When Paul Toffoli talks about cooking, he talks about his childhood.
He recalls standing with his mother at the counter, where she taught him to peel potatoes, chop garlic, roll pasta, and stir polenta. He speaks of summers spent in Italy and traveling through Europe, vacations to Australian sheep farms, and a love of food that came from his family and settled deep in his soul.
The certified executive chef trained at the Culinary Institute of America and Le Cordon Bleu in France, and worked in restaurants in Chicago, New York City, and his native Michigan until five years ago, when he began to experience symptoms of psoriasis.
It took a full year before he was diagnosed with severe psoriatic arthritis."It began a downhill slope," Toffoli says. "It took over my life for a year. I felt like I wasn't a chef anymore."
Psoriatic arthritis affected Toffoli's work in his restaurant kitchen, but equally difficult was cooking at home.
As Toffoli says, "You don't have to do what I do, and I don't have to do what you do, but we all have to eat."
Getting a grip
Those living with psoriatic arthritis may experience swelling, stiffness, pain, and changes to their skin and nails that make tasks such as cutting food, grasping utensils, and opening jars difficult, says Teresa Jeardeau, an occupational therapist and certified hand therapist with Mayo Clinic.
But the right tools and modifications can help.
"We typically talk about adaptive equipment first," Jeardeau says. "We want to help people avoid tight pinching or grasping, so we advise them to look for larger-grip handles. Adaptive equipment used to only be available through medical supply stores; now it is so much more available in the real world."
For Kyran McCarthy, one of the small changes that has made cooking easier for him is a chef's glove, which holds food in place during chopping.
McCarthy, who is semi-retired and also works as a golf coach, has spent much of his life at the cutting board. He had written a cookbook to benefit a local men's shelter near his home in Fairport, New York, and volunteered there before his diagnosis about eight years ago. He learned he had moderate psoriatic arthritis, which was complicated by gout.
But by avoiding foods that cause flare-ups and incorporating healthy habits, McCarthy has been able to keep cooking, volunteering, writing, and catering for friends.
"A good cooking routine begins before you even walk in to the kitchen," McCarthy says. "It includes being active. Cooking is really part of the day — you sleep, you cook, you eat, you walk. The more you stay active, the more you can keep doing."
Small changes, big rewards
Hand exercises help McCarthy maintain hand and arm strength. He says he can now spend about an hour at a time doing food preparation, and he often chops fruits or vegetables in advance and seals them in airtight bags, refrigerating them for later use.
Toffoli, who now owns his own catering business, Catering by Paolo, on Hutchinson Island, Florida, made cutting easier by swapping his professional chef's knives for a $22 kitchen supply store brand with a different grip. He also recommends that those with psoriatic arthritis consider using anti-fatigue mats in the kitchen. The thick, black mats often used in restaurants and bars reduce stress on the knees and back, keeping both the professional and at-home cook comfortable in the kitchen.
That's important because cooking can provide more than just simple nourishment for those living with psoriatic arthritis, Toffoli says.
"No one wants to concede, especially those recipes they grew up with," he says. "Food is comfort. The smell of a roast, or chili, something that has been simmering all day, the right spices … we don't know how to make medication, but we can make food."
Use a kitchen stool at the counter instead of standing for extended periods of time.
Use different, larger joints to complete kitchen tasks. For example, use a sponge and a flat palm instead of a rag, which must be grasped, to wipe down countertops.
Try what occupational therapists call "adjusted movement patterns," such as holding a spoon like a dagger to reduce stress on small joints.
Slide heavy items across the counter instead of lifting them.
Seek out the right equipment, including food processors or countertop choppers, angled measuring cups (to help avoid the need to bend over), self-opening scissors, hands-free can and jar openers, and ergonomic knives. Brands such as OXO make many common kitchen tools with big grips. You can find OXO in large stores or online through sites such as Amazon.com.
By Kara Anderson for NPF