We may be a small Island nation but we’re an immensely diverse one too, with over 135 nationalities represented. However, with a population of just touching 80,000, rare diseases are indeed rare. That means that variants of rare diseases are sufficiently rare that identifying them requires a true expert with the benefit of many years working with larger populations.

In this case, Dr Azad Esack, Consultant Neurologist at Doctors Hospital, not only diagnosed a rare case of Guillain Barre Syndrome, but managed to identify it as an extremely rare variant. It’s all the more remarkable when you consider that those of greatest risk are commonly over the age of 50 and yet this was during a pregnancy.

In March 2023, a pregnant woman in her 3rd trimester began experiencing strange physical health symptoms that caused her and her family some concern. After consulting her Obstetrician, she was referred to an Ophthalmologist. Apart from the exception of no eye movement, an examination from the ophthalmologist returned normal. They needed another opinion. The symptoms she was experiencing were associated with multiple cranial nerve palsies. So, she was referred to DH’s Neurologist and Neurophysiologist, Dr. Azad Esack, with the following symptoms:

• Difficulty with speech
• Difficulty swallowing
• Double vision
• Weakness in arms
• Unsteadiness

These are symptoms that can have many etiologies, including many that are far more common than Guillain Barre Syndrome. Her examination with Dr Esack, and subsequent investigations, established:

• No eye movements
• Marked bilateral weakness of the face
• Drooling/excess saliva
• Neck weakness
• Abnormal speech/difficulties with articulation
• Strength in arms significantly reduced (particularly in upper arms)

Additionally, she had reasonably good leg strength, though she experienced slight unsteadiness when walking.

The results were conclusive. Though the brain scan returned normal, extensive nerve testing  gave significant clues to the diagnosis. Of note, when considering rare conditions is that they often present themselves with symptoms in common with more common conditions, without question reinforcing the importance of assessment by an experienced professional. Dr. Esack’s diagnosis was precise, and  immunological testing verified his conclusion. Our patient had an unusual variant of Guillain Barre Syndrome (GBS) called Pharyngeal Cervical Brachial (PCB).

In 2010, Dr Esack wrote a paper on GBS, having diagnosed 250+ cases in the UK and Caribbean. With a 1 in 100,000 chance of developing GBS, most commonly in the over 50 age group, in a population of 44 million persons living in the Caribbean, GBS clearly occurs, but this variant, PCB, is, especially in a pregnant woman extremely rare and potentially a once in a career lifetime occurrence. In fact, this is only the second reported case in the English literature.

Following a definitive diagnosis, our patient at DH could receive appropriate treatment for this illness, in this case infusions of Intravenous Immunoglobulins (IVIG) over a number of days. This treatment was started within four hours of the patient presenting to DH. In addition, and specifically because we had both the mother and the baby to consider, the patient’s vital signs, including her respiratory parameters, were monitored very closely while in our care, and we additionally monitored her baby’s health too. Safety and thoroughness are both paramount concerns in this situation.

By our patient’s third day of treatment, we noticed her speech, swallowing, and upper limb weakness had improved. She was discharged six days after admission.

Our patient had this to say about her condition at this sensitive time for her, and her stay at Doctors Hospital “The beginning was rough as I tried to process what was happening. I felt frustrated, but they [Doctors Hospital team] helped bring it down to my level of understanding, and after that, everything went smoothly.”

Besides Dr Esack, our patient was cared for by a team of skilled nurses, pharmacy staff, imaging, and lab professionals and we’re proud to be able to offer a multidisciplinary team approach consisting of such highly qualified health professionals.

Since then, our patient has undergone follow-ups in our Outpatient Clinic and continues to show steady improvement. Her strength in her limbs, speech, and swallowing have all returned to normal. But still, healing takes time. When last seen, her eye movements had almost normalized, but she was still left with mild bilateral facial weakness. “But this is improving,” shares Dr. Esack.

GBS patient recovery can extend from a few weeks to several months and so it is also important to have access to a team you are familiar with and trust as you go through the process of recovery.

There are health lessons for all in this case too. Although many illnesses turn out to be common and mild, it isn’t always the case.

If you find yourself developing an acute (sudden onset) difficulty with speech, swallowing, or mobility (mainly if this has occurred after an infection [viral or bacterial]), seek medical attention sooner rather than later.

A message from our mom-to-be, “Everybody knows their body best. If you feel like you’re not your normal self. Just go see a professional. You never know. You could actually save yourself.”

