Advances in Arthritis

Released Jan. 20, 2026 

PODCAST OPEN: Thank you for tuning in to the Live Yes! With Arthritis podcast, produced as a public service by the Arthritis Foundation. You may have arthritis, but arthritis doesn’t have you. Here, you’ll get information, insights and tips you can trust — featuring volunteer hosts and guest experts who live with arthritis every day and have experience with the challenges it can bring. Their unique perspectives may help you — wherever you are in your arthritis journey. The Arthritis Foundation is committed to helping you live your best life through our wide-ranging programs, resources and services. Our podcast is made possible in part by the generous financial contributions of people like you. Now let’s listen in. (MUSIC BRIDGE) 

Stacy Courtnay: Welcome to the Live Yes! With Arthritis podcast. My name is Stacy Courtnay, and I'm happy to be your host today as we talk about the top takeaways from ACR 2025. The American College of Rheumatology annual scientific conference, called Convergence, is one of the two biggest gatherings in the rheumatology world, aside from its counterpart in Europe. Rheumatologists, researchers, patients, occupational and physical therapists, representatives from the pharmaceutical industry and pretty much everyone involved in rheumatology from all over the world come to learn, network and share the latest information in rheumatology.ACR 2025 was especially exciting, with more discussions about a potential new treatment for autoimmune forms of arthritis, benefits of weight-loss drugs for arthritis and lots more. 

Cheryl Crow, the founder of Arthritis Life, was on-site as a presenter and is here to talk about some of the headlines for arthritis patients. So, I'll just say, personally, I know Cheryl. I think we met in 2019 at ACR when we were in, I think, San Diego. Cheryl is a fellow arthritis patient, and she is a wealth of knowledge, and I've enjoyed to get to know her. And I think all of you are going to love hearing her talk and share her experiences as an occupational therapist, and then what she learned at ACR. So, Cheryl, I'll turn it over to you. And tell us a little bit about yourself. 

Cheryl Crow: Yeah. So, in addition to being an occupational therapist, I've also lived with rheumatoid arthritis for a little over half my life. I'm 44, and I was diagnosed when I was 21. And I also... I keep forgetting to add this, but I also have osteoarthritis as well. So, I'll say, just for a quick overview for patients, the conference is mostly attended by physicians around the world who specialize in rheumatology, so usually rheumatologists, but it's also open to other allied health providers, like myself. And I love going to the conference not only to learn the latest and greatest in the treatments, but also to be inspired by the great work people are doing around the world. If you're interested in anything to do with arthritis, there's something there for you to learn. 

Stacy Courtnay: Well, it's amazing the thousands of people that are there looking for a cure and working for all of us to find better treatments, safer treatments. I was just blown away by the number of people who are behind the scenes fighting for all of us to have a better quality of life. 

Cheryl Crow: So true, yeah. 

Stacy Courtnay: Alright, so tell me a little bit about your presentations. 

Cheryl Crow: Well, what's great is a lot of the presentations are panel discussions, so they get to hear multiple voices, and it makes it more interesting as a listener, too. One was on health literacy, which is just a fancy word for saying, you know, "How do we, as patients, make sense of health-related information?" Particularly, I was focusing on online spaces, like social media or podcasts or blogs. There's so much great information that sometimes is vetted, like, as in the case of the Arthritis Foundation information. There's also a lot of misinformation out there. 

So, I got together with a rheumatologist and another patient advocate, and we looked through a lot of research from basic human psychology and health-related psychology into, "What is it about this misinformation that is so captivating?" And it's kind of this strange, basically paradox, where the things that are the most scientifically valid are the least kind of captivating and interesting and exciting for patients. And so, the people that say things like, "Oh, you just have to drink tart cherry juice, and you're just going to cure your arthritis." Or, "Guaranteed." Using those words like, "Guarantee you're going to heal," or, "Doctors don't want you to know…" There is something deep in our psychology that that taps into, right? 

