Rheumatoid Arthritis Remission — Off Medication, and Up Kilimanjaro

Climbing Kilimanjaro with rheumatoid arthritis — off medication. Jon did it. And in this episode, his rheumatologist explains how.

Most people hear "rheumatoid arthritis" and brace for a life sentence. 

Dr. Diana Girnita, a board-certified rheumatologist, sits down with Jon, a patient she guided from daily pain and methotrexate to drug-free remission — and, a few years later, to the summit of Kilimanjaro. 

Together, they walk through what that journey actually looked like, including the setbacks.

You'll hear how a personalized plan — nutrition, targeted supplements, sleep, stress, and exercise — worked alongside medication rather than instead of it, and why coming off methotrexate was a slow, carefully monitored process, never a sudden stop. Jon also opens up about why methotrexate is so often misunderstood, what the "chemo drug" fear gets wrong, and what it felt like to taper down while his blood work stayed clean.

This conversation is also about partnership. 

Jon was in Florida; Dr. Girnita was in California. 

They break down what made that telehealth relationship work, what to look for in a rheumatologist, and why the right doctor in your corner pays off not just this year, but over the next ten and fifteen.

What you'll learn in this episode:

• Why drug-free remission is possible for some people with RA — and what realistically has to be in place for it to happen
• How lifestyle changes (nutrition, supplements, sleep, stress, exercise) work with medication, not as a replacement for it
• Why tapering off methotrexate should always be slow, gradual, and guided by blood work — never a sudden stop
• What the common "chemo drug" fear about methotrexate gets wrong
• How to tell whether your treatment is actually working, and which markers your doctor should be monitoring
• What to look for in a rheumatologist — and the questions that signal a true partnership
• Why telehealth can work for chronic disease management, even across state lines

A note on hope and honesty: Jon's drug-free remission is real, but it isn't the outcome for everyone, and his results don't replace individualized care. What his story offers is a different question to bring to your own treatment — what's actually possible for you, with the right plan and the right monitoring.

If RA has ever left you feeling dismissed, overwhelmed, or resigned, this episode is a reset. Whether you were diagnosed last month or a decade ago, you'll leave with practical direction and a renewed sense of what thriving can look like.

Jon's story proves that with determination, education, and the right medical guidance, an active, vibrant life is possible. So — what's your summit?

