< PreviousHealth & Wellness 202310 FRIDAY, 27 OCTOBER 2023 WELCOME MESSAGE FROM SABRINA TURNER Minister for Health and Wellness Welcome to the 14th annual Cayman Islands Healthcare Conference. The Ministry of Health & Wellness understands the importance of hosting this conference annually, and we are grateful for yet another opportunity to bring this important information to professionals and lay persons alike. This year’s theme – Bridging the Gap Between Patient and Practitioner; Pathways to Optimal Health – is not only relevant, but also directly informed by our Ministry’s data-driven approach to decision-making. Data is an essential tool to bridge gaps in knowledge, access, services and policies, all of which help to mitigate the gap between individual patients and their practitioners. It is all interconnected, and we are looking forward to seeing how presenters connect the dots so that everyone can benefit from this information. The team in the ministry is continually looking at ways to gain a better understanding of the general health of the nation and use that information to effect policy, social and cultural change in the healthcare space which, in turn, helps to improve the patient-practitioner relationship. As I hope everyone is aware, we have recently completed the STEPS 2023 National Health Survey. STEPS 2023 will provide us with much needed data on the national prevalence for key non-communicable diseases and their risk factors. This national health survey was an exceptionally complex, taxing, time-consuming undertaking, that simply had to be done in order to help us address our data gaps. Along with obtaining invaluable information, conducting the STEPS survey has also served to cement the need for more regular, consistent and reliable data collection. Thus, we are diligently working on revamping, modernising and scaling up public health programmes and initiatives in order to deliver public health nationally. This is a priority of the current administration. It is imperative that, as a ministry, we have access to data from both private and public health practitioners so that we can compile accurate statistics about the prevalence, profile and demographics of illnesses and diseases in the community. This information is essential if we are to take a more proactive and preventative approach to managing the country’s collective health. Public health works at its best when it can capture and provide information from all spheres, and our goal is to provide an information clearinghouse for both government and health practitioners to use as we aim to protect, empower and improve the lives, health, and wellness of families and communities. Sabrina Turner Minister for Health and Wellness11 FRIDAY, 27 OCTOBER 2023 Health & Wellness 2023 In November 2019 Cindy Oostvogels felt a tiny lump, the size of a frozen pea, under her right breast. She booked an appointment with her doctor who recommended a mammogram and ultrasound. Nothing looked suspicious, however they decided to remove it for analysis. In July 2020 she found a new lump under her right nipple. Her doctor ordered a mammogram, ultrasound and biopsy. The country was now in lockdown, and Cindy became very anxious. “Waiting for the results was agony as you can imagine,” she says. “Will I need chemo? Or radiation? Will I lose my breast or part of it? Do I stay in Cayman if it is cancer, or do I go off island?” In August 2020 Cindy was diagnosed with hormone positive breast cancer in her right breast. She was devastated. But that was just the beginning. The next step was to undergo an MRI and CT scan. With her insurance benefi ts exhausted from mammograms, biopsies and ultrasounds, Cindy was told she would have to pay for these tests herself, totalling almost $8,000. Cindy’s business had been closed now for three months due to COVID, and her savings were depleted as the bills kept coming in. “I started crying and asking how am I going to pay for this?” remembers Cindy. “Dr. Tanja Ebanks suggested I write to the Cayman Islands Cancer Society (CICS) for assistance, a suggestion which was echoed by a friend of mine.” In less than a week, CICS agreed to cover the cost of the MRI and CT scan. The MRI results concluded that Cindy also had cancer in her left breast. She decided to get a double mastectomy. This surgery was covered by her insurance, but subsequent surgeries, check-ups, tests, and medications were not. CICS continued to support Cindy, covering her bills throughout this physically and emotionally draining journey. “All the surgeries