Posted 3/10/2015 10:14 PM (GMT 0)
nor would it have cared.
Going into my robotic prostate surgery in June of 2012 my odds of recovering normal erections were sort of so-so at best. I had moderate ED that responded (usually) to PDE5i drugs. Such men do recover erectile function after surgery but not always and only to the degree they had it before or near it. So with perfect nerve sparing I figured I had a 50/50 shot of recovering to the point where PDE5i drugs would be all I needed.
Then the doctor found more cancer during surgery than he expected and my hoped-for perfect nerve-sparing turned into "some" nerve sparing, "mostly on the left side."
OK, I thought. It's not 50/50. But it could still happen. Being optimistic I decided to call it one chance five with PDE5i pills and maybe one in four with pills and a ring. But there was still a 50/50 shot I could be happy with a VED and nine chances out of ten that I would be OK with injections.
Then I got my post-op pathology report and found out I would need radiation. That takes a bite too. Not only did it irradiate my part of a nerve, but it got the arteries that supply the blood, making them stiffer and narrow, less able to supply blood faster than it leaks out. So my one in five chance that pills would work dropped to (being optimistic again) maybe one in ten. It became less likely that I would be happy with a pump and started to call into doubt my previous near-surety that injections would work well enough.
Then I found out that I would be doing two years of ADT3 -- hormone therapy with a few extra drugs added in to make it even more gruesome. That meant that, for the next few years, at least, my chances of regaining natural erections had flatlined. My feeling at this point was that my odds that I would ever recover any natural erectile response, even with pills, at this point was getting into winning the lottery range -- possible but not at all likely. I still had some hope that injections might work. I made sure I started on injections before I started on the hormones -- while I still remembered why I cared.
While I was on ADT I found that I could still get a decent-looking erection with a pump -- adequately sized and well formed if you ignored the slightly purple hue -- but the rings wouldn't hold it long if I tried anything with it besides hands-off admiration. The longer I was on hormones the more pumping this seemed to require, the more trouble I had keeping "scrotal tissues" out of the tube, and the purpler the result. I attribute this to the further damage that ADT tends to have on the blood supply to the erectile tissues.
Except for the six weeks after surgery and the last few days I have either injected or used a vacuum pump every day. When injections were possible (the drugs require refrigeration) I would inject three times a week -- M, W, F, in the eventing, before bed -- or would pump -- other days, again before bed. On injection nights I would either stand (in the shower) or sit up straight (in the bath tub) for an hour to give the erection time since it would go away if I were to lay down. On pump nights I would either pump repeatedly or leave a ring on for 15 minutes to get at least 10 minutes of good stretch to the erectile tissues.
You may have noticed that while this is all about sexual function the word sex does not otherwise occur. There were two attempts at penetrative sex, both early in the period. One was attempted with the VED and it failed when the ring would not hold the erection after several attempts with different sized rings. The other was with trimix injections and it failed when we determined that the erection would only last as long as I remained vertical. I lost the erection any time I laid down. Unfortunately, I was also incontinent when I wasn't laying down. These problems could probably have been worked out if it weren't for the hormone therapy which changed my motivation somewhat. So, that was it for "penetrative sex". What else my wife and I may have gotten up to (and there was such) is none of your firkin business.
So, at the end of all this there was a small possibility that if I just waited until my testosterone recovered, thought frisky thoughts, clapped my hands, believed in fairies (without wanting to be one), and wished really, really hard to be really, really hard... that my part of a poor starved and irradiated nerve might spring back to life and Mr. Happy might twitch. You know... possible... right? Could happen. Couldn't it?
So when I talked to my surgeon about getting an artificial sphincter put in for my incontinence, and he asked if I wanted a penis pump at the same time, I told him "Heck yes. I'm not getting any younger here and I have no time to play for long shots like recovering natural erections at this point."
I had the operation last Thursday. I had my umbilical/incisional hernia fixed at the same time. (The hernia is also a lingering side effect of prostatectomy.) For those of you who are thinking about an AUS or an implant I am now able to tell you that the surgery and the first couple of days of recovery don't hurt at all... not a bit... at least not compared to that hernia repair which hurts like a son of a biatch.
