another strange Trimix experience

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Susan R
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Date Joined Dec 2010
Total Posts : 510
   Posted 5/20/2012 7:14 AM (GMT -6)   
OK, for those who know the history go ahead and skip this first paragraph. First attempt with Trimix .20 given by URO, ended up with 7 hour erection, 3 pills to bring down erection and trip to the ER, but didn't go in. Erection started to go down while in the parking lot of the ER. The next day we attempted .10, but didn't work at all, thinking there was so much trauma to his penis it just didn't respond and also possibly didn't keep needle in far enough when he depressed the plunger!

OK....so last night. It has been at least 3-4 weeks since trimix experience. Michael injected .10, which he was told to go half to try based upon URO directions. So, he injected about 9:45 last night, using auto-injector. We enjoyed about an hour of sex, and then he had an orgasm. At that point we decided to stop playing to see how this erection was going to play out. I fell asleep, about midnight I woke, he still had erection and was about to take one of the pills to reduce. I fell back to sleep, around 2:30, I woke again, he was still erect, was just about to take the last of the third pills. I told him that some guys on here said as long as the penis was pink and warm that the blood was still moving and he was ok to just let it go down. It was still warm and pink, so he decided to go ahead and wait. It was about an hour later and I hear "YAY!" from the bathroom, his erection was starting to go down. So....I can't give you the exact end time, since I was sleeping, but from 9:45 PM till about 5:00 AM he had an erection. He said it wasn't as painful as the first one, was uncomfortable but not painful.

I will direct him to call the URO on Monday. Any other ideas????? .10 still too much? This is what the bottle says.....
Trimix 27/0 .45/45
papaverine/phentolamine/alpros

Ideas???

Steve n Dallas
Veteran Member


Date Joined Mar 2008
Total Posts : 4049
   Posted 5/20/2012 7:36 AM (GMT -6)   
My gut reaction is to NOT let it go beyond four hours to avoid permanent damage.

Susan R
Veteran Member


Date Joined Dec 2010
Total Posts : 510
   Posted 5/20/2012 7:50 AM (GMT -6)   
My mistake. Michael just woke and told me I had the times messed up. He says it started to go Dow. Around 3-4 am. So it was about a 5 hour erection

Dave7
Regular Member


Date Joined Jul 2006
Total Posts : 197
   Posted 5/20/2012 8:35 AM (GMT -6)   
I think the mix is too strong.
You could reduce the volume of the injection or ask the uro for something much weaker.
 
 

KJ63
Regular Member


Date Joined Apr 2012
Total Posts : 286
   Posted 5/20/2012 9:58 AM (GMT -6)   
YES, and too bad...if you are catching my drift. lol
Husband...age 69..70/July
Diagnosed PC 12/09 DRE, PSA unreliable (1.7)
Lpros-poorly differentiated Prostatic Adenocarcinoma GS 5+5=10 (#1,2,5,6,9,10)
Rpros-same as above GS 5+5=10 (#3,4,8,11)
Radiation and Brachytherapy HT ED continues

Desertrat1
Regular Member


Date Joined Jan 2012
Total Posts : 336
   Posted 5/20/2012 2:21 PM (GMT -6)   
Glad to see your husband is back at it after the last mess. I've had one erection that lasted 6.5 hours because I fell asleep and wasn't aware of it. It isn't fun. I'm still working on what my correct dosage is but so far I've cut my dosage back to 25% from the 25 units the uro used in the office. My next injection will be .06cc or 6 units. The last two erections using 8 units lasted 2.5 hours. I have to have all of the lights on to see the hash marks on the syringe. It doesn't help that I need new glasses.

