4 month PSA .07 and start of injections

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Ripandburn
Regular Member


Date Joined Aug 2007
Total Posts : 125
   Posted 11/29/2007 5:40 AM (GMT -7)   
Hello everyone! Yesterday was a big day for me. Not only did I find out that my PSA is staying low, but I got to learn how to inject myself. The doctor had me start with 10 mcg of Caverject. They come with as much a 20 mcg in each syringe. You have to dial the dosage and throw the rest away. Seems like a waste to me. Oh well, insurance will actually pick up some of the cost of this one. My wife is an RN and I feel pretty comfortable with this type of thing so I asked the Doc if I could do the 1st injection, with his supervision. He said I could. Later he told me that I was the 1st patient he ever had that wanted to do it the first time. Well, I got it right. It wasn't as bad I had thought it would be. He said he would be back in 10 - 15 minutes....and I was to just leave it alone and he would check things out upon his return. Of course I couldn't help but try to help the process. My wife finally convinced me that I should do as he said and leave it alone. When he returned we evaluated the erection. It was not what I had hoped for, and there was quite a bit of pain. He told me that it looked good enough for penetration to him. Well, it was about what I have been getting on the Cialis with stimulation, which really hasn't been good enough for penetration. I told my wife later that it might have been good enough for a jelly dough nut, but I couldn't believe it was really good enough for penetration. Before I left I insisted that he not only give me a prescription for the Caverject but for a bi-mix or a tri-mix. He agreed that he would write one for the bi-mix as well and to start at .5cc. I am hoping that will stop the pain that I was feeling with the Caverject, and it is much cheaper. The effects of the Caverject lasted for about 1 1/2 hrs. I know that this will all take some experimentation, but I also know that I need to be careful. I have read where some of you add 50mg Viagra to help things along. How will this effect things?

A question that I had but failed to ask the Doc is....if I increase the dosage will that increase the hardness of the erection, the length of time that the effects last, or both?

Once again, I know this is a long trip I am on, and things will come slowly, but I really want to get this all back. I know that it will never be as it was, but it is difficult for me. I also know that there are many who have it much worse than me. I really wish none of us had to deal with these issues.
51 years old
T1c 3+3=6
DaVinci July 16, 2007
largest cancer .2mm
Bladder Sling installed during prostate removal
nerve sparing with both nerve bundles intact
all cancer contained within prostate nothing near margins
PSA after 6 weeks <0.1 - undetectable
PSA after 4 month .07 - undetectable
11 weeks post-op - no more pads


Tamu
Veteran Member


Date Joined Oct 2006
Total Posts : 626
   Posted 11/29/2007 9:00 AM (GMT -7)   
Ripandburn,

My only experience with Caverjet was not a good one as the aching was very uncomfortable. I immediately went to Bimix after following that and have not had any discomfort at all. As you increase dosage the firmness and erection time will both increase. In my case I started with .15 cc's which was enough for penetration but was not as firm as normal. I increased in .05 cc increments up to a dosage of .30 cc's. When I went beyond this I did not get any more firmness it just lasted longer. One difference for me is that the head of the penis does not get as large with the injection as it did before PCa. When I combine 100 mg of Viagra with the injection by taking the Viagra an hour before the injection I can reduce the dosage down to between .20 and .25 cc's and the erection does not last as long. In my case the erection begins to peak out at about 1 hour after the injection and then it takes another hour to hour and a half before it is totally gone. Stimulation makes a lot of difference. In the office you were not able to take advantage of that but at home you will see that it makes a lot of diifference.

Tamu
Diagnosed 7/6/06, 1 of 10 core samples, 40%,Stage T1c, Gleason 3+3
Da Vinci on 11/01/06, Catheter out on 11/13/06
56 Years Old
Post Op Path, Gleason 3+3, Approx. 5% of prostate involved
Prostate Confined, margins clear
Undetectable PSA on 12/18/06
No more pads as of 1/13/07
Began injections in April '07
Undetectable PSA on 6/25/07


lifeguyd
Veteran Member


Date Joined Jul 2006
Total Posts : 664
   Posted 11/29/2007 9:15 AM (GMT -7)   

Rip

I have been using Caverject for several months now.  I got my best erection with 100mg of viagra followed 1/2 hour later with a 20mcg injection of Caverject.  The resulting erection is very similar to  pre surgery.  However, it also is the most uncomfortable and longest lasting.  Usually I use 50 mg viagra and 10 mcg caverject.

