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Trans-Care

About the Author:


Jacoby Ballard is a white working class transman living in Brooklyn. He
is a yoga teacher and herbalist practicing out of Third Root Community
Health Center, which he helped to found in 2008. Third Root is a
worker-owned cooperative offering acupuncture, energy work,

Surgery Zine
massage, herbal medicine, yoga, and health education at sliding scale
prices. See www.thirdroot.org for more information.

Jacoby came out as trans when he entered herb school at the Northeast
School of Botanical Medicine, so his herbal work has always been
Written February 2006, revised Spring 2011 connected to his community and identity. Jacoby is also an Advanced
Yoga Teacher, having received his 200-hour training at Kashi Ashram in
Atlanta and his 500-hour training at Kripalu in Massachusetts and
By Jacoby Ballard teaches 3 weekly Queer and Trans Yoga classes. Jacoby has been part of
social justice work for the past 12 years, as is particularly grateful for
the work of CISPES in training him as an organizer and fundraiser.
Jacoby is on the Trans Community Advisory Board of Callen-Lorde
Community Health Center, is a provider in the Rock Dove Collective’s
Network, and a contributor to the Brown Boi Project’s Health
Curriculum to be released in August of 2011. Jacoby was part of the
Healing Practice Space at the 2010 US Social Forum, and continues to
participate in and grow the network of health justice in the U.S. Jacoby
teaches about holistic transhealth at conferences and herb schools
around the country.

Jacoby originally wrote this zine in 2006, when his dear friend was
getting surgery, and he used the protocol in his own surgery prep and
recovery. He hopes this work can help in the wellness and vitality of all
the beautiful and brave genderqueer, gender non-conforming, two-
spirit, transgender, transsexual, and intersex people.
Thank you to: Dori Midnight, a co-founder of the Transnatural listserv Preparing your body well before surgery, following with a good post-op
for choosing to work together on transhealth and being a terrific ally; program makes an enormous difference in accelerating your recovery.
Larken Bunce at the Vermont Center for Integrated Herbalism for your Your body has the power to heal itself, but its vital recuperative forces
wisdom and support; 7song for the ways in which you push and need extra nutritive help after surgery to do it; a speedy recovery calls
support your many students; Lauren Giambrone of Rock Dove for your for more concentrated nutrients than a normal diet provides. You are
continued interest and solidarity; Karen Rose of Sacred Vibes your own healer. You need the discipline, the commitment, the
Apothecary for all of the ways you support my work and how we grow intention to heal and be well.
the herbal community that we want through our Herbal Education
Program at Third Root; Angela Ueckerman at Third Root for your Depending on what kind of surgery you have, your body’s health pre-
wisdom at essential oils that informs the reprinting of this zine; B.Cole surgery, your body’s healing process, and how you care for your body
of Brown Boi Project for your amazing work in putting together the before and after, your body will heal on its own unique, fabulous
Brown Boi Health Curriculum; and all of my dear clients, for your trust timeline.
and commitment. And much gratitude to my beloved Lezlie Frye, for
growing together a vision of love and trust within relationship and How to use and respect Herbs:
justice, for all of your work, your inspiration, and your incredible Please know that these herbs are a gift from the earth and the people
presence. who have worked with them, harvested them, and researched them for
countless generations. These herbs benefit your body, and must be
taken seriously. If you are not going to use them, don’t purchase them-
this is a waste of the earth’s offer to heal you and a waste of your
resources. Herbs have profound effects and you must follow the dosage
guidelines outlined with each herb. Each herb is a different plant with
different properties and potencies. Some herbs do better as teas, others
as tinctures. Please follow the recommendations offered in these pages
or the herbs may give you a talking to.

Do NOT use herbs outlined for sleep or pain WITH medications


prescribed for the same reason. They do the same thing and can
make the side effects more drastic (and painful).

Telling your doctors about using herbs


As you may know, there is a profound disconnect between holistic and
allopathic (Western medicine) treatments, and medical providers
receive little to no training on herbs and supplements. As herbalists
who work without licenses, it is our job and necessity to know herb-
drug interactions and educate our clients about it. Our profession
depends on our knowledge of medical practices, given our limited
legitimacy within the power structure of US healthcare, while nurses,
doctors, and surgeons generally have no desire to know about our work food and herbs could help soothe my stomach. Some people have a
as herbalists. It would greatly benefit these providers to know about lower tolerance of pain and so the pain meds can be really helpful. Use
holistic health, since 80% of the world depends on herbs as their them if you need to, no shame! But also know that once your pain has
primary form of medicine, but the chasm between medicine and holistic lessened, but is still present and burdensome, there are herbs that can
healing has been growing vastly for the last 150 years. help you.