There's a recent study that 60% of young adults trust medical advice that they saw online more than talking to their actual doctors. So, I thought that was kind of scary to me, you know, a little bit. In this panel discussion, we were trying to inspire other physicians to meet patients where they're at. Most often, in my experience, people neglecting to take therapies, drug therapies, and... because they're scared of what they saw online, and then they end up regretting it later. 

Stacy Courtnay: And I can relate to that as well, because when I was first diagnosed, I got on the internet, and I started reading all the horror stories of what ifs, what ifs… and all the terrible, you know, potential side effects. And so, then I went down the rabbit hole of trying to find these alternative therapies. I think I told you about this years ago, but, like, I was doing oil pulling, which is supposed to remove toxins from your blood to get rid of your rheumatoid or, you know, all these other different crazy therapies that I read and I believed were going to cure me. 

Cheryl Crow: Humans are remarkably resistant to changing minds, even faced with contradictory advice. The whole phenomenon's called belief perseverance. And in fact, when people are presented with information that goes counter to their previously-held belief, they tend to double down on what they originally believed. But one thing that I mentioned that one of the physicians in the audience said they really resonated with is: I said, “If somebody has a deep-seated core belief that natural methods are better than Western medicine, and then, next to that belief also, ‘I believe that I should be able to control my health by my own natural actions,’ then you really are asking them to take a big step when you ask them to take a medication. 

One of the things I found that, the evidence shows, is for patients to be able to emotionally relate to other patients' stories. So, when they can connect emotionally to a patient, let's say somebody who also was like, "I really wanted to treat my disease naturally. And then I took the meds, and then I did amazingly well. And I'm so glad I did." That's going to be more convincing than just factual arguments. 

Stacy Courtnay: Yeah, absolutely, for sure. 

Cheryl Crow: So, anyway, that was number one. The second one I did (laughs)... You could tell, I'm really passionate about that one. The second one I'm very passionate about, too, which is innovative support group models leveraging technology to enhance patient engagement and quality of life. And so, I did shout out the Arthritis Foundation Connect Groups here. And we really wanted to say, "How can we use technology to get to help people of different diverse backgrounds access patient support and peer support in ways that feel the most helpful to them?" 

We talked about different technologies that exist. So, there's not just... There's Zoom, of course. And that's been amazing to connect those of us in different geographical regions. There's also some interesting apps and things like WhatsApp or things where you can connect asynchronously, which I find really exciting, and that's what I do in my own support groups, because a lot of times, we don't know if that one hour, where we're supposed to have our live meeting, if people are going to be feeling well that one hour. Because, as we all know, we have these fluctuating conditions that maybe we might get hit by a flare-up randomly. So, having the ability to use technology to allow people to connect offline, outside of that live meeting, is really great as well. We want people to understand that the research shows that virtual support groups are as effective as in-person support groups for most of the things people measure. 

Stacy Courtnay: What are some of the other platforms that you're referring to? You said WhatsApp. 

Cheryl Crow: If you're wanting to blend education in with support... So, I use a platform called Thinkific, where you can upload prerecorded lectures and PDFs and educational stuff. That's Thinkific. There's also a website called the Mighty Networks that was actually designed specifically for support groups. So, it has like, a community aspect, kind of like a Facebook group but with the ability to moderate it and put things into discussion threads. But, yeah, those are just a few. Yeah. 

PROMO: The Arthritis Foundation’s website is packed with helpful information about various types of arthritis and how to manage them. You can find inspiring stories from people living with arthritis every day, as well as opportunities to connect with others through support groups and community events. Get resources on physical activity with arthritis, nutrition tips that support joint health and so much more. Check us out at arthritis.org. 

Stacy Courtnay: So, you were busy during the conference. 

Cheryl Crow: Yes. There's hundreds of sessions every day, and there's posters and stuff, too, so you can... You can't even see it all in one weekend. 

