Endometriosis, For Providers, Prism Blog, Surgical Recovery, Transgender Wellness

Supplements for Surgery

Supplements and Surgery:

You most likely know already that there are certain supplements and medications that you should avoid before surgery. Mostly these are supplements and medications that can cause excess bleeding, as well as those that can interfere with the anesthesia.

Surgeons’ opinions vary on which medications and supplements are okay and when to stop taking them. You should follow your surgeon’s recommendations to the letter. These suggestions will likely be more conservative than the ones you receive from your surgeon, because in holistic healthcare, we are interested in helping you achieve optimal health, not just the absence of disease. You can choose to follow these recommendations only if they fit with your surgeon’s recommendations as well. Do not take any supplements or herbs which you know you are allergic or sensitive to or which your doctor or surgeon has told you to avoid.

What to Avoid Before Surgery:

It is most important to avoid potential blood thinners for at least 7 days before and 3 days after surgery. Your surgeon may tell you to avoid them for even longer, depending on the type of surgery you are having. This includes any prescription blood thinners as well as garlic, ginkgo, vitamin E, fish oil/omega 3, and aspirin, ibuprofen, aleve, and other NSAIDs.

Some surgeons may also recommend that you avoid St. John’s Wort, dong quai/dang gui/angelica, feverfew, goldenseal, ginseng, ginger supplements, saw palmetto, reishi, echinacea, ephedra/ma huang, kava, licorice, and valerian for 7 days before and 3 days after surgery, as these can cause excess bleeding.

I tend to err on the side of caution, stopping all herbs and supplements (and any medications your surgeon tells you to avoid) 7 days before surgery.

Most surgeons say that tylenol is okay to take before surgery as needed, but don’t take it if you can avoid it since tylenol can be hard on the liver and your liver is already going to be stressed by the anesthesia. Check with your surgeon when deciding what to take.

Ideally, avoid alcohol, tylenol, and anything else that is hard on your liver 1 month before and after surgery to allow your body to safely process the anesthesia. This obviously does not apply if your surgeon prescribes or recommends tylenol before or after surgery.

Get plenty of sleep, exercise, stay hydrated, and avoid sugar (to keep your immune system healthy) in the month before surgery, and always!

Before Surgery Supplements:

There are certain supplements that can help you recover faster from surgery and risk less side effects. It is helpful to start taking these at least one month before surgery. Do not take any supplements that your surgeon does not approve and remember to stop your supplements one week before surgery.

Starting one month before surgery:
A multivitamin with 25-50mg of B vitamin complex
50 mg CoQ10/day: reduces stress of surgery on heart, improves recovery
500-1000mg/day vitamin C: necessary for wound healing, helps your body produce collagen
Milk thistle: detoxes the liver to prepare for successful anesthesia
2000-5000 IU vitamin D/day with food if not already included in your multivitamin

Starting 2 weeks before surgery, add:
30-50mg zinc picolinate/day with food: necessary for wound healing
Probiotic blend with acidophilis and bifida: reduces risk of post-surgical infection

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After Surgery

After surgery, start off with broths, including bone broth, fresh juices, soups, and other easy to digest foods like oatmeal. Green drinks and whole food based protein shakes are also great when you’re not up for eating real foods yet. Stay away from sugary drinks like gatorade and pedialyte, starches, breads, and crackers, as they can deplete your immune system and cause constipation.

After Surgery Supplements

As long as your surgeon says it’s okay, take 1000mg vitamin C as soon as you get home from the hospital and continue daily. Vitamin C is necessary for wound healing, helps your body produce collagen, and helps your liver break down the anesthetic.

Some surgeons will recommend waiting a few days before restarting supplements and herbs. As long as your surgeon says it’s okay, the day after surgery, start taking Resinall E from Health Concerns (three tablets three times per day, available by prescription from Prism) or 1000-1500 mg standardized bromelain 3x/day on an empty stomach. This helps speed recovery and reduce swelling and bruising. It is mandatory to take it on an empty stomach, otherwise it will just help digest your food but not have any effect on swelling and bruising.