I have been experimenting and found that I now can get a usable erection with just 10 mcg of caverject and no viagra.  The discomfort is minimized and does not last as long.  My doctor said that is probably more like a natural erection. If I find I must use injections forever, I will try bimix to save money.

My orgasm is not very intense and my doctor has no suggestions to improve it. Good luck with your journey.


 
Biopsy 10/16/06
T2A,  PSA 4.7
Gleason 4+4=8 right side
adrenocarcinoma of prostate
DaVinci Surgery 01/16/07
Post op report,confirms Gleason4+4=8
no extra extension/invasion identified
age 65
no continence problems
Back on the golf course...
90 day PSA  less than 0.01 (undetectable)
Six Month PSA still undetectable
Dealing with ED problems with Caverject/Viagra
nine month psa slightly elevated + .02
 
 
 


Tim G
Veteran Member


Date Joined Jul 2006
Total Posts : 2249
   Posted 11/29/2007 10:03 AM (GMT -7)   
We tried Caverject and found the erection sufficient but experienced penile pain. The more you inject, up to 20 maximum, the better the chances of a more rigid erection.  My insurance does not cover it, and at $70 a shot for a painful erection, I decided to check with my urologist about an alternative. 
 
I now use Quad-Mix from a compounding pharmacy.  I works well, is not painful and costs significantly less per injection.  My insurance still does not cover it.  I had a problem with self-injection, so purchased an auto-injector (Inject-Ease from Amazon.com) that works great for me. 
 
I've read that the addition of oral meds (Viagra, Cialis, Levitra) can assist the injected meds in creating an erection, but I would consult your urologist before trying this.   

Age 59 PSA 2.6 (Quadrupled in one year) Gleason 5
Bilateral nerve-sparing RRP 6/21/06
Cancer confined to prostate, post-op PSA's non-detectable


lifeguyd
Veteran Member


Date Joined Jul 2006
Total Posts : 664
   Posted 11/29/2007 10:34 AM (GMT -7)   

Tim G

I too found the price of Caverject to be outrageous.  However, I have never seen it priced at $70 a shot...whew.  My medicare  online pharmacy has it at about $23 a shot, which to me is still too high.

You are right, pain is the downside, but that does seem to get better over time.  My doctor's PA admitted that they prescribe Caverject because it is  "idiot proof".  By that, he meant that it comes in a self contained syringe that make it easier for  storage, measurement and injection.  The "mixes" on the other hand must be prepared by  a compounding pharmacist and then stored in a refrigerator and then the patient must measure, fill the syringe and inject. Comments here tell us that isn't a problem for most users.



 
Biopsy 10/16/06
T2A,  PSA 4.7
Gleason 4+4=8 right side
adrenocarcinoma of prostate
DaVinci Surgery 01/16/07
Post op report,confirms Gleason4+4=8
no extra extension/invasion identified
age 65
no continence problems
Back on the golf course...
90 day PSA  less than 0.01 (undetectable)
Six Month PSA still undetectable
Dealing with ED problems with Caverject/Viagra
nine month psa slightly elevated + .02
 
 
 


Ripandburn
Regular Member


Date Joined Aug 2007
Total Posts : 125
   Posted 11/30/2007 6:33 AM (GMT -7)   
Thanks for the responses. I think I am going to be more comfortable working with the bimix. I am also going to pick up the Caverject today since the Doc wrote a prescription and it is covered by insurance. That way if I am traveling I can use the Caverject since it does not have to be refrigerated. I will report back to the group my experience.
51 years old
T1c 3+3=6
DaVinci July 16, 2007
largest cancer .2mm
Bladder Sling installed during prostate removal
nerve sparing with both nerve bundles intact
all cancer contained within prostate nothing near margins
PSA after 6 weeks <0.1 - undetectable
PSA after 4 month .07 - undetectable
11 weeks post-op - no more pads


Little Jem
New Member


Date Joined Sep 2007
Total Posts : 16
   Posted 11/30/2007 8:34 AM (GMT -7)   
Hi All,
 
My hubby has just started down the injection road.  His urologist recommended Caverject.  The first one done by his urologist was 10 mcgr and this didn't quite produce something 'usable' but almost. 
 
