Pseudo Psoriasis Soup

Originally Written on February 26, 2020

My Grandma Mallie always preferred her nails cut short. I would breathe in the cherry almond scent of her Jergens lotion — listening to the clicks of her nail trimmer, and watching her intentional expression as she leaned over the bathroom counter. And as a young girl, I knew; I sensed she felt uneasy if her nails grew too long. I inherited that tendency; when I feel overwhelmed, and I crave order, control — a fresh start even — the first thing I do is trim my nails. And then I make soup.

I make it when loved ones are sick and I make it to keep warm on a winter’s night. But, mostly, I make it to nurture myself — feeling the satisfaction of gathering this and that, and melding it all into fragrant goodness that will sustain me for days to come.

I always start out like my mom taught me. When I feel the heat hit my hand as I tentatively hold it over the pot, I know it’s time to pour my swirls of olive oil, or perhaps a healthy dollop of coconut. When the oil is sizzling hot, I add a whole chopped onion and a spoonful of minced garlic. About now, our house smells like a home, and I practically salivate at what is to come. In goes the shredded carrot for color and a hit of sweetness, some squash or sweet potato if I have it, and some chopped asparagus to detoxify. Celery or leek may join in if they happen to be residing in the crisper drawer. In dump the beans, bulging with protein and minerals. After adding broth, water, a couple of handfuls of gluten-free noodles for the ultimate comfort, I throw in liberal amounts of kosher salt, ground pepper, parsley, lemongrass with its velvety smoothness, basil, a copious amount of anti-inflammatory turmeric, ginger for heat and its immune boosting powers, fresh-squeezed lemon, and spinach to top it off. After the greens wilt, I swirl them in, bring all the fervor down to a simmer, and wait patiently.

I often refer to it as my “magic soup” or, sometimes, “immunity soup.” Either way, now that I am plagued with a skin malady, I make a lot of soup. I need the healing, the immune system building, the comfort. Frankly, I could use some magic.

It was almost a year ago when I found myself in the ER trying to pass stubborn kidney stones. Soon after, I was summoned back to the hospital to investigate some suspect lesions on my liver; I breathed a sigh of relief when the cysts were deemed benign. A month later, I spied a small red bump on my leg. Always paranoid about melanoma, I was able to slink into a dermatologist appointment the very next day due to a last-minute cancellation. The doctor spent five minutes with me, and pointed out two more spots hiding out on the back of my leg. He proclaimed, that without a doubt, I had eczema. He suggested some rich lotions, and prescribed a steroid cream. I innocently stood in line at the pharmacy having no idea those 3 tiny spots would multiply in hoards. Kidneys, liver, and skin — the three detoxing organs were working overtime. My body was not just talking to me — it was shouting.

As spring transitioned into summer, I worsened. I lost confidence in the Kaiser dermatology department, and entrusted my care to a “chiropractic internist.” He laid electrodes on me, and claimed his machine could detect parasites, infection, determine which supplements I needed, and which current ones were not agreeing with me. He discarded the eczema theory, and diagnosed me with ringworm. Gross, but a quick fix, I thought. I doused myself in tea tree oil, slathered on his all-natural balms, and swallowed his homeopathic tincture. After I sucked down a second bottle, I made another appointment and showed him how the rash had spread further. This time, his cryptic machine did not detect the ringworm, and he said, “Looks like you’ve had a reaction to too much tea tree oil. I don’t know what this is; have you seen a dermatologist?” Basically, thank you for stopping by and pay on your way out.

I decide to again pay out-of-pocket and visit my parents’ trusted dermatologist. I share my frustration, and he says, “I hate to tell you this, but I think Kaiser was correct. This is eczema.” He uses a magnifier to point out to his shadowing student how he can tell from the scaling that this is indeed eczema, and not psoriasis. I’m relieved because I’ve googled enough to know psoriasis is an incurable autoimmune disease I do not want to have. He then proceeds to prescribe the exact same steroid cream, but this time it isn’t $5; I’m outside of my insurance, so it rings up at $300 a tube. He suggests I try UVB light treatments at $25 a pop, and a 20 minute drive from my house. He reminds me to do at least the full 15 rounds for the treatment to work. I’m desperate, and I betray my stance on sun worshipping. Ever since I endured a blistering burn in high school, I’ve made a point of protecting my skin with hats and spf. I’m told our upcoming tropical vacation is perfectly timed because the sunshine and saltwater will do the eczema good. I return from vacation and go beyond the 15 sessions, only to end up with permanent white sun spots — a lifelong reminder of my throwing caution to the wind.

So far, the ailment has stuck to the right side of my body — but as the air turns crisp and the leaves change color — the patches spread to my left side as well. For months, I have endured almost unbearable itchiness, but now it’s at fire ant level. Not only are both my upper legs and upper stomach covered, but so is half my lower back, and it feels like sandpaper. One shoulder is blistered — and to my horror, the affliction has hunkered down on the right side of my face. As someone who has never dealt with acne or any skin issues whatsoever, I’m astonished at my lack of vanity. I figure I don’t have as much “skin in the game” as the younger women who typically are diagnosed with eczema or psoriasis. I don’t need to slip into a prom dress, go on a first date, or wear a bikini. I’m just a middle-aged mom trying to find my way.

