyone have a safe and happy holiday.

Google Reader

The tag cloud from my Google Reader pretty neatly sums up my life. 

Big Brother is Watching My Uterus - Part 3

The start of month 3.

Let's play a game. It's called "Symptom or Side-Effect".

First some easy ones...

Dry Skin? Side-effect

Chapped Lips? Side-effect

Runny nose? Probably allergies, so Symptom.

Now the hard ones...

Joint pain

Muscle pain

Stomach Issues

Headaches

I've been on this medication for a full two months now.  It's nothing nearly as bad as I expected, but there are so many things I didn't expect when I went on it.  You can never imagine just how dry your skin can get, or how chapped your lips could possibly be, until one day you realize that a significant portion of your brain is distracted by how much your arms itch and a significant portion of your time is spent licking your lips in a painfully counterproductive attempt at keeping them from bleeding.  

What I really didn't expect though, was how much I'd worry that every little ache or pain or twinge or bad mood was a side-effect of the medication.  The list of side-effects on the information sheet from the pharmacy fills the better part of an 8 1/2 by 11 sheet... at 7 point type.  The information sheet included with each 10-pack of pills, 2.5 x 3.5 when folded, unfolds to a daunting 34 x 19 - double-sided- 5 point monstrosity (not all of which is side-effects, much of it is the chemical information for the prescription, precautions, information about the ipledge program and birth defect information- arguably a side-effect, but not for my purposes).

The short list of side effects includes psychiatric disorders, intracranial hypertension, pancreatitis, elevated lipids, hearing impairment, hepatitis (elevated liver enzymes, not the kind caused by a virus), IBD, and vision impairment (including decreased night vision). Considering all the potential side-effects, it's no wonder that any time my head hurts, or my stomach is upset I wonder if it's the medication.

To some extent I've experienced a lot of things that could be side-effects of the medication, but I can't be sure. Of course the dry skin (which has now developed into eczema) and chapped lips are a given. 

But what about the muscle pain? Or the headache? 

Too much drinking? Which, of course, you're not supposed to do at all because of the increased incidence of pancreatitis.

What about the stomach issues?

Too much junk food? Not enough exercise? Not enough sleep?

Or the decreased night vision?

Am I tired? Are my eyes just dry? Did I leave my contacts in too long?

I've been lucky that my bloodwork has stayed completely normal.  My triglycerides were 72 last week and my bilirubin is exactly the same as when I started on Accutane. I guess all that drinking hasn't compounded the potential side-effects of the medication.  It still leaves me to wonder (and worry) though, that everything I feel is a potentially dangerous side-effect.  And even scarier, potentially something that will cause me to have to stop treatment.  (The fact that I think being forced to stop treatment is scarier than potentially life-threatening side-effects is even scarier still).

Right now though, it's time for me to go bathe in baby oil in the hopes that the itching will stop. 

Then to pick up round three at the drug store.

Round Three!

Fight!

Big Brother is Watch My Uterus - Part 2

5 weeks in.

Big Brother might try to control my uterus, but he's impotent.

Which is probably good, cause I'm trying not to get pregnant.

I spent a month on birth control. As usual I ended up gaining weight, having mood swings, and generally not feeling good. I did manage to keep from getting preggers, though. But after a month I'd had enough. I managed to make it 9 years without popping out spawn, I think I can make it another 6 months doing what I've always done. So back off birth control and on Accutane.

(It's actually Claravis, made by Barr, not Roche, who manufactures the original Accutane.)

I can't complain too much about the actual medication. Generally I've felt fine, some muscle pain in the beginning, the obligatory dry skin and cracking lips, but in general, nothing major. The depression that scared me the most before going on this medication has been nowhere to be found. In fact I'm the happiest I've been in a long time. It seems I got all worked up about the side-effects for nothing.

That's not to say the side effects are negligible. I cannot begin to describe how dry my lips are. It's always fun to go to work in the morning looking like someone punched you in the lip- swelling, bleeding and all. There is not enough Chapstick or Vaseline in the world to keep my lips hydrated. They're dry from the inside out.

Like my lips, my skin is dry, close to unbearably so at times. I expect it'll only get worse as the weather gets colder and dryer. The doctor prescribed some weird Swedish foam moisturizer for my face and a steroid cream for my lips. 150 dollars later neither seems to be doing much. Maybe I'm just not noticing it.

So far the Accutane seems to be doing it's job- which in the beginning is making my skin worse. I keep telling myself that in 5 months I'll never have to worry about acne again. There's spots of light at the end of the tunnel though. I can see it getting better, just not in the spots that have gotten tremendously worse.