My uro told me damage starts at six hours. I believe the four hour rule comes to play because you have to get to the ER, you have to be admitted, they have to call the uro on call, the uro on call gets a middle of the night phone call usually around 2:00 am, the uro has to get dressed and drive to the ER, and then finally they can start doing something about the priapism. I doubt there was any damage in five hours. I agree your trimix is a rather hot dose. My compounding pharmacy has two common mixes. The high dose is exactly double the low dose that I use. Here are my dosages:

Papavirine 15 mg
Phentolamine .5 mg
Alprosdtadil 5mcg

Your trimix is
Trimix 27/0 .45/45
papaverine/phentolamine/alpros

You are getting about double the Papavirine and nine times the alprostadil per unit. .1 is still way too much so I would suggest cutting back to .02, .03 or .04. It is you and your husbands call. When you get close to zero it becomes difficult to see the line, and you may have to get a weaker blend. I will only inject if it is before 6:00 pm until I get this figured out. I've had two misfires when shooting my left side because I'm right handed. One was a total dud and the other was a flash in the pan at .08. We got two minutes of sex out the flash in the pan. I was just about to increase my dosages but didn't and the last two injections have both gone a little over two hours which is the reason for further reduction. I figured those two miss fires are the results of not hitting the target and I need more practice.
Good Luck to you and your husband.
Personal Theme song "I'm still standing"www.youtube.com/watch?v=dq2uAUjkLIw
AGE 59, 9/2011 PSA 4.7
BIOPSY 9-2011, G6 3X3 4 CORES HOT
RALP 1-3-2012
Final PATH: 3X4 G7, 7% GLAND VOLUMN, LEFT SIDE, pT2a
perineural Invasion:Focally observed
MARGINS & EXTRAPROSTATIC EXT NEGATIVE
psa 4-2012 .01 ZERO CLUB
INCONTINENCE GETTING BETTER, STARTING TRIMIX Whopee

Susan R
Veteran Member


Date Joined Dec 2010
Total Posts : 510
   Posted 5/20/2012 2:44 PM (GMT -6)   
WOW, thanks for the info.....it is quite surprising to me that Michaels dosage is SO much stronger, I guess I assumed there was a fairly standard starting combination, my stupidity. Michael said he would half the .1 next time he tries it, so I guess .05.....will see how that goes. Probably be a week or so till we get the time to try again :-( Will report next time!
Husband 39 at diagnosis 12/2010.
No symptoms, PSA 18 in 10/2010
one month antibiotic then PSA 12.6 in 11/2010
biopsy end of 11/2010 Gleason 6
Da Vinci prostatectomy 2/2/2011
Taking 20 mg levitra daily June 2011.
Feb 2012 - 1 year post surgery PSA = undetectable
Low T - started Androgel Feb 2012
Started Trimix Feb 2012


staging: pT2aNo, Gleason6

Desertrat1
Regular Member


Date Joined Jan 2012
Total Posts : 336
   Posted 5/20/2012 3:06 PM (GMT -6)   
Everybody is different in their tolerance to these drugs.
Do you realize that if .05 works for you two love birds that you will get 100 injections out of a 5 cc vial and the stuff will only last three months refrigerated. Despite the fact that I'm still playing around with the dosage, this morning I pre-filled 15 syringes up with .08 cc and put the vial in the freezer. My trimix is already a month old so that leaves only another 8 weeks before it starts to go south. We will probably need 8 weeks to finish up the 15 syringes I prefilled. But at least the vial will last longer. I would rather waste 2 or 3 units out of each syringe than have the whole bottle go bad, I cannot remember what the life span of trimix is frozen but I think it was about double. As soon as we use up the prefilled syringes, I will defrost the trimix for just a couple of days and fill a dozen more syringes. By then I hope to have the dosage figured out. Straight Asprodil gives my penis a real ache. Trimix is tolerable but still isn't enjoyable after an hour so I'm hoping we can get this down to the bare minimum or erection time needed. I would be very happy if I could get it down to 45 minutes which was about how long the first .08 injection lasted. It is really strange how the dosage is a moving target at this point.
Good Luck
Personal Theme song "I'm still standing"www.youtube.com/watch?v=dq2uAUjkLIw
AGE 59, 9/2011 PSA 4.7
BIOPSY 9-2011, G6 3X3 4 CORES HOT
RALP 1-3-2012
Final PATH: 3X4 G7, 7% GLAND VOLUMN, LEFT SIDE, pT2a
perineural Invasion:Focally observed
MARGINS & EXTRAPROSTATIC EXT NEGATIVE
psa 4-2012 .01 ZERO CLUB
INCONTINENCE GETTING BETTER, STARTING TRIMIX Whopee

Worried Guy
Veteran Member


Date Joined Jul 2009
Total Posts : 3247
   Posted 5/20/2012 3:20 PM (GMT -6)   
Susan

Congratulations to both of you - for many reasons.
Go much lower. 0.05!
There is no point in having an erection for more than 2 hours.

