Update and trimix

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reachout
Veteran Member


Date Joined May 2009
Total Posts : 725
   Posted 6/15/2010 4:27 PM (GMT -6)   
Well, it's been 9 months since my DaVinci.  The good news is that I've now had 3 zero PSAs, and still 100% continent.  I'd be happy just with that.  The not so good news is that I still suffer from ED.
 
I tried the big three pills, and none of them work well enough for penetration, though they work pretty well to stuff me up and give me a headache.  The pump only works when I'm pumping, but as soon as I take it off I lose the erection, and those rubber band things never worked for me.
 
So today I went to the doc and he gave me a shot of trimix in the office.  I laid on a table when he gave it to me, and left the room.  After 10 minutes I noticed an erection starting, without any external stimulus.  He returned and I told him at that point the erection was about what it is at its max with Levitra, still not enough for penetration.  He said that's OK, he had given me a lower dose, and the fact that it was working that well was a good sign.  He said he wanted to check again in about 30 minutes, and that I could dress and walk around.
 
When I stood it got firmer, but then the ache started.  For the next hour I walked around the hallways with a folder I had brought in front of me (insert favorite joke here), and I got firmer and started aching more, about a 3 out of 10. 
 
After 30 minutes I went to the bathroom to check, and thought it was firm enough for sex, but I don't think the ache would allow it.  I then went back to see the doc, and told him about the ache.  He said that's normal with the first couple of times, because the penis has to get used to the blood flow.  He said this is a good way to rehab the penis that way, as well as allowing for intercourse. 
 
He is going to mix the stuff for me and in a couple of weeks I will be going back for training, and to get my supply.  He said he'd like to try this for 6 months, and will help the nerves remember what they are supposed to do.  He also said it might take two years for it to come back.
 
This gives me a lot of hope for the future, For those of you on trimix, did you have the initial ache?  And does it go away with repeated use?
 
Age 64 yrs
DX 5/2009
8 out of 12 cores positive
PSA 5.6
Gleason Score 3+4=7
Stage T2a
Da Vinci Surgery 08/07/2009
Upgrade Gleanson Score 4+3=7
Stage pT2c
Neg Margins and Nodes
Extracapsular extension noted but neg Extraprostatic Extention (??)
Dry immediately
Daily Cialis 5mg slow recovery
First PSA 3 Nov 09 <0.1
Second PSA 2 Feb 10 0.01
Third PSA 1 Apr 10 <.014
Fourth PSA 19 May 10 <0.1


James C.
Veteran Member


Date Joined Aug 2007
Total Posts : 4462
   Posted 6/15/2010 5:12 PM (GMT -6)   
Congrats on your progress. The ache for me did lessen with time, but there's still a little dull one, just a little nag, nothing to make me lose interest in the purpose... wink I've had a few time when there was no ache whatsoever, so it is still an individual thing, I suppose, like so many other things Prostate..
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, 110 gms., margins clear
3 Years: PSA's .04 each test since surgery, ED continues: Bimix- .3ml PRN, Trimix- .15ml PRN


cantexplain
Regular Member


Date Joined Jun 2010
Total Posts : 74
   Posted 6/15/2010 6:21 PM (GMT -6)   
Seven months for me since DaVinci and the E.D. pills were not effective (at least to a degree that might approach usable) so I took the tri-mix plunge and have had two injections.  One, at the surgeon's office (which was immediately effective and painful, too).  The second was self-administered and (a) again immediately effective, (b) put to good use with the Mrs, and (c) painful again.  But, the psychological lift was just thrilling!  Felt close to my old self again and looking forward to the next shot!  If that isn't a crazy thing to read, think how it feels to type it out.  But this journey is just that, new places and new experiences and tri-mix is just one of them.  I'm hopeful over the months I resume a more natural resolution to ED, but if not, I think I can handle it.
 
I was also amazed I gave myself the shot.  yeah

Age at Dx:  56
DaVinci Prostatectomy:  10/28/98
Stage: T2C
Gleason - 3+4 = 7
Prosate:  52 grams
Incontinence - absolutely
ED - Indeed
Married, father of two (boys 18 and 17)
6 months later:  member of the "zero" club, working on one pad for 24 hours.  Took Cialis for 4 months (no apparent affect), just had my 1st tri-mix yesterday, that worked in spades!
All good here in San Diego


James C.
Veteran Member


Date Joined Aug 2007
Total Posts : 4462
   Posted 6/16/2010 8:59 AM (GMT -6)   
Yes, one of the things we tend to overlook and not point out is the positive boost it gives to our sense of 'manliness', well being and healthy mental good it does us to have a good erections after so many weeks/months/years dealing with the down side of it. The fear of the injections quickly fall away once it is experienced, and like you, I look forward to them and the resulting good feeling of being a 'whole man' again.
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, 110 gms., margins clear
3 Years: PSA's .04 each test since surgery, ED continues: Bimix- .3ml PRN, Trimix- .15ml PRN


eggbe
Regular Member


Date Joined Feb 2010
Total Posts : 33
   Posted 6/16/2010 12:42 PM (GMT -6)   
I have to echo that, after 5 months of trying all the different oral meds with dissapointing results the simple trimix injection is like a miracle drug.