Stacy Courtnay: So, tell me some of the most exciting or important things that you learned at the 2025 Convergence. 

Cheryl Crow: I think the most exciting thing is CAR-T cell therapy, which is really... There's been more research in this in lupus than rheumatoid arthritis, but there are clinical trials right now in rheumatoid arthritis. And CAR stands for chimeric antigen receptor, and then the T is T-cell therapy. So, this is a therapy that was originally used in cancer, and it basically is very invasive and very expensive. That's the downside. What it actually has been shown to do in cases of lupus, and in a few handfuls of rheumatoid arthritis, is essentially reboot the immune system and effectively result in a cure. And this is the first time I've heard: a cure, which means a remission without ongoing steroids or ongoing immunosuppressants. Right now, what's common is to get into medicated remission with rheumatoid arthritis, which is, you're on your meds and you're in remission, but you still have to take the meds for the maintenance. 

This is a potentially one-and-done procedure, where you would effectively not have the disease anymore. You would still have whatever effects, where the permanent joint damage that occurs wouldn't be reversed. But it would... You would not have any further disease activity if this continues working. This sounds, at first, almost too good to be true, but it's the first time really in the history of rheumatology that there has been something like this that actually could result in a cure, to my knowledge. I even talked to researchers. I'm like, "Is this really... Is this what I'm thinking it is? Is this potentially a cure?" And they're like, "Yes, it is." So, it's really exciting. 

Stacy Courtnay: So, it's, like, one time... So, it's administered like an IV in a hospital-type setting? 

Cheryl Crow: I'm definitely not the expert in understanding it. They take a bunch of stuff out of your body, and then they put it back in. And I don't remember if it's blood or what it is, but it's very invasive. This is not available to anyone yet. It's only still in clinical trials. There are definitely rheumatologists who are like, "OK, this is very potentially great, but don't get your hopes too high yet." There's the main CAR-T one that's the chemo-like preparation, where basically, it kills a bunch of your immune system and then puts something back in. And then the CAR-Tregs: CAR-Tregs is a similar but more gentle process, which might be something that might be available earlier. But this... When I say it's expensive, I'm talking a half a million dollars at least is what they said. 

Stacy Courtnay: Wow. 

Cheryl Crow: I don't want to get anyone's hopes up too soon. Knowing that there's a procedure that could possibly do this is exciting. And, you know, I think if I'm an insurance company, well, looking at someone like me, who got diagnosed at 21, I've been costing my insurance company, like, $80,000 for over 20 years, so that's way over half a million dollars. Who knows? 

Stacy Courtnay: Yeah. 

Cheryl Crow: To know that… The science is there is really exciting. Yeah. 

Stacy Courtnay: That is exciting. So, tell me a little bit about the set point, the vagus nerve device. 

Cheryl Crow: Yes. This is the second big kind of story this year. You know, some rheumatologists are like, “This is the future.” And some are like, “This is overblown. Like, ‘I’m going to wait till there's more research to get excited about this.” A vagus nerve stimulator device, so kind of that you would have to have a surgery, kind of like the implant of a pacemaker, but instead of implanting something in your heart, it's implanting near your spinal cord. And these vagus nerve stimulators are called neuroimmune modulators, so they're modulating something in your nerves. And what they're doing is: They're trying to stimulate your vagus nerve, which is known as, like, the wanderer. It's the one that wanders down to your stomach, and it has a lot to do with inflammation, as well as digestion and many, many other things, including kind of getting us into that rest and digest state of relaxation. 

So, I'm really excited about this one. In this case, you would not be on immunosuppressants. Yes, you have to have this invasive surgery, which, I mean, anytime someone thinks about getting to my spinal cord, I get a little scared, right? But if it works, you are no longer immunosuppressed. You don't have to keep taking meds every day or every week. It's just in there. It's just implanted in you, as far as I understand. 

Stacy Courtnay: Wow. So, this is not a clinical trial. This is actually available now? 

