Needles (Again)

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Kolin6
New Member


Date Joined Mar 2010
Total Posts : 16
   Posted 5/15/2010 1:51 PM (GMT -6)   
I have been trying to find the right 'needle' for me.
I have been looking for a 50 Unit (1/2cc) 5/16" 31 guage.
when I asked the chemist about them, they told me they
are only good for insulin use, and would not work with Bi Mix.
I don't understand why. 
I have tried a couple of drug stores but cannot find syringes
marked with cc, only ml.  My Euro told me there is a difference
in the measurement, but when I look at them they look the same,
I am new at this, and trying to get used
to the injections. I have injected four times with up to  .35cc without much
luck. I get about 75% erection, but not firm.
In June it will be eight years since my surgery.  I was leaking for a couple
of years til I hade the sling 'installed' now everything is great  -  except
getting this injection thing working.
Thank you for any help or advice anybody can give me. 

Navyman
Regular Member


Date Joined Nov 2009
Total Posts : 22
   Posted 5/15/2010 2:28 PM (GMT -6)   
I too had a hard time finding the 1/2cc syringes. I was using the 1 cc but found them difficult to use since they are so long. I checked the forum rules and it seems it's OK to post this link to Amazon. You may find other sources if you search. BD seems to be the most common brand.

The 31mm needle works for me and is more comfortable than the 29mm I started on. Probably a little slower injecting the fluid, but not much. You have to watch though because the 31mm needle bends easily. Drawing the fluid into the syringe is where I have to be careful.

http://www.amazon.com/BD-Ultra-Fine-Insulin-Syringes-BD328468/dp/B001BZERZM

Good luck with this adventure seeking "fullfillment". tongue
72 years old, healthy and active, single.
Diagnosed 9/05/07 PSA 18.09
Biopsy 12 cores all positive, Gleason 4+4=8 Stage T2
11/07 Began 24 month HT Lupron Depot and Casodex
1/08 3d Conformal 36 sessions followed by IMRT 7 sessions
(hospitals first IMRT patient)
PSA: all followup tests continue to be undetectable
8/09 Final Lupron shot
8/09 Severe osteoporosis from HT leading to need for spinal fusion
10/09 Levitra, Cialis at highest doses gave 60% erection
11/09 Edex at highest dose gave 75% erection with aching
12/09 Cialis daily 5mg + Trimix gives 75% erection with no aching
1/10 Adding VED hoping to increase blood flow
4/10 VED gives 95% of pre-treatment size; return of nocturnal erections

Post Edited (Navyman) : 5/15/2010 2:34:55 PM (GMT-6)


Worried Guy
Veteran Member


Date Joined Jul 2009
Total Posts : 3732
   Posted 5/15/2010 2:58 PM (GMT -6)   
There is no practical difference between 1 cc and 1 ml! Look it up.
1 ml = 1 cc.
Why not buy 1 cc or ml syringes marked as 100 units. 100 units is 1 cc, 25 unit is a typical injection. Those are easy and cheap to come by.
(Just for fun ask your Uro why he thinks they are different. You would be helping him.)

I use a 31 gauge BD needle with an auto injector so the needle always goes in straight.

J

If you care, the true definition of a Liter is equal to the volume of a kilogram of water at 4 degrees centigrade and at standard atmospheric pressure of 760 millimeters of mercury. Since the density of water is 1, 1 ml of water is 1 cc and is also 1 gram.
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 next See Uro 1/22/10 Trimix #1. Try 0.08- 25%, 0.12-25%, 2/26/10 try 0.16 First Success! 90%.
Incontinence - 8/20 4 full pads per day
.. 9/7 3-4 full pads per day. Try controlling fluids.
12/11/09 5 months: 3 pads per day, 400-450ml/day
02/26/10 7 months: 3 pads but leak is now 320 ml (5 day avg.)
03/22/10 8 months: 3 pads per day, 280 ml/day (5 day avg.) PT says all muscles are tight and working properly. There must be another issue. Uro mtg 4/23. Did I waste 9 months? Mtg 5/22.
Post Surgery PSA - 9/3 6 weeks - 0.05; 10/13 3 months - 0.04, 1/14 6 months - 0.05, 4/14 9 months - 0.04 and <0.01 with ECLIA.


