Trimix still is not working.

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Ricky2
Regular Member


Date Joined Dec 2009
Total Posts : 97
   Posted 3/5/2010 3:14 PM (GMT -6)   
I had my trimix prescription (5ml) delivered from Axium Pharmacy in Lake Mary, FL. It came with a big supply of syringes/needles. 5/16 in long and 31 gauge. Delivered for $85. The mixture was Papaverine 30MG/ML, Phentolamine 0.5MG/ML, Prostaglandin E 10MCG/ML. I tried an injection for the first time on my own. Had Sudafed ready just in case. I guess the Sudafed will probably be used for my next cold. I tried Jim's method of pumping to about 25% and using a ring to keep the medicine in the penis. Left the ring on for about 3 min while I massaged around the injection site. Went up to .35ml. Only got just a little above 50% (I am not sure how I measure that, but definitely not a useable erection.) No pain or discomfort. The partial erection was gone in less than 30 min. My PA said keep increasing dose by .1ml until I get the desired result. That sound so much out of line with what everyone else on this forum is experiencing with the dosage. Do you guys have any recommendation as to where I should go from here?
Thanks so much for your help.

Ricky
Age 70

PSA 5/2008- 3.6, PSA 7/2009- 6.1, retested 9/2009-5.1.
Biopsy 9/2009. 4 of 12 positive. Gleason 3+4=7
CT and bone scan negative.
Robotic De Vince Surgery 10/29/2009. 1 night in hospital. No pain. Cath out on 11/6
Pathology Report: Gleason score 3+4. Margins slightly involved <.1mm to .25mm. Perineural invasion present, stage pT2c. Tumor 18%. Seminal Vesicle - absent, Lymph Nodes 0 of 6.
Continence- first 4 weeks after cath out Dry at night, rest of time, bladder held nothing. 6-7 pads per day. as of 12/30 no pads most of time. almost dry except for a few drips. I keep doing Kegels.
ED. Started VED on 12/17/2009. Every other day for 15 min. Cialis .20 mm twice a week
PSA 02/08/2010 <.1
02/22/10 Trimex injection .2ml less than 50% just a little discomfort.


James C.
Veteran Member


Date Joined Aug 2007
Total Posts : 4463
   Posted 3/5/2010 3:39 PM (GMT -6)   
That sounds about right for the first few times. Remember, the penis has been inactive for a while and it might take a few more sessions to 'wake' it up. Try it a couple more times at the present does, same technique, then increase as directed... Give it some time to get things working and to gain experience.
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


Ed C. (Old67)
Veteran Member


Date Joined Jan 2009
Total Posts : 2460
   Posted 3/5/2010 4:33 PM (GMT -6)   
Ricky,
I also use James' technique and it works for me. I also use the pump few minutes after the injection to draw to help the medication bring the blood in. You may want to try that after removing the ring.
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 in circumference.
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
8 months PSA test 10/9/09 result <0.1
11.5 months test 1/21/10 result 0.004


Piano
Veteran Member


Date Joined Apr 2008
Total Posts : 847
   Posted 3/5/2010 10:11 PM (GMT -6)   
I found a ring without the pump worked best for me, so that is another option worth trying.
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.


MrGimpy
Veteran Member


Date Joined Jul 2009
Total Posts : 504
   Posted 3/7/2010 2:41 PM (GMT -6)   
Pump to 25% ???

Why not pump it more, you should be able to get close to a 100% erection with a VED pump

I suspect the problem is that there is not enough blood in your penis so that the meds can be absorbed by the cells in both chambers. The shot will only reach one chamber the blood flow via your massaging will distribute to both sides. If there is insufficient blood ( erection) in your penis the medication will not flow to the other chamber

I would not go more than the .35, instead try to get a much larger erection before you administer the shot
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


hb2006
Regular Member


Date Joined Nov 2008
Total Posts : 299
   Posted 3/7/2010 6:45 PM (GMT -6)   
The other thing you might try, is to go with different needles. My first 3 months on Trimix worked fine with the 5/16 inch needle. But then it quit working, even if I would inject on both sides, which is not recommended.

I then switched to 29 gauge, 1/2 inch needles and now it works every time with .20 ML. Both Caverject and Edex prepared syringes are shipped with 1/2 inch needles.