Transcript

A|0:00|s1|Picture yourself at the summit of Kilimanjaro. The roof of Africa, it's under your boots. Clouds are under you, and your whole body is working. But now rewind a few years. The same person, you cannot open a jar, you cannot make a fist in the morning without your hands screaming.
A|0:21|s1|And a doctor just told you that this is who you are now. That diagnosis was rheumatoid arthritis. And for most people, these words land like a life sentence. But what if remission, real remission of medication is actually possible?
A|0:39|s1|I'm Dr. Diana Gernita, and the man who climbed that mountain is my guest today, John.
A|0:45|s1|When we met, he was in Florida, I was on a screen in California, and he was carrying the diagnosis that had already taken his sleep, his comfort, and the hope. But today he's in remission of his medication, living a life that a man at the first appointment probably could never have imagined. This is the story of how we get there together.
B|1:10|s2|JON welcome to the show. the Thriving with Arthritis. I am very happy to have you here. We have met a couple of years ago and you are still my patient, despite the fact that you live in Florida. But before we start to share your story, tell us a little bit about you.
C|1:30|s2|yeah, sure. So my background of I was always like into sports, very athletic. And then I started like noticing some issues with my wrists. And that's when first started like going to the doctor to say, Hey, what's going on with my wrists? Like just fix me. I want to go back to normal. And so I went and they started first giving me steroid injections. so they gave me that and then
C|1:52|s2|I came back a short while later, saying I still had the same issue, and then eventually they ran more tests and figured out I had the rheumatoid arthritis.
B|2:00|s2|Yeah, we're gonna get there, but before that diagnosis, before me, what was the first time that you felt that was something wrong with you?
C|2:09|s2|Yeah, I first felt something wrong. Like I said, it was with my wrists. so I was like doing pushups
C|2:15|s2|or things like that. And it was it was like unusually painful. So
B|2:19|s2|How many years ago was that?
C|2:21|s2|That would have been now like probably like maybe fifteen years ago when I first started noticing things and then a few years after that it got really bad. That's when I got the diagnosis.
B|2:33|s2|And how many doctors did you see before you had someone sitting in front of you and said rheumatoid arthritis?
C|2:41|s2|probably like two or three. Like saw a couple and then like 'cause nobody could figure out like what the issue was.
B|2:48|s2|Because you were a man and people were not probably thinking about an inflammatory arthritis. But did you had any swelling besides the pain? You had pain in the wrist, but did you s notice any swelling? Did you have difficulties to grip things or use your hands? How was it for you? Can you describe me one of those bad days?
C|3:08|s2|Yeah, no, there was no swelling or anything like that. I mean and the bad days were just like when I was trying to do like, you know, some type of sport or athletic activity. that's that's when I would really notice it.
B|3:21|s2|Did you have anybody in the family with a history of rheumatoid arthritis?
C|3:26|s2|Yes, my my grandmother had rheumatoid arthritis.
B|3:29|s2|So you heard it somewhere, correct, in your family. How was it for you, grandma?
C|3:32|s2|Right, right.
C|3:35|s2|for her it was yeah, for her it was pretty bad. towards the her hands were you know, it's harder for her to grip things and didn't have much dexterity in her fingers. she struggled a little with that.
B|3:48|s2|But when you heard that word, arheumatoid arthritis, what was in your head at that point? How did you picture your life at that point?
C|3:57|s2|Well, when I first heard it, I didn't know much about it. So I thought, okay, well, what's the cure? And so then I found out, it's not, you know, and then I learned more about it where it's, you know, you just try to prevent things from getting worse and things like that. So so that's where, you know, I heard that. I was like, okay, well, you know, like what can we do? What are the options and
C|4:15|s2|things like that.
B|4:16|s2|But when you started to learn about rheumatoid arthritis, and it's interesting that you said the word cure, and we're gonna talk about that in a second. When you heard about rheumatoid arthritis and you started to dig into the knowledge about this disease, what were the things that you were most afraid of losing?
C|4:36|s2|in general, like mobility and inability to, do all the things I like to do, whether it's sports or even just walking around, 'cause you learn about it and it's like, well, you know, it could get could get really bad depending on how things go. so first the initial concern was like, Hey, I wanna, you know, keep doing all my activities.
C|4:55|s2|And then it was like, wow, this is very serious. I wanna, still be able to walk and I, I work on the computer and need to be able to type and do all these other things just to function.
B|5:05|s2|And did you try any of the cures that are promoted out there on the internet? You mentioned the word cure.
C|5:12|s2|Yeah. Yeah. I mean, I was like just ho hoping for, you know, like, hey, just fix me, get me back to normal.
B|5:20|s2|And what did we try?
C|5:21|s2|I learned there was no cure, so so like I said, they did those steroid injections before they knew it was rheumatoid arthritis. And then once I was diagnosed, they put me immediately on the methotrexate, like right