My Trimix is called "double strength". The bottle says: 30/ 1.0 / 0.02
(the 0.02 might also be written as 20 mcg)

Another guy tried my single strength at 0.05ml and it worked so well he could have used even less! He said all he has to do now is wave his stuff over the bottle and he gets hard.

I wish you both well. What a great problem to have. ;-)
Jeff
Age: 59, Mar 36 yrs, 56 dx, PSA: 4/09 17.8, 6/09 23.2
Biopsy: 6/09 7 of 12 Pos, 20-70%, Gleason 4+3 Bone, CT Neg
DaVinci RP: 7/09, U of Roch Med Ctr
Path Rpt: Glsn 3+4, pT3aNOMx, 56g, Tumor 2.5x1.8 cm both lobes and apex
EPE present, PNI extensive, Sem Ves, Vas def clear, Lymph 0/13
Incont: 200ml/day ED: Trimix
Post Surg PSA: 10/09 .04, 7/10 <0.01, 7/11 <0.01, 1/12 <0.02
AdV Sling 1/10/11 Dry

Sleepless09
Veteran Member


Date Joined Jul 2009
Total Posts : 1252
   Posted 5/20/2012 4:00 PM (GMT -6)   
Hi Susan, I just want to salute you on your honesty, openness, and above all your ability to discuss a subject many wouldn't be able to with the same naturalness as if you were dealing with an ingrown toe nail.

While this allows others to respond with the same candor, to your's and Michael's benefit, it also allows legions of others to be a little less closed --- if only when dealling with their doctor, or wife, and not necessarily here.

Good on you! And warm cheers to Michael.

Sheldon AKA Sleepless
Age 67 in Apil '09 at news of 4 of 12 cores positive T2B and Gleason 3 + 3 and 5% to 25% PSA 1.5
Re-read of slides in June said Gleason 3 + 4 same four cores 5% to 15%
June 29 daVinci prostatectomy, Dr. Eric Estey, at Royal Alexandra Hospital Edmonton one night stay
From "knock out" to wake up in recovery less than two hours.  Actual surgery 70 minutes
Flew home to Winnipeg on July 3 after 5 nights in Ramada Inn  ---  perfect recovery spot!
Catheter out July 9
Final pathology is 3 + 4 Gleason 7, clear margins, clear nodes, T2C, sugeron says report is "excellent"
 
Oct 1st 09 -- dry at night, during day some stress issues.
Oct 31st padless 24/7 
 
First post op PSA Sept 09  less than 0.02
PSA on Oct 23, 2009 less than 0.02
PSA on Jan 8, 2010  less than 0.02
PSA on April 9, 2010 less than 0.02 
PSA on July 9, 2010 (one year) less than 0.02
  

RCS
Veteran Member


Date Joined Dec 2009
Total Posts : 611
   Posted 5/20/2012 6:54 PM (GMT -6)   
Susan,
I use 2 to 3 units of 30/1/10 Trimix. 5 units would be too much.

Syringes are made in a 30 unit size (versus 50 units .... See the markings on the barrel of the syringe). The smaller syringes are easier to read ... For those of us who need bifocals.

One of the other posters mentioned that your Trimix would last longer than it's three month expiration time. I've used Trimix that was a year old and had no problems. I tried this after receiving the advice on the uToo Wiki. I did keep the Trimix refrigerated at all times.
PSA 2007 - 2.8; 11/24/2008 - 7.6; PCa Dx 2/11/09; age at Dx 62; RLP 4/20/09
Biopsy - Invasive moderately differentiated prostatic andenocarconoma; G 3+3=6; PT2C; No evidence of Seminal Vesicle or Extraprostatic Involvement; Margins clear; Tumor identified in sections from prostatic apex. 70 gram prostate. Continent after removal of cath.
ED - Trimix works well; levitra @ 90%
PSA - <0.1, 8/10/11

lifeguyd
Veteran Member


Date Joined Jul 2006
Total Posts : 584
   Posted 5/20/2012 10:47 PM (GMT -6)   
I have used bimix for almost 5 years.  I have always had "semi" erections after injection that have lasted for five or more hours.  I was very concerned and had several discussions with my urologist.  He told me that "you will know the difference" between a full erection and a partial one.  In my case the partial one begins within an hour or so after injection and continues getting softer for hours after.  It is about 3/4 or less and can be "revived" if we want to. He said not to worry if it is warm and flexible.  Cold and very hard is the call to emergency room.  I have never needed to make that trip.
 