were done here on-island at Doctors Hospital and I had the benefi t of recuperating in my own home, which gave me much comfort,” Cindy says. “CICS was with me every step of the way. I have no doubt that I would not be alive today, if it were not for the Cayman Islands Cancer Society, with assistance from the Breast Cancer Foundation (BCF). I am healthy and happy thanks to CICS. Whatever I can do to assist them to raise money or awareness, I’m ready to help.” In February 2022, Cindy started the Shop for A Cause Yard Sale at the George Town Yacht Club. The CICS and the BCF were the fi rst charities to receive funds. She is currently co- organising a golf tournament at The Ritz-Carlton Golf Course in December 2023 to raise money for the BCF. “If anyone you know needs fi nancial assistance for a cancer diagnosis, do not hesitate to contact the Cayman Islands Cancer Society,” Cindy urges. “Early detection saves lives.” Cindy Oostvogels Shop for a Cause Sale: Meals on Wheels 2022Health & Wellness 202312 FRIDAY, 27 OCTOBER 2023 When it comes to healthcare, the term ‘holistic’ may conjure images of natural therapies. However, it is more than this. Holistic healthcare refers to an approach to medicine which addresses all aspects of a person’s well-being, rather than purely focusing on specific diseases or treatments. Drs. Roland Talanow, David Kwinter and Michael Boucher of Cayman Medical, collaboratively break down this approach and its benefits to patients and healthcare teams, and highlight where Cayman is lacking in this healthcare model. Q: Is holistic healthcare a new idea? A: Holistic healthcare is not a new concept, but rather one that has ancient roots. The idea of treating the whole person – body, mind, and spirit – can be traced back thousands of years to various traditional medicine systems worldwide such as ancient Chinese, Indian, Greek, Native American and African traditional medicine. Over time, especially during the rise of modern Western medicine in the 19th and 20th centuries, there was a shift towards specialisation and compartmentalisation. The advancements in science and technology led to incredible breakthroughs in understanding diseases and developing treatments. However, this also meant that healthcare often became more focused on treating specific symptoms or diseases rather than the whole person. Holistic care exists to varying degrees in different jurisdictions. In areas with strong primary care (where most patients are attached to a longitudinal family physician), care is more holistic as there is a continuous relationship from which all patient needs can be addressed. The trend towards sub-specialisation is important and represents advancements in medicine, however maintaining a relationship with a family physician who helps their patients navigate the system is critical. Q: Why do you think access to holistic care is an important part of a country’s healthcare system, and patients personal healthcare journeys? A: Holistic care is designed to address what are known as ‘biopsychosocial factors’ which can predispose a patient to certain diseases and compromise a patient’s ability to recover from health problems. Healthcare can be more effective if factors that impact patients’ outcomes are managed with comparable importance as their specific medical conditions. Some of the key benefits to patients of holistic care are: 1. Comprehensive care: All aspects of a patient’s well- being are addressed, not just physical symptoms. This can lead to more effective treatment outcomes and better overall health. 2. Empowerment: Patients are encouraged to take an active role in their health, leading to increased autonomy and self-efficacy. 3. Prevention: A focus on lifestyle, nutrition, and well- being can prevent many chronic diseases, reducing the incidence of illness and the associated costs. 4. Addressing root causes: Instead of just treating symptoms, identifying and addressing the root causes of illness can lead to longer-lasting health outcomes. 5. Mental and emotional well-being: By acknowledging the interconnection between mental, emotional, and physical health, holistic care can help address issues like anxiety, depression, and stress. 6. Reduced side effects: Holistic treatments, which often include natural and non-invasive therapies, tend to have fewer side effects than some conventional medical treatments. The benefits to practitioners include: 1. Job satisfaction: Many practitioners find it deeply fulfilling to treat patients as whole individuals rather than just addressing isolated symptoms. 