PPS The patient delivered a normal healthy baby boy and both mother and baby are doing well

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Doctors Hospital offers comprehensive services on-site at our hospital in George Town, at the top of Walkers Road, and we’re privileged to have state-of-the-art MRI or CT Imaging that’s the best in the Caribbean. Our pharmacy is dedicated to serving patients staying within our walls or quickly grabbing their prescriptions with an average 15-minute wait time but more importantly, as a hospital-located pharmacy, has the expertise to source and manage drugs that are unusual too.

As we commemorate International Nurses Day, a day dedicated to honoring the invaluable contributions of nurses worldwide, we take a moment to reflect on the significance of their unwavering dedication and compassion. At Doctors Hospital, a leading private healthcare facility in the Cayman Islands, our exceptional team embodies the spirit of nursing excellence. Today and every day, we celebrate the remarkable efforts of our nurses and express our heartfelt gratitude for their resilience, compassion, and commitment to patient care.

In the face of the COVID-19 pandemic, music played a vital role in uniting and inspiring the medical community worldwide. “Jerusalema,” a song that symbolizes resilience and hope, became a powerful anthem for healthcare professionals. Its uplifting melody resonates deeply with our dedicated staff even today. Watch the video of them dancing to the infectious rhythm of the song in celebration of International Nurses Day.

Inspired by the song’s message of unity, we strive to create an environment where patients feel supported, safe, and cared for with utmost dedication.

We extend our deepest gratitude to the remarkable nurses and staff at Doctors Hospital. Their selflessness, compassion, and unwavering dedication have been an inspiration to us all. In the face of uncertainty, they have remained steadfast in their commitment to patient care, going above and beyond to provide the highest standard of medical services. The impact of their work reaches far beyond the walls of our facility, touching the lives of individuals and families in our community.

At Doctors Hospital, we are proud to be a part of the medical community that embraces the spirit of “Jerusalema” and channels its message into our daily work. Our comprehensive range of healthcare services, including state-of-the-art imaging, a range of specialty services, lab and pharmacy, ensures that every patient receives the highest quality care. As we move forward, we are committed to being here for the health of our community and here for you, our valued patients.

A recent patient testimonial:

I had the feeling that this nurse really understood my condition and what scenarios it may take in the hours ahead and that she was “On Guard”. Luckily my symptomatic status did not change through the night, however, Nurse Sujatha very regularly check on me, gave my injection and monitored by cardiac and respiratory signs. I slept very well at DH that night. Nurse Sujatha applied the very gentle nursing appropriate care touches. So, anyone would say that she did her job and I whole-heartedly agree… but there was more in her sincere look of compassionate concern in her eyes and face. It was calming to a different degree that I have ever felt previously while in a hospital. I felt safe in the hands of an experienced, knowledgeable and caring Nurse.

Here for health. Here for you. Happy International Nurses Day!

World Health Day is celebrated annually on April 7th to draw attention to specific health concerns faced by many across the globe. Here in Cayman, we’re grateful to work alongside our partners in health to establish high-quality healthcare practices, services and offer state-of-the-art technologies to better care for our patients. Under this year’s theme for World Health Day, “Health for All” we’re celebrating our partnership with Integra Healthcare Ltd, who we joined forces with in May 2022 to support our local island community and international patients with the most comprehensive care available in the Caribbean. Together, we’re co-developing next-generation healthcare, right here in the Cayman Islands.

Here’s how:

Integra Healthcare specializes in a variety of different healthcare needs for their patients; these include:

• Family Health and Medicine
• Otolaryngology (ENT)
• Aesthetics and Cosmetic Surgery
• Midwifery Services
• Fertility Services
• Gynaecology Services
• High-risk Obstetrics
• Fetal Medicine
• Paediatrics
• Newborn and Neonatal Care
• Dermatology + Paediatric and Adolescent Dermatology
• Skin Cancer Screening
• Vaccinations and Screenings

The Integra Healthcare Paediatrics team is the largest on the Island, with several neonatologists from tertiary London teaching hospitals. The OBGYN team includes Dr. Madhavi Manoharan, who has advanced training in fetal medicine, and Lisa Joels, who specializes in diagnosing and treating infertility.

