Spit Out the Bone (Implant Surgery on YouTube)

The final frontier. Deciding when, if and how.

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AirWolf
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Spit Out the Bone (Implant Surgery on YouTube)

Postby AirWolf » Sat Sep 16, 2017 12:35 pm

Title of thread is in reference to a Metallica song about going from man to machine

Implanted by Dr. Kramer at 7:00am on Wednesday 9/13.

I travelled from Colorado on the Monday before. Dr. Kramer visited with me for an hour on Tuesday letting me ask all the questions I had and listening to my history of ED as well as going over his expectations of the surgery and recovery. His staff and all the nurses at the University of Maryland Hospital were very caring and professional, letting me recover for as long as I wanted before getting dressed to head back to my hotel.

Here's a video of the surgery:
https://youtu.be/ODpc2BKPHfw

Dr. Kramer texted me a few times on day 2 and 3 to check my progress, to answer questions and provide guidance on recovery. He also stopped by my hotel a few days later to see how everything looked and make sure things were progressing properly and again answer all my questions on what happens next.

I wore jeans to the surgery and trying to get back into those was not fun, so I would recommend sweat pants or something looser. I'm only at day 4, but so far day 1 was the only one where the pain level went up to about 7 or so -- this was primarily due to the catherter which was left in for about 24 hours. I took oxycodone until the catheter was removed. Since then, taking 3-4 Motrin every 6 hours with pain level at about a 2 and I'm tapering down to 1-2 Motrin on day 4. Pretty much stayed flat with occasional icing for 48 hours. Managed about 15 minutes total of walking throughout the day on day 3, and on day 4 I'll probably double that, with going back to icing and being flat in between those walks. Walking is a bit awkward with a scrotum that feels heavy and is a bit swollen -- testicles seem a bit annoyed at times with the pump down there. The location where the tubing goes to the reservoir is a bit tender, and definitely several locations that are numb and bruised -- this hopefully all improves with time. At this point I can't imagine squeezing a bump inside of the scrotum.

Once the catheter was removed, it seemed that aiming for the toilet to pee would be uncomfortable so for day 2 and 3 I would pee in the shower and then rinse it down.

Still got a ways to go for recovery and emotions up and down, but this is the best option for me at this point.
ED since 35 with no known cause -- injections successful for over a decade with 10/1/30 and less than 20units but that became ineffective. Implanted penoscratally by Dr. Kramer of Baltimore on 9/13/17 with AMS 700 LGX 21cm + 0.5cm RTE at 47 years old

bbb2.5
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Re: Spit Out the Bone (Implant Surgery on YouTube)

Postby bbb2.5 » Sun Sep 17, 2017 5:09 pm

Good Luck on your recovery... :)
My surgeon is Dr. Hakky , done on June 27, 2017. Cause of ED Venous Leakage. Implanted with a Coloplast Titan 22 cm with 1.5 cm RTE. Reservoir is 110cc. Gay male, if you have personal questions, please PM me.
Coloplast Patient Educator

AirWolf
Posts: 66
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Location: Northern CO

Re: Spit Out the Bone (Implant Surgery on YouTube)

Postby AirWolf » Mon Sep 18, 2017 1:59 pm

Thanks bbb

Day 5 -- I didn't end up tapering off of the Motrin as fast as I though -- been taking 3 tablets a couple times a day and icing 2-3 times a day. The incision site hurts a bit, and then the pump location/right half of scrotum is quite tender.

Still mostly resting but able to go out and walk somewhat normally for 15 minute intervals
ED since 35 with no known cause -- injections successful for over a decade with 10/1/30 and less than 20units but that became ineffective. Implanted penoscratally by Dr. Kramer of Baltimore on 9/13/17 with AMS 700 LGX 21cm + 0.5cm RTE at 47 years old

AirWolf
Posts: 66
Joined: Wed Aug 02, 2017 8:19 pm
Location: Northern CO

Re: Spit Out the Bone (Implant Surgery on YouTube)

Postby AirWolf » Fri Sep 29, 2017 9:08 pm

Day 16 Post Op Update

My scrotum is back to it's pre-surgery size, though its a bit wider now due to the "3rd nut". Since the hair hasn't grown back yet (scrotum tends to stick to my thighs), and since the incision in the scrotum isn't fully healed, I still have to walk slowly (I just have my phone out and pretend I'm reading something very interesting, ha), and have difficulty getting in and out of a car, and putting socks and shoes on, etc.

