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Trimix injection - can't do it

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Posted 9/13/2013 3:09 AM (GMT 0)
I am 8 mos. post-surgery and 100% ED. Have used Cialis since surgery with no effect, so I recently went for a follow up where they injected Trimix and did a doppler. Doppler was "good" said the doc, and then the tech went for the Trimix. Not to scare anyone, but it hurt like h..., and I did not get an erection. Some pain also post injection. I'm normally pretty tough but I can't wrap my head around this one. They recommended upping the dosage and I can't even get the courage to fill the prescription!

Emailed them I'd like to switch from Cialis to Viagra since I had success with Viagra pre-surgery. They are really wanting me to go for the Trimix and basically said the Viagra won't work, isn't worth the toruble and expense, etc. What trouble and expense! Fax it in,pay $35 and pick it up! I understand there are probably clinical reasons they want me to go Trimix, but I am not stopping until they max me out on Viagra. It's worth a try.

So I'm emailing the nurse now and asserting my right to not inject myself until I have tried everything. It may not work, but I have to try.

Anyone get a response from Viagra who didn't get a response from cialis or Trimix?? Gotta ask. Thanks.

Posted 9/13/2013 3:37 AM (GMT 0)
My nerves were not spared, so Trimix is my option, short of having the little bugger hollowed out and a prosthesis put in. I used to freak out when they took blood, but after 4 years of surgery, radiation, self-administered shots for all sorts of issues, blood-letting, and hormone deprivation, Trimix is easy. It works, even if I don't care much to do anything with it (HT side effect - no libido).

My uro is of the opinion that all three of the "vitamins" (Levitra, Cialis, Viagra) are so similar that it isn't much use to run months of testing. I take all of them as blood-flow enhancers as I can get samples, otherwise I buy Cialis. Ask for samples and give them a try. Pain is often relative -
Posted 9/13/2013 3:41 AM (GMT 0)
Franco, when you say hurt, can you be more specific . was it the needle? Of was the pain after the injection. If that is the case you may need to switch to bimix. The Alprostidal could be causing the pain. Hope this helps.
Posted 9/13/2013 3:50 AM (GMT 0)
All three types of pain - came off the table upon injection (wife was watching and said the male nurse took a good stab), pain of injection (every bit of fluid hurt), and pain afterward although not anything terrible, just pain in the Johnson.

I have had many painful incidents in my life and haven't flinched. Last week at doc I flinched!
Posted 9/13/2013 3:57 AM (GMT 0)
Franco, no one can know the level of pain you experience but you. But as Cajun Jeff said, it could be the Alprostidal that's causing the pain. Instead of trimix, maybe you can try bimix. If it's the idea of injecting yourself that causes pain, I totally understand. When my urologist first recommended trimix, I shuddered at the idea - I could never stick a needle "there!" But my desire to have erections again overcame my fear of the needle. I've been injecting trimix (painlessly) for a year and am finally getting erections from it (nothing spontaneous yet). I also take 5mg of Levitra daily, as 142 said, for a blood-flow enhancer. I had nerve sparing on my right side and partial nerve sparing on my left. I'm hoping that one day I can natural erections again (praying the spared nerves start working again).

Mike
Posted 9/13/2013 4:11 AM (GMT 0)
You need to find something that works for you. The trimix will work most of the time after you find the right dosage. The Viagra might work but it's not the almost-sure-thing that the trimix is. If I were you I'd try both -- get a scrip for a Viagra and also fill the scrip for the trimix. Get the 31 gage needles and be sure to let it warm up in the syringe after you draw the shot but before you inject -- it stings more when its cold. Don't inject and use the Viagra in the same 48 hour period.

I get an ache from Trimix but it has gotten less as I continue to use it ... or maybe I am getting used to the pain. In any event it is OK. If I can do it you can too.
Posted 9/13/2013 4:23 AM (GMT 0)
Franco -- Wow, the injection shouldn't hurt that much. I hate to say it, but I wonder if the tech really knew what he was doing? Was the doc in there with you? Where did he inject it exactly? You should inject about the middle of the shaft (closer to the base) at the 2 o’clock or 10 o’clock position at a 45 degree angle (as viewed in cross section). Think of it as directing the point of the needle towards the center of your penis. My NP told me not to use 3 and 9. Also, when you inject you should grab the head, fully stretch your penis straight out and keep tension on it while you inject. Avoid any veins you can see or feel. After you inject it usually requires some stimulation to get things going.

Do you know what size needle was used? Should be a 29 gauge, a 30 gauge, or even a 31 gauge (the larger the gauge number the smaller the diameter of the needle). The smaller the diameter - the less “ouch” when you inject. A 31 gauge might be too delicate and are more prone to bending or breaking, but I know a lot of guys use them with no problems.

Like Jeff said, if you’re having pain in the penis after the injection, you should talk to your doc about switching to Bimix.

And in my opinion, if you haven’t had ANY success with Cialis, then I don’t think Viagra or Levitra are going to do enough for you. At 8 months post op you really need to get injections working for you.

Best of Luck -- Tigerfan
Posted 9/13/2013 1:49 PM (GMT 0)
I bet it was the technicians technique.  Dave has been doing injections since June and has not had any pain.  All the tips are really right on. 

There is also Quadmix for those that experience pain.

Also, the caverjet is a spring loaded device like the devices for checking home glucose levels.  That might be an option.

It really works great after a little practice and I hope you will give it some more chances.  Our sexlive is darn near like it was before surgery with the injections.

Posted 9/13/2013 2:26 PM (GMT 0)
Franco,

Are you dealing with one of the "Men's Clinics" that are popping up around the country or are you dealing with your urologist?

The Mens Clinics push injectables only (NO pills) and charge what I think is an exorbitant rate compared to a urologist precription.