James C.
Veteran Member


Date Joined Aug 2007
Total Posts : 4462
   Posted 5/15/2010 3:03 PM (GMT -6)   
Kolin6, the measurements for syringes are equal .10cc=.10ml.=10units. I am almost positive that every guy here uses insulin syringes, there's no big reason why they can't be used. Here's a source:

www.americandiabeteswholesale.com/-strse-150/UltiCare-Ulti-dsh-Fine-dsh-II-Insulin-Syringes/Detail.bok

There many others online, this is just representative of availablity and of the average price. These are the size I use. There's several other manufacturers, of course
James C. Age 63
Gonna Make Myself A Better Man www.youtube.com/watch?v=a6cX61oNsRQ&feature=channel
4/07: PSA 7.6, Recheck after 4 weeks Cipro-6.7
7/07 Biopsy: 3 of 16 PCa, 5% invloved, left lobe, GS3+3=6
9/07: Nerve Sparing open RRP, 110gms, Path Report- Stg. pT2c, 10 gms., margins clear
32 Months: PSA's .04 each test since surgery, ED continues: Bimix- .3ml PRN, Trimix- .15ml PRN


Cajun Jeff
Veteran Member


Date Joined Mar 2009
Total Posts : 4088
   Posted 5/15/2010 3:28 PM (GMT -6)   
Some how I just knew that Worried Guy would have a full definition of the term on the syringes. LOL

Thanks Jeff for the knowledge. Some of us are just not into the measures like others.

Cajun Jeff
9/08 PSA 5.4 referred to Urologist
9/08 Biopsy: GS 3+4=7 1 positive core in 12 1 pre cancer core
10/08 Nerve-Sparing open radical
Surgery Path Report Downgrade 3+3=6 GS Stage pT2c margins clear

3 month: PSA <0.1
6 month: PSA <0.1
10 month:PSA <0.1
1 year: PSA <0.1
16 month:PSA <0.1

ED - Started Cialis at 3 months, tried all 3, 6 months added pump, 9 months Tried MUSE (YUCK) Bad experience.
1 year mark Found new Urologist visit was at 14th month post surgery
Started Injections, Caverject! (Success)
17 month: ED making improvements : Oral Meds gets me 85%


Kolin6
New Member


Date Joined Mar 2010
Total Posts : 16
   Posted 5/15/2010 4:00 PM (GMT -6)   
Thank you all for your help.
I knew I would get some answers here, and they help a lot.
Thank you all very much. yeah
Kolin6

Piano
Veteran Member


Date Joined Apr 2008
Total Posts : 847
   Posted 5/15/2010 4:20 PM (GMT -6)   
Kolin6,
Something that worked very well for me when injecting was to wrap a few rubber bands around the base of the penis just before the injection and leave on for 3 minutes after while massaging. The theory is that it forces the drugs to hang around until they do some good, instead of being swept away into the bloodstream.

Others here have used variations of this method, and still others pump a little beforehand to give a bigger target to aim at. That did nothing for me though. I think it is useful to experiment with these ideas to see if you can find something that works for you.
Pre-op:
Age 63 at diagnosis, now 65.
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)
25-month: 0.2 (yes, bummer)
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 5/16/2010 11:03 AM (GMT -6)   
I use the BD Ultrafine 1/2 ml, 1/2inch 30 gauge syringes, along with the BD autoinector, perfect every time, no pain, no blood either

www.amazon.com/BD-Ultra-Fine-Insulin-Syringes-BD328466/dp/B001BZCTFC/ref=sr_1_1?ie=UTF8&s=hpc&qid=1274029379&sr=8-1
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 5/16/2010 11:38 AM (GMT -6)   
Here's a post I made sometime back, sorta an overview of the whole injection process. Maybe some of it will pertain to your problems.

Injection drugs are obtained by a doctors prescription and must be filled by a specialized pharmacy- an compounding pharmacy- which mixes the drugs to be used. There are 3 types of drugs- Caverject (alprostadil), Bimix and Trimix. Alprostadil is a a single drug, bimix is a mixture of papaverine and phentolamine, usually in the strengths of 30mg papaverine/1mg phentolamine when written on the prescription. Trimix is the same as bimix, with the addition of alprostadil to it, and usually written as 30mg/1mg/20mcg, the 20mcg being the alprostadil. In listing strengths, the alprostadil is the strongest and seems to obtain the most effective result. It is also the most expensive and lots of guys have problems with both aching, pains and piraprisms (SP)- erections of longer than 4 hours. Trimix is the next strongest and results in very good erections, with much less chance of the aching/pain and the 4 hour hour erections. Bimix is the llowest strength of the 3 , but seldom gives the aching/pain or the 4 hour erections. Dosing sizes of Trimix is usually much less than Bimix, so it takes much less to get the same result, however it does seem to have a chance of giving more troubles with aching/pain and the problem erections.