Starting 3 days after surgery, add:
250mg B6 2x/day (or substitute your multivitamin if it contains B6): reduces swelling
100-200mg CoQ10/day: reduces stress of surgery on heart, improves recovery
Milk thistle: detoxes anesthesia from the liver
30-50mg zinc picolinate/day with food: necessary for wound healing
Probiotic blend with acidophilis and bifida: reduces risk of post-surgical infection
2000-3000mg omega 3 per day: reduces inflammation and improves circulation
Arnica 30C 4-5x/day: reduces pain, bruising, and swelling
2000-5000 IU vitamin D/day with food

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After one week post-surgery:
You can stop the B6/multivitamin, unless this is part of your regular supplement regimen

After two weeks post-surgery, you can stop taking:
Vitamin C or return to your usual dose
Zinc
Arnica
Bromelain
Lower your fish oil/omega 3 dose to 500-1000mg/day

One month post-surgery:
You are done with this supplement plan! Return to you regular supplements and herbs as recommended by your acupuncturist and doctors.

Happy healing :)


All information in this blog is for educational uses only. Always consult your doctor before taking any herbs or supplements, or changing or discontinuing your medications.


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Acupuncture, For Providers, Press, Prism Blog, Transgender Wellness

Acupuncture and Trans Medicine

Just a little throwback to this video about my gender-inclusivity activism at my alma mater, the Acupuncture and Integrative Medicine College (AIMC) Berkeley. It’s so wonderful to reflect on how much my practice and my knowledge has evolved; all with the support of my wonderful patients. This has been a long process and I’m looking forward to continuing the journey with all of you!


All information in this blog is for educational uses only. Always consult your doctor before taking any herbs or supplements, or changing or discontinuing your medications.


Contact us to see if your insurance covers services at our office!

Join the Prism Family! Subscribe to our newsletter and get $30 off your first visit.

Acupuncture, For Providers, hair loss, Menopause and Beyond, PCOS, Prism Blog, Transgender Wellness

Plum Blossom for Hair Loss

Plum blossom therapy is a great alternative to prescription finasteride (which can come with unwanted side effects) and toxic creams and over the counter medications.

I love plum blossom therapy, it’s gentle and effective for hair loss (more details). It involves using a tiny hammer with light pressure just until slight redness appears. This stimulates circulation to the scalp which helps to reawaken hair follicles and encourage hair growth. DHT, the compound responsible for hair loss, is only formed in low oxygen environments, so by increasing circulation with plum blossom therapy, the concentration of DHT is reduced. Studies have shown an 80% success rate for androgenic alopecia % and a 97% effectiveness rate for alopecia aureata in all genders.

Plum blossom therapy can be used both for scalp hair loss and also for encouraging facial hair growth. It can even be used for reducing scars, wrinkles, pores, visible blood vessels, and can increase collagen and skin softness (for facial feminization therapy).

In combination with herbal formulas, this technique can create significant hair restoration. Find out more about herbal formulas for hair loss here.


All information in this blog is for educational uses only. Always consult your doctor before taking any herbs or supplements, or changing or discontinuing your medications.


Contact us to see if your insurance covers services at our office!

Join the Prism Family! Subscribe to our newsletter and get $30 off your first visit.

For more herbal estrogens, ideas, and resources see my previous posts: Feminizing Herbs and “The Basics.”

Acupuncture, Endometriosis, Fertility and Pregnancy, For Providers, Menopause and Beyond, Prism Blog, Surgical Recovery, Transgender Wellness

Treating Post-Surgical Constipation

photo credit: Practical Cures on flickr CC

Constipation is extremely common post-surgery, especially in combination with constipating pain killers, less physical activity, and irregular fluid and food intake. Often a bowel movement is required before a hospital will let a patient go home, so encouraging this process is especially beneficial to get you home sooner.

Acupuncture

Acupuncture is extremely useful for alleviating postoperative constipation. Studies have shown that patients receiving regular acupuncture post-surgery actually perform better (have more frequent, easier,  less painful, more complete bowel movements) than those taking laxatives or stool softeners.

Points on your arms, legs, and abdomen are most frequently chosen for this purpose, especially points on either side of your navel and points on the stomach and large intestine ‘meridians’ (lines along the body in Chinese Medicine, sort of like dermatomes).

Acupressure

Several of these points can also be used at home as acupressure points for constipation. Press each point lightly (no more than an inch deep for abdominal points, about the pressure of holding hands for arm and leg points) for about 30 seconds at a time:

Massage

Belly massage is also helpful. You can find a Chi-Nei-Tsang practitioner near you, or watch this video demo to perform a similar belly massage yourself. You can also refer to the illustrated steps available here. There are many methods of breathing exercises for constipation as well that massage your belly from the inside!