If you choose to tell your surgeon about the herbs and supplements and Furthermore, as you will be on pharmaceuticals, it is useful to nourish
diet that you are using to prepare for surgery, they may advise against and flush your liver, which is the organ that processes the drugs. That is
the use of all herbs without any knowledge of them and their properties included in the post-op protocol.
and how they interact with the pharmaceuticals. I had one client tell his
doctors about the herbs he was taking, and the doctors proclaimed that
all herbs are blood-thinners and that he must cease taking them
immediately or he would need a revision for his surgery. This is
baloney, an uninformed scare tactic to cover their own asses. Please
assess whether you will be able to weather this from your doctors AND
take care of your body in your pre-op protocol, or whether you want to
not tell your doctor about the herbs and consult those who have herbal
knowledge.

It is my job to have researched the interactions between drugs, surgery,


and the herbs that I give you, and this entire zine is a thorough
explanation of my careful research over the past 7 years.

If you have questions, please ask a local herbalist or get in touch with
me, rather than researching on the internet, as clinical herbalists and
naturopaths have more information and considerations to offer than
the internet and can tailor our recommendations to your particular
needs and body.

The Drugs the Surgeon Gives You


Generally, the surgeon will prescribe that you take an antibiotic, pain
medication, medication for nausea, and sleep medication. The
prescriptions won’t necessarily say what they are for, so be sure to ask.
They can be very expensive, and truth be told, you may not need all of
them.