The most interesting thing that the Accutane has done is changed my relationship to my own self-image. Right now my skin is too bad to hide behind make-up, it has a mind of it's own- one day it's fine the next it's a war zone. I can't cover it up-make- it tends to hurt and certainly doesn't help my skin.

I can't pretend it's not there. I can't put my life on hold for months until my skin clears up. So what that all means is that I can't worry about it. I can't control it, or rather I'm in the process of controlling it. But I'm ok with it. My skin is my skin, and I'm comfortable in it.

Who knew it would take my skin getting worse for me to stop caring what people thought of it?

Big Brother is Watching My Uterus - Part 1

I don't believe in conspiracy theories.

This isn't so much a conspiracy theory as an observation- Big Brother is Watching My Uterus.

I know that makes me sound a little like a crackpot who's about to start going off about the Lone Gunman and Area 51, but bear with me for a moment.

I've always had bad skin.  There's really no two ways about it.  I have acne.  It sucks.  After about 10 years, and just about every product on the market, I am at the end of my rope.   I've done Proactive, and Neutrogena, every over the counter product shilled by every celebrity out there.  I've tried every prescription pill antibiotic, cream, and ointment.  They have succeeded in doing little more than make me photosensitive, ruin my clothing, and deplete my bank account.

I always hoped I would just 'grow out of it'.  That has yet to happen.

So now I'm at my last resort.  It's something I resisted when I was younger.  I tend to shy away from medication in general.  I would rather try to solve health issues with diet and exercise, instead of resorting to the Big Pharma Drug Pushers.  But I'm at the end of my rope.

It's not really about my appearance so much as it is about my comfort.  Sure I'd be much happier with the way I look if my skin were clearer, but in the end- and anyone who has ever had severe acne will know- acne hurts.  It's painful.  Even when I'm not looking in a mirror, I know it's there.  And that's the reason I've finally given in.

I decided to go on Accutane.

This was about three months ago.  In my naivety I assumed it would be like going on any other medication.  Go to the MD; Get a prescription; Fill it; End of story.  I knew it had some pretty dramatic side effects- extreme photosensitivity and depression being the two primary ones, not to mention the dry skin- but I didn't think it was that big of a deal.

I don't remember the last time I was that far off base.

The book of required reading for 'Female Patients Who Can Become Pregnant'  is about 50 pages long.  The vast majority of it is dedicated to educating girls who failed their sex ed classes that sexually active does not mean that if you lay perfectly still you will not become pregnant.  The rest of it is about the horrible birth defects your child will have if you get pregnant while on Accutane.  I understand that 'knowledge is power', 'knowing is half the battle' and 'the more you know...', but this is overkill.

The other portion of this guide is dedicated to laying out the rules under which this medication will be prescribed to 'Female Patients Who Can Become Pregnant'.  This is where we come to the title of my post.

Big Brother is Watching My Uterus (and Big Pharma's Back).

For a doctor to prescribe Accutane (or it's generic partners) a 'Female Patients Who Can Become Pregnant' must be on not one, but two forms of birth control, a primary form and either a second primary form or a secondary form of birth control.  Acceptable 'primary' forms of birth control are-

• a hysterectomy
• partner's vasectomy
• iud
• or hormonal birth control- the pill, patch, NuvaRing, Depo, etc.
  

Secondary forms of birth control are the barrier methods- condoms, diaphragms, sponges, etc. Whatever method of birth control a woman chooses, she must discuss it with her gyn who then has to fill out forms- signed, sealed, delivered- the attest to the fact that this patient has not only received 'contraception counseling' but that the gyn believes the patient will consistently use at least two forms of birth control at all times.

First of all, we're going to ignore the fact that they're listing a hysterectomy as a form of birth control for 'Female Patients Who Can Become Pregnant'.  We are not going to ignore the fact that they are listing both an iud and a partner's vasectomy as practical options for birth control for women and girls looking to cure acne.  I don't know about you, but I don't know too many 15 year old girls with iud's (many gyn's won't even consider inserting an iud for a woman who has not had a child).  I also don't know too many 17 year old boys who have decided, 'you know what, I don't ever want children, I think I'll have a vasectomy'.

So at this point we've narrowed our primary forms of birth control (for your average 13-25 year old) down to just one, the hormonals.  Hormonal birth control was revolutionary.  It allows women the opportunity to take much greater control over their own sex lives and the decision to have or not have children.  Awesome.  The Pill Rocks... except when it doesn't.

