Penile Rehab Plan

lewvino

Several asked about the penile rehab plan I mentioned in another post. Easist is to direct you to the link from Vanderbilt Hospital

http://www.mc.vanderbilt.edu/surgery/urol/video/Mar08-RecoveryErectileDys+SampleCalendar.pdf

The main plan is on the last page of that link but the plan given to me is slightly different from this link. Starting on Week 3 post surgery I will be taking 10 mg of levitra two times a week, Then on the 7th day to take a full dose of 20 mg levitra. I am suppose to due this for four weeks, then switch to the full dose of 20 mg at least one time a week. Also suppose to provide manual stimulation even if nothing happens daily. The goal is to ty and stimulate blood flow.

When I have my first post surgery appt on October 17th they will then discuss with my the next steps in the plan. I was even told that they have 'sex' classes that I can attend!

Like I said at least it sound's like fun!

This plan is also mentioned in the book: Saving your sex Life by Dr. John P Mulhall that some one else has mentioned in some of the threads.

Larry

novaguy

Thanks, that's very helpful.
Thanks, that's very helpful. I also ordered the book you and others have mentioned.

My doc didn't really spend much time on penile rehab, but he did put me on 5mg cialis daily starting after my catherer was removed, which was a week ago. His nurse told me the reason they use cialis is because it's the only FDA approved ED pill for daily use. Other than that, I have zero instructions.

I've been taking the 5mg cialis, and I note a very small erection, maybe 25%, every now and then with stimulation. I don't know if that's the cialis or just the nerves waking up, or protesting, or something. The doc said the purpose of the low dosage isn't really to create an erection, but to help the veins from atrophing.

I note you go back at 6 weeks for a PSA, my doc told me 3 months. I don't mind waiting that long for a PSA, but I should do something earlier than that for the rehab. I'll ask my doc if I can take a full dosage once a week, like your plan says. That makes sense to me, because the small dosage doesn't really do much.

lewvino

novaguy said:

Thanks, that's very helpful.
Thanks, that's very helpful. I also ordered the book you and others have mentioned.

My doc didn't really spend much time on penile rehab, but he did put me on 5mg cialis daily starting after my catherer was removed, which was a week ago. His nurse told me the reason they use cialis is because it's the only FDA approved ED pill for daily use. Other than that, I have zero instructions.

I've been taking the 5mg cialis, and I note a very small erection, maybe 25%, every now and then with stimulation. I don't know if that's the cialis or just the nerves waking up, or protesting, or something. The doc said the purpose of the low dosage isn't really to create an erection, but to help the veins from atrophing.

I note you go back at 6 weeks for a PSA, my doc told me 3 months. I don't mind waiting that long for a PSA, but I should do something earlier than that for the rehab. I'll ask my doc if I can take a full dosage once a week, like your plan says. That makes sense to me, because the small dosage doesn't really do much.

My appointment will actually
My appointment will actually come out at about 8 weeks post surgery they had to change it.
I've read also that the low dose is to the veins from atrophing. They may have slightly different PSA check plans based on your initial Gleason scores etc.

I think you will enjoy the book once you get it. It is very informative. My oldest son lives in NYC where the Dr. that wrote the book practices. I've thought about even setting up an appointment to see that Doctor but will wait and see how things are going in nine months or so down the road since the plan Vanderbilt gave me so closely follows the plan in the book.
Larry

Bill_4

Here's what my doc said....
My first PSA test is to be six weeks out (I am about 4.5 weeks post-surgery). As for rehab, my doc said we could talk about it at 6 weeks. Initially, I had no sensation and no interest given the normal aches and pains. Then last week I had the first of three erections at about 80%. Surprised me. I wonder if this will resume on its own or if I will need medication for that last bit? I'd like to try first without meds. I get a minor ache with the erection but think that is everything stretching out. Have moved from any pain to but periodic itching at 3 of the incision sites and occassional aches in the bladder area. Ice helps. Guess its the next stage in healing. I'm also fully continent (from the start).

lewvino

Bill_4 said:

Here's what my doc said....
My first PSA test is to be six weeks out (I am about 4.5 weeks post-surgery). As for rehab, my doc said we could talk about it at 6 weeks. Initially, I had no sensation and no interest given the normal aches and pains. Then last week I had the first of three erections at about 80%. Surprised me. I wonder if this will resume on its own or if I will need medication for that last bit? I'd like to try first without meds. I get a minor ache with the erection but think that is everything stretching out. Have moved from any pain to but periodic itching at 3 of the incision sites and occassional aches in the bladder area. Ice helps. Guess its the next stage in healing. I'm also fully continent (from the start).

Sounds like your on the road
Sounds like your on the road to a full and complete recovery Bill.

Larry

novaguy

lewvino said:

My appointment will actually
My appointment will actually come out at about 8 weeks post surgery they had to change it.
I've read also that the low dose is to the veins from atrophing. They may have slightly different PSA check plans based on your initial Gleason scores etc.

