Injection therapy

Can't help but am pulling for you. Our first appointment for the same thing is Wednesday. Will be watching your posts! Annnd good luck!
;o) Bob & Linda

Tamu - The practical question that I am concerned about is how do you conceal the erection to get from the doctor's office to the car? Any suggestions? From anyone?

EB02,

The day i had the injectionI wore a wind breaker that was long. I just zipped it up and went on. The erection was still flacid enough that it would bend but I have to admit I wished that home had been closer.

Tamu

I went for my first injection today. I was actually more apprehensive than the day I went for surgery. A male nurse runs the ED clinic at the university medical center where I had my surgery 18 months ago. I had not been to see him in about a year since I had hoped to eventually regain potency using the vacuum pump and Viagra.

First, the nurse reviewed my status and inquired about my use and effects of the pump and Viagra. Then he explained the injection therapy. The overall goal is to find the right dosage that will give me a medically induced erection that will last for one hour. Once I am on my own, I can lower the dosage if I want less than an hour, but I should never try to attain an erection that lasts more than one hour. During this first appointment, he determined a starting dose based on my description of what level of erection I have been able to sustain with the pump and/or Viagra. I will report back to him at the next appointment how long this erection lasted and then he will supervise my self-injection of an adjusted dosage. I will report back on the duration of that erection and then the doctor will issue a prescription recommending the maximum dosage that I should use on my own. The nurse explained all of the details of the pharmacy and gave instructions for how I am to regulate use of the pump and Viagra once I begin the injection therapy. He will want me to produce at least one erection by injection every ten days whether I use it or not (I don't think after all this it is something I would waste). There has to be a gap of at least 48 hours between injections and no more than three injections in a 10 day period.

Prior to injection, I asked about painful erections that I had read about in this forum and elsewhere. The nurse explained that one of the three medications in the tri-mix has been known to produce pain in the shaft and tip of the penis, and if that occurred, we could reduce to bi-mix, eliminating that medication depending on my tolerance level. However, he cautioned that the erection would probably not be as firm. I also asked whether he thought I would need the injections permanently. He said that he still considers this part of a therapy regimen that I should continue in conjunction with the pump and Viagra. He indicated that some patients eventually no longer need the injections, but that others need or choose to continue them indefinitely.

He explained the procedure for injection and then told me to drop everything so we could begin. When the needle has been prepared, you pull on the head of the penis to stretch it out and then turn it sideways, either to the right or left. He injected me on the left side today since you alternate sides and he thought it would be easier for me to inject the right side next time since I am right-handed. The needle is inserted directly into a position at either 9:00 or 3:00 near the middle of the shaft, wherever there is not a blood vessel. He noted that I am at an advantage because my veins and arteries are distinct. Immediately after the injection he said to press firmly on the injection site and to knead both sides of the penis in order to spread the medication and keep it in the penis. After I did this for about a minute, he told me I could pull my trousers back up and wait.

It didn't take long before I felt stirrings and had to adjust my pants. After about ten minutes, the nurse asked me to drop trou again and he checked on the firmness of the erection. He suggested that I pull on it to get an idea of how actual stimulation can cause growth. Although this was not the proper setting for further discovery other than a brief tug, I could tell that the injection definitely produces a usable erection. I had hoped for more in terms of size, but he explained that he had given me a very conservative dose since I had reported in response to his earlier questions that I normally retain some "chubbiness" on my own after using the pump. He will use a greater dosage the next time.

Even though it was a very warm day, I had carried a lightweight jacket so I would have something to hold in front of me as I scheduled my next appointment and went to the parking garage. The erection lasted for most of my drive home. It was not painful except for a minor dull ache from time to time. The greater discomfort was from the tightness in my clothing. It reminded me for the first time in a long time of the uncomfortable erections that would sometimes sprout spontaneously in school when I was much younger (like about 40 years ago - who would have thought then that this would ever be such an effort?). I had deliberately worn a long polo shirt that would cover everything with the shirttail out. I kept my pants zipper down in the car with the shirt over the opening. I was alone. I know others have debated whether the wife should go along. Every marriage is different, but this works better for both of us. I know she'll be there for the full hour when I finally get to self-inject at home.