The Trimix is refridgerated so it may have been kind of cold when injected, that means a bit of pain.

Posted 9/13/2013 2:44 PM (GMT 0)
Franco,

How many times have you tried injections? One time isn't enough to draw a conclusion, in my opinion. Here's why:

1) There are nerve endings in various places on willy. Sometimes, injections hit a nerve and hurt. Other times, no nerves and feel almost nothing but the pressure of the needle.

2) As your doc probably told you, the first injection needs to be a small amount of trimix, and then you slowly increase until you find the dosage that is right for you. It is unsurprising that the initial "baseline" dosage with the doctor didn't achieve an erection for you.

I use bimix (similar to trimix). In the doc's office, the first attempt was 0.05 cc and got no erection. (That first injection was done by me, with the doc instructing me every step of the way.) I got no erection. I was told to increase by 0.05 for each subsequent injection (0.10, 0.15, 0.20, etc) until I found the right dose that gave me a good erection for 45 minutes, followed by another hour or so of slow return to fully flaccid state. I found that 0.25 cc is the perfect amount for me, and use it regularly :-)

Yes, it takes time (and practice) to get accustomed to injections. Don't give up. You need erections to avoid atrophy (and lots of other good reasons!).

-Gedman
Posted 9/13/2013 3:45 PM (GMT 0)
Franco: Two easy fixes for your problem: 1. Tri-mix is noted for pain due to the third ingredient. Try Bi-Mix which is typically painless during erections. 2. As others have said, request the 31 gauge needle that is 5/16 inch long and this way you can quickly insert it until it hits the hub of the needle. This is much faster to do so the injection process is over in a wink. Also the warming up of the injection to room temperature helps too. To be honest, I could never inject myself, so I let my wife always do it. Another route is to get the auto injector. I know that this ordeal really takes away much from lovemaking, but it is part of necessary therapy. Don't let one or two "failed" or painful injections throw you off course. They can indeed jump start you natural erections!

At 8 months, like you, I had 100% ED. Bimix, the VED, and 5 mg. Cialis everyday were part of my therapy program. At 13 months the BiMix stopped working BUT I started getting natural erections with just 5 mg. of Cilais. At 1.5 years, I was able to have sex regularly without anything. Now at 26 months post-surgery, I can get erections mentally!

As I have mentioned before on this forum, ED recovery takes much longer than we are led to believe by our doctors. And the more we stress out about it the harder it becomes to get an erection since stress
plays a big part in furthering ED. Good Luck.

Bill K. from NJ
PSA at age 50=1.7, Age 58=3.3, free PSA 21%, neg. DRE
Bx. May 2011: 1/12 cores +. Gleason 3+4=7
daVinci: July 2011: Contained, 10% involvement, Downgraded to Gleason 3+3.
Immediate urinary control, but 100% ED for 13 months.
Now at 60, only very slight ED, all PSA's <0.015.
Posted 9/14/2013 1:04 AM (GMT 0)
Thanks guys (and lady!). I'm not ruling the injections out, I just feel like taking this one last step before taking the plunge.
Thanks for the info and, yes, I do think the tech went medieval on me (according to my wife who was spectator).

I'll be back on the forum with an update before long.
Posted 9/14/2013 2:50 PM (GMT 0)
Have you tried a VED (vacuum device). I am on coumadin (blood thinner) and have avoided the injections due to this . My wife and I have had good success with the VED.I still use Cialis daily as well.
Posted 9/14/2013 4:15 PM (GMT 0)
Franco: I've injected 111 times. I can think of only one injection where the injection itself hurt more than I liked but overall the experience was good. On that injection I hit a vein. I don't believe I got an erection from that one either.

My very first injection was pure Alprostadil and it caused one hell of an ache that wasn't tolerated well by me for the two hours that I had an erection. It wasn't the shot that hurt, but the drug itself. My second shot was trimix and it hurt too but not as bad. It hurt because the doctor overdosed me and it took six hours to go down. My third shot was 1/3rd the dose of trimix and things started working good. I still had to reduce the dosage some more and when I got it right it was a lot of fun to be back in the game again.

If cialis isn't working at all, I doubt viagra or lavitra will be that much better. You are still healing so don't give up. Try to get a copy of Dr. John Mulhall's book, "Saving your Sex Life".
Posted 9/14/2013 9:37 PM (GMT 0)
J. Mulhall's book is available from Amazon in paper, or electronically on Kindle for PC/or Fire. I read it before my surgery Dec 2012 and have found it to be indispensable - I reread parts of it periodically.
Posted 9/14/2013 10:26 PM (GMT 0)
Yes, Franco, injecting yourself can be fun... or so I've been told. Unfortunately, I've been on ADT for almost all of my trimix shots -- it's all been for rehab purposes. 166 shots so far and zero fun has been had.

But it's still important to get in the mood. For you, that would have something to do with your wife, as I vaguely recall. For me it's different. My motivation is a grim determination to salvage some part of my sex life or die trying. When my last Trelstar shot wears off (probably sometime in early 2015) I want to remain anatomically correct.

To get in the mood to inject, I draw my shot, lay out the syringe and the alcohol swab, and then do a dramatic reading of Ahab's last few words from Moby Dick.

In that sequence, Ahab said...
Ho, ho! from all your furthest bounds, pour ye now in, ye bold billows of my whole foregone life, and top this one piled comber of my death! Towards thee I roll, thou all-destroying but unconquering whale; to the last I grapple with thee; from hell's heart I stab at thee; for hate's sake I spit my last breath at thee. Sink all coffins and all hearses to one common pool! and since neither can be mine, let me then tow to pieces, while still chasing thee, though tied to thee, thou dammed whale! THUS, I give up the spear!"

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