Your husband will eventually find the right dosage and make life better. tongue

prop70
Regular Member


Date Joined Sep 2011
Total Posts : 51
   Posted 5/20/2012 11:40 PM (GMT -6)   
I was having poor to moderate success and worked up to .35ml then BAM! 5-6 hour erection. I now have bad case of peyronies I am sure from that prolonged erection.It was the most painful hours I have experienced. Currently I only need.05 ml but damage is done..Be cautious
Psa 6 at 41yo,abnormal DRE no symptoms. Biopsy G8. RALP 11/1/2011-upgraded G9(4+5) with EPE, negative margins, negative nodes, negative SVI,Perineural invasion present. angiolymphatic invasion present. Margins negative for tumor. High grade PIN. Staging pT3a N0.
8 week Psa 0.01 16 week Psa 0.06

Tigerfan53
Veteran Member


Date Joined Jan 2011
Total Posts : 811
   Posted 5/21/2012 1:12 AM (GMT -6)   

Susan – Michael should be very careful with the dosage given that he’s had two priapism events.  According to Dr. John Mulhall, a highly regarded ED expert, an erection lasting 4 hours (above penetration hardness) is considered a urologic emergency.  Erections lasting longer than this deprive the penis of oxygen which can kill erectile tissue much the same way that a heart attack kills heart muscle.  Men who’ve had several cases of priapism are more likely to no longer respond to pills or injections.  He says 90 minutes should be the maximum.  If it lasts 2 hours you should take 4 regular Sudafed 30 mg tablets in an effort to get it down under penetration hardness.  At 3 hours you should be in contact with your doctor and if it is still at or above penetration hardness at 4 hours – you should be IN the ER.

 

I agree that his mix may be too strong for him.  I believe the most active ingredient in Trimix is the prostaglandin (alprostadil is a variant).  By way of comparison my Rx is: Papaverine 30mg - Phentolamine 1mg – Prostaglandin 10mcg/ml.  Now I don’t know if Prostaglandin and Alprostadil compare one to one, but my dose is 10 and Michael’s is 45.  Of course, men respond differently to this medication so it’s hard to compare, but at any rate I would definitely talk to the uro about the dose.

 

However, no matter what dose you settle on, in my opinion, it would be better for him to go low and work his way back up to an ideal dose.  Expect a few flops along the way, but that’s better than going 4+.  And try each step twice before increasing, just to make sure.

 

Hope this helps – and Good Luck!

 

Btw, here’s a video of Dr. Mulhall.  He talks about priapism around 14 minutes into the video.

 

http://www.mskcc.org/multimedia/penile-rehabilitation-after-treatment

 


Diagnosed Dec 2010 at age 53
09/2010 PSA 4.8
11/2010 PSA 5.1
11/2010 PSA 5.3 after antibiotics
12/2010 Biopsy: 50% in 1 of 12 cores, PIN, G6, T1c
03/2011 PSA 5.6
06/2011 RALP negative margins, G6, pT2b, PIN, PNI, EPE
09/8/2011 PSA < 0.05
12/8/2011 PSA < 0.05

Post Edited (tigerfan53) : 5/21/2012 12:15:31 AM (GMT-6)