In my own surgery, I didn’t use the sleeping pill at all, and this varies on
the individual. If you generally have troubles sleeping, you may want
the medication, or you can try a tincture or tea for sleep, listed in the
following pages. I also didn’t need the nausea medication prescribed
after surgery (I was required to take one before surgery) and knew that
.sweat pants. Immediately after surgery you might be too swollen to fit
into the jeans that you wore that morning! Have something loose
around to wear at first.
Pre-Op Protocol: .More helpful Hints.
Holistic medicine approach emphasizes strengthening your body’s ability ~avoid high-reching stretching, or movements that can pull/rip your
to heal. A lot of the following herbs and supplements are generally stitches. Before you go for surgery, get everything down that is up hight
making your body stronger, giving it more vitamins and nutrients so that that you might need for the next two months: cereal bowls, plates, toilet
when you go under the stress of surgery, your body has a solid and paper, towels, clothes, etc. Two weeks before your surgery, start
healthy foundation from which to recover. For this reason, immune considering everything you use and bring it down to below shoulder-
system-enhancing herbs and supplements are helpful, so that most of height.
what is within your body is nutrient-rich. ~for surgeries in warmer weather: ask your surgeon to order you two
vests/binders for after surgery (yes, sad truth, you have to wear a
You can find most of these supplements and herbs in natural food stores. binder for another 3 weeks after surgery with most surgeons) so that as
As many people are not familiar with these supplements, I explain dosage one gets dirty you have a clean one to swap in.
and how to take them. The list of what you COULD take is long, and you ~if you have a skin reaction to the vest/binder, wear an undershirt
do not need to take everything. These are all just helpers for your body, beneath the vest.
and your body will be grateful for however many or however few you
provide. For friends to keep in mind while supporting you:
-lots of love and affirmation!
The herbs and supplements mentioned will help in wound closure, in -let the healing one talk about their fears freely
improving immunity, reducing inflammation, preventing infections and in -be available for post-surgery fashion planning
many other processes that play a vital role in the recovering process. -help do something meaningful to mark the end of one way of being in a
body and the beginning of another
Supplies for the process that aren’t herbs, supplements, or food -send a good luck kit with things for the healing one to do-crosswords,
.button down shirts. Because you won’t really have the range of Sudoku, snacks, weird toys, magazines
motion to lift your arms and slide into/out of tshirts -offer to go over the paperwork from the surgeon so that Team Healing
.bendable straws. For drinking water or juices during limited motion can ask the right questions when you get to the surgeon’s office
and healing. -have ALL the details worked out before getting to the surgery city
.wet naps. Helpful in the bathroom since the range of motion is limited (transportation, food, lodging, etc)
and because you can’t bathe/shower until your drains come out. -offer big hugs (cuz it may be a while before you can get tight, close
.movies and dvds. For entertainment during many hours at home hugs again!)
during healing. Stock up ahead of time! -offer to go to the consultation with the surgeon or the surgery itself
.loofah with a long handle. Reaching your shoulders, upper arms, and
back is painful for a while after surgery and also it can stretch or rip
your stitches. This can make your bathing easier.
.slip-on shoes. Makes the first couple of days after surgery easier.
Loafers, flip-flops, something you don’t have to bend over for. Don’t
bend over for several days after surgery as it puts pressure on your new
parts and can cause hemorrhaging, breaking of stitches, tears, etc. Stoop
by bending your knees, and keeping your back straight.
Pre-Surgery Protocol .Quercitin.
For the 2 weeks leading up to surgery Dose: 250 mg/day
Supplements: What is it: plant-derived flavonoid found in fruits, vegetables, leaves,
.bromelain. and grains with anti-oxidant and anti-inflammatory properties
Dose: 750 mg per day on an empty stomach What for: to reduce inflammation
What is it: an anti-inflammatory
What for: to reduce inflammation, helping your body not to puff up Herbs:
during and after surgery
.Arnica Montana.
Dose: homeopathic tablets, 200ck dosage-5 tablets the day before; 30c
.chlorella.
dosage the week leading up to and 2 weeks following surgery
Dose: 15 tablets per day
What is it: an herb from the Rockies that dispels the distress of
What is it: a green algae that provides high-grade protein, B-complex
accidents and injury and helps to speed recovery.
vitamins, and oxygen.
What for: reduces swelling after surgery
What for: B vitamins allow your body to handle stress a little easier.
Protein is important because anaesthesia can reduce your body’s ability
.Gotu kola.
to absorb protein, so your body simply needs more.
Dose: as a tea, 1 tsp per cup of hot water
What is it: herb known for benefitting the nervous system
.coenzyme Q10 (CoQ10):
What for: to accelerate the repair of nerve tissue damage and help
Dose: 120 mg daily
develop collagen
What is it: a huge antioxidant, destroying ‘free radicals’ in your body.
What for: CoQ10 is a substance necessary for the production of ATP, the
.Anti Oxidant Tea: elder, juniper, goji berries and rosehips.
main molecule that powers our cells, and enhances immune system
Dose: grind berries in coffee grinder, then simmer 2 tsp in 2 cups water
function.
for 20-40 minutes
What is it: all these berries are known for their vitamin C and anti
.Vitamin K. :
oxidant properties
Dose: daily food sources of leafy greens, alfalfa sprouts, molasses, or
What for: to create the most healthy environment within your pre-
probiotics
surgery body as possible!
What is it: a vitamin that aids in blood clotting
What for: so that the incision site can heal
.Meadowsweet tincture.
Dose: one dropperful once a day in the week leading up to surgery
.Probiotics.
What is it: an herb that was used to develop Aspirin; it has profound
Dose: 2 capsules/morning, 20 minutes before you eat. When you start
anti-inflammatory properties and is often used for pain relief.
your antibiotics, still continue the probiotics, just take 3 hours apart.
What for: to reduce the inflammation that is bound to happen as a
What is it: naturally-occuring bacteria in your digestive tract that
result of your surgery
benefits your immunity
What for: to ensure that your digestive and immune system are in tip-
top shape!
.Vitamin Tea. Nettles, Alfalfa, Peppermint, Red Clover, Calendula
Dose: 2 tsp per 2 cups hot water, let steep 20-40 minutes
Post-Op Protocol
What is it: Nettles, red clover, and alfalfa have tons of vitamins and
minerals. Calendula is great for nourishing and replenishing the skin For friends to keep in mind supporting you post-
What for: to strengthen the body before and after surgery surgery:
-be reassuring that body functions are human and ok and that its ok to
Foods: be in pain and whine a bunch
.Bioflavanoid foods. -make sure you do a lot of things for the healing one: tie their shoes,
Why: as part of the Vitamin C complex, bioflavonoids are particularly open doors, feed them, get them water, help them up and down from
helpful in preparing for surgery. They prevent arteries from hardening the toilet, wash their hair, place pillow supportively, etc.
and enhance the strength of blood vessels, capillaries, and vein -movies! Movies! Movies!
strength. They protect connective tissue integrity, control bruising, and -be really diligent about writing down when the healing one took their
internal bleeding. Bioflavanoids are anti-microbial agains infections and pills and supplements, when their drains were changed, and what levels
inflammation. of drainage they were at
What foods have them?: strawberries, blueberries, cherries, turmeric, -be extra loving!
ginger, alfalfa sprouts, the white part of citrus fruits -go to the doctor with the healing one-they need support!

