Taking Accutane for Acne Brings the Stress of Bloodwork

The thing about taking amoxicillin every day for years is that your body builds up an immunity. It works for a while, and then, without warning, it doesn’t, which is why it’s more or less a stopgap measure. You take it until you can’t, and then you look frantically for something else to try — preferably something other than an antibiotic, due to the slow and persistent breakdown of good gut bacteria.

I’m on my third cystic breakout of the year, which means my time on amoxicillin has officially run out. I’m on it for another month, but then I’m saying goodbye to the bubblegum-colored liquid — mercifully, because I’m more than tired of the pink dribbles trailing across my white duvet.

Instead, I’ll be starting Accutane (isotretinoin), an intensive, months-long course that, with any luck, will eradicate my acne once and for all. It’s a miracle drug, or so I’ve been told. Complete remission in over 70 percent of patients — what a world we live in!

There are, somehow, not many side effects. Prozac (fluoxetine) made me nauseated for the first few weeks, so I’m slightly suspicious. My dermatologist says, so long as I don’t get pregnant (ha-ha), there shouldn’t be anything to worry about.

It sounds too good to be true. A life free of acne? Is this what modernity has done to us? Are we so sure of our intellectual prowess that complete remission in over 70 percent of patients no longer seems fishy?

The downside

Accutane causes birth defects, so the medication is federally mandated. That means the government keeps track of who’s using it and I have to get monthly bloodwork to make sure I am not pregnant. (If I were sexually active, I’d have to be on two separate forms of birth control. Abstinence for the win!)

For most people, this wouldn’t be an issue, but my skinny, 75-pound self has terrible — and I mean terrible — veins. I was once poked 11 times in one sitting in an attempt to place an IV for my spinal fusion. Getting blood drawn is a special form of torture, not unlike gouging your eyes out with a red-hot fire poker.

Of course, I’m dramatizing things — and I’m not. I direct lab technicians to the one vein that’s ever cooperated. But when I say I’m a hard poke, they laugh and shrug and modestly admit to having some sort of mystical vein voodoo. “I’m actually pretty good at this,” they’ll say, to which I reply, “Knock yourself out.” When they give up (they always do), I smile placatingly.

The great thing about modern times is that there are all sorts of fancy gadgets out there. In particular, there’s an ultrasound that constructs an image of my veins. The technician and I watch the screen — they with practiced ambivalence, I with fascination and horror — as the white line of the needle pierces the dark smudge of my vein. Voodoo! One poke and a Band-Aid later, I’m on to the next thing, while vials of my blood are sent posthaste to the lab.

I love ultrasounds. They’re one of my favorite things in the world. But they’re very, very rare, meaning no one believes me when I say I need one. If I’m in the ER, wheezing into my BiPAP, I’m usually too exhausted to fight back. Jab me all you want, just get me some oxygen.

They send their best tech, said tech fails, and a few hours later I lie in a hospital bed with an ultrasound reconstructing the inside of my body. I’m not about to get poked several times a month just to get my acne meds. Ultrasound or bust, thank you very much.

I’ve been stressing about this ever since I decided to go on Accutane. After an entire day of phone calls, I managed to find a place that’ll get me the ultrasound without a fuss (Gillette is truly a lifesaver), so we’ll see how the appointment goes. Here’s hoping the pregnancy test is negative!

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Note: SMA News Today is strictly a news and information website about the disease. It does not provide medical advice, diagnosis, or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website. The opinions expressed in this column are not those of SMA News Today, or its parent company, Bionews Services, and are intended to spark discussion about issues pertaining to spinal muscular atrophy.