Desertrat1
Regular Member


Date Joined Jan 2012
Total Posts : 336
   Posted 5/21/2012 7:44 AM (GMT -6)   
I agree with tiger on this one: "However, no matter what dose you settle on, in my opinion, it would be better for him to go low and work his way back up to an ideal dose. Expect a few flops along the way, but that’s better than going 4+. And try each step twice before increasing, just to make sure."
Personal Theme song "I'm still standing"www.youtube.com/watch?v=dq2uAUjkLIw
AGE 59, 9/2011 PSA 4.7
BIOPSY 9-2011, G6 3X3 4 CORES HOT
RALP 1-3-2012
Final PATH: 3X4 G7, 7% GLAND VOLUMN, LEFT SIDE, pT2a
perineural Invasion:Focally observed
MARGINS & EXTRAPROSTATIC EXT NEGATIVE
psa 4-2012 .01 ZERO CLUB
INCONTINENCE GETTING BETTER, STARTING TRIMIX Whopee

shipper12
Regular Member


Date Joined Mar 2012
Total Posts : 110
   Posted 5/21/2012 7:55 AM (GMT -6)   
I wonder if penis size has anything to do with the size of the dosage. For example would a guy who is thick require more than a guy smaller?  It stands to reason that a larger penis may require more medication to get the same results as the medication is injected into the tissue not the blood steam as a pill would be.

Water Guy
Veteran Member


Date Joined Jul 2011
Total Posts : 2403
   Posted 5/21/2012 8:00 AM (GMT -6)   
I have to agree with Tigerfan on this as well. At 3 hours he should have been in a cool bath with his feet elevated after haven taken 4 sudafeds and at 4 hours he needs to be in the ER. I keep a copy of the instructions for the ER attendant on how to treat the priapism just in case. So far I have not had to visit the ER. The other thing after a long erection issue do not inject the next day, you need to have at least 2 to 3 days in between injections. Even with normal erections it is recommended that you wait 48 hours between injections. The wait time also has to do with the build up of scar tissue at the injection sites.
AGE 61 Dx with fam hist of PC
PSA
1.5 5/09
2.5 6/10
3.5 12/10 ref URO
5.25 2/11 DRE Neg
BX 4/13/11 2 of 12 cores diag both sides 15% & 20% GS7(3+4)
RALP nerve-sparing 6/8/11 path G7 pT2C, Marg-Lymph-Sem-Vas-PNI- organ confined 60% tumor involved 69grms 4.3X4X3 cm
100% dry 7/3/11
post PSA
8//11 <0.07
12/11 <0.04
3/12 <0.01
TRIMIX therapy for ED seeing improvement

Susan R
Veteran Member


Date Joined Dec 2010
Total Posts : 510
   Posted 5/21/2012 7:09 PM (GMT -6)   
Thank you all for taking the time to input. I do appreciate it!!
Husband 39 at diagnosis 12/2010.
No symptoms, PSA 18 in 10/2010
one month antibiotic then PSA 12.6 in 11/2010
biopsy end of 11/2010 Gleason 6
Da Vinci prostatectomy 2/2/2011
Taking 20 mg levitra daily June 2011.
Feb 2012 - 1 year post surgery PSA = undetectable
Low T - started Androgel Feb 2012
Started Trimix Feb 2012


staging: pT2aNo, Gleason6

JStars
Regular Member


Date Joined Oct 2005
Total Posts : 455
   Posted 5/21/2012 9:55 PM (GMT -6)   
Susan,

First, way to go you two on getting up to speed on injections. I am sure the next shot at half the last dose will be fine. But, A WEEK until your next try? A WEEK? That is so sad. I hope it is because one of you is traveling on business or something. What other reason could there be??

Also, on the prolonged erection thing. Here is what I have observed (over 200+ injections). Mostly I inject early in the morning not at night. In the morning , after doing what needs to be done and then getting up and showering etc the Big-E starts to go softer ( although does linger for a few hours but not a full E). The other night, however, I injected at around 11pm instead. After we were done, and I fell asleep the E lingered on for quite a few hours at a pretty good hardness level. . I have seen this often -- While lying down the erection lingers much longer (and possibly REM sleep etc might be stimulating some remaining nerves -- who knows?).

So maybe have him try a morning shot. The extra adrenaline of getting ready for work and worrying about the day ahead also will send things down quicker. And if not, well your Uro won't be nearly so miffed about heading to the ER early in the AM. (and your hub gets a few hours off from work -- with time to think up a really good other excuse for why he's late).

Keep on, keepin' on!

