New guy...trimix pain.

Actually, there is a lot to be encouraged by in your story. Your trip to the ER suggests that your 'hydraulics' still work and respond vigorously to the drugs. The fact that you got a so-so response to the lower dose suggests that there is a dose, somewhere in the middle that will be just right for you. All you need to do to find it is to move the dose up slowly (a unit at a time, trying each dose twice) until you find it.

That leaves the ache to deal with. It is probably caused by a reaction to the Alprostadil in the mix. Some guys get an ache from it, some don't. Of the achers, some report that the ache goes away over time, but some don't.

If you are a persistent acher there are two things you can do. You can switch to Bimix (which doesn't have the Alprostadil but doesn't generally work quite as well) or you can talk to your doctor about adding a dab of anesthetic to the mix to block the pain sensation.

I get a mild but persistent ache from Trimix and am working on getting hooked up with some Trimix plus Lidocaine. The current snag I am facing is that my local compounding pharmacy doesn't know how to add Lidocaine to the mix. Apparently you have to do something to tweak the pH and not all pharmacies know the 'secret' recipe that makes it work. I'll probably wait until I finish my radiation treatment to press the issue (in the meanwhile I will endure the ache).

If there are any others on the forum that use a mail-order pharmacy to get Trimix plus Lidocaine I'd love to know what pharmacy you use and what you pay for it, as quite possibly, would sanbenito.

Thanks, guys.

I forgot to mention that I'm going through radiation treatment as well. I should be done the first week of January. I go back to my urologist in January too for a follow up PSA read. My original PSA was 9.1 with a 'rock hard' nodule during the digital exam. My biopsy was 9/14 positive tissue samples for cancer. My wife and I decided the surgery with follow up radiation was the best choice of all alternatives. My post surgical PSA was 0.0... something which suggests they got all the cancer. The follow up radiation was advised to kill any microscopic cancer cells that may be left in the pelvic regions.

I really hated the catheter after surgery. Urination after the cistogram was good and is now excellent. So I'm glad for that. All in all I consider myself lucky. I have a $3,000 out of pocket ceiling for medical expenses on my healthcare plan so the insurance company is paying out well over $100,000 for the surgery and radiation treatment. I can't imagine what I would have done without that benefit.

So I guess I have a lot to be thankful for all things considered. But I do miss my former **** star erection and 'money shot' ejaculations somewhat. I'm hopeful my sex life will return some day soon.

And I'm feeling a lot less depressed being able to express my issues through these correspondences.

Thanksgiving blessings to all.

Like others have said. You probably need to try bimix. That stuff does work well and for those with the Ache from the alprostadil usually have no ache with the bimix. The good thing is that your getting good blood flow with the Trimix injection.

Best of luck with you treatment and in finding a fix for the limp willie. Many of us have been there.

Cajun Jeff

Hello:  As others have said: Try Bimix.  No ache of any kind and it has worked every time for me.  Seems like your blood flow is good enough and it should work nicely for you.

Bill K.

New Jersey  

Sanbenito – I can’t believe your doc started you with 0.20ml (20 units) of Trimix! Glad your pharmacist knew better. I was started on 0.05ml and cautiously and patiently (with his oversight) moved up to my maximum of 0.20ml – the dose you were started on! Did you really have an erection that lasted 16 hours? 16 hours at penetration hardness or harder? That’s horrible. And dangerous. An erection lasting 4 hours is considered an emergency – and you should be IN the ER at that point. Erections lasting longer than 4 hours (priapism) deprive the penis of oxygen which can kill erectile tissue much the same way that a heart attack kills heart muscle. Men who’ve had several cases of priapism are more likely to no longer respond to pills or injections.

90 minutes of penetration hard erection is about as long as you should go. If it lasts 2 hours, you should try to get it down by taking 4 regular Sudafed 30 mg tablets.

I agree with the others – to eliminate the ache, I do think you should give Bimix a try. Don’t give up. You are obviously responding to the medication – you will find the right combination of drugs and dose to make things right for you.

Best -- Tigerfan

I was what my doctor called the 1 in 20 who can't tolerate trimix. The pain was enough that I didn't feel the desire to make use of the erection. Switching to bimix worked for me. I started at about 6 months post surgery and used it for about 6 months at which point things started working on their own. (I was going to start sooner by my ED specialist injured his back and he missed a month of work really backed up his schedule)

I switched to viagra for a while, but didn't like the side effects. Fortunately at almost 2 years I can now get by without the pills.

Not to give you false hope, but I also did not have the nerves spared. The ED specialist said he sees this with a couple of guys a year. It was the first time through this whole process where I was glad to be an unusual case.

Tigerfan,

I should have been more careful in my wording. I wanted to respond to your note but, at the same time, I heard my wife coming up the stairs to ask me why I hadn't already left for work so I was a bit more brusque than I ought.

We don't know the concentration of the mix the doc injected him with. I assume it is more or less the same watery stuff that I use (sometimes called single strength) for which 20 units is a sensible starting dose. I asked the pharmacist and he said that 20-50 units is the usual range. Because of the mix that I use 20 units didn't sound like a lot to me. You probably use high test since your reaction to the dose was different than mine.

So, I don't fault the urologist for the dose. On the other hand, he doesn't seem to have managed the result very well. Usually the doctor should get the patient deflated, one way or the other, before he leaves the office, or at least give the patient clear instructions for what to do and where to go if he is still erect at two hours. This doesn't seem to have happened.

There is a pretty good argument for that first injection in the doctor's office to be substantial -- not a high dose but not that much less than the urologist's best guess where the patient will wind up. For the vast majority of patients that saves time and frustration and, for the occasional patient who is extra sensitive to the drugs, the urologist is there to deal with the problem. That last bit seems to be where SanBenito's first try went off the rails.

Feel free to pitch in here, SanBenito, this is your thread after all.