I think you will enjoy the book once you get it. It is very informative. My oldest son lives in NYC where the Dr. that wrote the book practices. I've thought about even setting up an appointment to see that Doctor but will wait and see how things are going in nine months or so down the road since the plan Vanderbilt gave me so closely follows the plan in the book.
Larry

I received the book today
I received the book today and started going through it. Gee, it sure is technical. I have to wade through a lot of jargon, but then I find numerous nuggets. I'm sure I will be referring to this book repeatedly as I go through rehab. He uses Viagra and Levitra more than Cialis in his examples, using low dosages every day and then a regular dose once a week. I'm not sure if that works with Cialis, since it's longer lasting. I'll have to ask my doctor about that.

brookjax

Implants and Trimed
When I first came to these blogs, I saw a blog for prosthetic penile implants. While this was never a very attractive option to me, I am wondering if anyone knows why that blog disappeared?

Implants were a mystery for a while to me, information being rather vague as to how they operated and the results to be achieved, although my surgeon did seem to endorse them. Then there was the mystery as to what desired results might not be achieved. The doctors try to be rather vague about this unless you go to their office to ask, I think. Maybe that's the way they are about many PC subjects.

I am probably going to use Trimed to get better blood circulation, since Cialis doesn't work very well for now. What I am more interested to know is what problems or successes anyone has had with Trimed injections, and whether they can be combined with Cialis or Levitra on alternate days (not at the same time). My doc did give me a prescription for Levitra at the same time as Trimed, but that may have been as an interim medication until I get the Trimed.

steckley

brookjax said:

Implants and Trimed
When I first came to these blogs, I saw a blog for prosthetic penile implants. While this was never a very attractive option to me, I am wondering if anyone knows why that blog disappeared?

Implants were a mystery for a while to me, information being rather vague as to how they operated and the results to be achieved, although my surgeon did seem to endorse them. Then there was the mystery as to what desired results might not be achieved. The doctors try to be rather vague about this unless you go to their office to ask, I think. Maybe that's the way they are about many PC subjects.

I am probably going to use Trimed to get better blood circulation, since Cialis doesn't work very well for now. What I am more interested to know is what problems or successes anyone has had with Trimed injections, and whether they can be combined with Cialis or Levitra on alternate days (not at the same time). My doc did give me a prescription for Levitra at the same time as Trimed, but that may have been as an interim medication until I get the Trimed.

Trimix and Levitra
I take 20 mg of Levitra once a week and 20 mg of Levitra four times a week for penile rehab. I also do Trimix injections once a week (0.025 units). My doctor said not to inject the Trimix for two days after taking the Levitra. I have talked to folks who have injected the next day after taking Levitra and they had no problems.

The Trimix really works well for me .... but be careful ... my doctor started me a 0.1 units. This provided me with the most painful and longest lasting (4 hour plus) erection I've ever had ... sudafed and lots of walking up and down the stairs saved me a trip to the ER.

Compared to the oral ED drugs, Trimix is cheap .... I think I paid $75 for the perscription ... I think the perscription was for 5 cc's ... at 0.025 units per injection I am guessing the Trimix will loose it's potency before I use it all.

By the way I use thin (#31) needles that are used by diabetics ... no pain from the injection.

Mark58

brookjax said:

Implants and Trimed
When I first came to these blogs, I saw a blog for prosthetic penile implants. While this was never a very attractive option to me, I am wondering if anyone knows why that blog disappeared?

Implants were a mystery for a while to me, information being rather vague as to how they operated and the results to be achieved, although my surgeon did seem to endorse them. Then there was the mystery as to what desired results might not be achieved. The doctors try to be rather vague about this unless you go to their office to ask, I think. Maybe that's the way they are about many PC subjects.

I am probably going to use Trimed to get better blood circulation, since Cialis doesn't work very well for now. What I am more interested to know is what problems or successes anyone has had with Trimed injections, and whether they can be combined with Cialis or Levitra on alternate days (not at the same time). My doc did give me a prescription for Levitra at the same time as Trimed, but that may have been as an interim medication until I get the Trimed.

Implants
I've gone thru all of the ups and downs of dealing with ED. The viagra did not work for me, I had minimal success with the pump. It worked I guess, but was really a bother to use, and there was positively no spontaniety. I also tried the injections. They did work but I couldn't imagine using it for the rest of my life. Not enjoyable to say the least. After lots of frustration and pain, I finally made up my mind to get an implant. It works!! There is finally some spontaniety again in our love life. The pump for my implant is in my scrotum. I can be ready for action in less than a minute. I went through lots of depression before I got this implant. I have not regretted it one minute. If you decide to go this route, find a surgeon that does lots of these procedures. Dr. Milan at the Vanderbilt Medical Center in Nashville did mine. He is good!! I wish you the best of luck in dealing with this problem. I know what you are going through.