For some people birth control is the magic pill- lighter periods, less cramping, clear skin and oh, yeah, no babies. For some people birth control is a living hell- nausea, weight gain, mood swings, cramping, not to mention the risk of a stroke.  I have been on birth control several times over the course of my sex life, with varying degrees of success.  The first time I tolerated the nausea and weight gain (nearly 20 lbs) for well over a year.  The second time, on top of the nausea and weight gain I had such violent mood swings that I started to believe I was bipolar.  

My doctor changed my prescription and while the mood swings that had made me a terror to live with subsided, I was still unable to lose any weight or control my near constant nausea.  When routine thyroid function tests started coming back abnormal I finally said enough is enough.  I went off birth control and promptly lost 15 lbs.  My thyroid function went back to normal. I swore I would never go back on birth control again. The only thing to recommend birth control? I had clear skin.

Now, 4 years later, at 24 years old, I am left with a difficult choice, give up the right to decide what I put in my own body, or stick with my decision and be denied medication, that, while not necessary, is my sole remaining option.  Thinking I could deal with anything for 6 months, I gave up my uterus to government control.  I agreed- feeling quite as though I had no other choice- to go back on birth control.

I know this appears a failing on my part.  A weakness of will.  In part, it is.  I don't have the time, energy, or money to fight the FDA.  I certainly don't have the time, energy, or money to fight Big Pharma.  They have all the power at this point and I have nothing to bargain with.  It is of no consequence to them whether or not I take this medication.  Had I decided not to, someone else will be happy to shell out 300-600 dollars a month to a pharmaceutical company that has seized control of her reproductive rights.

Moving Day

Deflated air mattress

Sitting, thinking 'man, this sucks'

The sex was really good.

I see you Mara.

On paper, it seemed like a pretty terrible idea.  Me in a 105 degree, 55% humidity room, doing yoga for an hour and a half.

After the fact it's still not the brightest of ideas, but that won't stop me from doing it again.

One of my co-workers talked me into it, but it didn't take much convincing; after 8 years (on and off) of yoga, I'm usually pretty open to trying something new.  I'd wanted to try Bikram for a while, even if it is a distinct departure from my normal vinyasa/ashtanga/power bend.  Ignoring the controversy over Bikram and his copyright issues, I figured it was something worth trying.  

Heat plus exercise always equals a workout, and I'm always looking for a good workout.  By the middle of the class I felt like I had already gotten exactly what I bargained for.  Barring the intense nausea (which I expected) and the lightheadedness (which I also expected) I felt pretty good.  I don't remember the last time I sweated like that.  It felt good, it beads up and rolls down your shoulder-blades, or down your temples.  

I had moments where it got to be a bit too much though.  The moments where, had I been outside (say at track or softball practice), I would have just given in to the dizziness and nausea.  But since I was in a yoga studio as a new student, I figured it best to pace myself and wait for the tumbling sensation to go away.  The temperature was about 106 in the studio today, but the humidity much higher than the usual 55%.  It's been raining for days and so that contributed to the heat, 

What surprised me most was that I didn't really notice a distinct increase in flexibility.  I think part of that probably owes a lot to the fact that I am more out of shape than I realize.  I didn't notice a change, but I suspect my baseline is not where I expect it should be at the moment.  

City Beautiful

I am beginning to really appreciate time spent on the train.  I've been spending a lot of time in the city as of late and so a lot of time on the train as well.  Its an hour of time with 'nothing else to do, nowhere else to go'.  I could catch up on any one of the books I'm reading, or listen to my ipod- both of which I do occasionally- but the past few times, I've spent a large part of the trip just staring out the window, trying to let my thoughts come and go as they please.

For the most part it's been pleasant thoughts- excitement, contentment, and a general sense of well-being. I've been generally happy for a few months now, and so I'm perfectly happy to stare out the window as my thoughts come and go like waves rolling onto the shore.

The Legend of Billie Jean

A week ago I cut off nearly 2 feet of hair.  

I've been doing a lot of reevaluating my life lately, a benefit of having a roof over my head, a steady income, and the luxury of making changes in my life and more importantly, in myself.

There are a lot of changes to be made.

I want to love more, without reservation; without worrying that I might get hurt.  I want to have more compassion.  I want to live more- to adventure, to explore.  I want to experience new things and new people.  I want to be more patient.

I want to fear less, to worry less. I want to be less judgmental.  I want to give up on mistrust of others and doubt of myself.  I want to let go of my hang-ups and be more honest with my friends and lovers.

I want to live my life without the need for guilt or regret.  

This is what I want to change.

The best Defense is a good Offense