It’s surreal gazing at my reflection in the mirror. My body now reminds me of the topography maps I studied in junior high earth science class. This altered skin of mine exhibits rugged terrain with bumps and valleys, borders and contour lines. Healthy skin presses up against a crest of infection — a marriage of two linked jigsaw pieces — one flourishing, one feeble. I fear I’ve crossed into a new frontier of chronic illness; I focus on the streams of unaffected skin that infrequently flow throughout the diseased surfaces. These are my rivers of possibility, and I pray the current carries me back to wholeness.

I must keep digging. I turn to a functional medicine nurse practitioner and the excavation for medical clues begins in earnest. She believes I have psoriasis, and we search for the root cause. She gets to know me well, and schedules longer appointments to accommodate my endless questions. Among other things, test results determine I have leaky gut and my immune system is compromised. Already gluten-free and eating a clean diet, I learn I’m reacting negatively to dairy, nuts, fish, mushrooms, and eggs. I’m noticing that nightshades are affecting my sometimes arthritic hands so I also cut out tomatoes, potatoes, and peppers.

I’m hungry and feel deprived, and yet once I nail down how to even spell psoriasis — a condition I had never really heard of before this outbreak— I dive deep into research. I start noticing the plentiful psoriasis commercials on TV. I follow young Instagrammers battling the heartbreaking disease. I read books and follow the psoriasis diet. I guzzle gallons of lemon water, attend sessions three times a week for colonics and infrared saunas. I juice celery and blend heavy metal detox smoothies every day. I drink L-glutamine to heal the wimpy junctions in my gut. I sip a cup of congealed slippery elm tea in the morning, and saffron tea at night. Good thing we’re empty nesters because caring for myself is a full-time job.

I do make some progress; my lower back loses the gritty sandpaper texture, and I feel hopeful. But as soon as I have some clearing, the rash pops up in untouched areas like my arms and calves. I’m growing weary of this cruel game of whack-a-mole. My husband assures me that despite 250+ photos on my camera roll tracking my progress — I am not obsessing. He says, instead, I’m researching. He tells me I’m smart. I’m beautiful. I’m figuring this out. He says I’ll beat this — and that he’s proud of me. He’s a broken record month after month — and it’s music to my ears.

The holidays are upon us, and we find mold in our house that we thought was fully remediated years ago after a basement leak. We also unearth it in our shower under layers of tile. Mold illness destroyed my daughter’s immune system — so I wonder if mold could be the cause of the psoriasis. My functional medicine NP draws my blood for mold testing, and it comes back sky high. I have mold inside my body that needs to be detoxed out. Even so, it seems far-fetched to blame my rash on the much more mild amount of mold we found and remediated this time around. I decide to return to Kaiser and see a third dermatologist; I want a biopsy and I want to hear about more treatment options. So far, I have dug my heels in and refused to consider a biologic immune suppressant. It’s just not resonating with me that my body is attacking itself, and I need to suppress my immune system. I also don’t buy into the idea that stress is my trigger, and I’m unsuccessfully managing it.

Nine months have languidly passed since those first innocent bumps premiered. Finally, the doctor takes a sample to biopsy, but in the meantime she orders me a boatload of more steroid cream, and explains why a biologic would be a quick fix for me. I explain we have found mold in our house, and I’m wondering if it is responsible. She looks at me blankly as if I’ve delivered completely irrelevant information. I barely apply the steroid cream because I don’t trust it, and a week later I receive a voice mail saying, “Stop the steroid cream immediately. Your biopsy came back fungal, and steroids will make it worse!”

She prescribes a medication that is taxing on my liver, and requires follow-up testing for damage. I’m not comfortable with the possible side effects like “permanent loss of taste and smell.” I tell her so, and suggest a gentler medication but probably since it’s more expensive she tells me it won’t work. My functional medicine NP offers to prescribe it instead, and believes the drug will be effective. I’m three weeks in and the infection is slowly, but steadily, disappearing.

I still have some miles to go, but my topography is changing. The ridgelines are receding and the circular perimeters are breaking up. Harsh boundaries between illness and soundness are now blurred. I don’t know why I’ve traveled this demanding path; my missteps and trip-ups have cost me. I’m certainly taking the long way to my destination — all the while relying on my internal compass to guide me. But I do know I can never retrace my steps back to where I started; I’m a wanderer navigating between two lands. I dare to believe wellness is within my grasp, but I’m not guaranteed health and restoration — none of us are. I thought I had found my tribe; I adopted their diet, culture, and customs. Their creams and potions lined my vanity, and I truly thought I saw myself in their images. Nevertheless, I went from feeling deprived to embracing the bounty of a plant-based diet. I became my own MD — medical detective — and I learned habits I will continue to incorporate in my daily life. Turns out I wasn’t simmering psoriasis soup on the stove after all; I was cooking up sustenance for the journey.