Cheryl Crow: Yes. It was FDA-approved in July 2025, so it is available now, but I'm not sure whether insurance companies are covering it yet, but yeah. 

Stacy Courtnay: Wow. That's exciting as well. 

Cheryl Crow: Yeah. I know. There’s a lot of… There’s actually a third one, in terms of like direct medications or treatments or procedures to really alter a disease. A big discussion in all of science right now, or all of health, is GLP-1s: glucagon-like peptide-1s. I had to look that up because I was like, "I actually don't remember what it stands for." But basically, these are things that traditionally were used in diabetes management. Now, if you know about diabetes, type 1 diabetes is autoimmune; type 2 is not autoimmune. But anyway, sometimes we learn things from diabetes that apply to inflammatory autoimmune forms of arthritis, like RA. People with rheumatoid arthritis typically have a higher risk of heart disease than the average person. There's a couple of studies that showed people who were on GLP-1 meds, along with their rheumatoid arthritis meds, they had fewer serious cardiovascular problems and lower death rates. So that's exciting. And same with psoriatic arthritis: lower overall mortality, and also, in rheumatoid arthritis, obese patients without diabetes had an 86% lower risk of death and 40% lower risk of major cardiovascular events if they were on GLP-1s. 

This is things like semaglutide, Ozempic. Obviously, you need to talk to your doctor about this. I would definitely not be a candidate for this myself because I have a difficult time maintaining my weight because I also have this thing called gastroparesis, which is, like, slow GI emptying. And I've already had a history of sarcopenia, which is unintended muscle loss and muscle wasting. The major downside of GLP-1s is that the weight loss comes from losing muscle along with fat. You can't just choose to lose the fat. And so, with rheumatoid arthritis, we are 16 times more likely than average to experience muscle loss. So, we need to work very hard to continue to keep our muscle mass because that helps us prevent things like osteoporosis and stuff like that. 

So, I think with RA, definitely talk to your own doctor about the pros and cons. Initially, people thought, "GLP-1s could help all these people with arthritis with their pain, because we know that being obese or overweight puts a load on the joints." But now they're finding... They're, like, "Something beyond that is happening. There's something about what this medication does that is beneficial beyond just the weight loss effect." I think that's definitely one that we're going to see more on in the future conferences, too. 

Stacy Courtnay: I agree. And then, of course, there's going to be the insurance issue and if insurance companies will cover it. That'll be interesting to see what happens in the months and years ahead. 

Cheryl Crow: Yeah. 

PROMO: As an Arthritis Foundation Advocate, you can help raise awareness about the unique challenges people with arthritis face. Advocates play a vital role in influencing policy changes that promote better health care options and reduce barriers to treatment. Help ensure that everyone with arthritis receives the care and support they need to live their best life. Sign up at arthritis.org/advocate. 

Stacy Courtnay: Let's move on to what you learned about mental health in some of the sessions that you attended on that. 

Cheryl Crow: Yeah. There's always some really great presentations by either social workers, psychologists, psychiatrists on mental health. There was actually one by a psychiatrist that talked about the different kinds of psychoactive medications that can also work with chronic pain and, like, fibromyalgia, things like Cymbalta you might have heard of. But the one that was the most deeply affecting to me personally is… It was about grief in arthritis. First of all, they wanted to remind everyone that it is normal to grieve your loss of function, grieve the fact that you're in pain now and grieve the life that you might have wanted to live. That's something I kind of already worked on myself, so I was like, "OK." I'm nodding along to this. 

But then they presented something I had never heard of, which is a concept from psychology called ambiguous grief or ambiguous loss. And this is the loss of something that had no clear ending or closure. So, basically, a loss of somebody who died is not an ambiguous loss because they're dead. They're gone. Whereas having a chronic illness is an ambiguous loss because you still have some of your health. You're still alive. You still have some of your function. But you're losing the person you once were or the future you once planned. 