Doctor’s Hospital offers the most advanced diagnostics and hospital services. The services offered include:

• Neurology
• Interventional Radiology
• Orthopaedics and Traumatology
• Rheumatology
• Cardiology
• General Practice
• Oncology
• Paediatrics
• Radiology
• Health Screening
• Surgery (General Surgery, Colorectal Cancer Surgery, to name a few.)
• 24/7 Urgent Care
• Child and Adolescent Health
• Obstetrics and Gynaecology
• Anesthesiology
• Diet and Nutrition

Doctors Hospital offers state-of-the-art imaging technology. This includes the most advanced CT machines to date; the 512-slice GE Revolution CT with 2nd Generation Gemstone Dual Energy and 16cm coverage. This machine offers faster scanning, lower doses of radiation, and provides the most precise images than any machines on Island. The CT scan is not the only state-of-the-art machine at Doctors Hospital, but also the MRI. Again, this is one of the most advanced MRI machines to date; the 1.5 Tesla GE Signa AIR Voyager with Deep Learning Reconstruction.

Do you have a passion for health as a career? You may be interested in joining our Doctors Hospital and Integra Healthcare Ltd family, please revert to the links below to browse the careers sections, and find what best suits you.

https://www.integra.ky/careers/

Careers

Doctors Hospital (DH) and the Cayman Islands Cancer Society (CICS) recognized March as Gastrointestinal and Colorectal Cancer Awareness Month in the Cayman Islands. Gastrointestinal cancer develops around the GI tract, which is known as the digestive tract. Colorectal Cancer, more specifically, is a cancer that begins in the large intestine.

Colorectal Cancer is statistically proven to affect 1 in 23 men and 1 in 25 women (US statistics). According to the American Cancer Society in the United States, in 2023, there were about 26,500 cases. 15,930 of these being men and 10,570 of those cases being women.

DH and the CICS cosponsored a Continuing Medical Education (CME) event on March 29th, 2023 to discuss these trends, technologies in screening for this cancer and advancements in treatment.

Generally, a CME serves as an opportunity for medical professionals to maintain, develop and increase the knowledge, skills and professional relationships that they use to provide services to patients. This event saw many medical professionals come out and share their thoughts on gastrointestinal and colorectal cancer in the Cayman Islands. It was insightful and thought-provoking—the night comprised of four healthcare professionals (see list below) speaking on the issue from their area of expertise and responsibilities.

• Dr Nick Gent, Chief Medical Officer of Cayman
• Dr Darley Solomon, Chief of Surgery & General Surgeon at DH
• Dr Yaron Rado, Chief of Radiology at DH
• Dr Sanjay Awasthi, Oncologist at DH

The push for screenings was heavily stressed so that early detection takes place. This can help reduce the risk of advanced cancer and lower the risk of undergoing operations and chemotherapy treatments.

Dr. Sanjay Awasthi, who is an Oncologist, shared his perspective on the advances in colon cancer, covering earlier detection, more precise treatment, shorter chemotherapy and new surgical approaches.

Dr. Yaron Rado, the Chief of Radiology at Doctors Hospital, expressed that the new Dual Energy 512 slice Revolution CT machine at Doctors Hospital is more than ready to be a regular part of the gastrointestinal screening program for colon cancer in the Cayman Islands.

This machine offers uncompromised image quality, clinical capabilities across all clinical areas, next generation AI/Deep Learning image reconstruction and best-in-class spatial resolution. Clinical lingo for, it’s a state-of-the-art machine and we’re indeed fortunate to have it available here in Grand Cayman.

So, what are the symptoms that you should look out for? With gastrointestinal cancers, it is essential to look out for the following signs:

• Pain or discomfort in the abdomen
• Loss of appetite
• Nausea or vomiting
• Weight loss
• Bleeding (vomiting blood or passing blood in stool)
• Early satiety (cannot eat a complete meal because of a “full feeling”)

Please note that these symptoms do not mean you have gastrointestinal cancer, but it is good to check with your healthcare physician if any of the following symptoms occur.

Dr Darley Solomon, Chief of Surgery and General Surgeon at DH has been working with CICS, championing the screening of colorectal cancer since his return to Cayman over 10 years ago. This cancer is preventable. How do we know this? Because it begins with a mole, it’s called a polyp. And over time, it can develop into a cancer.

“If we can catch these polyps early enough, you won’t have to deal with it developing into a cancer” – Dr Darley Solomon.

Why we work with CICS:

The Cayman Islands Cancer Society is a non-profit charitable organization established in 1995. They receive no assistance from the government and rely on donations which it receives from individuals and corporations.