The second injection, again 10 mcgr, done by me under the urologists supervision was on the opposite side and produced a very one sided erection and his foreskin was very swollen, similar to a very large blister.  I felt really bad, that I'd injected in the wrong place or something but the urologist did supervise so logic says this wasn't the case.  It certainly was too painful to be usable.  Anyone else had this experience?
 
On his urologists advice the 3rd injection was 20 mcgr, again done by me, this time at home, on the same side as the first injection, and this worked fine, usable though it did last longer than we would have liked and we'll try 15 mcgr next time.
 
I know he won't want an injection on the same side as the second time ever again and I'm worried about scarring and peyrones.  However, if we leave the injections 2-3 weeks apart will this reduce the risk if we use only one side for the injection site?
 
The aching afterwards is minimal and worth putting up with he says just for the storage advantages of Caverject over trimix or bimix.
 
Little Jem

Swimom
Veteran Member


Date Joined Apr 2006
Total Posts : 1732
   Posted 11/30/2007 9:41 AM (GMT -7)   
Jem,

Use alternating sides when injecting. Scar is scar. No matter how slowly it builds, the risk is still there. Also, Something wasn't quite right about how that painful injection was delivered. Sounds like it didn't go deep enough.
I really hope DH will try another. Perhaps using a small dose. Good Luck.

Swim
 


geon
Regular Member


Date Joined Oct 2007
Total Posts : 103
   Posted 11/30/2007 8:49 PM (GMT -7)   
Little Jem,
What length syringe needle are you using?  I believe 1/2" is recommended and it has to go all the way in the penis side. Both sides ahould be alternated.  Two to three days apart is also recommended.  Vary the dose minimaly.  Too much and he will pay the price with a prolonged erection and pain.
 
I don't believe you can get to far off of target with injecions.  My experience says that emotions play a large part in firm erections.  Same dosage can produce beautiful erections most of the time but with the right distraction I have seen it go soft in seconds and not return even with a fair degree of stimulation.
 
Convince your hubby to try the weak side again and continue the alternating repetition.
Let us know about your success.
 
Geon
64 years old 100307; healthy; active,
married 41 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.
Tried Viagra 100mg on occasion-no erections.
Incontinence almost gone after three months.
No pads, occasional  dribble.
Lavitra every other day 5/12 to 7/22.
Muse 1000mcg - no help (50% at best).
Cialis twice a week 7/25 to 11/6/07.
Vacuum pump daily/twice a day 8/2 and going - no help.
Begin Trimix injections, two low dose per week, 11/05/07.
Currently, vacuum pump and low dose Trimix twice per week each.
Trimix in office - 0.10cc.  Low dose set at 0.05cc
First drug induced erection 10/8/07....Wow!
Natural erections - 0 as of 10/25/07.
PSA's, three to date undetectable.  Thank God!
 
Geon


bluebird
Veteran Member


Date Joined May 2006
Total Posts : 2542
   Posted 12/1/2007 9:41 AM (GMT -7)   
tongue    Yea!! Ripandburn,

 

  4 month PSA   !!!~~~>>>  Woo~Hoo <<<~~~!!! undetectable

 

Cause for celebration!!!!!  Definitely!!!

What a wonderful day it is ~ each and every-day….   

Enjoy it to the fullest. 

 

In Friendship ~ Lee & Buddy

*     *     *     *     *     *

The ultimate “goal”… we all strive for… Thank you for sharing ~ that your goal has been met….

