Trimix Experience

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pa69
Regular Member


Date Joined Mar 2009
Total Posts : 260
   Posted 8/22/2009 5:59 PM (GMT -6)   
Hi Everyone,

I'm more than eight months past surgery and to date have not had the slightest response from Willie. Levitra didn't help with his coma either.

I had a doctor's appointment last Friday, to try a Trimix injection. The doctor explained the procedure in great detail and assured me it would not hurt. He asked me if I would like to insert the needle but I declined because I wanted to know how it would feel being administered by an expert.

He inserted the needle while I watched and true to his word it did not hurt. Not even in the slightest. The only sensation was a small amount of pressure.

After about 10 minutes Willy sprang to life! It's been so long it felt really strange, but it wasn't painful. My concern at the moment was if it would settle down after a while so I wouldn't need emergency room treatment later. As it turned out Willy went back to sleep after about an hour.

I haven't tried to self inject yet but I think I'll be able to do it. Oh, the dose the docter gave me was 0.5cc.

I hope my experience will help those of you contemplating an injection. It's not so bad.

Bob
Age 70, First ever PSA 7.8 taken June 2008, Biopsy July 2008, 10 of 12 cores positive, Gleason 3+3=6
da Vinci surgery December 10, 2008, catheter removed December 29 2008
St. Lukes Hospital, Bethlehem, Pa.
Dr. Frank Tamarkin
Prostate weight 73.0 grams, Gleason 3+3=6, stage pT3a
Tumor locations: right anterior apex, right posterior apex to mid
left anterior mid to base, left posterior apex to mid
extensive perineural invasion in right anterior apex, right and left posterior apex to mid
seminal vesicles negative
Three PSA tests undetectable, latest July 18


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25380
   Posted 8/22/2009 10:00 PM (GMT -6)   
Bob, that would have to have been an encouraging episode for you after all this time. Yeah, I remember the first time the old weiner came to life, honestly thought at first it was in a perm. vegatative state, lol, and needing to be on life support. Never had to inject or do anything else, and not sure I could. But yours was a positive spin on what many new to ED face when contemplating injections. Good luck on the next step.

David in SC
 Age 57, 56 at DX, PSA 7/7 5.8, 7/8 12.3,9/8 14.5
3rd Biopsy Sept 08: Positive 7 of 7 cores, 40-90%, Gleason 7, 4+3
Open RP surgery 11/14/8, Right nerves spared, 4 days hospital, staples out 11/24/8, 5th cath out on 1/19/9
 Pathlogy Report:Gleason 3+4=7, pT2c, 42 grm, tumor 20%, Contained in capsule, one post. margin, clear lymph nodes 
2009 PSA   2/9 .05, 5/9 .10, 6/9 .11, 8/9 .16
Lastest 7/13 met with Rad. Oncl, considering options, 7/20 Catheter #6 after complete blockage, 8/14 met with Rad Oncl, still talking option, 8/18 - had laser scope surgery to clear blockage, now on Catheter #7
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 


Piano
Veteran Member


Date Joined Apr 2008
Total Posts : 847
   Posted 8/23/2009 3:26 AM (GMT -6)   
Hi Bob, that's good news.

I find just a little discomfort with my 28g needles. l prefer not to watch when getting an injection anywhere and "there" is no exception. My wife administers my injections and they cause her no pain at all :-) Others here use an auto-injector and get good results with that.

Overcoming the initial trepidation is the hard part, and once you are past that, the rest is easy.
Pre-op:
Age 63 at diagnosis, now 64.
No symptoms; PSA 5.7; Gleason 4+5=9; cancer in 4 of 12 cores.
Operation:
Non-nerve sparing RRP on 7 March 2008.
Two nights in hospital; catheter out after 7 days.
Post-op:
Continent; no pads needed from the get-go.
Pathology showed organ confined and negative margins. Gleason downgraded to 4+4=8.
PSAs:
6-week : <0.05
7-month: <0.05
13-month: 0.07 (start of a trend?)
ED:
After a learning curve, Bimix injections (0.2ml) are working well. VED also works but we find it inferior to Bimix.
14 months: Occasional nocturnal erections.


