At a recent cooking demonstration in trendy Tribeca, I was fortunate to sample a tantalizing braised chicken dish with figs, lemon, zaatar and fennel (tough part of the job but someone’s gotta do it!) What astounded me more than this delectable culinary fare was the story behind the person who made it. Chef Michelle Bernstein, a Miami native of Jewish and Latin descent, has earned many accolades as an author, James Beard winner and guest judge on Top Chef. But what most people may not know about the celebrity chef is that a life-altering diagnosis could have ended her illustrious career. Bernstein is one of 830,000 Americans living with a chronic, inflammatory disease known as psoriatic arthritis (PsA). She recently partnered with Novartis’ PsAvor Life campaign to inspire others with PsA to live healthy and productive lives.
A Chef’s Jarring Introduction to an Inflammatory Illness
“I had never even heard of it,” Bernstein confessed when I asked about the start of her PsA journey. Her initial symptoms were joint pain and stiffness. “I’m a chef who’s standing 14 hours a day so I felt [joint pain] in my legs, but also in my elbows, wrists and shoulders.” The first clinical manifestation, however, can often be a benign-looking rash, as it was with Bernstein: “Years prior to any joint pain, I had a tiny rash on my leg which my dermatologist said was psoriasis, but I never thought much about it because it was so small. I had no idea it could cause arthritis. I couldn’t even walk anymore.”
Psoriatic arthritis resembles rheumatoid arthritis (RA) as far as joint pain and swelling but affects fewer joints than RA. PsA is also associated with psoriasis, a chronic skin and nail disease that causes red, scaly rashes and thick, pitted fingernails.
“Chef Michelle is in a job where her hands can be visible, especially if she’s cooking on a televised cooking show,” explains David S. Pisetsky, Professor of Medicine, Division of Rheumatology and Immunology at Duke University Medical Center. “Involvement of nails or red scaling skin could be as problematic as pain.”
Co-Existing as Patient and Chef
When she first received the diagnosis, Bernstein’s reaction was not exactly optimistic. “In my mind, I thought my career was done. I worked SO hard to get here, and the pain was so great. I was so limited in my movement.” But over time, the renowned chef made several adjustments at work and at home. In the kitchen, she uses smaller and lighter utensils like smaller knives. Bernstein also stopped using glass because of breakage: “I broke a lot of dishes because of joint pain and stiffness. I don’t like to be limited, especially when it comes to cooking. But I’ve become smarter.” Instead of glass, she uses rubber, plastic and silicone.
The culinary master has also learned to lean on others, personally and professionally. “I ask for help because I have to.” Bernstein talked about her beautiful cast-iron pots and pans which she only uses on special occasions when someone else can help carry them.
She’s also made changes at home. “I have difficulty playing hide and seek with my 12-year-old son because I can’t bend my knees. So, my husband has to play with him and he’s not as fun as I am!” Bernstein has also adopted more of an anti-inflammatory diet. Not only have these adjustments reduced her symptoms and improved her quality of life but they have NOT impaired her cooking. “I put in the same amount of love and passion, and even more flavor. I’ve taken away pro-inflammatory ingredients and added more things that I love like fennel and figs (I’m very seasonal with my ingredients). I’m more intentional with my cooking.”
Treatments for Psoriatic Arthritis
Bernstein urges people to get help. She is a firm believer in being your own self-advocate. As a physician, I remind patients all the time that treatment plans must be tailored to the individual. No two patients with lupus, diabetes or psoriatic arthritis are alike. The author and entrepreneur agreed. “Find a doctor you trust. Don’t stop until you find an answer.”
“The treatment of PsA has come a long way and there are now many effective options,” according to Dr. Pisetsky. “The correct diagnosis is key.”
Bernstein’s rheumatologist started her on secukinumab, i.e. Cosentyx, a monoclonal antibody that inhibits the inflammatory cytokine, interleukin-17. Other treatment options for PsA include medications such as NSAIDs, steroids and disease-modifying agents (such as Cosentyx); exercise; physical therapy and assistive devices; and surgery, although joint repair and replacement are rare in patients with PsA. Self-care is also key: healthy diet, tobacco cessation, skin moisturizers and stress reduction are helpful tools in managing psoriatic arthritis.
Advocate for Yourself!
Bernstein could not emphasize self-advocacy enough. “Fight for yourself. Be outspoken. Be honest with yourself. It took me a little while in the beginning, but I found my answer.” The professional caterer and owner of MBC has no shortage of supportive super-fans including fellow celebrity chef, Carla Hall.
“Michelle is not just a chef. She’s a culinary storyteller and, in my eyes, a cultural ambassador who weaves the vibrant flavors and rich cultures of Miami and Cuba into every dish she crafts.” The Food Network co-host continued to praise her friend: “Michelle’s heritage is evident in each plate, inviting diners to experience each city’s essence through her creations.”
Today, Michelle Bernstein leads a happy, healthy and productive life. Like anyone with a chronic illness, she acknowledges her limitations and has adjusted accordingly. She follows the guidance of her physicians and care team, practices self-care and asks for help. As a doctor who specializes in stress-related conditions including substance use, addiction, anxiety and sleep disorders, I wholeheartedly agree with Bernstein’s multidisciplinary and evidence-based approach. Connection is key – talk to others who have similar symptoms; find appropriate medical care; and lean on others to help out (there’s no shame in this). In the words of the delightful Chef Bernstein, YOU are your best advocate!
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