Trimix attempt. Second try is better than the first.

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Worried Guy
Veteran Member


Date Joined Jul 2009
Total Posts : 3734
   Posted 2/22/2010 7:57 PM (GMT -6)   
Here's an update on my Trimix saga. 7 months post DaVinci.

Exactly one month ago I had a bad reaction to my first shot of 0.15 ml Trimix #1 - very low blood pressure, passed out, required IV. See attached thread.
http://www.healingwell.com/community/default.aspx?f=35&m=1698786
I had been taking Cialis, and tried to go light on fluids so I would not be dripping when engaged in the anticipated activity. My blood pressure dropped to 49/26. I was told to reschedule after the Cialis cleared - at least 2 weeks. I waited 4 weeks.

Today I ate and drank a lot, so I was ready for the second attempt. The Uro cut the dose in half, to 0.08ml and everyone was standing by in case I had a reaction.

Well, I did get a little tumescence near the base and the size was larger than anything I've had since joining the club. Nothing usable but at least something. I was told to wait 48 hours, bump up the dose and try again. And never try it when I had been taking Cialis. Fair enough. I will try 0.12 next time. Can't wait!

How long did it take you guys to find your correct dosage? Did you take baby steps or jump right in and make large changes?

Jeff
Married 34 years, DX Age 56. First routine PSA test on April 8, 09: 17.8. Start 2 weeks of Cipro to rule out protatitis. May '09 PSA: 22.6, 3 weeks later: PSA: 23.2.
Biopsy 6/10/09: 7/12 scores positive, 20%-70%, Gleason 6=3+3. Bone and C/T scans neg.
RP DaVinci -7/21/2009 @ Univ of Roch Medical Center
Left nerve gone, right partial spared.
Catheter removed - 7/31/2009 Pathology report received:
Gleason 3+4=7, Tumor size: 2.5 x 1.8 cm, location: both lobes and apex.
Extraprostatic extension present; Perineural invasion: present, extensive.
No Malignancy in Seminal Vesicle, vasa deferentia, lymph nodes 0/13
Prostate mass 56 grams. Pathologic Stage: pT3aN0MX
Post Surgery Status:
Potency - 12/11 5 months, Still no activity, zip. Using pump daily since 11/11. No effect with 20 mg of Cialis or 100 mg of Viagra. Shots, See Uro 1/22/10 Trimix unsuccessful.
Incontinence - 8/20 4 full pads per day
.. 9/7 3-4 full pads per day (Try cutting down on fluids. Bad idea. I know.)
11/14 4 months: Still 3 pads per day. 420ml/day, 91 um leak.
12/11 5 months: Still 3 pads per day. 400-450ml/day
1/11/10 6 months: Still 3 pads but leak is now 320 ml (5 day avg.)
Post Surgery PSA - 9/3 6 weeks - 0.05; 10/13 3 months - 0.04, 1/14 6 months - 0.05.

Post Edited (Worried Guy) : 2/22/2010 6:21:08 PM (GMT-7)


pigeonflyer
Regular Member


Date Joined Nov 2009
Total Posts : 85
   Posted 2/22/2010 8:09 PM (GMT -6)   
good go at the wood woried, sorry it didnt bat a homer for you but it sounds like your on your way. im 5 months out from surgery and with some cialias i get about 95 percent. the other night with no drugs and using the pump i got another 95 percent. had breakfast cooked for me the next morning. hope it works out for you in the future.and by the way enjoy your eggs when its solid. neil
50 years
da vinci on 9/28/09
gleeson 3+3
psa before surgery 5.1 oct/09 psa 0.06
cather out on oct 5, back in on oct 5
two more trys for cather out, still in .
cather out nov. 13/09
cystocope nov.13/09 , cather back in , out again on nov 15/o9, was taught to self cath, still pluged with scar tissue but no cather. have to self cath 6 to 8 times a day. scar tissue removed on jan. 11 2010. no cathing and totally dry. 


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25380
   Posted 2/22/2010 10:01 PM (GMT -6)   
neil, you mean the wife of yours wouldn' fix you breakfast with out your "performance" the night before? lol, just kidding.