And this is something that resonated with a lot of people in the audience. And when I was sharing about this on social media, is that we also don't have, as a culture, typically, in American culture, any sort of rituals of this kind of grief, right? No one... People get you a “get better” card, but there's no, “I hope you deal with this chronic illness that's probably going to be a little better for a few years and then a little worse and then a little better.” You know what I'm saying? (laughs) Does this resonate with you at all? 

Stacy Courtnay: Absolutely. And then you grieve: What could have been, or how things would have been different, if you weren't diagnosed, and if you weren't challenged every day? You know, I always say, like... And I don't know how this relates or how it would relate to family members, but I always wonder how my son or my husband may have been different had they not been dealing with me all these years. It's kind of like they experience this type of grief as well. 

Cheryl Crow: I thought of this exact same thing because I remember we both have a son. And I think the power of naming it, like having a label and a name for it is, for me, it was really helpful, because I'm like, "Oh, this is... Yes, this is not just me having a hard time. Like, this is something that psychologists and mental health providers have recognized." So, I hope it's helpful to those listening as well. 

Stacy Courtnay: Yes. Thank you for sharing that. So, let's talk about microbiome and diet. 

Cheryl Crow: Yes. This is always a hot topic. There were multiple talks on this. And one of them, I thought, was a really interesting take. Because I mentioned earlier that a lot of people do well on rheumatoid arthritis medications. However, there are some that, even if the medicine works, the side effects are too difficult. The microbiome is a set of good and bad bacterias that live in all of us in our entire GI tract. We're talking mouth to anus. So, you have an oral microbiome. You have microbiome stuff happening in your esophagus, in your stomach, in your intestines, in your colon. And there's definitely many years now of research that show there's something different about the gut microbiome of people with rheumatoid arthritis as compared to the "normal," quote, unquote, or healthy controls. 

The thousand-dollar question is: "What do we do about that? Which one's the chicken? Which one's the egg?" A lot of people think, "Well, therefore, diet must be what either caused or cured this." That's not clear from the fact that there's just a correlational relationship at this point. However, in this case, they found that people who respond well to methotrexate have a different gut microbiome profile before treatment than those who didn't respond well to methotrexate. It said that you might be able to predict who could benefit from methotrexate versus who wouldn't, and who would have more side effects versus who wouldn't. So, that is lumped into the whole category of what's called precision medicine, which is, like... The goal of a lot of rheumatologists and patients would be to be able to walk into that room when you get your RA diagnosis and say, "OK. We know, because of your unique blood work and your unique biomarkers, then we believe that you will do well with X medicine versus Y versus Z." Right now, we're not quite there yet. 

Stacy Courtnay: And this goes back to what we were first talking about in the beginning of the conversation when you were talking about health literacy and people believing everything they read online. You can alter your bio by what you eat and your diet, but it's not going to cure you. And so that is one of those health literacy things that I had to get over, because I read many articles that it was something that I was doing or not doing with my diet, and I was sick because of what I had done to my gut. 

Cheryl Crow: Yeah. It's really not your fault, because there are people out there... I know when I was in medicated remission for numerous years, I was just eating whatever I wanted. You know what they call it? The SAD, the Standard American Diet. But that said, I do want to just highlight a different researcher and rheumatologist: Nisha Manek. She's an integrated rheumatologist from Loma Linda, and she did do some studies on the Mediterranean diet, which is lots of vegetables, fruits, whole grains, nuts, seeds, olive oil and moderate amounts of fish and poultry, and avoiding highly-processed foods. And her studies have shown that you can show reduced inflammation and support a healthier gut microbiome. 

Nutrition doesn't exist in a vacuum. And she talked about how managing stress, improving your sleep and basically getting your nervous system into that kind of rest and digest mode is also really helpful for reducing inflammation. She said, "Relaxing the mind may actually help calm the immune system," which I thought was a wonderful thing to think of alongside diet. It's not just about changing the foods you put in your mouth. It's about kind of supporting what they call overall, like, an anti-inflammatory lifestyle. That makes me feel empowered to hear that. 