.fermented foods. Rest


Why: all fermented foods are fermented by the same positive bacteria
Don’t jump back into life as normal. Life will never be the same for you
that is helpful to your body-acidophilus and bifidus. Make sure when
after this experience, and its important that you sit back and absorb this
you purchase the fermented foods listed that they are not pasteurized-if
huge shift. Recognize the stress you have been through and avoid other
they are, they would be on a shelf-unpasteurized you would find in the
stress-producing events. Eat with attention and care. Take time to
refrigerators.
breathe, to notice things. Feel textures, smell aromas, enjoy colors. Go
What foods have them: yogurt, miso, tempeh, kefir, sauerkraut,
SLOWLY. Keep your priorities very clear, the first of which is your total
kombucha, kim chi
healing. Wellness is a choice and a process.
**Do not consume blood thinners like garlic or gingko for 3 days
Allow friends and loved ones to take care of you, to reach for things that
before surgery! You want your blood to clot!**
are tough to get to, to run to the store, do your laundry, cook your food,
wash your hair.
Food What do these herbs do? arnica will reduce swelling and bruising,
Generally, make sure that your diet supports your immune system: low in provide pain relief, and rapid healing.
sugars and caffeine and rich in beta carotene. Make sure you have a lot of
food that is easy to access and will fill up your stomach. .arnica, comfrey and cypress oil.
.mixed vegi broth. For potassium. Dose and application: rub on site of wounds 2x/day after scabs have
.green salad. Daily for all of their many accessible nutrients. formed.
.protein drink. Daily protein helps the body rebuild. Use hemp or whey What do these herbs do? Cypress has anti-fungal, anti-septic (cleans
protein, found in a healthfood store and mix it into juice or smoothies. wounds), and antibiotic actions. Arnica reduces swelling and bruising.
.sushi and sea vegetables. Eat daily for their Vitamin B12 and to Comfrey is used for healing bones, tendons, ligaments, and cartilage,
enhance new cell growth and can help in surgery recovery for healing deep bruises on the bones.
.yogurt, nuts, bananas. Easy to eat and provides lots of energy! *arnica and cypress oil can be found in most health food stores, but
.fermented foods. (see pre-surgery section) for probiotics cypress is more rare. You can add 5-10 drops of cypress essential oil to
.water. make sure to drink TONS of water: 64-96 ounces. It will help the bottle of arnica if a cypress in olive oil is more difficult to find.
flush the anesthesia out of your system and will speed up your post-
surgery recovery. Sleep Tea
.california poppy, passion flower, oatstraw, and chamomile. Equal
parts in mixture.
Supplements Dose: 1 tsp mixed tea steeped in 1 cup hot water for 20 minutes before
.bromelain. 1500 mg (higher than pre-surgery)
bed.
.quercitin. 500 mg (also higher)
What do these herbs do? California Poppy helps to relieve pain as well
.evening primrose oil or flax seed oil.
as help you sleep; Oatstraw nourishes your nervous system to do what
Dose: 1-2 tsp
it does well; Passion Flower is a sedative and nervine; chamomile helps
What is it: cold-pressed volatile oils that are rich in Omega Fatty acids
you rest and also calms an anxious stomach.
What for: To rebuild and nourish delicate post-op skin.
*Do not use at same time as sleep medications like Ambien*