After my surgery, Dr. Kramer said at the 2 week mark I could attempt to deflate if I wanted -- at about day 10 the swelling was reduced enough that I could start to feel various components of the pump. On day 12 I attempted to deflate; I had issues though despite doing everything I thought was correct.

Sorry for the redundancy as this next part is from another thread, but just to be comprehensive, I discussed this with Dr. Kramer on my day 13 --

I talked to Dr. Kramer for over half an hour at 10pm his time the other night (what a great, accessible Doctor he is!) -- he was able to talk me through my difficulties. To summarize the discussion:
* He mentioned that this is very early to attempt deflate/inflate, since I was just at 13 days, so I shouldn't be too discouraged (or too aggressive)
* Since he had only inflated me ~20% at surgery, there's not much pressure in the cylinders, so there's not going to be much "feedback" when trying to deflate -- ie., it may not be obvious that I've put the pump into deflate mode -- it will require some squeezing/milking/wringing of the penis towards the body to assist in deflation (and since it is still healing, and may have some swelling, blood, etc., in the penis it may not be wise or easy to try that just yet). He also mentioned that there will be a "new normal" to the flaccid/deflate state with the cylinders in there.
* Dr. Kramer also said that when he has trouble going one direction, he tries the other. Since I was only at 13 days, and a bit tender in the scrotum/testicle region, it was a bit difficult, but he had me try to inflate. I did a half pump and felt the pop, and then did another half pump, so that was cool. He then had me try to deflate -- at this point I definitely felt a mild, short buzz. That was a great feeling that I was able to exercise the pump in both directions.
* Dr. Kramer stated that being between 10 and 65% inflated is fairly easy, but that getting to the extremes of 0% and 100% will be much more difficult. He suggested that I wait until I'm at 3 weeks post surgery to begin cycling, and that I should be able to manage 10 - 65% inflation on my own, and that 65% will be satisfactory for sex. He recommended (since I live in Colorado) that rather than come back to see him at 4 weeks, I should come back at 6-8 weeks after I've been cycling on my own for a while -- he says he can add value in techniques to get to the extremes of fully deflated, and 80%+ inflated.
ED since 35 with no known cause -- injections successful for over a decade with 10/1/30 and less than 20units but that became ineffective. Implanted penoscratally by Dr. Kramer of Baltimore on 9/13/17 with AMS 700 LGX 21cm + 0.5cm RTE at 47 years old

PFracture
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Re: Spit Out the Bone (Implant Surgery on YouTube)

Postby PFracture » Sat Sep 30, 2017 6:24 am

Thank you for the update! You seem to be on a good recovery path! Is there any way you might share in the future, those techniques, if you come to know them?
Suffering from moderate E.D. following a penile fracture.
Merrix: Thank you for everything you have done to this community. You are missed!

AirWolf
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Location: Northern CO

Re: Spit Out the Bone (Implant Surgery on YouTube)

Postby AirWolf » Thu Oct 05, 2017 10:03 pm

Hi PFracture -- sure, I'll update with any tips or advice that I think others can benefit from -- I learn a lot from other users so gotta pay it back :D

Day 23 Update (just over 3 weeks post surgery)

It was about day 21 that swelling in the scrotum was pretty much 0 and I could walk normally again. Wouldn't consider running, but was able to go at a decent pace on an elliptical machine for 30 minutes.

On day 21 (with the consent and advice/instruction from my doctor) I attempted to inflate. It was a bit difficult -- I think I may have done about 8 half pumps or so. Note that there's already some fluid in the cylinders as I definitely can't deflate to 0, so I think I started at maybe 15% inflated. The penis shape was a bit oval, and there was a mild protusion on one side of the shaft. The length was about 1 1/4" less than my previous injected erection length. Even at 8 or so half pumps it was pretty rock solid though -- I was surprised by this. I left it inflated for about 20 minutes.

