Rheumatologist OnCall

06/18/2026

Day 3 of 7 — and if you're over 50, this one's for you. 👆

Exercise #3: Thumb Touches.

Hold your hand open. Touch your thumb to the tip of your index finger, forming an "O." Then middle, ring, pinky. Then reverse. Do it slowly — 10 full cycles per hand.
Why it matters: this is critical if you have osteoarthritis at the base of your thumb — one of the most common forms of hand arthritis after 50, especially in women. Without exercise, the thumb loses its ability to oppose — meaning you can't pinch, write, hold a fork, or zip a jacket.

My advice — do this while you're watching TV. It takes 60 seconds and saves your thumb.

👉 Follow so you don't miss it — exercise #4 drops tomorrow.



Telehealth in 21 states — link in bio.

06/17/2026

Will Ozempic cause a gout flare?

The honest answer: it's nuanced.

When you lose weight fast on a GLP-1, fat breakdown releases purines → uric acid rises → and in the first few months, some patients get a gout flare. This is real and documented — the same thing happens after bariatric surgery or any rapid weight loss.

But it's short-term.

Once your weight stabilizes, GLP-1s appear to lower uric acid and reduce flares long-term. You're better off down the road.

The key is getting protected through that early window — usually low-dose colchicine or adjusting your urate-lowering therapy. That's where a rheumatologist who understands both gout and weight-loss meds matters.

💬 Comment "GOUT" to learn more.

Rheumatologist OnCall — telehealth in 21 states → rheumatologistoncall.com

06/17/2026

Day 2 of 7 — and this one prevents the deformities arthritis is famous for. ✋

Exercise #2: Finger Bends.

Hold your hand up, fingers straight. Bend your thumb down toward your palm. Then index. Then middle, ring, pinky — one at a time. Hold each a few seconds, then straighten. Repeat 10x on each hand.

Why it matters: this isolates each finger joint. Moving them one by one keeps the tendons gliding and prevents the contractures that lead to permanent deformity.

Let me tell you — patients who do this consistently keep their finger dexterity for decades. The ones who don't? They come to me 5 years later.

👉 Follow so you don't miss it — exercise #3 drops tomorrow.



Telehealth in 21 states — link in bio.

06/16/2026

Can Ozempic help lupus and autoimmune disease?

The evidence here is earlier than for RA or osteoarthritis — but it's growing fast.

Lupus is driven by inflammation, and many patients also carry extra weight, insulin resistance, and high heart risk (often from steroids). In lupus patients on GLP-1s, studies show fewer flares and a lower risk of lupus nephritis and kidney failure.

A large ACR 2025 analysis also tied GLP-1 use to a lower risk of developing new autoimmune disease in people with diabetes or obesity.Important: these are early, observational findings — not approved treatments for lupus.

But for selected patients, GLP-1s may be a powerful adjunct to standard therapy.

💬 Comment "LUPUS" to learn more.

Rheumatologist OnCall — telehealth in 21 states → rheumatologistoncall.com

06/16/2026

Resting your hands when you have arthritis?

That's one of the worst things you can do.
🛑I'm posting one hand exercise every day for 7 days.

Follow along and do them with me — here's #1.
The Fist — do it every morning before you get out of bed:

Slowly close into a soft fist, thumb across your fingers. Hold 30–60 sec. Then open wide and stretch. Repeat 10x on each hand.Why it matters: when you stop moving arthritic joints, the inflammation thickens and your tendons start to stick. Within weeks you lose range of motion — and once it's gone, it's hard to get back.
👉 Follow so you don't miss it — exercise #2 drops tomorrow.

Telehealth in 21 states. Book your appointment with us on rheumatologistoncall.com

06/16/2026

Hand exercises for arthritis can protect your joints, ease morning stiffness, and preserve your grip — if you do the right ones, every day. Wondering which hand exercises actually work for rheumatoid arthritis, osteoarthritis, or psoriatic arthritis? In this video, board-certified rheumatologist Dr. Diana Girnita shows you the 7 best hand exercises to keep your fingers, thumbs, and wrists mobile — and why resting your hands is one of the worst things you can do.
You'll learn the exact daily routine Dr. Girnita recommends to her patients to keep tendons gliding, calm inflammation, and prevent the deformities and grip loss that come with progressive arthritis.
In this video:

Why resting arthritic hands makes stiffness and stiffness-related damage worse
The one safety rule before you start (and when to skip a joint in a flare)
Exercise 1 — The Fist (do it before you get out of bed)
Exercise 2 — Finger Bends to prevent contractures and deformity
Exercise 3 — Thumb Touches for base-of-thumb osteoarthritis
Exercise 4 — Soft Grip Strengthening + what grip strength reveals about your lifespan (the Lancet study)
Exercises 5, 6, 7 — Wrist Bends, Finger Lifts & Wrist Rotations to protect your wrists
The early-intervention window that determines whether you keep hand function for decades!

https://youtu.be/OByTGqIff0Y

Share with others to learn!

