I fear we need to stop Trimix

FYI: With my last near-ER experience, when I decided to stop trimix for now, I was at 0.08 ml of half-strength trimix. Admittedly, I appear to be very sensitive to trimix when compared to most men. But, if my math is right, Michael is using over 40x of my last dose. Needless to say, that is a lot!

SC

Susan – I totally agree with Worried Guy and back him up 100%. Furthermore I am willing to be Worried Guy’s wing man and while Cajun Jeff holds your Uro down – we’ll both kick him in the nuts!!!

I am just as outraged as they are by this. I remember back when you posted about Michael’s first injection horror story. I was alarmed then - in my response to that post, I said that I thought your Uro was insane … my opinion hasn’t changed.

It’s worth repeating - EVERYONE starts with a low dose and goes up from there. NOBODY starts high and comes down.

My Rx is: Papaverine 30mg - Phentolamine 1mg – Prostaglandin 10mcg/ml.

I’ve been injecting Trimix for over a year.
My first injection in the Uro’s office was 0.05 ml.
My second injection, also in the Uro’s office was 0.10 ml.
My 3rd (1st at home) was 0.07 ml.
From there I went to 0.08, then 0.10, 0.11, a “big” step to 0.15, 0.18, and I finally settled on 0.20 ml as the dose that works for me. At that dose on my Rx I’m getting erections that last 35 to 45 minutes.

Going from 0.05 to 0.20 was a very deliberate, intentionally slow process with strict monitoring by my doctor. It took a month. I had to check in by phone, with my results to his NP along the way. I only increased the dose under his instructions. And each dose was tried at least twice, just to be sure of the results, before going higher the next time. I am still under strict instructions not to increase the dose without talking to the NP or the doctor first.

Regarding your concerns about his health: Noted ED expert Dr. John Mulhall says a 4 hour erection above penetration hardness is considered to be a urologic emergency. Penetration hardness is considered to be an erection of 60%. So anything above 60% is cause for concern. This situation deprives the penis of oxygen and that can cause a degradation of erectile tissue. His instructions for an erection lasting 2 hours, you should take 4 Sudafed 30 mg tablets (regular Sudafed not the extended release) to knock it down, if it’s still up at 3 hours you should be in contact with your doctor, and if you’re still 60% or more at 4 hours you should be IN the ER.

I am also willing to talk with you or Michael. Email me if you’re interested.

Best -- Tigerfan

I will make sure to purchase some sudafed before next use. I have read the responses to Michael and he says "next time I will only use .05" He is afraid of the long lasting erection and the pain that causes.

What is it that you feel I should do? I can talk to the Dr, I would need lots of research and back up. I can put together a "report" or letter and send it to him. Either way, I would need lots of specific medical information to back up what I say to him. I am willing to do this, I just dont have the info I would need to sound educated and not like a pissed off wife (which will get us no where) Of course, if one of you know one of the HUGE named UROs, they could write a letter to him explaining the protocol for Trimix dosage/use and medication used to deflate (not talking about a tire!). I'll do whatever, just dont want to sound like a PO'd wife without any medical backup. Make sense??? I could also give you his name and contact info and you could get in touch with him directly.....not sure he would speak with you but could try that as well. Give ideas of how to handle this.

142 beat me to the punch, change URO. I do not know anything about Trimix other than what I have read in this thread. But Jeff's numbers are absolutely on the mark. The dosage is just way out of line.

I am betting your husband really likes his URO and will be hesitant to change. But I think my first step would be to try the lower dosage, prove there is validity to what others have been saying and then find another doctor. Surely your primary doc and/or the surgeon (if he was not the URO) can get you to somebody else quickly.

(Wow Jeff!)

Susan and Mike
I have not needed injections
Sounds very much like a failure by uro to understand the quantities/concentrations involved, plus how to trial and error the way to the optimum dose. I think you do need to tackle the uro about his treatment plan, the meds are resulting in erections so you would surely benefit from getting the dose right so that you can use both the needles and the erections without additional worries.

In Holland nurses now have to undergo regular testing on their numeracy skills. I also think I have read somewhere that there has been a call in Holland for medicines to be of the same strength/concnetration as far as possible to reduce mix-ups about how much is a normal dose etc. (My mum, a nurse, was always petrified she was going to muddle up quantities and strengths.)

(Even though I have not (yet) needed jabs, I am bookmarking this thread to be able to refer to it in case I need to inject later on.)

Alf

Susan,
I just can't let it go...
Do a quick google search for "initial trimix dosage" There are tons of references.
Look at these instructions that come from a pharmacy.
Note they start low and work up. Also note what you are supposed to do if you are at the 2 hour point.

I'll let you do your own search so you are ready to shove the data up the Uro's a** calmly discuss the information with your Uro.

Jeff

Susan,
I'm feel sorry for your husband's history. Don't give up! His dose is too high!
I started using Caverject with so much pain. After moved to Trimix [papaverine 30/phentolamine 1/alprostadil 10mcg/ml] . 1st dose 0,1 ml [10 units] which endured for more than 4 hs, pain, and subsided after some pills, workout, luckly! 2nd dose 0,05 [5 units] about 3,50 hs, pills too; finally I got a 50 unit syringe and tried only 0,03 [3 units] and it was very pleasant - no pain, 1,5 - 2hs. This stuff is too strong! regards and good luck. I'm from Brazil.

Susan – I recommend that you get Dr. John Mulhall’s book, “Saving Your Sex Life – A Guide For Men With Prostate Cancer”. There is a chapter devoted to Penile Rehabilitation and Preservation; a chapter on each of the different therapies: pills, injections, VED, etc.; and a chapter on Testosterone.

I think 142 already mentioned this but, Dr. Mulhall is the Director of the Male Sexual and Reproductive Medicine Program at Memorial Sloan-Kettering Cancer Center in New York. I was treated there – if you think it would help, I would be willing to share with you the handouts I received at MSK. – Tigerfan

PeterDisAbelard,

You have a way with the written word. I've been thinking along those lines myself recently. No disrespect intended at all for my surgeon. I'm very happy with him achieving the desired outcome on the top priority, and setting the stage for me to work quickly through the second issue of continence. Also worth noting is that there are too many men in his office that still need his oncology expertise.

What remains takes a different kind of approach. It is now a team effort, with a different doctor, my willingness to work on dosage, and my wife's understanding support.

Let's hope Susan can show the support that will swing her husband around and let them realize a successful outcome.

Hang in there Susan. You and your husband can beat this!

Explorer

Susan,

All I Can say is where did your URO get his degree, University of Phoenix, off shore or a trade school? What a quack. I use the double strength Trimix at .35ml and never have an erection last more than 1 1/2 hours. My Rx is: Papaverine 30mg - Phentolamine 1.5mg – Prostaglandin 20mcg/ml.

I am in for the GFMPH intervention trip to NC, only 6 hours away for me.

Terry