jeff, glad you are making some progress there too, if it were me, i would be doing it in safe, baby steps.
Age: 57, 56 dx, PSA: 7/07 5.8, 7/08 12.3, 9/08 14.5, 10/08 16.3
3rd Biopsy: 9/08 - 7/7 Positive, 40-90% Cancer, Gleason 4+3
Open RP: 11/08, Rht nerves saved, 4 days in hospt, on catheters for 63 days, 5th one out 1/09
Path Rpt: Gleason 3+4, pT2c, 42g, 20% cancer, 1 pos margin
Incontinence:  1 Month     ED:  Non issue at any point post surgery
Post Surgery  PSA: 2/09 .05,5/09 .1, 6/09 .11. 8/09 .16
Post SRT PSA: 1/10 .12
Latest: 7/9 met 2 rad. oncl, 7/9 cath #6 - blockage, 8/9 2nd corr surgery, 8/9 cath #7 out 38 days, 9/9 - met 3rd rad. oncl., mapped  9/9, 10/1 - 3rd corr. surgery - SP cath/hard dialation, 10/5 - 11/27 IMRT SRT 39 sess/72 gys ,cath #8 33 days, Cath #9 35 days, 12/7 - Cath #10 43 days, 1/19 - Corr Surgery #4,  Caths #11 and #12 in at the same time, 2/8-Cath #11 out - 21 days


MrGimpy
Veteran Member


Date Joined Jul 2009
Total Posts : 504
   Posted 2/22/2010 10:02 PM (GMT -6)   
Hi Jeff,

I was started at .10, then went to .14,.18 then finally .22 which is the dosage I have been on for the past few months. Works perfect every time, 100% success, erection lasts approx 1.5 hours, no pain at all

I think the post injection process is very key, perhaps just as important if not more important than the actual dosage
Stats:
Age: 52, PSA (2008)=1.9
Biopsy on 01/09/09, Gleason Score = 3+3
One (1) out of twelve (12) cores was positive, plus external nodule found
Surgery (Da Vinci, robotic prostatectomy): 4/7/09
Post Op Path 3+3
Removed Catheter: 04/19/09
100% bladder control - Pad free 7/09
PSA 7/09 undetectable, <0.01 - 3 months post-op
PSA 1/10 undetectable, <0.01 - 9 months post-op
Trimix provides 100% erectile function


Piano
Veteran Member


Date Joined Apr 2008
Total Posts : 847
   Posted 2/22/2010 10:14 PM (GMT -6)   
Good news -- you seem to be making progress.

One method that lead to 100% reliability for me was to wrap a few rubber bands around the base of the penis before the injection and leave on for about three minutes after the injection. The theory: this forces the drugs to hang around while they do some good.

Another option that others here recommend (did nothing for me though) is to pre-plump with a pump before injection.

If you try either or both of these, I suggest you don't bump up the dose for that test -- hard to believe this, but too much erection is worse than not enough :-)
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?)
19-month: 0.09 (maybe)
ED:
After a learning curve, Bimix injections (0.2ml) worked well. From 14 months, occasional nocturnal erections. Have "graduated" to just the pump.


Cajun Jeff
Veteran Member


Date Joined Mar 2009
Total Posts : 4110
   Posted 2/22/2010 11:09 PM (GMT -6)   
Well Well Well. Not quite lift off but sounds like the rocket is starting up. Happy that this one went better.

Jeff T
Jeff T Age 57

9/08 PSA 5.4, referred to Urologist
9/08 Biopsy: GS 3/4=7
10/08 Nerve sparing open RRP- Path Report: GS 3+3=7 Stg. pT2c, margins clear
3 mts: PSA .05 undetectable

10th month PSA <0.01
1year psa <0.01
ED- 5 mg Cialis daily, pump daily, going to try MUSE next. Next step injections.
15 months out injections Caveject (success)


Worried Guy
Veteran Member


Date Joined Jul 2009
Total Posts : 3734
   Posted 2/23/2010 3:16 AM (GMT -6)   
Great advice here. I will go up in 0.04 increments and see what happens.

Mr Gimpy- After the injection I held my finger around the base and worked it in for 3 minutes.

Piano - I like the idea of the rubber band too. I think a VED pre-plump would be very helpful in my case since I am working with so little. It is hard to find the base.
I promise to be very careful.

You can bet I will be taking data. I just have to think what the Excel chart will plot.
Jeff

MrGimpy
Veteran Member


Date Joined Jul 2009
Total Posts : 504
   Posted 2/23/2010 3:17 AM (GMT -6)   
I second Piano's comment

Holding the medication in the penis for at least a minute is extremely important to your success, the blood flow will simply flush it away if you just inject and leave it be.

