Week #12

I think, if you take away the cysts, we look as good as week 5. Progress? I hope so, but I don't want to jinx it by saying so.

Week #11

Not much to say this week. Notice the cysts now developing on his left cheek.

Week #10

Well, things got a little interesting at our last dermatology appointment. Because I missed my son's last appointment, this appointment was with a different nurse practitioner. She treated us like brand new patients and essentially started our medication regiment over.

She told us she had another case similar to ours where the high dose of accutane actually caused more irritation. She said she ended up lowering this other patient's dose of accutane which his body responded to much better. I guess this young man is cured and according to the nurse cant even tell he had acne.

So... she weighed my son and decided that 30 mg was the correct dose for someone 102 lbs. That was a decrease of 10 mg. She also put him back on a low dose of steroids and added an antibiotic. She thought the cysts on his right cheek may have a small infection festering in them. She did drain a couple of them and the fluid did look yellowish??? So maybe there was, I don't know.

I brought up his acne surgery, because the second appointment for that was coming up. The nurse said as long as there was noticeable swelling and irritation there should be no acne surgery. So we canceled our next appointment until further notice.

The nurse then asked my son how he was dealing emotionally with his acne. He responded with his usual "I don't know" She then asked if he felt self conscience or if kids at school were being mean. He answered with a "yeah kinda". She mentioned that some patients find it helpful to start home schooling....GRRRRRR This is not a new idea for us because I have mentioned this before to my family, but it was the first time a nurse/dr had brought it up to me.

Before we left the office we were introduced to a beautiful young lady who was suffering from a cyst on her right cheek and acne similar to my son's. She was starting her second month of accutane and it looked like she was really responding well to the drug. She was, I believe, in her late teens and both kids were kind of embarrassed by the situation. The nurse was trying to show me how cysts often start merging together. I thanked her for letting us observe her and she responded with a great question. The question I asked when we started down this accutane road...."why isn't there a support group set up for people who are on this drug. I smiled and gave her our blog address and my e-mail. I told her she could contact us anytime and that she could consider us the first two people in her support group. :)

The next day the nurse contacted me to tell me she spoke to the doctor about my son's situation and he decided to drop the accutane dose even further. So now we are doing the 30 mg every other day, essentially doing 15 mg every day. I have to admit that I am feeling like this is all still very experimental. I know each person's response is different, but it doesn't help us feel any better....

We missed last weeks blog because my son went on a Washington D.C. trip with his eighth grade class. I know he was stressed about it, but I was proud he decided to go through with it. Truth be told, I think he had a good time for the most part. He said the kids weren't too bad to him and he seemed to get along with his roommates.

He has been home for two days now and his face is looking really good! I think stress is playing a bigger role than we think with his acne. The last photo was taken today the others are from Friday afternoon. You can see the difference just two stress free days did for his face. The redness is much less and the swelling on the right is down. He wasn't able to use warm compresses while he was in D.C. so we will start that back up tonight.

I circled a section on his back because I wanted you to see how much worse his back is getting. When we first started on accutane he only had six or so in this circled area. Now as you can see its getting out of control.

Week #8

Last week we went in for Acne Surgery. The technician extracted many black heads with an unusual device. Used like a pen this device, from what I understood, had a small needle at the end along with a suction capability. The tech first numbed the face with a topical. We waited about 30 minutes until he was numb. The bottom picture shows us goofing around and laughing at the hair band. That smile was quickly reversed however, when it was time to get busy extracting. I am not sure how much numbing ability the cream had but, I can tell you that he tolerated only a very short time without much pain. After about five minutes he started his usual shaking and moaning. The right side was the worse as you can see from the photo there was a good amount of pressure being placed on those cysts. The ears were the second most tender. Its hard to get in there and both ears have cysts behind them.

The next day his face looked really good. The cysts were down and just having all those black dots gone improved his overall look.

The last photo was taken Sunday afternoon. He is making slow improvements. I feel we are doing the proverbial one step forward and two steps back. Today his cysts are swelling again.