Now the world and I will never know if my nerve would have miraculously recovered. I've burned that bridge. Good riddance. Next couple of months will determine how I like things on this side of the river. I'll look for my miracles over here where I expect the pickin's are better.
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A note on my rehab: With the implantation of my implant, and given that I haven't had any sex during the process, you may be wondering what good, exactly, I think I got from all that pumping and injecting. The first step in putting in an implant is measuring. The doc puts in the biggest implant he thinks will fit. If I had let Mr Unreliable shrivel up my surgeon would have had to pull one out of one of the bottom drawers with the smaller numbers. So my 350 jabs* and my near a thousand dates with the uncomfortable pump allowed be to deny several centimeters that would have been otherwise lost to the beast. Reason enough, I say, and more.
* I was going to count up my injections so I could have an exact figure but I am too lazy just now. 350 is close. Here is my trimix log file in it's entirety. Feel free to count them for yourself.
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24 July 2012 Prescribed
25 July 2012 Filled Scrip -- Papaverine 75mg / Phentolamine 2.5mg / Alprostadil 25mcg per 4.5ml.
26 July 2012 25 Units (right. very minimal effect).
28 July 2012 35 Units (left. better but still never hard).
02 Aug 2012 30 Units left. injected by Dr. T. (never hard)
05 Aug 2012 30 Units (right. minimal effect, bruise)
08 Aug 2012 35 Units (left. never hard)
12 Aug 2012 40 Units (right. Pretty good. about 35 minutes.)
15 Aug 2012 37 Units (left so-so)
19 Aug 2012 36 Units (right so-so)
22 Aug 2012 36 Units (left somewhat disappointing).
26 Aug 2012 40 Units (right. Minimal effect. Drug getting old?)
29 Aug 2012 46 Units (left. Close but no cigar. Last of the month-old drugs)
Impressions for the first vial of Trimix. So far the Trimix is for rehab only. If I were attempting to use it for sex I would probably be
dissatisfied with the results at the lower dosages. Until my incontinence improves (assuming that it does) I am not likely to use
Trimix for sexual relations. I get a pretty noticable ache from the shot. A sort of burning ache for several minutes after I inject and
a duller ache that outlasts the erections. For now the ache is tolerable but if I were attempting sex I would find it a big problem.
05 Sept 2012 36 Units (right Adequate response but short-lasting -- about 20 min)
09 Sept 2012 38 Units (left Adequate. Fairly achy. Came on slowly.)
12 Sept 2012 40 Units (right Decent. Bit of an ache.)
16 Sept 2012 38 Units (left Quite OK, except for the ache.)
19 Sept 2012 40 Units (right)
25 Sept 2012 42 Unts (left)
27 Sept 2012 42 Units (right. OK on and off for about 40 minutes. Less hard when I sit still.)
30 Sept 2012 44 Units (left.10:58. Firm but not that hard for 1:15. Better when I move around. )
03 Oct 2012 40 Units (right 11:29)
08 Oct 2012 45 Units (left -- last of the old stuff)
10 Oct 2012 40 Units (right - starting a new bottle)
15 Oct 2012 42 Units (left)
17 Oct 2012 45 Unite (right)
21 Oct 2012 50 Units (left Nothing special. lost erection when I sat down.)
24 Oct 2012 45 Units (right)
28 Oct 2012 45 Units (left)
31 Oct 2012 40 Units (right. Used w/ biggest Vacurect ring [no 1] Results much better but uncomfortable to remove)
07 Nov 2012 35 Units (left)
11 Nov 2012 30 Units (right failed to use ErecAid medium standard tension ring.)
14 Nov 2012 30 Units (left)
19 Nov 2012 37 Units (right -- Inject 12:23 standing - 12:33 70%, lie down - 12:43 mostly flaccid 20%, stand up -
12:53 75% slight ache - 1:20 starting to lose it - 12:30 chubby ==> results depend on position.)
22 Nov 2012 35 Units (left -- last of vial)
26 Nov 2012 35 Units (right)
28 Nov 2012 35 Units (left)
30 Nov 2012 30 Units (right)
02 Dec 2012 35 Units (left)
06 Dec 2012 40 Units (right) Disappointing response. I notice that glans remains blueish. (less well oxygenated?)
10 Dec 2012 40 Units (left) DIfficult to push plunger. Injection left palpable lump that took time to massage away. Poor response.