Two days later (today) on day 23 I attempted to inflate again (at this point, inflating every other day feels about as aggressive as I can handle). I was able to do maybe 12 pumps -- I'm not really sure how well I'm pumping (don't think it's a full pump, maybe 3/4 pump?), but I think I pumped it up more than previously -- some of the pumps were after waiting a few minutes as other forum members have mentioned. The mild protusion on the side of the shaft was decreased to almost imperceptible, the shaft a slightly better shape (not as oval) and about 1/4" longer (so now about 1" less than my previous injected erection length). I left it inflated for an hour. The shaft was very sensitive during this inflated period -- can't imagine having sex with it quite yet (the fact that there are still stitches at the base wouldn't help either). The head was sensitive too, but not nearly as much as the shaft of the penis. For the rest of the day the whole shaft had a mild burning sensation so I'll probably wait 3 days before repeating this cycle of ~12 pumps or so. My anxiety is much reduced after having cycled twice and already having seen improvement between the two cycle events.
ED since 35 with no known cause -- injections successful for over a decade with 10/1/30 and less than 20units but that became ineffective. Implanted penoscratally by Dr. Kramer of Baltimore on 9/13/17 with AMS 700 LGX 21cm + 0.5cm RTE at 47 years old

AirWolf
Posts: 66
Joined: Wed Aug 02, 2017 8:19 pm
Location: Northern CO

Re: Spit Out the Bone (Implant Surgery on YouTube)

Postby AirWolf » Tue Oct 10, 2017 4:49 pm

Day 28 Update -- 1 month since surgery!

I mentioned that at 21 days I could walk normally -- I should note that my pace is normal, though my wife mentioned that I walk as if I've pulled something, so my gait isn't completely normal yet.

Several members have mentioned that they point the penis down when flaccid -- I still can't get totally deflated so having it point downward was a bit more painful than keeping it up. I noticed a hard spot on the top left side at the base of the penis after having it pointed down for a while -- I can only guess that it is the tubing putting pressure on the skin at that angle. Also, there was a recent thread in which Zxylpk mentioned that his doctor has him keep it pointed up (the theory being that you'll get a more upward angle when erect). So, I think I'm going to stick with keeping it up. The only downside of this is that if I take off my underwear in a locker room, it looks like I have a mini-stiffie, ha. But that may not be as much of an issue once I can deflate more. At night, I find letting it be totally free of underwear the most comfortable, since it really wants to be not up or down but somewhere in between.

I would say the pain decreases about 1-3% each day, so it is slow and incremental and over the period of a few days I notice small improvements. There are still random, momentary, acute/sharp pains in the glans, shaft, or scrotum throughout the day -- but it is decreasing in frequency and severity; maybe once or twice every few hours or so at this point. My penis and scrotum are still not 100% happy with the cylinders in the penis, or what feels like a thumb drive in the scrotum. But, based on other members here, it should just be a matter of time before it's all one happy family (6 months maybe?)

Did a 7 mile hike on day 25 on a paved trail with only 400 feet elevation gain -- but that was probably 2-3 miles too many. Uphill was more awkward and uncomfortable than downhill. Also have been running about 3.0 miles on an elliptical runner every other day -- I formerly ran about 210 revs/minute but now can only do about 170 revs else there can be sharp, momentary, intense pain.

Been cycling every other day -- as other members have mentioned, I've found pumping 2-3 times, and then waiting several minutes allows for easier pumping on subsequent pumps. The pump can feel quite hard but if I wait a few minutues, I can do another few squeezes almost as easy as the first. So I've done 4 cycles since activating on day 21. And used the fourth cycle for intercourse as well! -- the shaft and glans are quite sensitive right now so the whole intercourse motion was fairly slow and controlled -- I got more out of it than my wife did, but it was a really great experience to be able to connect like that again -- it was about 4 months ago now that injections just stopped working, and about 2 months before that when sex started to become not satisfying and almost something I wanted to avoid. The 4 month period when I couldn't get an erection was a very difficult period -- of course I felt very unmasculine. And since I couldn't have sex, I found it difficult to make suggestive or sexual comments to my wife, or to even touch her (more than just simple hand holding that is) -- after all, why get all hot and bothered when I couldn't do a damn thing about it. This of course caused a strain in the relationship, and I know many members have had to deal with even longer periods of sexual frustration. This implant will allow us to reconnect and repair the emotional divide -- so super thankful for it!! Not to mention my improved self esteem and confidence, and positive outlook on life.

