Blogging From the Caymans One Last Time

It’s hard to believe that about 15 years ago, I began seeing patients in Grand Cayman several times a year and that this is my last trip. Not that the Cayman advanced treatment site will be any worse for wear. In fact, the Cayman site is about to get a big upgrade with a CSC fellow moving his practice and family here full-time. So, let’s dig into a little history and why this is my last visit.

The Grand Cayman Site

In 2005, I began using culture-expanded mesenchymal stem cells derived from bone marrow as part of an IRB-approved study. It’s crazy how far ahead that procedure was almost two decades ago. Most physicians had never heard of the term “stem cell” in 2005, and the few that had would have been using things like bone marrow concentrate. After two years of basic safety and efficacy clinical research, we began offering the procedure in our Colorado practice. That all went well until the FDA took the position that even though we were using the patient’s own cells, this was a drug. So, several years later, it was clear that if we were to continue this work, it would have to be in a country that recognized the use of those cells as the practice of medicine. At a medical conference, my practice manager met Phillip Ebanks from Cayman, and the idea was born that a new home for that technology could be here. Thus, I began a pilgrimage from Colorado to Grand Cayman several times a year to continue doing this important work.

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Growing Up In Grand Cayman

I grew up in South Florida, and when I escaped the heat to move to Colorado, I thought I had found climate magic. The place was dry and beautiful, temperate in the winter, and no matter how hot it got in the summer, you could always find a cooler spot by going up into the mountains. Growing up in South Florida as one of seven kids whose dad was an electronics salesman meant we all worked summers to help pay for college. For me, that often meant construction sites in the intense South Florida sun where the only air conditioning I got all day was when the afternoon rain showers came in; so when I say that Colorado was escaping the heat, my relationship with the Florida summer heat was different than most.

When I first came to Cayman to continue using culture-expanded cells, it reminded me quite a bit of South Florida. Meaning I had escaped the Florida heat only to find myself right back in it! Now granted, the Caribbean is cooler than South Florida, largely because of the trade winds, but suffice it to say that my first few visits down here reminded me of those summers working outside.

Most of my kids turned out to be my climate opposite. They loved coming to Grand Cayman. In fact, in a very real way, my kids grew up here part-time. I had always joked to my wife that having grown up around the beach I wanted to live in the mountains, but our kids who grew up in the mountains would crave the beach. That all turned out to be very true.

I would often say, tongue in cheek, that the net result of our crazy whirlwind disagreement over the regulation of cultured cells forced me to spend 6 weeks a year living on the beach while seeing patients! I also would eventually love my trips to Grand Cayman as we experienced this little island turn into a first-world hub for banking and finance. One of my favorite things to do on earth became the long walks at night on a 7-mile beach, commuting from our condo to various restaurants. That was always a great time to reconnect one-on-one with family.

Getting Older

As the years passed, I became older, like many of my patients. Age for a physician is the world’s greatest teacher, as you suddenly find that many of the problems your patients presented to you through the years are no longer abstract. They become the problems you experience firsthand. For example, that knee you injured 20 years ago comes back to say “hello,” or that achy back turns it up a notch.

Last year, I turned 60. As I have often told the younger doctors in our practice, unlike many workaholics, I wouldn’t be the kind to die at my desk. The experience of watching my own father get very sick towards the end of his life and not get to do the things he and my mother had always wanted to do had taught me a valuable lesson. That exiting stage left while you can do that gracefully is far preferable to the alternative. Hence, back in 2022, post-pandemic, I bought a boat and have been taking a few months a year off to sail the Mediterranean with my best friend and wife.

As life would have it, as that plan came into focus, I found my personal medical practice focusing more on the treatment of craniocervical instability or CCI. This was because, true to form, I had developed a new procedure to treat that difficult problem without surgery. As I began to see more and more of these patients, it became clear that between time off sailing and seeing these patients, coming to Grand Cayman three times a year was no longer a good fit for me. Hence, about a year ago, I decided to wind down this part of my practice and leave this beautiful island and special work site to my younger colleagues at CSC and the Regenexx network.

My Last Trip

This last trip to Cayman was supposed to be just my wife and I. However, two of my kids, who grew up in Cayman and love it like a second home, tagged along at the last moment. They couldn’t miss one last time here. My son, who gets capitalism like you and I breathe air, has decided that he wants to buy a house here on the beach. I have no doubt that he will be able to do just that, even though Cayman Beach properties have become crazy expensive.

Word went out to my patients, many of whom I have been seeing for 1-2 decades, that this was my last trip here. Hence, this clinic is special, as many flooded here one last time. It’s crazy seeing my aging face in the mirror and then greeting their aging faces. It’s also wonderful greeting them again down here, sometimes after 5 or 10 years since their last treatment. For example, I saw a young man yesterday whose right knee I last treated in 2015, who only now needs another treatment. When I first met him, he was a 20-year-old kid, and now he’s finishing law school and is a young man of 30.

What Will Happen to the Cayman Clinic?

The Cayman clinic will continue. This site was always set up with a local owner, Phillip. He is now bringing on Chris Williams, M.D., who is one of our fellows who has been practicing in Atlanta. Chris is moving his family here and will be full-time. So, the Cayman clinic will have an expert IO physician down here every day rather than a few weeks a month. In addition, the CSC physicians and the Regenexx network doctors will continue to bring their own patients. So, this advanced culture expansion site will continue to be even more robust than in the past.

The upshot? This is my last time “Blogging Again from the Caymans.” I will miss my patients down here and the long beach walks at night. However, with how much my kids love the place, I suspect I’ll be back, but likely as someone’s grandfather rather than their doctor!

Chris Centeno, MD is a specialist in regenerative medicine and the new field of Interventional Orthopedics. Centeno pioneered orthopedic stem cell procedures in 2005 and is responsible for a large amount of the published research on stem cell use for orthopedic applications. View Profile

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