Last Friday I went to the dermatologist for my maintenance plan. Happily for me, he said it would be Targretin, at least to start with. Targretin has some side effects, the most serious of them is that it shoots your triglycerides up so high that, if not controlled, you could be in danger of pancreatitus or liver problems. I’ve seen pancreatitus. I don’t want it. But I’m more than willing to give this a try. I’ll be having blood tests every month and if things get out of hand, changes will be made.

So, I got the prescription and we went to drop it off at our local pharmacy that evening. Easy, right? No, of course not. Targretin is apparently only used to treat cutaneous t-cell lymphoma. It doesn’t appear to have any other application. Cutaneous t-cell lymphoma is a rarity. So, the drug costs $2000 a bottle. My insurance covers it. My little neighborhood pharmacy didn’t have any, but they called around and found a drug store that did have it and my neighborhood druggist could get it from the other place. My prescription is for 30 capsules. The drug comes in bottles of 100 and is normally prescribed that way. My pharmacy of choice really can’t afford to break up a bottle, not knowing if they’ll ever sell the rest. It’s possible that I’ll turn out not to be able to tolerate it. I could get hit by a truck. The chances that they’d be able to unload the balance of the bottle to someone else are slim to none.

Ok, so, at my local guy’s suggestion I went to the other place, about ten miles away, to see what could be done. I went Saturday morning. The pharmacist - one of several at this larger place - has been looking things up. Mostly having something rare is a pain, but it does catch the interest of medical personnel of all sorts. He says the absolute base starting dose is 300 mg. My prescription, as written, is for 75 mg. He would be able to break up a bottle, but is very reluctant to fill the prescription when he suspects a mistake might have been made. He doesn’t know what effect the lower dosage might have and he’d at least like to speak to the doctor first. I’m with him on this. I have faith in my doctor, but the practice is part of a teaching university. I think my prescriptions were written by a medical student. It might be that the doctor wanted to start me out slowly, but it’s worth checking to make sure this is right. The only thing is, this kind of practice isn’t open on Saturday. In fact there are office hours only three days of the week. Monday isn’t one of the days either. I left a couple of messages, just in case, but no callback today. So, as far as my doctor is concerned, I started the maintenance meds on Friday night, but in fact I still haven’t even seen a capsule.

Tomorrow is another day.