The rock hard nature of the implant seems to give stronger orgasms -- and of course since everything is quite sensitive, at this stage it really does "hurts so good" ha. I've been staying inflated for about an hour each cycle. Once I deflate the whole shaft will have a moderate burn for several hours -- almost intense enough I think about taking an Advil but haven't needed to, so I'd say the pain is maybe a 5. After a few hours it calms down and feels alright -- I think if I could deflate it more that would lessen the burning sensation.
ED since 35 with no known cause -- injections successful for over a decade with 10/1/30 and less than 20units but that became ineffective. Implanted penoscratally by Dr. Kramer of Baltimore on 9/13/17 with AMS 700 LGX 21cm + 0.5cm RTE at 47 years old

AirWolf
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Location: Northern CO

Re: Spit Out the Bone (Implant Surgery on YouTube)

Postby AirWolf » Tue Oct 17, 2017 9:49 pm

Day 35 Update -- 5 weeks since surgery

Been cycling every other day for about 60 minutes for 2 weeks -- the shaft and the head get quite sore during inflation -- after about 30 or 45 minutes there's almost continuous "bursts" of sharp pain in the shaft and head. It's hard to gauge, but I think it may be getting slightly better. Of course, I'm trying to max the inflation which pushes the penis into new territory (ever so slightly) and thus continued pain. I think if I wasn't "pushing" the pumping (if I pumped up to a comfortable level) the pain would be decreasing, so this is progress. I've gained about 1/4" over these two weeks. I think I'm at most still 1" from my previous length though. There's a noticeable bend to the right in my inflated penis -- not sure if this is due to uneven healing, or what. It's mild enough that I don't think it will cause any issues (even if it never straightens out), but of course I hope it straightens out. It's pretty mild, maybe a 5 degree curve (10 at most).

I've had a few issues inflating -- one time, I kept feeling the "pop" on every few pumps and the pumps had no effect. After about 20 minutes of this the pops stopped occurring and I was able to inflate to a good erection. This was after having a fairly hot bath so I can only guess that due to the high temp (which causes materials, like the pump, to change size) (and due to my still inexperienced pumping) I didn't fully engage the inflate mode. I often also have pumping where every pump after taking a short break between pumps, is very soft/spongy and doesn't seem to have an effect. I may not be giving my first pump a hard enough / fast enough pump to fully engage; though I don't really know as I don't know the mechanics.

If I'm not inflated, then pain is typically a 0-1 on the 10 pain scale, so fairly pain free.

Getting shoes/socks on, and getting in and out of a car is still a bit uncomfortable. Walking speed and gait are normal -- having tried running yet

Intercourse is still a bit cumbersome (slow and not that fulfilling) due to these reasons:
-- sore shaft
-- underside of the penis has no sensitivity
-- I don't know my original girth, but it seems to be less at this stage.

The head is very sensitive so oral sex has been quite good, though due to the soreness in the shaft, orgasms are waves of pleasure and pain, with the pain slightly outweighing the pleasure -- the pain seems to be decreasing. The shaft pain will remain for a few hours after orgasm/deflating. The first time, about a week ago, I had to go vertical after as the level of pain was fairly high -- now it is uncomfortable, but I was able to go shopping which involved walking around for a few hours

On the plus side, there's more pre-cum going on. I think this is due to how hard the implanted erection is, how sensitive the head is, and how I no longer have anxiety regarding erection duration.
ED since 35 with no known cause -- injections successful for over a decade with 10/1/30 and less than 20units but that became ineffective. Implanted penoscratally by Dr. Kramer of Baltimore on 9/13/17 with AMS 700 LGX 21cm + 0.5cm RTE at 47 years old

AirWolf
Posts: 66
Joined: Wed Aug 02, 2017 8:19 pm
Location: Northern CO

Re: Spit Out the Bone (Implant Surgery on YouTube)

Postby AirWolf » Wed Nov 15, 2017 2:17 pm

9 week update

Brief summary is:
- Week 2 got acquainted with the pump and did small inflate, deflate cycles (guys who are pumping on day 3 totally impress me, week 2 was awkward enough for me)
- Week 3 got serious about inflating and deflating
- Week 4-5 had very careful sex -- head of penis very sensitive though. One mistake I made was that I would often pump up to very high levels trying to take advantage of sex to help maximize length and girth but it made sex quite uncomfortable!
Thus, I would recommend pumping up 60-70% for sex (it is still hard enough for sex) and maxing out only on non-sex cycling. Pumping up to max doesn't really change the length anyways (at least for me), it just adds crazy pressure to the penis and head.
- Week 6-7, due to pumping up too much (too much pressure in cylinders) for sex (at least this is what I attribute it to) the head became super sensitive (and maybe because the wife was too aggressive ha) -- I couldn't even touch it without it causing pain and thus had 0 sex these two weeks.
I talked with Dr. Kramer about it and he assured me the hypersensitivity would run its course and would subside.
I also noticed a small opening in the incision line at week 7 that had small amounts of clear fluid. I checked in with my doctor and he said there's no concern. I kept the flaccid penis up just so it could heal better and not be too warm/moist on the wound.
- Week 8, hypersensitivity faded a lot and I could resume sex at a few days shy of week 9
I would subjectively say that sex during weeks 4-5 were 70% awareness of pain and discomfort so not highly enjoyable
Sex during week 8 was 10% awareness of pain and discomfort and thus much much better -- of course, intercourse and sex aren't super aggressive, I would say I'm at maybe 60% of force/thrust of where I used to be at.
Not too aggressive oral and intercourse is very good. Some positions (which force the penis more upright) had pain/discomfort levels at 60-70% or so, while others had low levels of pain (where penis could be more perpendicular from the body) so I can't do all positions yet.

