Bi-mix (mixed results)

[franklee]

My story;

I'm in my early 60's and in good health (knock on wood). Was on Viagra for about 15 years, which worked fine until I divorced two years ago, and started dating a bunch of new women.

Went in to see my Urologist a year ago, (previously diagnosed with probable vascular ED due to high blood pressure). Asked about injections, and he obliged with a bi-mix prescription of Alprostadil (PGE1) 10 MCG/ML and Phentolamine .5 MG/Ml, which I get at the local compounding pharmacy, there is only one in town (5 ML for $95)

Been using the injections for a year. Had very good results in the beginning and mostly throughout; strong erections and ability to control so lovemaking sessions could continue for an hour, to the obvious delight of my partner. Really, I was in seventh heaven as I never had that ability before with Viagra (injections giving me pretty much total control).

I started with .40 (40 units) of a ML, which worked great for a couple of months, then needed to up the ante to around 70 units. Then about 6 months ago, I would get a new batch and zilch, nada. Thinking it was batch related, I would get another batch which would work fine, then the next batch would be a dud.

Just lately, I have hit the wall. I have upped the injections (over the last couple of months) to the full 100 units, as I haven't had a problem with prolonged erections and I was starting to get a hit and miss track record. The last three injections (last weekend) results as follows; Friday night (zilch), Saturday night (almost there but no cigar), Sunday morning (zilch). Friday night was from a previous "questionable" batch, Saturday night and Sunday morning was from a previously known "good" batch. Sunday morning injection was a little closer to the head, and I may not have gotten it in right, as I experienced more pain than usual.

I know I am rambling here, but it seems to be such a mysterious and variable process for me. Thank god, I stumbled upon this board last week, as I have been operating in the dark when it comes to trying to figure out the hit-and-miss results I have obtained.

I have talked to the compounding pharmacist numerous times over the last six months. Of course, she would be a woman, and not bad looking either. But I have not been shy to suggest to her that I think the variable results have been batch related. But now, I'm not so sure.

I also went in to see my Urologist a couple of weeks ago, and expressed my frustration to him, but he just said, "You gotta make sure you are getting it in the right place". He also said he put one guy on tri-mix and it "bent his penis', and he is not going to take that chance with me. The thing about my Urologist is he talks fast and acts like he is way behind in his schedule and needs to get to the next patient, even though I have waited over an hour to see him. A meeting with him is just not conducive to brain storming why an injection might or might not have the desired effect upon the quality of my erection and possible remedies. There are a couple of other Urologists in town, but I think they are all in the same office.

My thinking is this; 1) I need to find a new Urologist, one who is more knowledgeable about injections. But who? I live in a small town. And how would I find the right Doc? And how would I be able to see him? 2) I need a new prescription and a new compounding pharmacy, which I don't think would be a problem, since mail order is an option, if I have accomplished #1 above.

Any advice from the board would be much appreciated.

[tomas1]

I think you know the answer.
Get a urologist who you know will prescribe tri-mix.
If none in the office, can you go to another town?
Maybe the compounding pharmacy can tell you which doctor will prescribe tri-mix for you.
I hope it will work for you, but it may not.

[once a writer]

Find another urologist, one who really seems to know about injection therapy and who seems willing to give you the amount of time worth the money you're spending with him.

It would seem that as a bi-mix user you have lots of options, once you find a uro who deals with trimix and the multiple strengths available. In that sense, you may just be on the first step of a journey.

The price you're currently paying is about double what you might be charged at one of the reputable mail order pharmacies.

[franklee]

Update;

After doing considerable research, it appears I am on a starter dose of bi-mix, and an increase in strength to a more standard tri-mix is in order. There are many compounding pharmacies advertising on the web, but you need a prescription, and for that, I will need to see a more understanding Urologist.

Apparently, there is another office in town with three Urologists, but they need a referral from my PCP before they see me, so I just made an appointment there so I can get a referral.

Hopefully when I get the referral, I can be steered to the right Urologist, so I don't have a Deja-vu experience.

[tomas1]

Good luck, please keep us posted.

[ocitgo]

Update;

After doing considerable research, it appears I am on a starter dose of bi-mix, and an increase in strength to a more standard tri-mix is in order. There are many compounding pharmacies advertising on the web, but you need a prescription, and for that, I will need to see a more understanding Urologist.

Apparently, there is another office in town with three Urologists, but they need a referral from my PCP before they see me, so I just made an appointment there so I can get a referral.

Hopefully when I get the referral, I can be steered to the right Urologist, so I don't have a Deja-vu experience.

This what I do for Trimix. I have a local doctor that sent my prescription to Talon it was 1/2 the price of my local pharmacy.

My Trimix (30-2-20)
Was (30-1-10)

Talon Compounding Pharmacy
http://www.taloncompounding.com/compoun ... nquiry.asp
About $104 overnight

Trimix (30-2-20)
Papaverine 30
Phentolamine 2 <duration>
Prostaglandin 20 <rigidness> other names Prostaglandin E1, PGE1 Prostaglandin E1 (PGE1)

Caverjet = Alprostadal = PGE-1. Different names/forms, but same medication.

Rigidness is mostly due to the PGE-1
Duration is due to the Phento.

[franklee]

Update;

Picked up what will probably be my last dose of bi-mix today.

Told the pretty pharmacist lady that bi-mix was too unpredictable for me, and I wanted to get a prescription for tri-mix, but my Urologist wouldn't write it, and she injected, "Then you can't get it"!

Undaunted, I persisted. Said I was seeking out another Urologist who would write tri-mix, and, "Who would you recommend", and she said, "Can't tell you, but there is only one other Urology office in town, go there". I'm thinking really, is it that big a secret who writes tri-mix prescriptions in town?

I probed with some questions. All I could get out of the pretty pharmacist lady is they make bi-mix and tri-mix, each prescription is individually mixed to the Urologists specs., and between the two mixes, there are about a dozen variations. I persisted further, "What is the typical formula for tri-mix?". You probably already guessed her answer, "Can't tell you".

Ok, obviously, customer service is not a first priority with the pretty pharmacist lady, who also happens to be the owner of this one-and-only compounding pharmacy in town. Obviously, the "knights in shining armor" are the Urologists who write the scripts for this lucrative prescription. My Urologist mentioned some time ago; the chemicals involved in any of the mixes "cost pennies".

So obviously, pretty pharmacist lady, have some consideration for the poor slob who is scraping together $100 for 5 ML of your secret mix which is pretty much total profit and has allowed you to build your nice and spacious, new pharmacy building.

[tomas1]

Funny, I also have pretty pharmacist lady, but she's a peach. She told me what docs prescribe Testosterone and was also quite helpful getting the tri-mix.
If you don't mind can you tell us what state you live in?
It sounds like you live in the middle of nowhere.
Maybe in the wilds of Alaska?

[ocitgo]

My urologist won't prescribed Quad mix because even trimix isn't certified. I am on my 4th prescription with him. It is 30-2-20 and works good only with a pump and rino. Even trimix isn't so what?