James C.
Veteran Member


Date Joined Aug 2007
Total Posts : 4462
   Posted 8/23/2009 6:41 AM (GMT -6)   
Glad you had a positive first time with the injection. The first time sticking yourself does require some courage, but it becomes routine quickly. I would advise you get 31 ga. needles to use. They are so small they reduce the chance of pain greatly. When you do start self-injecting, rememebr there will be failure once in a while but each time gives more experience in making the successful stick.

Mr. Piano, I'd switch to 31 ga. also, unless there's a real need for 28 ga.
James C. Age 62
Co-Moderator- Prostate Cancer Forum
4/07 PSA 7.6, referred to Urologist, recheck 6.7
7/07 Biopsy: 3 of 16 PCa, 5% involved, left lobe, GS 3/3=6
9/07 Nerve sparing open RRP 110gms.- Path Report: GS 3+3=6 Stg. pT2c, 110gms, margins clear
22 mts: ED- 50 mg Viagra 3X week, pump daily,Trimix 30/1/20-.05ml 2X week continues
PSA's: .04 each test since surgery


Ed C. (Old67)
Veteran Member


Date Joined Jan 2009
Total Posts : 2458
   Posted 8/23/2009 10:07 AM (GMT -6)   
Bob,
I use trimix with a 31 ga needle and it doesn't hurt at all. I strated out with .02 and it didn't quite do the job. I'm now at .35 and that works every time. The erections last from 1.2 to 2 hours. You may want to try a smaller dosage so you don't have to worry about going to the hospital with Willie sticking out.
Age: 67 at Dx on 12/30/08
PSA 9/05 1.15; 8/06 1.45; 12/07 2.41; 8/08 3.9; 11/08 3.5 free PSA 11%
2 cores out of 12 were positive Gleason (4+4) and (4+5)
Negative CT scan and bone scan done on 1/16
Robotic surgery performed 2/9/09 Dr Fagin, Austin TX
Pathology report:
Prostate weighed 57 grams size:5.2 x 5.0 x 4.9 cm
Posterior lateral lesions measuring 1.5 x 1.4 x 1.0 cm showing focal capsular penetration over a distance of 3mm.
Prostatic adenocarciroma accounts for approx. 10-20% of the hemisphere.
Gleason 4+4
both nerve bundles removed,
pT3a Nx Mx, Negative margins
seminal vesicles clean, lymph nodes: not dissected
continent after 4 months
8 weeks PSA test 4/7/09 result <0.1
5 months PSA test 7/9/09 result <0.1


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25380
   Posted 8/23/2009 11:10 AM (GMT -6)   
hey james, is a "successful stick" the same thing as "good wood"? curious down in south carolina
 Age 57, 56 at DX, PSA 7/7 5.8, 7/8 12.3,9/8 14.5
3rd Biopsy Sept 08: Positive 7 of 7 cores, 40-90%, Gleason 7, 4+3
Open RP surgery 11/14/8, Right nerves spared, 4 days hospital, staples out 11/24/8, 5th cath out on 1/19/9
 Pathlogy Report:Gleason 3+4=7, pT2c, 42 grm, tumor 20%, Contained in capsule, one post. margin, clear lymph nodes 
2009 PSA   2/9 .05, 5/9 .10, 6/9 .11, 8/9 .16
Lastest 7/13 met with Rad. Oncl, considering options, 7/20 Catheter #6 after complete blockage, 8/14 met with Rad Oncl, still talking option, 8/18 - had laser scope surgery to clear blockage, now on Catheter #7
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 


James C.
Veteran Member


Date Joined Aug 2007
Total Posts : 4462
   Posted 8/23/2009 11:42 AM (GMT -6)   
I can't see when there would be anytime that a stick to that area that didn't yield 'good wood' as successful. tongue Also, depends on the whittler if its a stick or a good piece of wood, I suppose.

Ed C.: a thought. Given the large amounts of Trimix you need, relative to the rest of our experience, I wonder if I might make a suggestion to help possibly reduce the amount of Trimix needed, and also reduce the risk of a 4 plus hour erection?