Most doctors will begin the injection treatment with Caverject (alprostadil) injected in the office to get a baseline of what is needed and to teach the man how to inject. Some men have a bad experience with this, as the alprostadil is usually injected at a much higher dose than needed, which creates the aching/pain and the over 4 hours erections which we hear about once in a while. It seems doctors have a set formula of what they are taught to inject and that isn't always the best. If it works in the office, he will usually send the patient home with a prescription for alprostadil and further instruction on how to use it. It seems that most doctors don't begin with Trimix or Bimix, unless they are dealing with an educated patient who can ask for, explain why, and can advocate for themselves trying something different. I am fortunate to have a doc who will deal with me on an equal basis and is willing to try what I suggest with different ratios of strengths to dial it in for me. I feel that a man who is starting injection therapy should begin with either Trimix or Bimix, rather than alprostadil, as the chances of a ache/pain free experience will have him much more willing to continue. The physical act of injecting is simply pain free for me now, but it took quite a bit of repetition and experimenting to reach this state. Once a guy begins injecting, he needs to keep at it, experimenting and dialing in what he needs to get the best results with the least amount of drug or trouble.

As far as technique, its simple, actually. Use the least diameter needle, usually a 5/16" 31 ga. insulin syringe, and inject into the penis midway between the head of the penis and the body, at the 9 or 3 o'clock position. A little milking motion of the penis will help open the cavernous cavities a little, so the drug cane be deposited into the space. A little massage and the erection should begin, usually within 5 to 10 minutes, and if enough drug is injected and adsorbed, results in a penis erect for an hour or so. That's the idea goal. It can vary. Done right, with practice, the injection can and will be painless for most guys. There's no reason to think you would be any different. I don't combine by injections with other items such as pills or pump, but some here do. I, and several other guys, use what I call a pre-plump method to ensure successful injections. It begins with a penis pump, if you have one, and a penis ring. You can accomplish nearly the same thing using a milking motion to fill the penis with blood, and a regular rubber band. Using the pump, obtain a partial- maybe 30%- erection and apply the ring. This engorges the penis with blood, opening the cavernous cavities and filling them with blood. Then inject into this expanded cavity. Imagine injecting into an uninflated balloon, and putting the drug into the inside, versus injecting into a partially inflated one. That's what is being accomplished with this method. When injecting, you can easily tell when the needle point enters the cavity, as the resistance will drop and the needle will feel like it has 'fallen' into it. Inject and very lightly massage the penis, the purpose is to spread the drug around and ensure optimium adsorption of the drug. Keeping the ring on for 3 or 4 minutes holds the blood (and drug) inside and lets it have the best chance of being adsorbed. Continue to gently massage the penis and the drug around for 3 to 4 minutes, then remove the ring- the blood will most likely run back out of the penis, until the erection begins. You should get the drug induced erection in 5 minutes or so. Most of us who use this method find we can use much less drug, we can control results more consistently from one time to the next and reduce the chance of priaprisms.

Yes, once in a while we will have guys here have a bad experience, resulting in a 4 hour erection and a trip to the hospital or doctors office. It's traumatic, of course, but frankly still part of the risk of using injections. The draining of the penis blood was sorta overkill, IMO, usually the penis is injected with epenephrine(SP) or such, which counteracts the penile injection drug. I have only had one over 4 hour erection, I relieved it with Sufafed, rathert than a hospital visit. That was the first time I self-injected, it was alprostadil and it was the doctors recommended dose, which was 3 times more than I found I needed.

There's several excellent websites with great instructions on the process, and we can look at them later, when you are ready to start the injections.

This is a general overview of the process, stressing they general or average, or normal process and results by the majority of the guys here, to give you a general look at the normal experience and answers to your questions.

Here's a few links to a posts that will contain some research info for you to continue your study:
www.healingwell.com/community/default.aspx?f=35&m=1347869&p=1
www.healingwell.com/community/default.aspx?f=35&m=897291
www.healingwell.com/community/default.aspx?f=35&m=1062508
www.healingwell.com/community/default.aspx?f=35&m=1115024
www.healingwell.com/community/default.aspx?f=35&m=1022627&p=1&ord=d
www.healingwell.com/community/default.aspx?f=35&m=1069182
www.healingwell.com/community/default.aspx?f=35&m=1110785
www.healingwell.com/community/default.aspx?f=35&m=992063
www.healingwell.com/community/default.aspx?f=35&m=1285932
www.healingwell.com/community/default.aspx?f=35&m=1072323
www.healingwell.com/community/default.aspx?f=35&m=1274734&p=1&ord=a
www.healingwell.com/community/default.aspx?f=35&m=106647[
www.healingwell.com/community/default.aspx?f=35&m=767571
www.healingwell.com/community/default.aspx?f=35&m=1012934&p=1&ord=d
www.healingwell.com/community/default.aspx?f=35&m=897291
www.infertility-male.com/erectdys/injxn1.htm
James C. Age 63
Gonna Make Myself A Better Man www.youtube.com/watch?v=a6cX61oNsRQ&feature=channel
4/07: PSA 7.6, Recheck after 4 weeks Cipro-6.7
7/07 Biopsy: 3 of 16 PCa, 5% invloved, left lobe, GS3+3=6
9/07: Nerve Sparing open RRP, 110gms, Path Report- Stg. pT2c, 10 gms., margins clear
32 Months: PSA's .04 each test since surgery, ED continues: Bimix- .3ml PRN, Trimix- .15ml PRN