I guess that I was too thick or had too much tissue for the 5/16 inch needle.
Age 60, PSA 2007 4.1, PSA 2008 10.0
Diagnosed April 2008, Biopsy: 6 of 12 cores positive, Gleason 4 + 5 = 9
CT and Bone Scan negative, Open surgery at Shawnee Mission Medical Center May 21, 2008
Right side nerves spared, Radical prostatectomy and lymph node dissection
Cather removed on June 3rd, totally dry on July 9th, pT2c, lymph nodes negative
PSA Sept 28, 2008 0.00, PSA Jan 22, 2009 0.00, PSA June 29, 2009 0.00
ED Status- Currently using Trimix, Levitra daily for increased blood flow.
Noctural Erections have completely returned on a nightly basis, same hardness as before.


geon
Regular Member


Date Joined Oct 2007
Total Posts : 103
   Posted 3/7/2010 7:17 PM (GMT -6)   
Ricky,
Good advice above.
If these suggestions don't improve anything, consult your URO or ED Doc or sex clinic.
Marc
66 years old 01252010; healthy; active,
married 43 years, good strong erections before surgery.
DaVinci Prostate Removal February 5, 2007
2/12 samples malignant.
Catheter removal 2/13.
Viagra 25mg every other day from 2/14 to 5/12. no help.
Incontinence almost gone after three months.
No pads, occasional  dribble.
Lavitra every other day 5/12 to 7/22. no help.
Muse 1000mcg - no help (50% at best). little help.
Cialis twice a week 7/25/07 to 11/6/08. no help.
Vacuum pump - Huge erections but not useable.
Trimix injections started.  0.09cc is great! 10/08/07.  Still good at 0.10CC and stimulation.
First drug induced erection 10/8/07....Wow!
Natural erections - 0 as of 2/5/07.
PSA's, many to date undetectable.  Thank God!
Total ED...Since 2/5/07  URO took me off oral drugs 11/2008.
Geon


James C.
Veteran Member


Date Joined Aug 2007
Total Posts : 4463
   Posted 3/8/2010 10:57 AM (GMT -6)   
Mr. Gimpy, pump to 100% and inject? My first instinct is to say no, but I don't have any medical info to back that response up. I can't say one way or the other. Maybe one of the guys who is so good at researching can find something definite.,
James C. Age 62
Co-Moderator- Prostate Cancer Forum
Gonna Make Myself A Better Man: www.youtube.com/watch?v=a6cX61oNsRQ&feature=channel
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


MrGimpy
Veteran Member


Date Joined Jul 2009
Total Posts : 504
   Posted 3/9/2010 2:29 AM (GMT -6)   
Hi James,

Not sure if 100% is possible with a VED then keep it that way and take it off so that Rick can inject. Whenever I used the VED I always deflated as well when I took it off. I have never used the VED with Trimix myself, perhaps its worth a try to see if it makes any difference

Point was that it is safer to try getting more of an erection pre-shot vs just upping the dosage of Trimix
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 : 4463
   Posted 3/9/2010 9:22 AM (GMT -6)   
MrG, yes, I have the same leakage when the pump is removed. There's always gonna be something less than 100% when dealing with the pumps and rings. I find that the best I do, I still get some amount of extra tissue inside the ring, so when I push this extra back out, I lose some more then. smilewinkgrin I just may try the full pump and inject thing and see what happens (if I don't find a caution against it somewhere) smilewinkgrin
James C. Age 62
Co-Moderator- Prostate Cancer Forum
Gonna Make Myself A Better Man: www.youtube.com/watch?v=a6cX61oNsRQ&feature=channel
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


Redman55
Regular Member


Date Joined Jan 2010
Total Posts : 87
   Posted 3/9/2010 8:29 PM (GMT -6)   
I use .35 ml and have good results some times and partial on others. I recently tried viagra on the last pass with trimix and that did the trick and no duration issues. I was told that you can easily expand dosage up to .7 ml's and then if that doesn't work that they will prescribe a stronger trimix. I have not been using erecaid before hand which I see others have. One thing may be to regular use erecaid as it will expand chambers. I do that about 5-6 times per week.
Age 54
PSA 8/2009 5.6 Gleason 8
DaVinci surgery 11/2009
Pathology - totally contained in margins -one bundle spared
PSA now undetectable at < .05
Continance: 1 pad and almost normal
Doing 3 P's and now using trimix

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