Stacy Courtnay: Yeah. I like that as well. 

Cheryl Crow: I definitely upped my green smoothies after going to that talk, like you said. The next one, too. 

Stacy Courtnay: Talk about the science of aging and how diet, exercise and strength training can help. 

Cheryl Crow: Yeah. The session overall was called Nutrition for Rheumatic Disease: Where Aging, Biology Sarcopenia (which is that muscle wasting) and Diet Intersect. In that session was Dr. Brian Andonian, who talked about age-related changes and nutrient senesence and its impact on inflammation. And basically, long and short of it is: Rheumatoid arthritis, specifically when the disease is not controlled, it leads to accelerated aging throughout the lifespan, which I didn't know that before. And I'm somebody who eats, lives and breathes arthritis. (laughs) Like, I literally have a podcast called Arthritis Life. Like, arthritis is my life. But I knew that people with rheumatoid arthritis had a shorter lifespan on average, but for some reason, I thought it was towards the end: We're more likely to die of heart attacks and stuff like that, which is true. But also, what he's saying is: "The disease itself causes premature aging throughout the whole body." That's the bad news, OK? But let me... Stay with me because there's good news. 

Stacy Courtnay: That is bad news. That's depressing. 

Cheryl Crow: OK. I know. I was sitting there like, "What?" But we can slow it down and reverse it. Again, one of those words that sounds too good to be true. We can slow down that accelerated aging, effectively not experiencing that accelerated aging — with lifestyle, specifically strength training and exercise, having that overall anti-inflammatory diet, that Mediterranean-style diet, and focusing on sleep, which I call sleep: the forgotten lifestyle variable. But sleep is extremely important for your immune system. So, he went really in-depth about how people with RA show mitochondrial dysfunction and poor efficiency of oxidative ATP generation. And I was like, "I have to go back to high school biology." (laughs) But basically, it was helpful because it explained that when you improve the diet, when you have more of a plant-focused diet, and especially adding fiber and fermented foods, those actual biomarkers in your cells are better. 

So, basically, he talked about the health span versus the lifespan. Not just how many years can you live, but how many healthy years can you live? Or years of feeling robust? And I thought that was also really inspirational. It made me want to continue being as healthy as I can in my lifestyle, with also a little bit of moderation, because we have got to live a little. We have to have chocolate. (laughs) 

Stacy Courtnay: Well, and you talked about sleep being so important, and you and I both know... I think the first time we met at ACR, we were in this, like, a suite. Remember that? (laughs) We had this big meeting. And we're like, "Where's Cheryl?" And you were in the other room taking a nap. You just kind of disappeared. And then that's the same for me. When I need my sleep, I need my sleep. 

And that leads us to the next point here: the brain fog associated with it. Earlier today, I was not feeling great, so I took my nap before this podcast. And there's always this planning around what you have to do and, "Oh, I might have a late night tonight, so I'm definitely going to have to get my nap in." Talk to me about what you learned at Convergence 2025. 

Cheryl Crow: This was a really great session. It was called Cutting Through the Fog: Understanding Cognitive Function in Rheumatic Diseases. So, this was about all rheumatic disease, not just rheumatoid arthritis, also fibromyalgia, scleroderma, psoriatic arthritis. And this is again one of those kind of good news/bad news. I think like many patients, I want to feel validated. A lot of us feel like doctors or other people have been like, "Your brain fog is not that bad or it's not real." Well, according to the researchers here, it's very real. People with all rheumatic diseases "consistently show cognitive dysfunction along multiple domains." That's from my notes. (laughs) So I'm like… I actually went through a little existential crisis listening to this, like, "OK. So, it's real. I feel validated." And I'm like, "OK. Now I feel bad." Like, my brain is not working. 