12 Dec 2012 35 Units (right)
14 Dec 2012 45 Units (left)
17 Dec 2012 50 Units (right )I get a good reaction as long as I stand up. Even at this dose I go flaccid when I lay down but recover when I stand.back up.
19 Dec 2012 35 Units (left)
21 Dec 2012 34 Units (right)
24 Dec 2012 35 Units (left) no reaction at all -- drew shot w/o glasses: probably air.
26 Dec 2012 45 Units (right) Good reaction. Still deflated when I laid down.
28 Dec 2012 12 Units (left) First injection of Super mix (approx 3.57 x strength) 12 units seems comparable to 40 of the old mix.
30 Dec 2012 14 Units (right) Seems similar to 12 units.
02 Jan 2013 14 Units (Left)
04 Jan 2013 16 Units (right) This is the highest dose I have ever used. Still slightly underwhelmed. Definitely goes when I lay down.
07 Jan 2013 18 Units (left) Injected and waited 12 minutes before I stood up. Not really erect until I stood up.
09 Jan 2013 14 Units (right) I'll try 20 units some other time.
11 Jan 2013 14 Units (Left)
14 Jan 2013 14 Units (Right)
16 Jan 2013 14 Units (Left)
18 Jan 2013 14 Units (Right)
21 Jan 2013 16 Units (Left)
23 Jan 2013 14 Units (Right)
25 Jan 2013 15 Units (Left)
28 Jan 2013 18 Units (Right) Slightly disappointing, actually, for the dose. Not sure if I hit it right.
30 Jan 2013 15 Units (Left)
04 Feb 2013 12 Units (Right)
06 Feb 2013 14 Units (Left)
08 Feb 2013 12 Units (Right) Honolulu
11 Feb 2013 14 Units (Left) Ship
13 Feb 2013 16 Units (Right) Ship
15 Feb 2013 14 Units (Left) Ship
17 Feb 2013 16 Units (Right)
20 Feb 2013 20 Units (Left) Largest dose yet.
22 Feb 2013 16 Units (Right)
25 Feb 2013 16 Units (Left)
27 Feb 2013 22 Units (Right) New high dose.
02 Mar 2013 24 Units (Left) New high dose.
04 Mar 2013 24 Units (Right) Last in the bottle.
06 Mar 2013 22 Units (Left) New vial. May be stronger. Pretty good reaction.
08 Mar 2013 20 Units (Right) about as good as 22. Right side seems to work better?
11 Mar 2013 16 Units (Left) Try a bit less. See if there is a difference. Maybe a bit less. But similar to 20 and even 24.
13 Mar 2013 14 Units (Right)
15 Mar 2013 15 Units (Left) New syringes. Smaller needle.
18 Mar 2013 16 Units (Right)
20 Mar 2013 16 Units (Left)
22 Mar 2013 25 Units (Right) Verified still not successful while lying down.
25 Mar 2013 16 Units (Left)
27 Mar 2013 16 Units (Right)
01 Apr 2013 16 Units (Left) Hard to depress plunger. Palpable lump (massaged away). Disappointing results. Seen this before on left.