Thank you!

DR G

➡️Book a Consultation: https://rheumatologistoncall.com/Hand exer...

06/14/2026

Be careful: those overseas clinics offering CAR-T are not what they seem. ⚠️

There are clinics outside the US — in Mexico, parts of Asia, some private
European centers — advertising CAR-T cell therapy for autoimmune disease for around $200.

I understand patients with severe disease are desperate. But I have to be honest with you.

Real CAR-T requires specialized manufacturing facilities — clean rooms certified for cellular therapy. Highly trained staff. Intensive monitoring for 2-3 weeks after infusion, including the ability to manage cytokine release syndrome in an ICU.

If someone offers you CAR-T at a wellness clinic, through a private "stem cell center" overseas, or as a one-day outpatient procedure — it is not the real therapy. It may be something else entirely: untested, unmonitored, and potentially harmful.

Real CAR-T for autoimmune disease in 2026 is only available through clinical trials at major academic medical centers. ClinicalTrials.gov is where you find them.
Protect yourself. Ask hard questions. Real medicine takes time.

💬 Tell me, has a clinic ever pitched you something that sounded too good to be true?

Rheumatologist OnCall Team: Dr. Diana Girnita, MD, PhD and Dr. Vishnuteja Devalla, MD (rheumatology). Telehealth in 22 states.

06/14/2026

Collagen peptides — what they actually do in your body?

Most people take collagen for skin or nails. But here's what the research actually shows for joints and inflammation.

1. They reduce inflammation.
Collagen peptides lower pro-inflammatory cytokines — the same molecules that drive joint pain in RA, osteoarthritis, and autoimmune flares.
2. They may stimulate your body to make MORE collagen.
Specific bioactive peptides reach your joint cartilage and signal your chondrocytes — the cells that build cartilage — to produce new local collagen.
3. They reduce joint stiffness and pain. Studies suggest that 10 grams daily for 3-6 months may improve joint comfort and function.

The key — only collagen peptides or hydrolyzed collagen work. Regular collagen and gelatin are too large to absorb. Third-party tested only. NSF, USP, or ConsumerLab.
—

06/13/2026

How long does CAR-T cell therapy actually last?

This is what every patient wants to know.

Here's what the data shows.

The CAR-T cells themselves disappear from your body in about three months — that's normal, they're not supposed to stay forever.
What stays is the reset of the immune system.Your B cells eventually grow back, but they grow back naive — without the memory of attacking you. The autoantibodies stay gone.In the original studies from Germany, patients with severe lupus, scleroderma, and inflammatory myositis received a single infusion.
The longest follow-up is now over three years, and these patients remain in drug-free remission.
No flares. No autoantibodies. No medication.
But here's the honest part: we still don't know what happens at year five, year ten, or beyond.
Some patients may need a second infusion in the future.
Some may not.
The follow-up is still short.
Still — one treatment, three years of remission, in a disease that used to flare every six months?
That's something we have never seen before.

💬 Tell me, would you consider a one-time treatment over lifelong medication?

Rheumatologist OnCall Team: Dr. Diana Girnita, MD, PhD and Dr. Vishnuteja Devalla, MD (rheumatology). Telehealth in 22 states.

06/13/2026

Ever wonder why Biofreeze or Icy Hot actually take the edge off a gout flare?
That cold, tingly sensation isn't just a distraction. Menthol activates the cold receptors in your skin, tricking your nerves into prioritizing the cold signal over the pain signal coming from your inflamed joint. It's called the gate control theory of pain, and it's why a thin layer of cream can quiet a throbbing toe in minutes.
How to use it during a gout flare:

Apply a thin layer to the painful joint
Reapply every 3 to 4 hours as needed
Pair with elevation, ice, and your prescribed medication
Avoid combining with heating pads, which cancel the effect
Keep away from eyes and broken skin

What menthol can do:

Provide fast, drug-free relief on top of your gout medication
Reduce burning and throbbing sensations
Help you sleep through the worst hours of a flare

What it can't do:

Lower your uric acid
Dissolve urate crystals
Prevent the next attack

Menthol calms the pain. It doesn't treat the disease underneath it.
If you're reaching for Biofreeze every few weeks, that's a sign your gout isn't controlled. Call 650-525-4404 or book a consultation at rheumatologistoncall.com with Dr. Girnita and Dr. Devalla.