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4 Months Post RALP - ED Issues

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Posted 3/18/2014 5:06 AM (GMT 0)
Hello
I'm four months post RALP and ED is becoming more of a problem. It was not this bad 2 months ago but now nothing really happens even with 100mg Viagra. Once in a while I'll get some reaction but never enough for penetration. I read here about the 3 month slump that is the peak of nerve bruising, how long does that last? I talked to my URO, he wants me to try a VED while I wait for the nerves to heal. Is this a 3 month or 6 or even one year process?

Frustrated in more ways than one

Pat
Posted 3/18/2014 6:31 AM (GMT 0)
Pat... Sorry to hear of your situation. I can tell you that my recovery in the ED realm has been baffling. Some days it appears like I'm so close to being like I was, and others, it seems so far away. It's a little maddening to see the wild swings in ability.

The path to recovery is not linear or constant. It's quite jagged. I got some good response in the first month, then some dormancy, then recently I was almost back to what I was it seemed and now a giant step back.

As I've read, it can take up to FOUR years for a man's issues to resolve. Some never. That's a long, long time when every single day you're hoping for progress.

You're only 4 months out...I'm two months ahead o you. Sugars seem to take the life right out of me as well as illnesses. Exercise and lots of it seems to really help.

Hoping you find resolution and satisfaction in that area. My post is pretty worthless to your question but wanted you to know you're not alone in this.
Posted 3/18/2014 12:27 PM (GMT 0)
Patrick,

I highly recommend you read Dr. Mulhall's book (linked in my signature below) to fully understand what you are experiencing and options for ED rehab and erections for intimacy.

Many guys here (myself included) use bimix/trimix injections to achieve regular erections for both rehab and intimacy while we wait patiently (or not so patiently) for our nerves to recover from the trauma of surgery.

One key topic covered in Dr. Mulhall's book: Adrenaline causes the body to reduce/prevent erections. Therefore, stress (which creates adrenaline) will counteract natural or Viagra-assisted or injection-assisted erections. This is a vicious cycle. If someone has difficulty getting erections, it creates stress, which makes it even harder to get erections, which creates even more stress, etc, etc, etc. In fact, this may cause more difficulty getting erections with your wife/partner (when you feel the stress/urgency to get an erection for intimacy) than when alone.

-Gedman
Posted 3/18/2014 12:47 PM (GMT 0)
It took a year and a lot of patience for me.
Posted 3/18/2014 1:00 PM (GMT 0)
I had the same experience, but thankfully it did resolve itself with time. During the time the Cialis didn't do much, I used a pump to keep the blood flowing. I could easily get an erection, but couldn't maintain one initially. At about 6 months the meds kicked in and at almost exactly a year it was like someone flipped a switch and I had normal erections with no meds. Patience and exercise are the key--along with trying--even if you're not always successful. Use it or lose it!!

Good luck,
Tom
Posted 3/18/2014 2:10 PM (GMT 0)
Thanks Guys
I'll reread the book, I know that the problem is both mental and physical. The mental part and stress of lack of performance causes more performance problems. On my own things seem to work ok, not as good as before but it does work 70/80%. So, I know that at least I'm getting some rehab... But its more fun with the wife.

I have a VED on order and hopefully that device will help ease the performance anxiety.

Failing that its off to get shots, the mental part of sticking myself there is awfully difficult to overcome..

Thank you for your continued support

Pat
Posted 3/18/2014 2:23 PM (GMT 0)
I think the shots are really not as bad as most people would imagine. A 31 gauge insulin needle is tiny and I barely feel it.

I do find myself questioning the amount of money I'm paying for Cialis right now at 10 weeks post-op. My insurance pays nothing for any ED meds, with the slight exception of Cialis for BPH if other BPH meds have failed. Having no prostate, it's hard to argue that I have BPH.

So, the Cialis costs me about $6/day. And, I've been trying a full dose (20mg at $24) every other week or so. After that dose, I skip a few days to keep my total costs down. I'm seeing some results from that larger dose, but not a true erection yet.

Even if that dose did work fully, it's a lot more expensive than Trimix, so perhaps I shouldn't be doing the higher dose at all.

I think we all need patience. I'm fairly convinced that the function will return, but I don't get to pick when.
Posted 3/18/2014 8:21 PM (GMT 0)

gedman said...
Patrick,
..................................I highly recommend you read Dr. Mulhall's book (linked in my signature below) to fully understand what you are experiencing and options for ED rehab and erections for intimacy.