Herbs

Acupuncture can be complemented with some herbs that stimulate bowel motility like:

Nutrition

Hydration is key. Drink plenty of water and incorporate more warm foods and beverages to wake up your digestive system gently. Try ginger tea, hot water with lemon, and bone broth. If you urinate more frequently than every 2 hours you may be drinking too much or too fast. If you urinate less frequently than every 5 hours you are dehydrated!

Eat warm, easy-to-digest foods like rice porridge, oatmeal, and mashed sweet potato or yams. When you’re ready, try lamb or vegetable and mushroom soup. Give your family and friends recipes to make for you during your recovery, such as: Magical Mineral Broth, Congee, and Almond flour ginger cookies.


All information in this blog is for educational uses only. Always consult your doctor before taking any herbs or supplements, or changing or discontinuing your medications.


Contact us to see if your insurance covers services at our office!

Join the Prism Family! Subscribe to our newsletter and get $30 off your first visit.

For more herbal estrogens, ideas, and resources see my previous posts: Feminizing Herbs and “The Basics.”


Further study:

  Acupuncture at ST25 and BL25   Acupuncture at LI11 and ST37   Acupuncture at ST25, BL25, LI11 and ST37   Medicine:oral use of mosapride citrate: 4-week oral use, 5mg, three times daily 0.5 hour before meal   Total
SBMs [1]
[units: times per week]
Mean (Standard Deviation)
  2.7  (1.9)   2.5  (1.7)   2.9  (2.0)   2.9  (2.8)   2.8  (2.1)
Bristol scale [2]
[units: units on a scale]
Mean (Standard Deviation)
  2.8  (1.3)   2.9  (1.4)   3.0  (1.5)   2.7  (1.4)   2.9  (1.8)
Degree of straining during defecation [3]
[units: participants]
0   5   8   9   5   27
1   63   60   68   59   250
2   68   69   58   72   267
3   30   35   28   31   124
no defecation   2   0   2   3   7

 

Acupuncture, Endometriosis, Fertility and Pregnancy, For Providers, Menopause and Beyond, Neuropathy, Prism Blog, Scar Reduction, Surgical Recovery, Transgender Wellness

Acupuncture for Scar Treatment

Why Should We Treat Scars?
Scars may not only be cosmetically undesirable, but may also have an impact on the health of the individual. This is especially true for very large scars; scars with abnormal coloration, lumpiness, numbness, tingling, itchiness, heat or cold sensations, achiness or pain, tenderness to touch, and muscle restriction.
Such scars and associated adhesions can indicate or lead to nerve and blood vessel damage, decreased range of motion and muscle strength, increased likelihood of future injury, and chronic pain (especially pins and needles, tingling, and numbness). Scars are especially notable on the torso, where underlying adhesions can impair bowel function, chronic pelvic pain or infertility, depending on the site of the scar.
In Chinese medicine, significant scars are considered to block the flow of the meridians, (similar to the nerve and blood vessel damage pointed to by Western medicine) causing not only pain and decreased circulation, but also potentially impaired internal organ function depending on the meridian affected.

Scar Treatment with Acupuncture and Herbs
Scars that are at least two weeks old can be treated with acupuncture and herbal medicine.
A 2014 study used local acupuncture (“surrounding the dragon“: using needles directly around and through the scar) with distal points (4 gates and ST36). After eight treatments in 5 weeks the scar pain had reduced from a 7/10 to a 1-2/10. Such treatments can not only reduce scar pain, but also help to break up scar tissue and adhesions, increase local circulation, and aid healing. This leads to flatter, smaller, less noticeable scars and a reduction of keloiding.
Moxibustion (a gentle warming treatment achieved by burning dried mugwort), may also be used. Small amounts of moxa may be burned directly on the skin -with a sesame oil cream as a medium to prevent burns- around the scar, or a stick of rolled moxa may be burned above the site to warm the area. Both methods are pleasant and effective.
Topical herbs can also be very beneficial for scar healing. It is generally best to apply your liniment of choice over the affected area before bed and cover with a tshirt (or other clean soft article of clothing depending on the site of the scar), so that it has plenty of time to soak in without washing or sweating which would interfere with product absorption during the day.