2. Better patient relationships: A deeper, more Holistic healthcare13 FRIDAY, 27 OCTOBER 2023 Health & Wellness 2023 collaborative relationship between patients and healthcare providers, leading to better communication and trust. 3. Broader toolkit: A wider range of therapeutic options, from traditional medical treatments to alternative therapies. This fl exibility can be invaluable, especially for complex or chronic conditions. 4. Long-term patient outcomes: Focusing on root causes and overall well-being can lead to better long- term outcomes for patients. 5. Interdisciplinary collaboration: Leading to a richer exchange of ideas and approaches. Benefi ts for the healthcare system: 1. Cost savings: Emphasis on prevention can reduce the burden of chronic diseases and expensive treatments on healthcare systems. 2. Improved public health: A population that is educated about holistic health principles is likely to have better overall health outcomes. 3. Patient satisfaction: Patients who feel seen, heard, and treated as whole individuals, are more likely to be satisfi ed with their care, leading to better reviews and trust in the healthcare system. 4. Reduced burden on specialised services: Addressing health issues holistically can prevent the progression of diseases that would otherwise require specialised care. Q: Does Cayman’s healthcare system, whether private or public, cater for holistic healthcare? A: Although pockets of holistic healthcare do exist in Cayman, it is generally lacking, overall. Specialist care is often fragmented resulting in patients doing a lot of back-and-forth between providers. Barriers put in place by some insurance companies with respect to whom their patients may see, limits access to appropriate and timely care. While done to arguably reduce costs in the short term, we know that effective holistic care can prevent serious disease, improve outcomes, and lower costs in the long run. Q: What can be done to improve holistic healthcare offerings? A: Providers should work to seamlessly provide online access to test results, barriers to family physicians caring for patients should be removed, and providers should be encouraged to collocate to improve communication as well as patient experiences and outcomes. To have holistic care, a patient should have a family physician who works closely with an interdisciplinary team that takes care of the whole patient and oversees all aspects of their health. Ideally, these teams should be located under one roof to facilitate improved communication and information sharing, as well as to provide a better patient experience. Dr. David-Kwinter Dr. Roland Talanow Dr. Michael BoucherHealth & Wellness 202314 FRIDAY, 27 OCTOBER 2023 TIPS TO TACKLE CHILDHOOD OBESITY Set a good example. Make healthy eating and regular physical activity a family affair. Everyone will benefit and no one will feel singled out. Have healthy snacks available. Options include air-popped popcorn without butter, fruits with low-fat yogurt, baby carrots with hummus, or whole-grain cereal with low-fat milk. Offer new foods multiple times. Don’t be discouraged if your child doesn’t immediately like new food. It usually takes multiple exposures to a food to gain acceptance. Choose non-food rewards. Promising candy for good behaviour is a bad idea. Be sure your child gets enough sleep. Some studies indicate that too little sleep may increase the risk of obesity. Sleep deprivation can cause hormonal imbalances that lead to increased appetite. Have an annual well-child check-up. Be sure your child sees the doctor for well-child check- ups at least once a year. During this visit, the doctor measures your child’s height and weight and calculates their BMI. A significant increase in your child’s BMI percentile rank over one year may be a possible sign that your child is at risk of becoming overweight. Obesity in childhood is a growing public health concern in the Cayman Islands. According to 2022-23 data from the School Health Programme, 26% of children entering school were either overweight or obese, and that percentage climbed to 40% for Year 6 students. Simone Sheehan, dietitian with the Health Services Authority, discusses the impact of childhood obesity, its contributing factors, and steps to address this multi-faceted issue. Q: WHAT ARE THE MAIN HEALTH IMPACTS OF CHILDHOOD OBESITY? A: Obesity in childhood is one of the most challenging public health issues in the 21st century and has emerged as a pandemic health problem worldwide. Childhood obesity