We kind of got lax on our hot compresses and aloe over the holidays. It was hard to remember when we were busy entertaining friends and family. Last night, without being told, he did do the warm compresses. So we will get back on track with that because that did help with the dryness for sure.

I pulled an air head moment this week when I forgot about his derm appointment. I saw and actually said out loud the night before "oh tomorrow is your appointment" Well for some reason I found it important to go shopping when I should have been taking him in. I was so upset with myself!! I called immediately to reschedule but, I was told they were book solid all week at both locations. To make a long story short I ended up calling Monday morning and someone did cancel and I grabbed that time slot. Just in time to because he only had four more pills left. Good Grief, I will not do that again!!!

Week #7

I was so busy getting ready for the holidays I forgot to post a picture last week. My son is still improving on his left side. His right is starting to show the same three cysts. In addition there is a new cyst, that I mentioned on week 5's post, on his jaw line that continues to swell. He is still taking his steroids, Accutane, using compresses and finishing with Aloe.
I don't know if there is a correlation or not, but it seems the higher the humidity the worse he starts to get. It might be a coincidence, but I will try to remember to ask the dermatologist if there is anything to be said about that. We have an appointment next week.

Week #5

Not too much different this week and actually this picture makes him look pretty good. He has three cysts that are becoming a problem. One is still on the right side of his right cheek bone. The picture doesn't really show the swelling, but it is pretty swollen.... The second is on his left temple and the third, on his left jaw line. We are still spending 30-40 min a night using warm compresses, gently rubbing dead skin off and following up with the aloe gel with vitamine E &A. His face is a lot less dry since we started this routine. We have an appointment on the 28th for what the derm calls acne surgery. They will just be removing all blackheads on his nose and in his ears. I haven't asked, but I think I will see if they can inject his cysts again. I know it hurts him to get that done, but it really makes a big difference.

Week #4

Finally! I can report that there is noticeable improvement today. We had a dermatology appointment Thursday and I have to say we came back from that appointment feeling very concerned about our outlook. We knew when we went in that he was looking much worse. The derm. looked for several minutes without saying much. What came out of her mouth was not at all what I was expecting or wanting to hear. "I am not ready to call this Accutane failure".... My heart skipped a beat.

I knew he was looking bad, but I also read that Accutane makes you worse before getting better. I was expecting to hear a variation of those exact words. We also discussed his cysts which seem to be getting bigger and spreading. I asked what is done about cysts and I was told they never go away. Again, not something I wanted to hear. After all, its the cysts that look the worst. We were told the therapy would consist of just injecting them to keep them down.... and surgery?... not recommended on the face because of scaring.

I am not sure I am convinced of all that, so I will continue to research the latest derm procedures and ask if its an option for my son. I will take him out of country if I have to. There could be something out there that the U.S. is not using yet.

We ended our visit with six injections in three major cysts on his right cheek. Its quite an ordeal and everyone leaves with tears in their eyes. Poor kid!! He was also given oral steroids to hopefully help in the swelling and was told to start warm compresses to start loosening dead skin.

He started his steroids Saturday. It would have been Friday, but the pharmacy was having computer problems and we didn't receive them until 5pm. My son is better with medications in the morning as part of his ritual of getting ready so we started the next morning. We did start the warm compresses as directed and in fact just finished our third day of that.

I've included two pictures for this posting because you just have to see the difference. The first is the day we got back from the dermatologist and the second is from just a few minutes ago. Getting the dead skin off has exposed new skin! His face was looking kind of gray and now pink new skin is showing and it looks soooo much better. I have to say that I am not ready to give up on this Accutane! And I am pretty sure the steroids have not kicked in yet so even more swelling should be going away soon. Now, its just dealing with the cysts. Two of the three that were injected are not so swollen, but that one under his eye is STUBBORN!

We finished up our X-mas shopping today. I invited my son to come along and tried to tell him he was looking so much better, he told me "I think by next weekend I will be ready to come along". I so hope that will be the case. I think he is cautiously optimistic for the first time.