The Cayman Islands Cancer Society uses its donations and puts them back into the community. Whether it is by supporting public health initiatives, educating, and informing on prevention, providing financial aid and assistance (provided to cancer patients who need financial help), and they provide voucher programs for those who qualify to help them get screened. You can visit their website to learn more. [https://www.cics.ky/]

“Properly constructed screening systems, designed to achieve the best outcomes, are complex and need to be carefully constructed around call-recall systems and multi-disciplinary care management system. Simple opportunistic one-stage testing can rarely, if ever, be effective.” – Dr Nick Gent, Chief Medical Officer

Over the next 5-10 years Colon Cancer is predicted to be the leading cancer killer of all people under the age of 50. Colorectal Cancer is preventable. Get screened, and build a relationship with your healthcare providers. At Doctors Hospital we offer a wide variety of services alongside our partners in health, Integra Healthcare.

If you or someone you know is experiencing joint pain, stiffness, or swelling, it may be time to see a rheumatologist. Rheumatologists are doctors who specialize in the diagnosis, treatment, and management of rheumatic diseases, which can affect the joints, muscles, bones, and organs. But how do you know when it’s time to see a rheumatologist? To answer this question, we spoke with Dr. Sharon Chambers, Rheumatologist, and Dr. Grant Rogers, GP. Here’s what they had to say:

What are some common rheumatic diseases?

Dr. Sharon Chambers, Rheumatologist: “Some common rheumatic diseases include osteoarthritis, rheumatoid arthritis, lupus, gout, and fibromyalgia. These diseases can cause a wide range of symptoms, such as joint pain, stiffness, swelling, fatigue, and fever.”

When should someone see a rheumatologist?

Dr. Grant Rogers, General Practitioner: “As a family physician, I often refer patients to rheumatologists when they have joint pain or swelling that is not responding to traditional treatments, such as over-the-counter pain relievers or physical therapy. I also refer patients who have a family history of rheumatic diseases or who have symptoms that suggest a systemic disease, such as lupus.”

Dr. Sharon Chambers, Rheumatologist: “I agree. It’s important to see a rheumatologist if you have persistent joint pain, stiffness, or swelling, especially if it’s affecting your ability to perform daily activities. In some cases, early intervention can help prevent long-term joint damage and disability.”

What can someone expect during a rheumatology appointment

Dr. Sharon Chambers, Rheumatologist: “During a rheumatology appointment, we’ll start by taking a detailed medical history and performing a physical exam. We may also order imaging tests, such as x-rays or MRIs, or blood tests to help diagnose your condition. Depending on your diagnosis, we may recommend a treatment plan that could include medications, lifestyle changes, or physical therapy.”

Dr. Grant Rogers, General Practitioner: “It’s also important to note that rheumatologists often work closely with other healthcare providers, such as physical therapists and occupational therapists, to provide comprehensive care. They may also collaborate with your primary care physician to monitor your overall health and manage any other conditions you may have.”

Final thoughts

If you’re experiencing joint pain, stiffness, or swelling, don’t hesitate to talk to your doctor about seeing a rheumatologist. With the right diagnosis and treatment, you can manage your symptoms and improve your quality of life.

Remember, early intervention is key. So if you have any concerns, speak up and get the care you need.

When it comes to our health, food is more than just fuel. As a Dietitian working at a hospital, I have seen firsthand the transformative power that food can have on our bodies and minds. By making small changes to our diets, we can unlock the potential of food to improve our health and wellbeing.

At Doctors Hospital, I work closely with healthcare specialists to help patients understand the connection between their diet, lifestyle and their health. Together, we develop personalized nutrition plans that take into account each patient’s unique needs and goals.

One of the most important things to keep in mind when it comes to nutrition is that there is no one-size-fits-all solution. Everyone’s body is different, and what works for one person may not work for another. That’s why it’s so important to work with a healthcare professional who can help you develop a nutrition plan that is tailored to your specific needs.

Another key factor in unlocking the potential of food is to focus on whole, nutrient-dense foods. This means choosing foods that are as close to their natural state as possible, such as fruits, vegetables, whole grains, nuts, and seeds. These foods are packed with vitamins, minerals, and other nutrients that our bodies need to function at their best.

Of course, we all have our favorite indulgences, and there’s nothing wrong with enjoying a treat now and then. However, it’s important to remember that these foods should be enjoyed in moderation, and that they should not make up the bulk of our diets.