03 Apr 2013 18 Units (Right)
05 Apr 2013 18 Units (Left)
08 Apr 2013 18 Units (Right)
10 Apr 2013 16 Units (Left)
12 Apr 2013 18 Units (Right)
15 Apr 2013 16 Units (Left)
17 Apr 2013 15 Units (Right)
19 Apr 2013 29 Units (Left) I carried this to Baton Rouge as a filled syringe with a cold pack. Worked ok.
23 Apr 2013 15 Units (Right)
25 Apr 2013 15 Units (Left) Hard to depress plunger again. Slight lump.
27 Apr 2013 15 Units (Right)
29 Apr 2013 16 Units (Left) First time with autoject2.
01 May 2013 18 Units (Right) Second time autoject2.
03 May 2013 18 Units (Left)
06 May 2013 20 Units (right)
08 May 2013 26 Units (Left) Finished bottle.
11 May 2013 18 Units (right) New vial.
13 May 2013 18 Units (Left)
15 May 2013 18 Units (right)
17 May 2013 20 Units (Left)
20 May 2013 18 Units (Right)
22 May 2013 18 Units (Left)
24 May 2013 16 Units (Right)
27 May 2013 18 Units (Left)
29 May 2013 18 Units (Right)
31 May 2013 18 Units (Left)
03 June 2013 18 Units (Right)
05 June 2013 18 Units (Left)
07 June 2013 20 Units (Right)
10 June 2013 18 Units (Left)
12 June 2013 18 Units (Right)
14 June 2013 18 Units (Left)
17 June 2013 18 Units (Right)
19 June 2013 18 Units (Left)
21 June 2013 22 Units (Right)
24 June 2013 18 Units (Left)
26 June 2013 18 Units (Right)
28 June 2013 18 Units (Left) Difficult to inject. Persistent lump that could be felt days later. Stick to the right for a while.
01 July 2013 16 Units (Right)
03 July 2013 18 Units (Right)
05 July 2013 24 Units (Right)
08 July 2013 30 Units (Right) Tried laying down for first 15 minutes. Never more than maybe 50-60%, New Vial.
10 July 2013 35 Units (Left) Problem injecting. Difficult to depress plunger. Tried backing out slightly and got a palpable lump and so-so results.
12 July 2013 18 Units (Right)
16 July 2013 20 Units (Left) Again problems injecting. Something is going on on my left side. Dr T said to inject around it but it is hard to find a spot.
18 July 2013 38 Units (Right) Try again for a dose that will keep me up while lying down. Closer. Nice chubby laying down.
20 July 2013 44 Units (Right) Almost... But not quite.
22 July 2013 20 Units (Left)
24 July 2013 20 Units (Right)
26 July 2013 22 Units (Right)
29 July 2013 20 Units (Left)
31 July 2013 22 Units (Right)
03 Aug 2013 25 Units (Left)
05 Aug 2013 20 Units (Right)
07 Aug 2013 18 Units (Left)
09 Aug 2013 18 Units (Right)
12 Aug 2013 18 Units (Right)
14 Aug 2013 18 Units (Left)
Did not take trimix on vacation...
21 Aug 2013 18 Units (Right)
23 Aug 2013 18 Units (Right)
26 Aug 2013 18 Units (Left)
28 Aug 2013 16 Units (Right) Last of vial.
30 Aug 2013 20 units (right) New vial.
02 Sept 2013 20 units (left) Palpable pea sized lump. Disappointing result.
04 Sept 2013 20 units (right) Pumped first. Somewhat lackluster result.
06 Sept 2013 22 units (right)
09 Sept 2013 22 units (right)
11 Sept 2013 25 units (right)
13 Sept 2013 25 units (right)
17 Sept 2013 25 units (left)
21 Sept 2013 25 Units (right)
23 Sept 2013 22 Units (right)
25 Sept 2013 25 units (left)
30 Sept 2013 24 Units (right)
02 Oct 2013 25 units (left)
05 Oct 2013 28 Units (right)
07 Oct 2013 25 Units (right)
09 Oct 2013 20 Units (left)
11 Oct 2013 28 Units (right)
14 Oct 2013 25 Units (left) Needed two jabs to depress plunger. Disappointing result. Left side continues to be difficult.
16 Oct 2013 25 Units (right) Again, two jabs. Better result than last time. Still a bit of a lingering lump at injection site.
19 Oct 2013 20 Units (left)
21 Oct 2013 20 Units (right)
24 Oct 2013 25 Units (left)
29 Oct 2013 25 Units (right)
31 Oct 2013 20 Units (left)
04 Nov 2013 25 Units (right)
06 Nov 2013 35 Units (right) Unable to find site on left so injected right. Ok but not anything special for the extra 10 units.
08 Nov 2013 25 Units (right)
11 Nov 2013 20 Units (left)
13 Nov 2013 25 Units (right)
15 Nov 2013 25 Units (right)
18 Nov 2013 25 Units (left) Had to stick twice to avoid (scar tissue?) problem injecting.
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18 Apr 2014 17 units (left) Last drop in vial
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Alaska -- pump only...
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...nyc...
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03 Mar 2015 47 units (left) What was left. Last jab... ever.