B|5:33|s2|Let's talk about Metotrexate because I know many people are scared about this medication. If you research it on Google or one of those new tools that we have, Chat GPT or Claude, it's gonna show up like the chemo drug, correct? Did you have that impression that metotrexate is a chemo drug?
C|5:52|s2|No, I had the when I looked it up I just had the impression that it was one of the safer, more well tested drugs, that it wasn't like one of the newer ones that were more experimental or less history behind them.
B|6:05|s2|Probably you're one of the few patients that were not afraid to try methrexide.
C|6:10|s2|C correct. I I wasn't afraid to try it. And and they told me up front that it wouldn't cure anything or make anything better, but that the whole goal was to prevent things from getting any worse.
B|6:21|s2|And have you had any side effects from metatraxate?
C|6:24|s2|no, I didn't have any side effects from methotrexate.
B|6:27|s2|You know, most people when they start this medication, they are afraid of side effects because they read somewhere on the internet that this is, like I said, a chemo drug and this is also gonna cause, from
B|6:40|s2|nausea, vomiting, abdominal pain, up to hair loss, severe hair loss, and sometimes can cause cancer. So many of my patients when they come to me and I start the discussion with metotrexate, the first thing that I go over is this common side effects, but I also give them the perspective that they might not have any of the side effects. And like in your case, most of my patients do not have this
B|7:07|s2|horrendous side effects that they figure out that other people had. And you were on metodrexate and that was for a couple of years at least. We've met actually about four years ago while you are in Florida and I was in California, I was on a screen.
B|7:25|s2|why did you trust a rheumatologist that was not in the same room with you?
B|7:29|s2|That was not in the same room? okay. yes, yes, I see what you mean.
B|7:31|s2|Yes, yes, because I was on a camera. I was yes, I was in California and your appointment was through telehealth from Florida.
C|7:42|s2|Yes. Well, yeah, for for a few reasons. Like I, you know, did some research on who you were and you also came from a personal recommendation. And so based on those factors, I felt very comfortable.
B|7:54|s2|And what felt different in that first appointment that you decided to continue to work with me?
C|7:59|s2|well, I really liked your focus on like you weren't just gonna follow a protocol. It was, learn about the patient, see what they need, and then your focus on nutrition. Like I really like to focus on nutrition and then we also talked about like vitamins the first time. so it was good to know that it wasn't it was gonna be, you know, tailored towards like what I needed and what I could do and
C|8:23|s2|And that that you also had this perspective of, how your nutrition also affects your health as well, especially for RA. So so based on those factors, that was that was why.
B|8:34|s2|Thank you, John, for giving me the trust. Now I remember that some of our appointments were in person. You actually traveled from Florida to my office in Irvine, and some of the appointments were through telehealth. But when you came to me, I remember that we started to build a plan together because your focus was to
B|8:57|s2|Understand what you can do, how you can help yourself from nutrition to supplements to exercise, improving your sleep, your way to manage stress, because you're a person that works a lot, but you're also focused on decreasing the medication and eventually getting off the medication. And we sat down and we talked about the plan and we started to implement the plan.
B|9:24|s2|Do you remember how long it took until you started to feel much better and we were able to start decreasing the dose of metotrexate?
C|9:34|s2|yeah, I think we
C|9:35|s2|started decreasing the dose like a small bit, like pretty pretty early. And so and so, you know, I felt good. And we also talked about I got set up on a vitamin regimen and you know, made sure I was eating healthy and and then we yeah, we s slowly started lowering the dosage, like very gradually. I think it might have been probably over a year.
B|9:38|s2|Yeah? Correct, correct.
C|9:57|s2|Like until it was until it was full fully off of the mouth of the track saying.
B|9:58|s2|Correct.
B|10:02|s2|It's absolutely correct. It took us about a year, but we gradually went off the Metatrex A. Did you have any periods where you had flare ups, like setbacks?
C|10:12|s2|there was nothing major. There's like occasionally I would have a flare up, but it wasn't it it it wasn't like long lasting or anything like that. So there was there was no no major issues there.
B|10:23|s2|And when did you know that this is actually working? When did you start figuring out that you finally gonna get off the metotrexate?
C|10:32|s2|I mean so as part of like what we we would also monitor like blood work and other things. So so the fact that we were just continually, lowering the dosage, but then seeing all good numbers in terms of the blood work and then also I was still feeling good, no no major issues or flare ups and so
B|10:37|s2|Mm-hmm.
C|10:51|s2|And so eventually it was just like, you know, an an inevitability in my mind.
B|10:56|s2|I love the fact that you said about the monitoring because what I want people to understand is that it is not safe to do it on your own and it is not safe to stop medication at once and it is not a good approach not to follow with a doctor who's gonna check your blood work, your markers of inflammation, and obviously to be in contact with someone that could change things rapidly if you have a flare up.