Finally, it’s important to approach nutrition with a positive mindset. Food is not something to be feared or avoided; rather, it is something to be enjoyed and celebrated. By focusing on the positive aspects of food and the benefits that it can bring to our bodies and minds, we can unlock its true potential and improve our overall health and wellbeing.

If you’re interested in learning more about how to unlock the potential of food, I encourage you to speak with a healthcare professional or a registered dietitian. Together, you can develop a nutrition plan that works for you and helps you achieve your health and wellness goals.

Remember, food is more than just fuel. It has the power to transform our lives and unlock our full potential. Let’s embrace it with open arms and enjoy all the benefits that it has to offer.

GRAND CAYMAN – May 2022 – Doctors Hospital (“DH”) has announced its acquisition of Integra Healthcare Ltd with a view to co-developing next-generation healthcare for patients in Cayman. DH and Integra share a commitment to evidence-based medicine delivered by leading tertiary medical and nursing staff. Under the Doctors Hospital umbrella, the combined group will work towards developing a seamless approach to clinical healthcare, including primary care, specialist care, diagnostics, and more. 

Dr Yaron Rado, Chief Radiologist and Chairman of the Board for Doctors Hospital, explained, “Our deep Cayman roots – spanning more than two decades – have provided us with the privilege of helping shape the healthcare system here. We’ve proudly dedicated significant resources and innovations to the support of our community. We continue to invest in our facilities, top-of-the-line technology, and the clinical talent that will help further elevate healthcare delivery locally, without the need for patients to travel abroad for medical treatment. In alignment with this, the team of professionals at Integra brings years of experience and an impressive set of credentials to the DH family. We are genuinely excited to welcome them and what we can achieve together for our patients.”

Speaking about the future, Dr Francisco Martinez, Medical Director at Integra, said, “Integra has built an unrivalled reputation for care, delivered by a highly respected team. Primary care is the gateway to hospital services, and when patients need hospital care, that need is often urgent. This collaboration will help support improved speed and coordination of care for patients, ensuring that our patients are provided with a service that is truly extraordinary.”

Dr Sara Watkin, Consultant Paediatrician, Neonatologist, and Clinical Director of Care for Maternity and Paediatrics, added, “At Integra, we already have the Cayman Islands’ most comprehensive combined women’s and children’s service. We will now be able to co-develop these services hand-in-hand with Doctors Hospital, ensuring that maternity, neonatal, and paediatric care and facilities are designed and evolved with care quality, patient experience, and exceptional service at their heart. I am passionate about all of these dimensions, so this was just too exciting an opportunity to pass up.”

Andrew Vincent, Director at Integra, shared his perspective, “Our view has always been you can either lead the changes we need to see happening in healthcare or be subject to the changes others decide for you. We have always favoured the former and notice the same tendency in Doctors Hospital too. DH is an organisation that has demonstrated tremendous resilience, an increasing commitment to the same ideals as Integra around quality and levels of care and has the financial resources and commitment to invest in best-in-class facilities and equipment, too. I believe we can do truly breath-taking things together that will benefit the entire population of Cayman. I know we have a combined team committed to and excited by the challenge of creating an enviable standard of care and services that is accessible to all and supports a healthy future for the Cayman Islands.”

The combined group puts primary care, office-based specialist care, diagnostics, urgent care, hospital medicine, and surgery within the same organisation, creating the Cayman Islands’ most comprehensive private healthcare group.

To book an appointment with Doctors Hospital:

Contact DH Care Centre at (345) 325-9000 (ext. 1), or (345) 949-6066.

To book an appointment with Integra Healthcare:

You can book an appointment online with any of the Integra physicians. Please select the booking button against the physician you’d like to book with and you will see live availability. Your appointment with be instantly confirmed. If you are unsure of who to book with, please see our services prior to confirming your appointment at Integra.

Appointment Availability:

If you cannot see an Integra appointment slot available, please call us on (345) 745-7450 within office hours, and we will do our best within our capacity.

Sick Children Specifically:

Please call us on (345) 745-7450 within office hours or on the Paediatric Out-of-Hours Service (345) 326-4370 (Note: Calls only, Out-of-Hours Only) as we carry specific sick child capacity to help ensure your child can be seen when necessary.

Doctors Hospital helped to support the music and arts community at this year’s Cayman Arts Festival (CAF) which included young musician and rising star Dequan Smith…

Doctors Hospital Supporting Cayman Arts Festival and Young  Musicians