J

Update for Shipper: Yes the morning shot is for S_E_X. Its just in the early morning that's all. ;-)

Post Edited (JStars) : 5/22/2012 3:33:58 PM (GMT-6)


shipper12
Regular Member


Date Joined Mar 2012
Total Posts : 110
   Posted 5/22/2012 7:10 AM (GMT -6)   
Maybe Im missing something but I thought the purpose for using Trimix was to be able to have sex. So why would you inject in the morning before you off to work if you were not going to have sex.  I inject when the moment is right beteen my wife and I.

James C.
Veteran Member


Date Joined Aug 2007
Total Posts : 4453
   Posted 5/22/2012 9:45 AM (GMT -6)   
There are a few studies that indicate that use of the injectables will speed renewing and regrowth of the damaged nerves, resulting in earlier than usual resumption of erectile function. I can't speak for others as to why they would take them without sex, but that fact, combined with the stretching and blood engorgement is a reason why I do it.
James C, 65, A Better Man, Injections? Read This
4/07: PSA 7.6, 3/16 PCa, 5% inv, lf. lobe, GS6
9/07: open RP, Path: pT2c, 110 gms., Prob. micro.inv.-left apical margin -GS6
4 Yrs: .04 'til 4/10-.06, 12/10-.09, 5/11-.08, 9/11-.14, 2/12-.10

Susan R
Veteran Member


Date Joined Dec 2010
Total Posts : 510
   Posted 5/22/2012 11:34 AM (GMT -6)   
Yes the reason for the week off is because I am out of town Sunday's- Friday's. For another few weeks. He could use it alone, but that would make me sad. I want full use of that hard erection!!! Woo hoo!!!! (was that too much info?)
Husband 39 at diagnosis 12/2010.
No symptoms, PSA 18 in 10/2010
one month antibiotic then PSA 12.6 in 11/2010
biopsy end of 11/2010 Gleason 6
Da Vinci prostatectomy 2/2/2011
Taking 20 mg levitra daily June 2011.
Feb 2012 - 1 year post surgery PSA = undetectable
Low T - started Androgel Feb 2012
Started Trimix Feb 2012


staging: pT2aNo, Gleason6

InTheShop
Veteran Member


Date Joined Jan 2012
Total Posts : 3099
   Posted 5/22/2012 11:43 AM (GMT -6)   
Susan R said...
Yes the reason for the week off is because I am out of town Sunday's- Friday's. For another few weeks. He could use it alone, but that would make me sad. I want full use of that hard erection!!! Woo hoo!!!! (was that too much info?)


That you want to use it normal and natural.

How you would use it would be too much information. smilewinkgrin

shipper12
Regular Member


Date Joined Mar 2012
Total Posts : 110
   Posted 5/22/2012 1:13 PM (GMT -6)   
I think itys great Susan's react to Trimix and it sounds like she's very supportive of her husband.

My wife was too. It was so great not having to worry about me getting "up" or staying up, Also she actuallys helps me with the injection. Massaging it in., Thats a turn on for bother of us.

Tigerfan53
Veteran Member


Date Joined Jan 2011
Total Posts : 811
   Posted 5/22/2012 1:49 PM (GMT -6)   
Shipper – Most of us here are recovering from prostate cancer treatment that has damaged and/or traumatized our nerves. Getting erections by whatever means: injections, pills, suppositories, keeps the erectile tissue healthy by bringing fresh highly oxygenated blood to the penis while we wait for the nerves to recover. Our mantra: “Use it – or lose it.” Do we use Trimix for sex? Absolutely! But sometimes when moment is not right or the wife/partner is out-of-town, etc. we use it anyway for rehabilitation purposes.

It’s the erections (at penetration hardness) that are necessary for rehab; sex and even orgasms are not required … although they are certainly a welcome side effect!

I know you are here for ED info and that you don’t have PCa (yay! hope you keep it that way), so just thought I’d explain from “our” perspective.
Diagnosed Dec 2010 at age 53
09/2010 PSA 4.8
11/2010 PSA 5.1
11/2010 PSA 5.3 after antibiotics
12/2010 Biopsy: 50% in 1 of 12 cores, PIN, G6, T1c
03/2011 PSA 5.6
06/2011 RALP negative margins, G6, pT2b, PIN, PNI, EPE
09/8/2011 PSA < 0.05
12/8/2011 PSA < 0.05
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