But the good news is that traditional cognitive rehabilitation programs, like the kind that are used in brain injury rehab, can help. The presenter was from the University of Michigan, and they developed a brain training program that is a combination of what we call in occupational therapy: compensatory strategies, which are workarounds... Things like alarms. If you forget to take your meds, put an alarm on. I think a lot of us do some of those naturally, but there's even more we could be doing. And then also rehabilitation, so things that are fixing or improving the underlying problem; things like brain games, you might see those online: memory games. Doing those things can lead to improvements in your cognitive function. But, yeah, this was kind of a wake-up call to me. I've seen research that exercise, specifically engagement in cardiovascular and strength training, can directly lead to cognitive improvements. That was another kind of data point, motivating me to continue. 

Stacy Courtnay: Alright. Any updates or groundbreaking research that you heard about regarding Sjögren's or osteoarthritis? 

Cheryl Crow: Sjögren's was huge at this conference. It was everywhere. There were billboards about it. And what's really exciting is that the name has officially changed from Sjogren's syndrome to Sjögren's disease, which is meant to help validate it as a systemic whole body inflammatory autoimmune condition, not just a little bit of mouth dryness. Sjögren's is associated, if you don't know, with dryness of all your moisture-producing glands all through your entire digestive tract, from your mouth, including your sexual organs and stuff like that. So, it's really, really important to find treatments to actually slow down this disease process. 

PROMO: Have a great idea for the Live Yes! With Arthritis podcast? Emailing us to suggest topics is a great way to contribute to the conversation. Share your thoughts with us at [email protected]. Your ideas can help shape future episodes and ensure we address the interests and needs of the arthritis community. Play an active role in helping us create arthritis resources. Email us at [email protected]. 

Stacy Courtnay: We posted a question on social media, and we asked: “As a patient or caregiver, what do you think rheumatologists should be focusing on over the next five years?” And we got a lot of responses to this. And most of them focus on just a few points, which were diet, holistic care, mental health and communication. And here are a few. Chas Marie: “Food. In 20 years of dealing with this, I've tried every treatment under the sun. Finally, I changed my diet, taking out sugar and carbs, and it's been life-changing. I have never felt better.” 

Cheryl Crow: Yeah, and I think I would say, as an occupational therapist, our whole focus is on the non-pharmaceutical treatments, on the lifestyle treatments, so that includes exercise, sleep, diet changes and stress management, mental health. With diet, you never get a one-size-fits-all. It's like, "This one study shows that vegan worked for X number of people," but it's never 100% of them. First of all, Chas, thank you for sharing your individual experience. And as an educator, I'll just remind everyone that every person's experience is different. There have been randomized controlled trials on low-carb diets, and they don't work for everyone, but they do work for some people. So, our job as patients is to try to figure out which intervention is going to give our unique body the most bang for our buck. And that can be really overwhelming in the case of food and nutrition, because, in my opinion, compared to any other area, nutrition is the most confusing, because there's so many different things. How is it that carnivore works for one person and vegan works for another? These are, like, the opposite foods. 

Stacy Courtnay: Kim Zimmerman Johnson, she said, "Looking at the big picture, not just individual symptoms," and Karen Baker agreed: "I am fed up with endless waits and appointments with different people who are only interested in a tiny bit of me. We are the sum of all of our parts, and there seems to be no holistic approach." 

Cheryl Crow: I agree with that 100%, and I think there are individual providers that are more holistic than others. One thing I noticed at the conference was that the people that were more looking at the big picture; they tend to brand themselves as integrative rheumatologists. It's an additional certification. They're getting additional training in things like nutrition, stress, sleep. There's also a lifestyle medicine board certification. I have a couple of rheumatologist friends who've gotten that certification. If you want to find a doctor that really looks at the big picture, not just the individual symptoms, I recommend looking at one that either identifies as an integrative medicine rheumatologist or a lifestyle medicine one. They tend to have that. And also, I think nurse practitioners. And depending on your state... Like, I have a nurse practitioner friend who's fully independently practicing rheumatology. 