can profoundly affect a child’s physical health, social and emotional well-being. They may experience teasing or bullying by their peers. This can result in a loss of self-esteem and an increased risk of depression and anxiety. Children who are obese tend to stay obese in adulthood and are prone to increased risk for diabetes, hypertension and cardiac problems at a younger age. Q: CHILDHOOD OBESITY HAS BEEN A BIG CONCERN IN CAYMAN – AND WORLDWIDE – FOR QUITE SOME TIME. WHAT ARE SOME OF THE MAIN FACTORS CONTRIBUTING TO THIS ISSUE? A: The prevalence of childhood obesity worldwide has alarmingly increased. The overall burden of obesity has almost tripled since 1975. However, an eight-fold increase in obesity burden in the 5-to-19 years age group has been noted between 1975 and 2016. According to school entry screening statistics provided by the Public Health Department, 26% (571) of children ages 4 to 6 were reported overweight or obese during 2022-23. And 41% (13) of Year 6 students were reported to be overweight or obese during 2022-23. Lifestyle issues which include too little activity and too many calories from food and drinks are the main contributors to childhood obesity. Regularly eating high-calorie foods, such as fast foods, baked goods, vending machine snacks, candies and ultra-processed foods, can cause a child to gain weight. More and more evidence also points to sugary drinks, including fruit juices and sports drinks, as culprits. Genetic and hormonal factors might play a role as well. If a child comes from a family of overweight people, they may be more likely to put on weight. This is especially true in an environment where high-calorie foods are always available and physical activity isn’t always encouraged. Lack of exercise is a contributor. Children who don’t exercise much are more likely to gain weight because they don’t burn as many calories as those who do. Too much time spent on sedentary activities, such as watching television or playing video games, and extended screen time, also contributes to the problem. TV shows also often feature ads for unhealthy foods. Q: IN YOUR VIEW, HOW BIG OF A CRISIS IS THE RATE OF OVERWEIGHT/OBESITY FOR CAYMAN’S YOUTH? A: For the past six years, rates of overweight/ obesity have remained stable among children ages 4 to 6, peaking during 2021-22 at 35% (104). However, we’ve seen a significant increase in overweight/obesity among Year 6 students. During 2017-18, Public Health reported 12% (3) students obese/overweight. This number has increased to 41% (13) in 2022-23. Based on these statistics, the children entering high school would, in the long-term, be more at risk for obesity in adulthood and other co-morbidities such as type 2 diabetes, hypertension and heart disease. Based on historical data comparing the current data to the incidence of overweight/obesity from 2011-12, the incidence of being overweight/ obese in Year 6 students has increased by 3.7%. Q: WHAT DO YOU SEE AS SOME OF THE SOLUTIONS TO ADDRESS CHILDHOOD OBESITY? A: To improve health outcomes for paediatric obesity, a collaborative care approach is essential. It is a complex issue to solve. Some suggestions include: • Comprehensive obesity management strategies such as interventional programmes, screening and education of individual children at risk, parents/families, schools, and the community. • Ensuring healthy meals/snack policies at schools. • Collaboration between public, primary health and private sector interests to increase sales of nutritious food and to reduce the flood of high fat, sugar and salt products consumed. • Robust free or very affordably priced sports and extracurricular programmes. • Access to comprehensive behavioural intervention opportunities. Childhood obesity: A WEIGHTY ISSUE IN CAYMAN Simone Sheehan15 FRIDAY, 27 OCTOBER 2023 Health & Wellness 2023 Simone SheehanHealth & Wellness 202316 FRIDAY, 27 OCTOBER 2023 The Cayman Islands’ premier medical resource and directory, available on stands island-wide and online at caymanhealth.com. General Health & Wellness | Maternal, Infant & Child Health | Mental Health | Health Administration & Policy | Medical Tourism | Directory Have you been diagnosed with a serious illness? We are here to help. No matter where you are on your journey, our expert team are dedicated to your care and well-being, including while you are receiving treatment. Jasmine will work alongside your primary physician to create tailored care plans that meet your unique needs and preferences, help manage your symptoms, and provide