So that was my adventure for the day. In hindsight, it was all very easy and I wish I had done this a year ago. The shot was not painful and in fact I barely felt it. I think my only challenge in self-injecting will be to make sure I have a good enough view over my belly of the injection site. An added incentive to lose weight. I know many others have been through this and others have reported their experiences here. I hope this helps anyone who is going through this same process or thinking about it. I will report back after my next appointment.

Do most insurance plans and or medicare pay for the injections? If not , what is the typical cost per injection?

I am still trying to get the viagra and pump to work and have seen some improvement. I don't really know what to expect.

Thanks for your help

My urologist's office told me the medication for injections would have to come from them directly - not the pharmacy. Not sure about insurance coverage. As far as my ErecAid pump, I bought a new one at around $500, and was reimbursed slightly more than $300 by my insurance company. I have PPO coverage.

Well, today was our day for experience with Trimix injections. EB your post helped us so much. It pretty much went as you explained with yours. In our case it was the urologist who did the explaining.

He appeared in the room and asked the questions about previous sexual function prior to surgery and then about the difficulties in the six months since.

We had our prescription for Trimix filled already and had it with us as instructed. He showed both Bob & myself how to fill the needle and is starting with the lowest dose of .10.

He had Bob drop his pants and showed us both where the needle should be inserted (reminded Bob to be watching - I had to remind him to breathe!)

Then he said to hold the spot for 5 mins and then try and stimulate things and he'd be back in a total of 15.

In surroundings like this it's rather weird to be trying to get an erection, but Bob did end up with the best one he's had in the six months, however, wouldn't be enough to successfully complete intercourse.

Dr. advises to try the .10 next time and then go up in increments of .05 until successful. He thought that for such a low doseage, this was a good start.

He also recommended no more than 3 times per week, which is the most we've heard so far.

This minimal erection lasted a total of an hour and disappeared almost as quickly as it began. . . . .

There has been no discomfort, however, so Tamu . . . you may want to experiement with a different injection for the result you are hoping for as well.

Take care all!
;o) Bob & Linda

Thanks for the reply EB - yup, amazing what a guy will go through once it becomes a necessity. <<grin>>

Yes we are free to go on our own . . he just recommended using same dose as today one more time before increasing at all, and then to only go up .05 at a time, and never go higher than .50 but we're thinking a slight bit will do the trick, just finding out where.

Do keep us posted as well.

;o)

Thanks Tamu - good luck and please let us know how the Bimix works! 5 ml sure doesn't look like a whole lot, does it?

;o)

Good for you, Raheeb! My doctor believes that the injection therapy actually "jump starts" the recovery process. I hope you have success. We'll be waiting to hear of your progress.

Your experience gives me greater appreciation for why my doctor's office requires me to come back and self-inject under supervision before turning me loose to go on my own. I have great empathy for Bob. I remember how hard it was to learn to self-inject Heparin (blood thinning medication) into my abdomen that I had to do for five days before and after my surgery. I had to muster courage all over again each time and I was so glad when the time ran out. I was helped by having had several years of experience of giving twice a day injections of insulin to a pet. I wonder if getting some empty syringes from a pharmacy and practicing on a piece of fruit might help him get more comfortable with the needle and inserting the needle before trying real medication again. Or perhaps your physician's assistant can supervise the next round so that he is more comfortable. This is tough. It really is mind over matter and feeling pressured is going to make it worse. Give him time and space to work through this. This isn't easy. Hopefully others who have been through this can weigh in with helpful solutions. Good luck!

Well, 2 nights ago I tried again,using a 9 cc dose of prostaglandin.I was away on a business trip at the time, which is when I generally have more time to experiment given that I have a very young child. This time I definitely got an erection that was suitable for intercourse; in fact it lasted a couple of hours and I had to take sudafed and do some exercise to make it go down. I'll have to check back with the physician's assistant, but seems like the 9 cc may be too much.

The other interesting thing was that the erection, while firm, was smaller than what I get with the pump. I am wondering if this is a sign that I did lose some significant length in surgery; what I had with the pump was much closer to what I remember from before. Oh well.