Stacy Courtnay: Emily Power says, "Mental health and chronic pain management. Our rheumatologist really pushed my 10-year-old daughter to see a therapist, and it's been so helpful for managing pain and social anxiety around her living with JIA." 

Cheryl Crow: Yes. Emily, I'm so glad. Give yourself credit as a mom for being open to that and supportive to that and taking your daughter to the therapist because it can be hard to do that. I don't know if you had the same thing, but I resisted going to therapy for a long time because I thought, "Well, it's just RA, but, like, everything else in my life is going OK. So, what am I going to talk about? She's not going to cure my RA. What's going to help?" One of the best things I've ever done, because I didn't even realize how much there was to process and unpack around my disease. And so, I'm a big proponent of therapy. And don't just say, because other people have it worse, you shouldn't go to therapy. Because that would literally mean only one person gets to go to therapy, and that's not fair. 

Stacy Courtnay: That's not fair. 

Cheryl Crow: You know what I mean? Someone always has it worse. 

Stacy Courtnay: Yeah. This has been a great discussion, Cheryl. You are a wealth of knowledge. I always love talking with you. And so, let's each of us talk about our top three takeaways from our discussion today. 

Cheryl Crow: I think the first one... And this is something that I mentioned earlier, but to reiterate: One thing I'm going to be doing differently directly as a result of attending these sessions is continuing to add more anti-inflammatory foods to my daily lifestyle, and things like chia seeds, spinach. I have a smoothie now every morning, a green smoothie, green and purple with blueberries. And then also upping my strength training and understanding more: These aren't just good things to support your bones and muscles. These are actually systemically helping your systemic symptoms, like brain fog, like fatigue. So, that's number one for me. And sleeping better. Basically lifestyle, continuing to have as an anti-inflammatory lifestyle as I can, given that I'm a very high-energy person that doesn't like to rest. 

OK, number two is: I really have taken with me this concept of ambiguous loss. And I actually mentioned it in the support groups that I run, and people have been really receptive to it as well. So, I'm still just finding that whole concept something that makes me feel more seen and more validated. And then the third thing is basically... And this is something I heard a rheumatologist say, but we're entering, basically, a fourth wave of treatments for rheumatoid arthritis and similar conditions. It's not just another immunosuppressive biologic, which, look, I take all I can get. They've worked for me. But they do suppress your immune system. Now there's new therapies that are possibly non-immunosuppressive... that are not immunosuppressive, like vagus nerve stimulators, like CAR T-cell therapy and… 

Stacy Courtnay: Very similar to you. I'd say my top one is the CAR-T therapies. That's very fascinating, and I'm anxious to see how that progresses over the next couple of years. Also GLPs: I'd love to learn more about those and how it does help with inflammation, not just weight loss. And like you said, I mean, you know, if you do lose weight, you're automatically going to have less pressure on your joints, but there's also more benefits than just that, which you were talking about. I guess my resolutions for the new year, I have really gotten into Pilates lately. I love Pilates. But I have not been so great with my strength training. So, I'm going to up my strength training in 2026. And then, also, I'm really going to focus on the Mediterranean diet because I do really, really well, like, for a month of eating, you know, very healthy. And then I go off the deep end. So, I'm going to try to focus on the Mediterranean diet in '26. 

Cheryl Crow: Yeah. And what I found was just focusing on one meal, the easiest meal, like breakfast for me, focusing on having that smoothie in the morning, has helped me feel some momentum. 

Stacy Courtnay: Well, you're so wonderful. I really enjoyed the conversation. Thank you to all of our listeners for joining us as Cheryl Crow discussed ACR 2025: Convergence. Thank you for your time, and thank you to our listeners. And I hope you have a great day. 

Cheryl Crow: Thanks. Bye. 

Stacy Courtnay: Bye. 

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