I would have to read back through my notes but I think I started working out, doing cardio at week 4 with moderate discomfort. I am now running about a 10 minute mile (my best was about 8:30 minute/mile pace so I'm still much slower) without discomfort.
There is pretty much 0 discomfort when flaccid throughout the day (and it's been this way for several weeks)

Other notes:
* Pump placement: I've noticed several members here with pump placement too high from Dr. Kramer -- my heart goes out to them -- for me, it is just about perfect -- my scrotum is on the smaller side and the way the pump hangs it is very accessible -- it creates a small bulge, maybe 1cm on the bottom of the scrotum where it sits but it is in the back partly behind the right testicle. I can easily grab it and pull it forward to pump and deflate.
* Flaccid penis: Occasional discomfort at the base of the penis on the top side where it bends due to tubing. I might be able to deflate more aggressively though to help reduce the pressure.
Due to tubing, the flaccid penis is stiffer and bigger than my previous one
* Dr. Kramer encouraged posting my experience, and he encouraged me to make sure to include negative and positive -- a good doc doesn't want unreasonable expectations!
* I had my follow up with Dr. Kramer on week 7 (since I am out of state) -- it was much too fast of a visit for the time and cost I took to get out there, but he did go over my primary concerns. I then texted him a few additional queries and he responded within minutes. I also had a phone call with him once at 10pm his time for about half an hour. So he is very busy but he makes an effort to be accessible.
* Numbness around incision and underside of shaft of penis -- Dr Kramer said that these nerves will heal and I should get back full sensitivity, I can't recall, but he something like 1cm a month of regained sensitivity. In any case, I can feel that this is getting slowly better but there is still a large region that feels numb
* I was cycling every other day for 70 mins, but Dr. Kramer recommended 5 min 2x day, though he stated this isn't based on any study and is more instinctual. Part of my sensitivity issues were probably due to the long cycling times I was doing. I find it a bit uncomfortable twice a day so I just do max inflation once a day for 5 minutes. Doing max inflation does cause intense pressure and pain in the penis and head -- the kind of pain that creates: seeing stars, can barely walk, start to have minor sweats and shakes
* I was pumping slowly, with full depressions, but Dr. Kramer had me do quick bursts -- in this case the bulb doesn't fully get depressed (at least when I do it) but it seems to pump quickly.
* Length is about 5" from fat pad to tip, and I think about an inch shorter than previous. Girth is more oval than round. I think it will take up to a year and a half to optimize length and girth from what I've read and heard
* The amount of cum has significantly increased -- I think this is just due to a very hard penis, so sensitivity is better than my previous, past few years of 80% hard erection with failing injections. The last few years the cum was dime sized amount -- I would say it's about 75 cents worth now
* Besides having a very hard anxiety proof erection, the other major positive is that my head still swells with stimulation and before orgasm. This is one thing I remember Dr. Kramer telling me, that he tried to preserve blood flow to the head during the surgery, and this was the one thing I noticed from day 1 of cycling -- if I stimulate the head it does become engorged

Best wishes to all others out there!
ED since 35 with no known cause -- injections successful for over a decade with 10/1/30 and less than 20units but that became ineffective. Implanted penoscratally by Dr. Kramer of Baltimore on 9/13/17 with AMS 700 LGX 21cm + 0.5cm RTE at 47 years old

TomW46
Posts: 68
Joined: Mon Sep 18, 2017 5:52 pm

Re: Spit Out the Bone (Implant Surgery on YouTube)

Postby TomW46 » Wed Nov 15, 2017 5:37 pm

Great journal. Thanks for the detailed reporting.
71, slight curve and hourglass (Peyronies?). Used V, C and L for over a year. Tried Trimix a few times and then the VED with limited success. By August 2017, nothing worked well enough. Titan Implant (20 + 1) on October 18, 2017, by Dr. Kramer.


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