emotional support for you and your family. Our services are 100% free of charge. Contact us to fi nd out how palliative care can improve your quality of life. This ad was generously sponsored by an anonymous donor. jasmine.ky | 945-7447 | info@jasmine.ky Emotion al supp ort Symptom management Bespoke care plans17 FRIDAY, 27 OCTOBER 2023 Health & Wellness 2023 7 Mile Beach Tel: (345) 949-8900 rx@healthcarepharmacy.ky OPEN Mon-Fri 9am-6pm Sat 9am-6pm 1053 Crewe Rd. George Town OPEN 7 DAYS A WEEK Mon-Sat 8am-10pm Sun & Public Holidays 10am-6pm GRAND HARBOUR GOVERNOR’S SQUARE www.healthcarepharmacy.ky ORDER OR REFILL YOUR RESSCRIPTIONS ONLINE AT Tel: (345) 947-8900 healthcaregh@ healthcarepharmacy.kyHealth & Wellness 202318 FRIDAY, 27 OCTOBER 2023 Dr. Piloto currently serves as the medical director at the Huizenga Executive Health Department at Cleveland Clinic Florida’s Weston Campus. His primary focus lies in the prevention of illnesses such as cardiovascular disease, cancer, hypertension, diabetes and obesity. In his role at the Huizenga Executive Health Department, Dr. Piloto leads a multidisciplinary team, offering comprehensive medical care to patients. He believes in disease prevention to enhance patients’ quality of life, and his approach is rooted in proactive healthcare that can prevent disease before it impacts them. Speaking at the opening night of this year’s Cayman Islands Healthcare Conference, Dr. Robert Piloto – medical director at the Executive Health Department of Cleveland Clinic Florida – will give a presentation on ‘Prevention of Disease with Proactive Care’. Here, he outlines simple steps for good health: HEALTHY EATING A balanced diet helps in achieving and maintaining a healthy weight. Obesity is a major risk factor for numerous health issues, including heart disease, diabetes and certain types of cancer. A diet rich in fruits, vegetables, whole grains and lean proteins can help lower the risk of heart disease by reducing cholesterol levels, blood pressure and inflammation. Healthy eating is not just a matter of personal preference; it is the foundation of preventive medicine. A well-balanced diet provides the body with the tools it needs to function optimally and maintain good health throughout life. REGULAR HEALTH CHECKS Regular health check-ups are essential to catch and address potential health concerns before they become more serious problems. They are also an opportunity to discuss preventive measures such as vaccinations, lifestyle changes and screenings that can reduce your risk of developing certain diseases. REDUCING STRESS Reducing stress is crucial for both your mental and physical well-being. Prolonged stress can have a significant impact on your health, contributing to conditions like high blood pressure, heart disease, depression and anxiety. I see many patients that are in professions that deal with high stress, and I always recommend to make time for hobbies or activities that will help them relax. If stress does impact your everyday life, seeking help from a mental health professional is also a valuable tool. Managing stress is an ongoing process, and what works for one person may not work for another. It’s important to experiment with different strategies to find what works best for you. PRACTISING MINDFULNESS Mindfulness is the practice of being fully present in the moment. It can help reduce stress by promoting relaxation and providing a way to manage and cope with stressful situations. One of the most accessible ways to practise mindfulness is through meditation. Some patients have said that they practise mindfulness with other activities they enjoy doing, such as fishing, hiking, writing in a journal, planting flowers, getting a massage, just to name a few. TAKING MEDICATION ON TIME It is crucial to take medication on time and as prescribed, to ensure that it effectively manages your medical condition. Skipping doses or taking them at irregular intervals can reduce their effectiveness, making it harder to manage your medical condition. I always suggest for my patients to set an alarm on their phone to remind them. Also, it’s important to organise your medications with a pill organiser, and setting them in the same place all the time, so you don’t forget to take them. If you have questions or concerns about your medication, always consult with your doctor or pharmacist for guidance. Focus on preventative healthcare PROACTIVE STEPS TO HELP ENSURE OPTIMUM WELL-BEING.19 FRIDAY, 27 OCTOBER 2023 Health & Wellness 2023 Focus on preventative healthcare Next >