My own experience first. I found that it would take a large amount of Bimix- up to .5ml to get much erection, even then it failed some of the time. I also was having to use .3ml or more of Trimix to acheive anything useful. The problem for me, I think, is the valves didn't close to hold the drug in the cavities and thus let the tissues adsorb it, rather it ran out of the penis before proper adsorption. I started using a pre-plump technique. I would use a pump to pump up just a little bit, enough to get the cavities opened some, then apply a penis ring. I then injected the Trimix or Bimix, I could easily tell if I had made a good stick and there would be less resistance when the nedle passed into the cavitiy. I gently massaged the penis for 3 mintues or so, letting the drugs which was captured in the cavities to adsorb into the tissue. Upon removing the ring, the penis would lie there a minutes or so, then begin getting erect easily and fairly quickly. Using this method, I reduced the amount of Trimix needed (and the accompanying ache) from .3ml to .06ml. This is something you might consider, given that it seems the drugs is not adsorbing but rather running out of the penis. This method is especially useful for guys with unresponsive or slender or small penis types, as this allows the cavernous cavities to expand and allows the needle to inject the drug properly and directly into the cavity, one that may be flat and not expanded otherwise. I believe this little trick would work for any size or shape, as it's purpose is to use the least amount of drugs to the most amount of benefit, and the less drugs we inject into our penis, the less chance of long term problems we might create there. Something to consider..
James C. Age 62
Co-Moderator- Prostate Cancer Forum
4/07 PSA 7.6, referred to Urologist, recheck 6.7
7/07 Biopsy: 3 of 16 PCa, 5% involved, left lobe, GS 3/3=6
9/07 Nerve sparing open RRP 110gms.- Path Report: GS 3+3=6 Stg. pT2c, 110gms, margins clear
22 mts: ED- 50 mg Viagra 3X week, pump daily,Trimix 30/1/20-.05ml 2X week continues
PSA's: .04 each test since surgery

Post Edited (James C.) : 8/23/2009 11:45:59 AM (GMT-6)


Piano
Veteran Member


Date Joined Apr 2008
Total Posts : 847
   Posted 8/23/2009 4:00 PM (GMT -6)   
I agree with James' suggestion of constriction at injection time -- I believe that now gives me 100% good sticks. If you don't have a specific penis ring, rubber bands work too.

Just to show that we are all different, I did try James' pre-plumping trick, and that led to my last failure now several months ago. Now I do just a little pre-injection massage, and that leads to a slight increase in length -- nothing more -- maybe gives a little extra to aim at.

The important thing with injections is persistence and not to give up at the first failure. After an initial success or two, I had a string of six failures. If I hadn't had those early successes, I may have given up then. But aided by advice from this forum, I tried things, and happened upon something that worked and still works for me.

So along with persistence, you need to experiment. If you have failures, try to analyze why and make the necessary changes.
Pre-op:
Age 63 at diagnosis, now 64.
No symptoms; PSA 5.7; Gleason 4+5=9; cancer in 4 of 12 cores.
Operation:
Non-nerve sparing RRP on 7 March 2008.
Two nights in hospital; catheter out after 7 days.
Post-op:
Continent; no pads needed from the get-go.
Pathology showed organ confined and negative margins. Gleason downgraded to 4+4=8.
PSAs:
6-week : <0.05
7-month: <0.05
13-month: 0.07 (start of a trend?)
ED:
After a learning curve, Bimix injections (0.2ml) are working well. VED also works but we find it inferior to Bimix.
14 months: Occasional nocturnal erections.


Ed C. (Old67)
Veteran Member


Date Joined Jan 2009
Total Posts : 2458
   Posted 8/24/2009 7:28 AM (GMT -6)   
James,
I actually do use the pump and the ring before injecting the trimix. I started using the 3.5 dosage before I started using the pump and didn't haven't tried a smaller dosage since. I will try to reduce it to ,2 next time.
Age: 67 at Dx on 12/30/08
PSA 9/05 1.15; 8/06 1.45; 12/07 2.41; 8/08 3.9; 11/08 3.5 free PSA 11%
2 cores out of 12 were positive Gleason (4+4) and (4+5)
Negative CT scan and bone scan done on 1/16
Robotic surgery performed 2/9/09 Dr Fagin, Austin TX
Pathology report:
Prostate weighed 57 grams size:5.2 x 5.0 x 4.9 cm
Posterior lateral lesions measuring 1.5 x 1.4 x 1.0 cm showing focal capsular penetration over a distance of 3mm.
Prostatic adenocarciroma accounts for approx. 10-20% of the hemisphere.
Gleason 4+4
both nerve bundles removed,
pT3a Nx Mx, Negative margins
seminal vesicles clean, lymph nodes: not dissected
continent after 4 months
8 weeks PSA test 4/7/09 result <0.1
5 months PSA test 7/9/09 result <0.1

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