Post Edited (James C.) : 5/16/2010 11:46:05 AM (GMT-6)


biker90
Veteran Member


Date Joined Nov 2006
Total Posts : 1464
   Posted 5/16/2010 11:16 PM (GMT -6)   
1/2 cc (.5ml), 31 gauge, 5/16 inch insulin syringes work just fine for penile injections. They are marked in units (1 unit = .01 ml) and there are 50 units marked on the syringe.

I use 5 units of Trimix so a 5 ml vial lasts a long time. At 5 units per injection, the vial contains 100 injections. The Trimix costs me $75 and the syringes are $25 per 100. So I pay $1 per injection. I always was a cheap date.

Jim
Age 75. Diagnosed 11/03/06. PSA 7.05. Stage T2C Gleason 3+3.
RRP 12/7/06. Nerves and nodes okay.
Catheter out on 12/13/06. Dry on 12/14/06.
Pathological stage: T2C N0 MX. Gleason 3+4.
50 mg Viagra + .05 cc Trimix = Excellent Results
PSAs from 1/3/07 - 7/17/09 zero.
Next PSA - July/2010
Lung cancer dxed on 5/16/08. Surgery on 6/25/08 T1N1M0 - Stage IIA Finished 4 cycles of chemo on 11/7/08.
CT scans on 12/2/08 - 12/22/09 - in remission!!!
Next scan in June 2010.
Biker90's Journey
http://www.caringbridge.org/visit/jimrobinson
"Patience is essential, attitude is everything."


Kolin6
New Member


Date Joined Mar 2010
Total Posts : 16
   Posted 5/17/2010 9:03 PM (GMT -6)   
Thank you all for your replies, they are all very helpful.
I am going to make one more injection at .4cc If that don't work as it should
I am going back to the Euro, maybe suject Tri Mix (Bi Mix does not seem to do it)
my Euro has a lab right in the office and mixes them himself, so
it should be no trouble to him. He charges $75 a time.
I am thinking of getting a pump to help, I am able to get one
free of charge on medicare, so what the heck.
Thank you all agine for your help and advise, I will be back
when I need more help. It's great to have people ready to help.
Thank you.

MrGimpy
Veteran Member


Date Joined Jul 2009
Total Posts : 504
   Posted 5/18/2010 4:12 AM (GMT -6)   
Your Dr mixes it right there and charges $75 ?
Wow, I am getting a deal, $64 and that includes Overnight shipping with 2 reusable freezer bags

Remember, the process is more important than the amount of medication that you inject.
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


Kolin6
New Member


Date Joined Mar 2010
Total Posts : 16
   Posted 5/19/2010 1:37 PM (GMT -6)   
One more thing I forgot to ask is....
If you use a pump to increase the blood flow, does that mean
you use less Bi Mix of Tri Mix in the injection?
I am trying to get a "handle" on all this at the start.
Thanks again for any help.

Piano
Veteran Member


Date Joined Apr 2008
Total Posts : 847
   Posted 5/19/2010 3:56 PM (GMT -6)   
I don't know about the pump, as that did nothing for me. However I found using constriction completely eliminated the hit and miss nature of injections: sometimes a certain dose would give a good erection, another time exactly the same dose would give almost nothing. That consistency allowed me to reduce the bimix dose to a fairly low 0.2ml.
Pre-op:
Age 63 at diagnosis, now 65.
No symptoms; PSA 5.7; Gleason 4+5=9; cancer in 4 of 12 cores.
Operation:
Non-nerve-sparing open surgery 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)
25-month: 0.2 (yes, bummer)
ED:
After a learning curve, Bimix injections (0.2ml) worked well. From 14 months, occasional nocturnal erections. At 18 months, "graduated" to just the pump.

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