Uro has me coming in repeatedly for injections - UPDATE

[Caidan]

Hi everyone,
I m looking for some advice and if your experience is anything like mine. I have high blood pressure, type 2 diabetes (controlled very well). Have been experiencing ED for some time now. I am blessed with an incredible wife and we have an awesome sex life. But i really miss intercourse and would love to be able to offer that to my wife again as well. So I headed to the urologist for injections (pills didnt work at all).

This is where I would like some input. The uro started my on 5 units of trimix. I got semi hard for about 20 minutes but not enough for penetration. She told me to come back in one week. I did. she went up to 7 units - same results. She told me to come back in another week at which time she went up to 10 units again same results. She told me to come back in ANOTHER week (tomorrow) and she would increase by three more units. At this time I mentioned to her that I was aware of others who just took the script home and increased a little each time on their own. She said it shouldnt be done that way. I cant imagine returning over and over and over again until we find that magic number.

Is this normal protocol? I was under the impression that others followed the method I mentioned to the doc.

Also, the shot actually hurts first at the injection spot for about 6 minutes and then the whole thing starts to throb like a toothache for another 10 minutes or so. And even though its only semi hard it is uncomfortable and sensitive to where I dont even want to do much walking around. I am wondering if it is the usual component in the trimix causing that and should consider bi-mix. But then I dont know how the doc will proceed if we switch.

Any insights, experiences, or suggestions are greatly appreciated as I am in unfamiliar territory here and rather at a loss as to how to continue. Thanks.

[Jamesbond]

Think maybe she is a new dr.

I had 1 dr show me how to use trimix other Dr Edex. Went down very different.

Uro sold me auto ejector kit. Showed me how to use it and gave me bootle of sailine told me to shot it into a tomato at home.
My Uro explained to me how to set up auto-eject. He set the depth of the needle. Told ne not to change it. Later I had to change it. He thought it was not working because of depth.

Watched me do it. I used 10 units. Checked me 10-20 minutes later. Then he told me I could go someplace. I went to library and come back in 2 hrs. Then told me to come back another hr and 1/2 to see if it was going down.
Before 4 hrs.

I thought he told me to stay at 10 units. I spoke to him a few weeks later he told me I could increase it by small amounts like 3 units. Then maybe 1 or 2 units at a time to fine tune it.. But make sure if i was stil up and it was getting near 4 hrs not to increase more.
Think he told me not to increase over 20.

I had the same burning and soreness at injections site. I was talking to dr he gave me a prescription for lidocaine cream to rub on before I inject then rub it off and clean area to inject. The prescription stuff was lower dose than over the counter.
It is called
Rectacream, i talked to Dr he was okay with me using it I had much less soreness and burning was less.
I thought it stretched you out causing some soreness. Uro told me to make sure I use it every about 10 days to keep it loose and stretched out.
Talk to your Uro about it
But injections did not work good with me. Later I think we found the reason why.

[JimStars]

Cai,

Even before I read past your posting title, I said to myself.. Well, if it was a female Uro or Nurse I would come back as many times as she wanted me to! Nothing like showing off to a pretty professional!

But yes .. she sounds a bit too tentative. Is she holding on to the prescription or is it just her own private stock?

Also on the aching and throbbing. I had to recheck your post to see if it was really Trimix you were talking about since it sounds more like what happens if you use straight Alprostadil (PGE-1) solution -- which does ache a bit. Now we have to ask you what strength it was.

Also is this her own private stock or your own prescription? Doctors seldom keep Trimix in stock themselves, but DO keep PGE-1 solution around (for venous leak testing and stuff).

Maybe double check with her if it is not your own prescription.

laters..

J

[Caidan]

Hi Jim,
My saga just gets weirder and more confusing. So, today I go back to the uro's office. After i am shown to a room, the NP that has been treating me pokes her head in the room and says that the Dr will be given me my injection because he is more willing to increase the increments than she is. Sounded weird to me, but OK.

So the actual uro doc comes in and the first thing he says is - "So, why dont you just get a penile implant?" That sent up a red flag immediately. I explained that I didnt want to do that at this time and wanted to see if we could just try the injections. (I also dont have the money and insurance wont cover it. I am only 63, so not coverage from medicare for it either - but I didnt say any of this).

Anyway, he asked me if I have increased the dosage any at home. I was incredulous. I told him that even though I asked the NP about tritrating at home, she said it wasnt done that way and that I needed to keep coming back til the right dosage was found (as mentioned in my first post). He left the room and returned with a ziplock baggie that had a small vile in it and a large prescription bottle that had 4 small vials in it. He told me he was going to do the injection at 10 units again because the NP might not have done it right. (THAT sure didnt take any of my increasing anxiety and confusion away). The prescription bottle had my name on it and the strength was 40/2/30, but I dont know what the vial in the baggie was labeled at and thats the one they drew from for my other visits.

At this point I made sure he knew that I had told the NP I was experiencing pain and was concerned about it and would it be possible to try a bi-mix. He said he was unfamiliar with bi-mix and that if trimix didnt work, than no injection would. I explained that bi-mix was a possible alternative to guys that have pain with trimix. He responded by saying that ALL injections hurt.

Now, that did not gel with the information that I have been gleaning from this amazing site. He then wanted to know how I was going to pay for the prescription he had there. I told him I was hesitant to pay for the prescription when I didnt even know if it would provide me with a usable erection and I certainly was concerned about the throbbing pain. I also said that this whole thing was not going the way I had expected and I was confused

He said fine, I will call the pharmacy right now and have them send the prescription directly to you. He called them and right there in the room and started to give the prescription to the pharmacist. He said that his patient was asking about something called bimix at which time they cut him off and seemed to explain it to him. He then said "Well, then go ahead and fill it for the bimix then" he then said "I dont know, what do you suggest" (this was in response to something the pharmacist said). The next ting was almost laughable - the pharmacist apparently asked him a question to which he responded "yes, I am the urologist"

I thought geez, can this get any more confusing or unbelievable. Anyway, apparently he has now called in a prescription for bimix at 3/30 (not sure what that is exactly) and I am suppose to call the pharmacy to complete the purchase and get it shipped out.

He told me to start with 5 units and increase up 2 units at a time, but dont go over 10 units. I quickly did the mental math and realized that you cant reach 10 if you go up 2 units at a time from 5 - but oh, well nothing about this visit was surprising anymore!!

I asked him what should I do if I reach 10 and it still isnt usable and he responded (as he was leaving out the door) "Then you asked for the wrong medicine - if 10 doesnt work with injections, then you need an implant" - to say I am dumbfounded is a MAJOR understatement.

At least I can continue in the privacy of my home under more ideal circumstances and with my lovely bride!
any thoughts? And yes, I will be looking for a new urologist.

[tomas1]

Holy shit, you really need a different Uro. Even a considerate GP may help you.
My Uro also pushed the implant when his weak solution didn't work.
When I asked for a stronger prescription, I went to the pharmacy and they gave me his instructions. I said this will make me end up in the ER.
Right then, I took control of things and halved what they said and now thing's are fine.
I don't know why you're experiencing pain, but it doesn't sound normal to me. Maybe operator error?
Tom

[williamb]

I agree if your Uro is not more informed than this I would be looking for a different one. If you have a problem I do not know who will be the one that you can depend on for good advice. My Uro's PA is a 28 yr old female who is super, good advice, very knowledgeable and very helpful. Interested in helping me, correctly!