Big Brother Part. 4

5 months in. Or is it 4? Or 6?

It feels like it's been forever and generally, I'm just sick of being on this medication. Otherwise though, there isn't anythnig epic to write about. My skin's still dry, my lips are still dry, the soap in the bathroom at work irritates my hands to a ridiculous degree. I've got prescription moisturizer, prescription steroid cream, and a deep regret I didn't buy stock in baby oil when I went on this medication.

I've gotten over the whiny "why isn't it working yet?" phase I went through last month and have kind of resigned myself to just taking the pills every day, regardless of the result.

Tuesday though, for the first time, I could actually look in the mirror and almost convince myself that my skin was healing. There is a glimmer of hope in this whole mess. I'm just keeping my fingers crossed that I'll be done with this whole process by May. Just in time for a trip to Ithaca.

10 for 10

Inspired by Stef I've decided to do my own mini version of 25 goals for my 25th year. Really I'm shamelessly stealing her idea, but imitation is the sincerest form of flattery. I don't much intend to blog about it, save this once, but I feel like making a public announcement of my intentions will help to hold me accountable.

I'm already well into my 25th year, so it seems silly to me to try to cram 25 things into 3/4 of a year. So I've shortened things a bit, trying to focus on the things that are a the top of my 'To Do' list, and in many cases, have been for quite some time. Really, I'd make one of my goals 'Stop Procrastinating' if it didn't already encompass all of them.

So here's my list- 10 things to do in 2010.

1. Get reacquainted with old friends.

No more putting off writing an e-mail, sending a text or making a phone call. My friends are scattered across the country (and the world) and I've lost touch with many of them who helped shape my life up until this point. Part of the goal is resolving to be more proactive in my friendships, instead of feeling guilty that I didn't say 'hello'.

2. Get Certified.

By the end of the year I will be a Certified Yoga Instructor. Period. I think this is the most non-negotiable of my goals.

3. Get into Shape.

My goal isn't to lose weight, fit into a smaller dress, look like Natalie Portman. I want to feel strong, and powerful. I want to feel like I did when I was fencing. I want to kick ass and take names. Mostly, I want to feel comfortable in my own body again, and secure in the knowledge that I can do what I ask of it.

4.Get Organized.

My space is in a perpetual state of chaos. It's time to change this.

5.Get a Motorcycle.

Or at least a license. I might not be able to afford a motorcycle, but I can treat myself to lessons and the license, for when I have less time to sit at the DMV for hours on end during the middle of the week.

6.Put Money in the Bank.

10,000 is the goal, which is kind of lofty considering I make only slightly above minimum wage.

7. Get Enlightened.

Or at least sit on it. That means getting my butt on the cushion, consistently, consciously, and sincerely. Making it to a DPX meeting once a month, no ifs, ands, or buts. And making it to any East Coast Silent that happens- within my budget. This also ties into number one and means connecting- and reconnecting- with my sangha, far-flung as it may be.

8. Have more Patience.

With my parents, with my friends, with my boyfriend, with the dog, with the cat, with myself. Don't let work get to me so much.

9. Get Working.

Right now this is kind of an amorphous work goal. Get Inspired. Get something I enjoy. Get something that pays better. Get something that makes me Happy. Get something that lets me be creative, and active and thoughtful. Get something where I can advance, and grow and imagine. Get something that makes me better.

10. ?

Number ten is up for grabs. I figured I should leave myself some wiggle room, I also wanted to leave room for suggestions. Something I should work on? Something I should try? Let me know.

Wisdom

Forgiveness means letting go of the burning ember that is anger.  It doesn't mean inviting them in to hurt you again.  

I am trying to remember this lesson.

And more importantly, put it into practice.

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.