Many guys here (myself included) use bimix/trimix injections to achieve regular erections for both rehab and intimacy while we wait patiently (or not so patiently) for our nerves to recover from the trauma of surgery.

-Gedman

Thanks Gedman for those video links. Listening to Mulhall was very helpful. I am a long way from even trying intimacy or trying tp produce an erection right now, still struggling too much with the incontinence, at least if I am standing or walking. I am 4 weeks post op ( there was no full nerve sparing due to the G9 I went in with), and the catheter is out and taking 5 mg Cialis for 2 weeks now. Go back in 2 or 3 weeks for my 1st check up ( 4 hours away at Vanderbilt in Nashville). We thought we saw a hint of filling 2 nights ago, but that is all there has been so far. Debating ordering a vacuum device for rehab before the 6 wk ( actually, more like 7 wk) post op visit. Apparently no one knows if the VEDs actually help with rehab, due to trapping old, poorly oxygenated blood? Will probably be asking for the shots, at least for rehab, then unless there is more sign of life between now and then.

Yep, worrying more with the slow progress on incontinence right now, will be worrying more about the ED once this gets better, but in the mean time will be worrying about rehab and maintenance in that department! Patrick, I hope you steadily progress!
Posted 3/19/2014 11:12 AM (GMT 0)
Patrick, I had strong erection 6 weeks out. They have since diminished in firmness and solidity. I was told this would happen.The GOOD news is - if you've had them before they do come back - patience!

I've also noted that erections vary: lying on my back gets very little reaction; however, standing up gets me a good erection with or without PDE5is.

Try some "up standing" positions.

...
Posted 3/19/2014 4:54 PM (GMT 0)
Last night, I did the full 20mg dose of Cialis, instead of the daily dose I've been using. Very little response at all. I'm 10 weeks post-op, and I may wait another month before trying that again, mostly due to the cost.

The real erections from Trimix are a lot cheaper than the failures with Cialis.
Posted 3/19/2014 6:57 PM (GMT 0)
I think the Cialis after surgery is a bill of goods. Now, maybe Cialis 6-12 months down the road is different.

Not sure what any of you were told about Cialis and why you were prescribed it but I was told it was to help "speed up" the rehabilitation process. Never was I told that taking Cialis was going to produce erections.

The only reason I took it is because I found a coupon online for a free 30 day supply. I had it, initially, upon checkout at Mayo but when I saw the cost I told them I didn't want it. 160 some bucks for 30 pills? Robbery.

I believe there are many effective herbal supplements available that can do as much or more than Cialis/Viagra etc. Some of the amino acids like Arginine show promise. Tribulus Terrestris and things of that nature not to mention certain foods like sweet potatoes, bananas, watermelon etc. all help in recovery at much lower prices.

One of the things I've been meaning to try and haven't is eXtenze. Blood flow is why Cialis is taken. eXtenze would seem to do the same.
Posted 3/20/2014 3:13 AM (GMT 0)
Well as it turns out I woke up with wood, well maybe a willow branch but at least something. I also got the call that I am getting a VED sent to me. That will take the pressure off and hopefully get my head right. Both of them.
Posted 3/20/2014 3:36 AM (GMT 0)
Patrick

As you remember we are in the similar timeline and as time goes on, we may be sharing the same experiences. Just had a visit to my Uro last week. He told me that if it worked before there's a good chance it will work at some time, but it takes time. BTW, my second post op PSA was <.1.
I have experienced much of the same. My leakage has become slightly worse and I have been passing what appears to be segments of sutures. I am getting hints of a "woodie" some nights. I am using a VED and taking daily doses of sildenafil. I am "practicing" but it is actually less fun than I thought it would be.

I have been concentrating most on having a PMA. (Positive Mental Attitude). Whenever I get a little down I think of where I could have been in a year or so if I had not taken action.
Posted 3/20/2014 12:36 PM (GMT 0)
Hey Scooter
Big congrats on the second PSA reading, that is great news

Pat
Posted 3/20/2014 2:08 PM (GMT 0)
Regarding Cialis & Viagra.. I tried them, too as URO recommended...As time went by I'd notice a few of the symptoms from them .. FLUSHING etc....but notihng down below.

So I asked the DOC on my visit, and his response was that it stands to reason that until the nerves heal (if they do), that that would be the case.

Makes sense to me.

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