age 59 psa 6.3 Nov 2009
gleason 7 (4+3) Dec 2009
HIFU 1-17-10
PSA 0.2 3-4-10 (before recommended 3 months wait)
PSA 0.1 4/14/10


reachout
Veteran Member


Date Joined May 2009
Total Posts : 725
   Posted 6/16/2010 4:38 PM (GMT -6)   
Thanks for the responses, guys, this is very encouraging. One question, with the trimix, after you climax does the erection go down, or do you stay up for the time it takes for the trimix to leave your system? And have you had any of those four hour erections that make you go to the ER? Guess that's two questions :-)
Age 64 yrs
DX 5/2009
8 out of 12 cores positive
PSA 5.6
Gleason Score 3+4=7
Stage T2a
Da Vinci Surgery 08/07/2009
Upgrade Gleanson Score 4+3=7
Stage pT2c
Neg Margins and Nodes
Extracapsular extension noted but neg Extraprostatic Extention (??)
Dry immediately
Daily Cialis 5mg slow recovery
First PSA 3 Nov 09 <0.1
Second PSA 2 Feb 10 0.01
Third PSA 1 Apr 10 <.014
Fourth PSA 19 May 10 <0.1


James C.
Veteran Member


Date Joined Aug 2007
Total Posts : 4462
   Posted 6/16/2010 4:57 PM (GMT -6)   
The trimix produced erection will remain until the drug stops acting on the erectile tissue. Usually 3 hours or less. Once done, it's best to leave it alone, no more stimulating, etc, as it can be revived with more stimulation, resulting in longer time used during the 4 hour window. I'd guess most guys have had at least one of the 4 hour jobs. If the erection is going down and the penis isn't completely rigid, my doc said it's ok. It needs to be getting softer by at least half by then. Keep Sudafed in the house and available. The real epeneprine stuff, not the other. It's the one you have to sign for that's kept behind the pharmacists counter. Guys who do go to the ER usually will receive an epheneprine flush in the penis, gruesome looking but effective.
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, 110 gms., margins clear
3 Years: PSA's .04 each test since surgery, ED continues: Bimix- .3ml PRN, Trimix- .15ml PRN


eggbe
Regular Member


Date Joined Feb 2010
Total Posts : 33
   Posted 6/16/2010 5:32 PM (GMT -6)   
Although I would never make a medical decision based on info from this site I did figure out from reading the posts that I would start with a dose of about .03ml, and it worked out lasting a little over an hour. Many said their Dr's started them at .1 and that was too much. Due to inconvenient circumstances I wasn't able to see my Dr for the first dose which we all should do.
age 59 psa 6.3 Nov 2009
gleason 7 (4+3) Dec 2009
HIFU 1-17-10
PSA 0.2 3-4-10 (before recommended 3 months wait)
PSA 0.1 4/14/10


Piano
Veteran Member


Date Joined Apr 2008
Total Posts : 847
   Posted 6/16/2010 5:59 PM (GMT -6)   
For those who like trimix, but who don't like the ache, consider bimix. It is like trimix but with the alprostadil ache-causing component removed. As always, there is a downside -- the erection quality may not be so good and you will likely need a higher dose, but worth trying to see if it works for you.

Also, don't forget the common trick of applying constriction at the time of injection -- I found that led to consistently good results.
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)
27-month: 0.2 (not up; glad about that)
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.


cantexplain
Regular Member


Date Joined Jun 2010
Total Posts : 74
   Posted 6/17/2010 5:29 PM (GMT -6)   
The compounding pharmacy  recommended .2ml when I picked up the vial and syringes; my surgeon who did the first injection (and demonstrated the technique) cut that in half to .1m.   Even so, a dull ache and 3+ hours leads me to believe I'll cut it down even further, trying to find the most comfortable dose.   As James C commented, the erection lasts as long as the drug is in your system and certainly long after orgasm.  I kept my eye on the clock and sure enough it started to go down after 2 hours, thus no trip to ER. 
Age at Dx:  56
DaVinci Prostatectomy:  10/28/98
Stage: T2C
Gleason - 3+4 = 7
Prosate:  52 grams
Incontinence - absolutely
ED - Indeed
Married, father of two (boys 18 and 17)
6 months later:  member of the "zero" club, working on one pad for 24 hours.  Took Cialis for 4 months (no apparent affect), just had my 1st tri-mix yesterday, that worked in spades!
All good here in San Diego

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