Once you get the hang of it you can hold the penis base with your left hand tightly, then inject with the right hand and massage the medication in, count to 60 ( or longer) and you are assured that the cells are saturated with meds before being flushed out
Stats:
Age: 52, PSA (2008)=1.9
Biopsy on 01/09/09, Gleason Score = 3+3
One (1) out of twelve (12) cores was positive, plus external nodule found
Surgery (Da Vinci, robotic prostatectomy): 4/7/09
Post Op Path 3+3
Removed Catheter: 04/19/09
100% bladder control - Pad free 7/09
PSA 7/09 undetectable, <0.01 - 3 months post-op
PSA 1/10 undetectable, <0.01 - 9 months post-op
Trimix provides 100% erectile function


Paul1959
Veteran Member


Date Joined Nov 2007
Total Posts : 598
   Posted 2/23/2010 7:25 AM (GMT -6)   
hey Jeff! good news. I would stop by your local sex shop and buy a $5 adjustable cock ring. As everyone agrees, keeping the meds in the penis longer will only help. You obviously have a flow-through filter on that thing so the drugs could be going out as fast as they come in.

Mr. gimpy is the expert in all this. He has the highest success rate I've ever heard of. Or, wait. I know, We'll ALL come and give you a coaching session. 15 guys standing around watching. That will help a LOT.
Paul
www.franktalk.org ED website for PCa guys

46 at Diagnosis.
Father died of Pca 4/07 at 86.
10/07 PSA 5.06 (Biopsy 11/07 1 of 12 with 8% involvment) (1mm)
Da Vinci surgery Jan 5, '08 at Mt. Sinai Hosp. NYC www.roboticoncology.com
Saved both nerve bundles.
Path Report: Stage T2cNxMx
-Gleason (3+3)6
Pad free on March 14 - (10 weeks.) Never a problem since.
ED - at one year, ED is fine with viagra.
Two year PSA - undetectable!


Paul1959
Veteran Member


Date Joined Nov 2007
Total Posts : 598
   Posted 2/23/2010 7:26 AM (GMT -6)   
hey Jeff! good news. I would stop by your local sex shop and buy a $5 adjustable cock ring. As everyone agrees, keeping the meds in the penis longer will only help. You obviously have a flow-through filter on that thing so the drugs could be going out as fast as they come in.

Mr. gimpy is the expert in all this. He has the highest success rate I've ever heard of. Or, wait. I know, We'll ALL come and give you a coaching session. 15 guys standing around watching. That will help a LOT.
Paul
www.franktalk.org ED website for PCa guys

46 at Diagnosis.
Father died of Pca 4/07 at 86.
10/07 PSA 5.06 (Biopsy 11/07 1 of 12 with 8% involvment) (1mm)
Da Vinci surgery Jan 5, '08 at Mt. Sinai Hosp. NYC www.roboticoncology.com
Saved both nerve bundles.
Path Report: Stage T2cNxMx
-Gleason (3+3)6
Pad free on March 14 - (10 weeks.) Never a problem since.
ED - at one year, ED is fine with viagra.
Two year PSA - undetectable!


MrGimpy
Veteran Member


Date Joined Jul 2009
Total Posts : 504
   Posted 2/23/2010 9:46 AM (GMT -6)   
Paul,

The $5 ring is a great idea. In the early days while I was experimenting on where the heck to inject, it was much, much easier if the penis was at least partially erect. It made locating any veins much easier. The rubber band or VED pump idea would also work. The sight of a drip of blood on the wipe really turned me off

Now I try to stimulate myself as much as possible before injecting (which is not really much, maybe 40% erect) . Funny, but now I consider it a success if I see not a single spec of blood on the alcohol wipe that I use after injecting. Gaining an erection is foolproof once you get the process down

The key thing is that You need to be 100% comfortable and confident that you know what you are doing. If need be also pick up a cheap rubber penis at the store and experiment on it to perfect your technique.
Stats:
Age: 52, PSA (2008)=1.9
Biopsy on 01/09/09, Gleason Score = 3+3
One (1) out of twelve (12) cores was positive, plus external nodule found
Surgery (Da Vinci, robotic prostatectomy): 4/7/09
Post Op Path 3+3
Removed Catheter: 04/19/09
100% bladder control - Pad free 7/09
PSA 7/09 undetectable, <0.01 - 3 months post-op
PSA 1/10 undetectable, <0.01 - 9 months post-op
Trimix provides 100% erectile function


James C.
Veteran Member


Date Joined Aug 2007
Total Posts : 4462
   Posted 2/23/2010 12:49 PM (GMT -6)   
Well, you got enough hands on the problem (Ha, Ha) , so you know what you need to know and do now. Good luck the next try...
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
32 mts: PSA's: .04 each test since surgery, ED Continues-Bimix .3ml PRN or Trimix .15ml PRN


Worried Guy
Veteran Member


Date Joined Jul 2009
Total Posts : 3734
   Posted 2/23/2010 1:03 PM (GMT -6)   
I figure with all this great advice I'll have things well in hand in a couple of weeks.
Who knew woodworking would be so hard?
Jeff
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