Herbs Pain Tincture


For this section, I offer formulas for those less familiar with herbs. You can .white willow, Jamaican dogwood, and meadowsweet.
put together these mixtures at a natural food store, or contact an Dose: 1 dropperful hourly if needed up to 3 times per day, less often if
herbalist near you for their assistance. not, not to exceed 6 days in use.
What do these herbs do? White willow and meadowsweet both have
Preventing Infection: salicylic acid, which is what Aspirin is made of, and that reduces pain
.Yarrow and Goldenseal tincture. and inflammation. Meadowsweet soothes the stomach and can relieve
Dose and preparation: this is to be used only for one week after surgery. nausea, making it especially appealing for tender post-surgery bellies.
Get one oz. of goldenseal and one oz. of yarrow tincture, mix together in Jamaican dogwood is pain-relieving, anti-spasmodic, and nourishes the
larger bottle. Take 1 dropperful 2x/day. You may also use this tincture nervous system.
directly on the wound to clean it and prevent infection.
What do these herbs do? Yarrow is wound-cleaning and antibiotic, and Nausea Tea
goldenseal is a strong antibiotic and anti-inflammatory. .Peppermint Leaf and Ginger.
Dose and preparation: use fresh or powdered ginger. ¼ tsp ginger to ¾
For Wounds and Bruises: tsp peppermint. Pour hot water over top tea and let sit 20 minutes.
.arnica tablets. Strain and drink.
Dose: Homeopathic tablets at 30c dosage. 5 tablets/day.
What do these herbs do? A surgery can be discombobulating, and What for: comfrey helps the bones and cartilage of your ribs heal from
nausea can result. Both herbs are great for digestion and soothing a the constriction of binding. Arnica helps with pain, bruising, and
nervous stomach. swelling. Cayenne helps with pain, and Eucalyptus helps open up the
longs and create more expansiveness in the chest.
Scarring and Nerve Damage Oil
.Gotu Kola, St. John’s Wort, Copaiba.
Dose and Preparation: St. Johns Wort oil is easy to find. Add 5-10 drops
Copaiba essential oil. Gotu Kola oil can be prepared by an herbalist or
by steeping the herb in oil in the sun for 1 month prior to surgery. Rub
oil site daily after scabs have healed and fallen off.
What do these herbs do? Gotu kola and Copaiba help reduce scarring
and break down scar tissue. St. Johns Wort oil helps nerves ‘find
themselves’ again-bringing back sensation.

Cleansing the liver after anesthesia and pharmaceuticals


.burdock, yellowdock, dandelion, reishi, turmeric and milk thistle
tincture.
Dose and preparation: Use as a tincture, made up of equal parts of each
herb and take 2 droppersful daily. You can take a tincture in tea or
water.
What do these herbs do? Burdock, yellowdock, and dandelion cleanse
the liver; reishi and milk thistle are both liver protective and help
restore a damaged liver; turmeric acts on the liver and works to reduce
inflammation.

Recovery from Binding


Binding can have significant effects on the ribs, the intercostal muscles,
and the lungs. If you had surgery after years of binding, it could be
important to support your body in healing from binding, as well as from
the trauma of surgery.

Supporting the Lungs Tea: coltsfoot, mullein, lobelia (1/10 of formula-


use a small dose or it will make you vomit)
Dose: 1 Tbsp each of Mullein and Coltsfoot, and ½ tsp of Lobelia; pour 2
cups water over herbs, let sit 20-40 minutes, strain and drink.
What for: coltsfoot and mullein nourish the lungs; lobelia opens up the
bronchioles.

Supporting the ribs and muscles salve: comfrey, arnica, and cayenne
oils, eucalyptus essential oils.
Recommendations from clients:
“I'm a little under 4 weeks out, and things have been going really easily. Third Root’s Treasure Chest Surgery Kit available for purchase!
I've had almost no pain at all, things seem to be healing well, and even
in the first week I felt really with it and healthy. I absolutely credit so The kit was borne out of the zine, and uses most of the herbs discussed
much of that to your zine + surgery kit: so thank you for putting those in the zine, all compounded into ready-to-use formulas with easy-to-
resources out into the world!!” –Lex Horan, client, Minneapolis, MN follow directions.

“Using the oils from the surgery kit, six months out, continues to remind $40-50 plus shipping if you’re not local in Brooklyn
me that my body deserves care. In the hazy painful days after the
passive (though longed for!) experience of surgery using the teas and from jacoby@thirdroot.org or by calling 718-940-9343.
tinctures gave me ways to actively take hold of my own healing. My
partner and I used your phrase "the healing one" quite a bit - it felt like
a spiritual title and helped me remember to slow down and rest. The
pointers for friends and partners were extremely helpful!”
--client, Brooklyn, NY

“We read the zine over and over again. It was a lifeline of information
and gentle advice. I was grateful for the section included for caretakers,
as I have come to believe that the better supported caretakers are, the
better supported the healing ones will be.”
--client’s partner, Brooklyn, NY

“Jacoby Ballard has put together a really wonderful and much needed
resource for people undergoing top surgery. The zine especially is good
at providing useful information, creating a sense of community and
shared experience, and showcasing the talent of trans artists and
writers. As a therapist who works within trans communities, I've
started to recommend this kit to my clients.”
--Sand Chang, PhD, Licensed Psychologist, San Francisco and Berkeley,
CA