At each appointment, after I saw my doctor and she reviewed my blood work, she would submit her portion of iPledge. Once my pharmacy received the information, usually within a few hours, I could finally pick up my prescription—so long as it was done within a seven-day window of the pregnancy test. Thirty days later, I’d repeat the entire process.
Once I finally had the pills in hand, dry skin was the side effect that impacted me the most day to day. My once-oily face transformed into a desert. A light touch was all it took for the skin on my forehead to come off in flakes, and thin layers peeled off like an onion. Chapstick became a constant necessity. Even though I was always armed with something to soothe my cracked lips (I had at least one stick in my backpack, another in my car, another in my bathroom, and others strewn about my bedroom) my lips remained unusually swollen and puffy. This was followed by nasal dryness that led to the occasional nosebleed.
As isotretinoin waged a scorched-earth strategy on my face that left me feeling like my skin was practically falling off, I was also weirdly excited by the changes I saw taking place. If I could molt my skin like a snake and discard my bacteria-ridden, blemished skin, it gave me hope that a fresh, healthy layer would finally surface.
Out of all of the drawbacks to the drug, the biggest hurdle for me was the monthly blood test. I have low blood pressure that causes me to routinely pass out after having my blood drawn, and just the sight of blood makes me queasy.
Each month I would try my best to avoid ending up in a heap on the floor of the lab. I would request the one room with a chair where I could lie all the way back and put my feet up. I’d take slow, deep breaths until the nurse removed the needle, wait a few more minutes for good measure before sitting up, and then, barring any lightheadedness, I’d breathe a sigh of relief that I wouldn’t be back in the chair for another 30 days. Still, on more than one occasion I wouldn’t make it farther than the waiting room before I’d slump down into a chair, putting my head between my knees until the dizziness would pass.
Now, however, it turns out that I might not have needed those monthly tests. In 2015, Kirby authored a study that suggested only two blood tests would be necessary: one to measure baseline levels of blood fats, and another two months after beginning treatment, when levels reach their peak. Not only would this alleviate the cost of co-pays for the procedure, but it would have relieved the anxiety of having my blood taken each month, something Kirby said many of her patients experience.
“When we tell people ‘You’ll need blood work,’ sometimes we see that fear or concern on their face,” she said. “When we can say it’s going to be just two [times], sometimes I see those faces relax.”