It is very important to “all ”of us!  This is a way of positive feedback…

A way of showing others Hope… and a way of Sharing.

 

:-)  Caring is Sharing ~  Thank You for Sharing :-)


mama bluebird - Lee & Buddy… from North Carolina

 

v          We invite you to visit our personal thread:  Click Here:  “Our Journey” ~ Sharing is Caring 

April 3, 2006  53 on surgery day

RRP / Radical Retropubic Prostatectomy

PSA 4.6   Gleason  3+3=6    T2a   Confined to Prostate

3rd PSA 08-07-2007 Less than 0.1 Non-Detectable :)


Little Jem
New Member


Date Joined Sep 2007
Total Posts : 16
   Posted 12/3/2007 12:57 AM (GMT -7)   
Hi All,

We're using the 1/2inch needle and the injection I did which caused the painful, 'one sided' erection was done under supervision by the urologist. Would he have allowed me to inject in the wrong place???

This seems to have created yet another barrier that hubby is now very reluctant to cross. The next injection should be on the same side that caused the problem and he doesn't seem interested in pursuing that one at all. He also says he does get some pain along that same side of his penis and on that same side of his groin, both before the injection and since. Could this have something to do with it? He's now 18 months since his open RRP.

Big fat ZERO PSA's since the op though so that's one good thing. Next PSA due March 2008.

Take care all,

Little Jem

Ripandburn
Regular Member


Date Joined Aug 2007
Total Posts : 125
   Posted 12/3/2007 6:18 AM (GMT -7)   
I just wanted to reply after the weekend use of Bimix. Let me say, that I will only use Caverject in an emergency. The Bimix was great. I took 1/2 a Cialis the night before, and used .5 of the Bimix the next day (about 16 hours after the Cialis). There was no pain and I had an erection as hard and as normal as before surgery. I know that there will be some tweaking. I intend to try .5 without the Cialis the next time. Let me say that my wife had a smile on her face all weekend long! The total duration of the erection was about 2 hours. After about 1 1/2 hours it started to reduce in size. Perfect. For all of you who are using Caverject and having the pain from it, I SERIOUSLY would like to suggest that you find an Apothecary that will mix the drugs for you. It will be worth while!
51 years old
T1c 3+3=6
DaVinci July 16, 2007
largest cancer .2mm
Bladder Sling installed during prostate removal
nerve sparing with both nerve bundles intact
all cancer contained within prostate nothing near margins
PSA after 6 weeks <0.1 - undetectable
PSA after 4 month .07 - undetectable
11 weeks post-op - no more pads


geon
Regular Member


Date Joined Oct 2007
Total Posts : 103
   Posted 12/3/2007 4:58 PM (GMT -7)   
Little Gem,
Gomgrats on the BIG FAT yeah 0.0 PSA!  This is the one that really counts, the rest we can deal with.
Very happy for both of you.
 
No, I don't believe the URO would let you shoot in the wrong area.  I find that my right side is susceptable to much more pain (shooting) then my right and the pain travels the length of the penis making it very difficult to continue inserting the needle.  I go slow but I manage.  The results do not seem to be as effective on the right as the left but I am still in the process of resolving the issue.  I am 10 months post DaVinci RP.
 
Keep in touch and hope all will be favorable.
 
Marc yeah
64 years old 100307; healthy; active,
married 41 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.
Tried Viagra 100mg on occasion-no erections.
Incontinence almost gone after three months.
No pads, occasional  dribble.
Lavitra every other day 5/12 to 7/22.
Muse 1000mcg - no help (50% at best).
Cialis twice a week 7/25 to 11/6/07.
Vacuum pump daily/twice a day 8/2 and going - no help.
Begin Trimix injections, two low dose per week, 11/05/07.
Currently, vacuum pump and low dose Trimix twice per week each.
Trimix in office - 0.10cc.  Low dose set at 0.05cc
First drug induced erection 10/8/07....Wow!
Natural erections - 0 as of 10/25/07.
PSA's, three to date undetectable.  Thank God!
 
Geon

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