B|11:22|s2|that's very important for patients to know that they need that kind of monitoring, especially for patients with rheumatoid arthritis, because this disease, like you said, could impact not only the next five years, but also the next 10 years, the next 15 years. what do you think about having that kind of doctor in your corner? Was that helpful to you?
C|11:44|s2|yeah, that was very very helpful knowing that, you know, makes you feel good that they're they're looking out, you know, for the long term and like I said, more it's more about like who you are and what your goals are and what you wanna do. So it's yeah, that's very good to have. That's why like, yeah, I still still have you as my doctor. So
B|12:02|s2|Thank you, John. I want you to tell us about your experience going up the mountains and actually conquering the Kilimanjaro Mountain.
C|12:13|s2|yes, so I did do a hike a couple years ago up to Kilmanjaro and at that time I had been off the methotrexate. I went to the hike and it was very difficult because the temperatures are cold and you're at very high elevations, so it's a little harder to breathe because the air is a lot thinner.
C|12:31|s2|I had more issues with the air and making sure I was, you know, breathing properly than than I did with my arthritis.
B|12:37|s2|Weren't you afraid to go in such a journey?
C|12:41|s2|no. I mean it's like you know, you challenge yourself and do the best you can, see how it goes and and kinda go from there. And you know, I went with a a tour guide. I wasn't like just going completely solo on my own. So I knew, you know, like, you know, so I had the you know, in the back of my head it's like, Okay, well if anything goes severely wrong, they'll get you down the mountain one way or another. But
B|13:02|s2|Was it a group of people that was with you or one one person only?
C|13:07|s2|it was it was a group. So there's a whole group of guides that go with you up the mountain. And so Kilmanjaro is a little different than Everest, where Everest they have fixed campsites, whereas at Kilmanjaro there's not really fixed campsites. There's so they always the guides will pack all your camping gear along with you on the trip. So there were several guides like carrying gear as well as the the main guides like guiding the group.
B|13:19|s2|Mm-hmm.
C|13:35|s2|So I just signed up and they put me with some other people in the group as well. And so we all went up together.
B|13:41|s2|Did anybody else have a disease like yours, like rheumatoid arthritis? And did they knew that you have rheumatoid arthritis?
C|13:50|s2|no, there was nobody else on the group like that that that I was on. but yeah, I did let them know ahead of time medical conditions. So
B|13:59|s2|Wonderful. And weren't they surprised that someone with rheumatid arthritis could climb the mountain?
C|14:05|s2|I don't I don't know if they were surprised, but you know, they d they didn't act like it. They were just like, Okay, let's go.
B|14:11|s2|John, I was very surprised and you remember that I wrote this book, Triving with Rheumat with Arthritis, and I end my book with your story. but I tell people that this is possible with this kind of bridging approach. Yes, we have to use sometimes medications, but sometimes you can get off the medication and you are a living proof of that, that with determination.
B|14:38|s2|And with hard work because it is your hard work. and with a little bit of help from me, you were able to climb a mountain and tell your story today to the world. Now I'm really impressed with your work. I have to tell you that, and I have to tell everybody else about that. There are not many patients that will be so diligent like you are, but there are patients like you that exist, and I'm I'm very happy to be part of your journey.
B|15:04|s2|Now for someone that is listening right now and they feel dismissed, they feel stuck, they feel disappointed that they have such a disease, can you let them know that it's possible? Can you give them a a message to encourage them and you know to show them that they are not alone?
C|15:25|s2|yeah, I would say, you know, it it's definitely possible. You know, I've done it. Like I'm continue to be active, you know, I go to the go to the gym and do other things and play sports. And yeah, it's just a matter of, you know, taking things one day at a time. Like some days you might have a bad day or, you know, miss your vitamins or not eat so good, but you know, you just say you shake it off and then get back on track and and just keep going.
B|15:50|s2|Like I say to every of my patients, if you do the right things 80% of the time, the rest of the time, the 20%, you are allowed to cheat. And that will bring you to the right place. one more question. If they want to build that kind of partnership with their doctor, what should they look for in their rheumatologist?
C|16:11|s2|I would say just look at their history, make sure that they're focused on, exercise and nutrition as well as, any potential medication. you know, cause that's you you need a complete picture to help treat the patient at the end of the day.
B|16:28|s2|John, I want to thank you very much for sharing your story, for sharing this message of empowerment to other people. And I wish you to continue on this journey and to stay off the medication. And why not climb the next mountain, the Everest, this time?
C|16:45|s2|There you go. Well yeah, I don't know. I've I've done one might be enough, but yeah, we'll see.
B|16:51|s2|Thank you so much. I wish you a wonderful day.
C|16:53|s2|All right, thank you. Good to see you.