Which Topical Should You Choose?
  • Prism’s Scar Oil has frankincense and other essential oils that break up scar tissue in a tamanu oil base, a great oil for reducing the appearance of scars, including keloids.
  • Zheng Gu Shui is beneficial for deep scars that may have adhesions to underlying tissues (for example surgical scars). They can improve local circulation, healing of the scar and the area that was injured, and reduce associated pain. It is better for healing and restoring health to the area than for cosmetic scar reduction.
  • Wan Hua Oil prevents scarring, increases blood circulation, reduces swelling, and helps regenerate damaged tissues. Once the wound closes, massage the oil directly over the scar daily to prevent scarring and promote healing. This option is best to prevent cosmetic scars from surgery. It is also effective for scars from burns.
  • Aloe aids scar healing and reduces infection and swelling. If used during the healing process it can reduce the formation of scars. Be sure to use 100% aloe (fresh is best), not aloe with alcohol or other additives that can dry and irritate the area.
  • Ching Wan Hung oil promotes healing and new tissue growth, reduces scarring, and prevents infection. It is especially effective for scars from burns.
  • You can also use castor oil compresses, to break up deeper scar tissue and adhesions, but I don’t recommend this for new scars that are still healing (or any open wounds).

Note: Many people recommend the usage of Vitamin E on scars, but newer research shows that Vitamin E does not help reduce the appearance of scars, and in the case of surgical scars can actually make scars more visible due to the development of irritation or contact dermatitis.


Providers: read more about acupuncture scar treatments from Skya Abbate, DOM.

Additionally, my colleague, Dena Gold LAc, suggests a Japanese style version of surrounding the dragon that involved needling slightly outside the scar, towards and under under the scar superficially enough that the needle falls rather than roots. Dena also suggests checking the fire points of the channel the scar intersects and if they are tender, needle the metal and water points of that channel before treating the scar directly.


All information in this blog is for educational uses only. Always consult your doctor before taking any herbs or supplements, or changing or discontinuing your medications.


Contact us to see if your insurance covers services at our office!

Join the Prism Family! Subscribe to our newsletter and get $30 off your first visit.

For more herbal estrogens, ideas, and resources see my previous posts: Feminizing Herbs and “The Basics.”

 

Acupuncture, For Providers, Press, Prism Blog, Transgender Wellness

Article Published in CJOM: Making Clinics Trans-Inclusive

I’m so honored to have had my article (First Steps Towards Making Your Clinic Trans-Inclusive) recently published in the California Journal of Oriental Medicine (CJOM), a semiannual peer-reviewed publication of the California State Oriental Medical Association (CSOMA). My hope is that this article will help other practitioners to start making their clinics more trans, queer, and gender spectrum inclusive.

To read the full article, subscribe to CJOM, pick up a copy at your local Acupuncture College, or view in PDF: Page One and Page Two.


All information in this blog is for educational uses only. Always consult your doctor before taking any herbs or supplements, or changing or discontinuing your medications.


Contact us to see if your insurance covers services at our office!

Join the Prism Family! Subscribe to our newsletter and get $30 off your first visit.

 

Acupuncture, For Providers, Prism Blog, Transgender Wellness

Yin and Yang; Masculine and Feminine

 

“Instead of saying that all gender is this or all gender is that, let’s recognize that the word gender has scores of meanings built into it. It’s an amalgamation of bodies, identities, and life experiences, subconscious urges, sensations, and behaviours, some of which develop organically, and others which are shaped by language and culture. Instead of saying that gender is any one single thing, let’s start describing it as a holistic experience.” –Kate Bornstein & S. Bear Bergman (Gender Outlaws)

Most diagnoses in Chinese medicine, represent the interaction between hot and cold, day and night, yin and yang, masculine and feminine. However, Chinese medicine’s outlook on these dualities is actually much more inclusive of LGBTQ identities when you look beyond this basic binary.

Yin and yang, though often associated with male and female, are more accurately represented by masculine and feminine. Masculinity and femininity are indeed seen as opposites, but they are also in a constant state of transformation from one into the other, and at each stage yang contains yin and yin contains yang.

Basic Principles of Yin & Yang/Masculinity and Femininity:

1. Masculinity and Femininity are opposites

2. Masculinity and Femininity are interdependent: There is always masculinity within Femininity and femininity within Masculinity

3. Masculinity and Femininity are mutually consuming and in a constant state of transformation of one into the other

In this way, masculinity and femininity cannot exist without both opposing each other and containing a piece of the other. Most people in discussing yin and yang theory today, and even most Chinese Medicine practitioners, only focus on the first principle, which alone can be used to reinforce our culture’s thinking of gender as binary. However, traditionally this medicine was much more inclusive of gender variations and spectrums!

Further Sources:
genderevolve.blogspot.com
acupuncturetoday.com


All information in this blog is for educational uses only. Always consult your doctor before taking any herbs or supplements, or changing or discontinuing your medications.


Contact us to see if your insurance covers services at our office!

Join the Prism Family! Subscribe to our newsletter and get $30 off your first visit.

 

For Providers, Prism Blog, Transgender Wellness

3 Ways for Healthcare Providers to Respect Diversity

  • Avoid making harmful assumptions about your patient. Whether you’re assuming they’re straight, cisgender, uneducated, dealing with addiction, or any number of things, any time you’re assuming rather than asking and listening to your patient you aren’t giving them the care they deserve. (For example, don’t ask a patient about her boyfriend when she hasn’t told you her sexuality or relationship status. In fact, personal questions like this are really only relevant if your patient brings them up first.)
  • Listen to your patient’s primary symptom and make sure to address it, regardless of other things you’ve learned (or assumed) about their health during the interview. Regardless of drug use, body size, relationship style, gender identity, mental illness, or any other issue, your patient won’t come back if you treat what you’ve decided is most pertinent to their health rather than what’s most important to them. This may seem obvious, but these kind of mistakes happen a lot. (For example, don’t treat a patient for weight loss who has come to see you for headaches!)
  • First and foremost we are here for our patients’ health and well-being. Never ask a patient about changing their lifestyle or identity. Furthermore, make sure you are not using up their valuable appointment time by trying to educate yourself. Look things up online on your own time if you need to learn more and save appointment time for your patient.
  • Provide gender neutral bathrooms. 
    • Who can benefit from gender neutral bathrooms? Parents with children of a different gender, people with an attendant of a different gender, trans* people, and individuals with non-normative gender presentations.
    • Why are gender neutral bathrooms important for trans* people? When a bathroom is gender neutral, trans* people can use it without risking harassment or violence from people who think they are in the “wrong” restroom. Access to gender neutral bathrooms also prevents UTIs and other health issues caused by “holding it” until a safer restroom is available.

All information in this blog is for educational uses only. Always consult your doctor before taking any herbs or supplements, or changing or discontinuing your medications.


Contact us to see if your insurance covers services at our office!

Join the Prism Family! Subscribe to our newsletter and get $30 off your first visit.

 

For Providers, Prism Blog, Transgender Wellness

How to Ask About Gender Pronouns for Healthcare Providers

  1. When asking about gender or pronouns, consider your intentions. Do you need to know a patient’s gender/sex-related medical history for your treatment? Or do you just need to know their preferred name and pronouns to develop practitioner-patient rapport? Knowing what your goals are will help you decide what and how to ask. Remember, curiosity is never an appropriate reason to ask personal questions of your patient.
  2.  Ideas for asking about gender or preferred pronouns include the following: “Which pronouns would you like me to use for you?” or “How would you like me to refer to you?” (This one is great if you’re not sure if you need to ask about pronouns. Patients can respond simply with “I go by Katie, not Katherine,” or, “Please call me Mrs. Smith.” Other patients may take this opportunity to share preferred pronouns or other information with you). Another good option is, “I like to ask all my patients which pronouns they prefer. Would you mind telling me yours?” Patients may feel more comfortable responding if they know you’re not singling them out.
  3. How do we know when we should ask patients questions about their identities? If you are just curious, don’t ask. There are many website available for you to educate yourself. Use patient time only to gather information relevant to their health concerns and goals. It is appropriate to ask how a patient would like you to refer to them, and what hormones they are taking because you need to know how to refer to them and medications may affect what herbs you prescribe. Though more sensitive, it can also be relevant to ask what your patient’s plans are for transitioning (or not transitioning) so that you can best support their goals.
  4. What’s the basic difference between gender and sex? Take a look at the “genderbread person” to learn the basic difference between sex and gender. As a generalization, gender is is your head; it’s how you identify. Sex is what the doctor decides you are when you’re born, based on your genitals at birth.
  5. The hardest part: Both gender and sex are social constructs! Your sex is decided based on your genitals at birth, which do not necessarily match with your chromosomes, what internal reproductive organs you have, what sex hormones or secondary sexual characteristics you will have, or even what your genitals will look like later in life. Most people like to think of sex as black and white (male, female, and nothing else), but this simply doesn’t match up with reality.

All information in this blog is for educational uses only. Always consult your doctor before taking any herbs or supplements, or changing or discontinuing your medications.


Contact us to see if your insurance covers services at our office!

Join the Prism Family! Subscribe to our newsletter and get $30 off your first visit.