Avoiding Holiday Heartburn

Prone to heartburn? You'll want to pace yourself during the holiday feasts.

Prone to heartburn? You’ll want to pace yourself during the holiday feasts.

The holiday season is in full swing and undoubtedly, you’re already salivating at the thought of enjoying Thanksgiving, Hanukkah, Christmas and New Year’s feasts. Unfortunately, many a holiday spread goes awry for those who suffer from acid reflux and resulting heartburn. Acid reflux occurs when stomach acids are regurgitated back up through the upper body, courtesy of an esophageal sphincter failing to close at the right time. The resulting burning sensation in your chest is known as heartburn. For some people, the symptoms may present differently resulting in hoarseness, a sensation of something being stuck in the throat or difficulty swallowing. These are the symptoms of laryngopharyngeal reflux, when acid from the stomach is regurgitated farther than the esophagus up to the larynx.

Even if you’re prone to acid reflux symptoms, you can enjoy Grandma’s holiday turkey and fixings without dread by eating smart.

  • Don’t overdo it: Piling up and chowing down on a heaping plate of food is temping, but overeating or eating too quickly can push acid into the heartburn-generating danger zone. Choose small portions of a few of your favorite items on the table and take your time.
  • Make smart choices: Dark meat has a higher fat content, and fat is a top acid reflux trigger. Choose light meat cuts instead. Avoid creamy or dairy-based foods and sauces and choose multigrain rolls. Know that some otherwise healthy options also can trigger symptoms, too, including citrus fruits, tomatoes, raw onion and garlic.
  • Flavor with ginger: Small amounts of ginger can actually help ease heartburn, and it’s a great way to flavor veggie side dishes including carrots, cabbage, peas, broccoli and green beans.
  • End your meal on a healthy note: Even if you make all the best choices at dinnertime, know that popular after-dinner items can wreck your efforts. Alcoholic or caffeinated beverages and rich, high-fat desserts like chocolate pie are common culprits. In any case, a post-meal walk or a short nap with your head elevated six to eight inches can help to ward off a bout of acid reflux.

The good news is that acid reflux is highly manageable and symptoms can be alleviated with over-the-counter medications. However, if you’re hit with a case that seems more severe than usual, symptoms may be accompanied by a persistent cough, difficulty swallowing or a sensation of something in your throat (globus sensation) that lasts more than two weeks. Then, it may be time to see a doctor.

Five Possible Reasons for Your Nosebleeds

Repetitive nosebleeds may signal an underlying medical condition.

Repetitive nosebleeds may signal an underlying medical condition.

Upward of 60 million Americans experience a nosebleed each year, and not because of clumsiness or someone’s mean right hook. Rather, many of these seemingly instantaneous nosebleeds have no immediately discernable cause. Here are five possibilities:

  1. Dry air: Winter is soon upon us, and with it many hours cozied upon the couch enjoying the warmth of your indoor heater. Trouble is, artificial heat can sap the moisture out of the air in an enclosed space and that can cause your nasal lining to dry out, leaving it highly susceptible to cracking and bleeding. Using a high quality humidifier inside can help keep this type of nosebleed at a minimum.
  2. Use of certain medications: Blood clotting is a necessary step in stopping or preventing a nose bleed. So use of any anticoagulant (blood-thinning) or anti-inflammatory medication can contribute to a nosebleed or hinder its being stopped. Common culprits are prescription medications like warfarin or clopidogrel, as well as over-the-counter drugs like aspirin, and nonsteroidal anti-inflammatory drug (NSAIDS) and any medication prescribed to treat irregular heartbeats or the effects of stroke or heart attack.
  3. Underlying health conditions: While they may seem harmless, some nosebleeds can be an indication of potentially serious underlying health conditions. These may include liver disease, kidney disease or heart conditions like hypertension (high blood pressure) and congestive heart failure.
  4. Drug and alcohol use: Chronic consumption of alcohol or certain illicit drugs such as cocaine can lower the blood’s ability to clot and cause frequent nosebleeds.
  5. Deviated septum: The nasal septum is the wall that separates your right and left nasal cavities. Normally, it’s perfectly straight. But when it’s deviated (leans to one side) air that enters the nose hits the septum where it curves. This causes the lining of the septum to dry, crack and bleed frequently.

An occasional nosebleed typically is nothing to worry about. However, if you or your child experience multiple nosebleeds in a week, or a nosebleed that lasts more than a few minutes or won’t stop with direct pressure, it’s highly recommended that you seek medical treatment. Call 904-461-6060 to schedule a consultation at St. Augustine Ear, Nose and Throat’s St. Augustine or Ponte Vedra locations.

How to Know if you Need a Tonsillectomy

Is it a simple sore throat or tonsillitis?

Is it a simple sore throat or tonsillitis?

Sore throats are a dime a dozen, especially as the temperatures drop and we head into the cold and flu season that begins in September and runs through February. But sometimes, what you’re experiencing is far more serious than a run-of-the-mill throat infection. It just may be tonsillitis.

Because they produce certain types of disease-fighting white blood cells, your tonsils are considered your immune system’s first line of defense against bacteria and viruses that enter your mouth. Unfortunately, this means that your tonsils themselves are particularly vulnerable to inflammation or infection. What you think is a garden variety sore throat may actually be tonsillitis if it’s accompanied by:

  • Pain on one side of the throat
  • Painful or difficult swallowing
  • Hoarseness in your voice
  • High fever
  • Enlarged or swollen lymph nodes or glands in your neck
  • A white or yellow coating on your tonsils
  • Severe or recurring sore throat

Another clue is in the frequency of symptoms. A single case of tonsillitis likely will pass in about 10 days in children, slightly longer in adults. However, if you experience multiple episodes of tonsillitis in year, a tonsillectomy may be in order.

But a sore throat isn’t the only reason to consider a tonsillectomy. Obstructive sleep apnea, a potentially serious disorder in which the throat muscles intermittently relax, blocking your airway and causing your breathing to repeatedly stop and start during sleep, also can be effectively addressed with a tonsillectomy.

If you have children, be aware that tonsillitis is more common in pre-pubescent youth because that’s the period during which the tonsil’s immune system function is most active. However, the condition can hit at any age.

If you believe you or your children are suffering a bout of tonsillitis or may be in need of a tonsillectomy, St. Augustine Ear, Nose & Throat can help. Call 904-461-6060 to schedule a consultation at our St. Augustine or Ponte Vedra locations.

Common Sounds That Can Cause Permanent Hearing Loss

Daily driving a motorcycle or convertible vehicle can contribute to hearing loss.

Daily driving a motorcycle or convertible vehicle can contribute to hearing loss.

Statistics show that some 14 percent of people between the ages of 45 and 64, and one in three age 65 and older experience some degree of hearing loss. Some hearing loss is attributed to natural causes like age, earwax buildup or otosclerosis, an overgrowth of the middle ear bone. But in most cases, it can be attributed to noise exposure.

Noise is all around us every hour of every day. That’s concerning because hearing loss can occur after just a one-time noise exposure at 120 decibels, such as gunfire, or with continuous exposure to noise at levels of 85 decibels or above over a prolonged period of time.

Here are just a few common noises that can cause permanent damage to your hearing:

85-100 decibels:

  • Garbage trucks
  • Power mowers
  • Motorcycles
  • Convertible vehicles
  • Jackhammers

110-140 decibels:

  • Music concerts
  • Home stereo speakers at maximum volume
  • Jet engines
  • Firecrackers
  • Nail guns
  • Ambulance sirens
  • Chainsaws
  • Home stereo speakers at maximum volume

It’s important to know that just one minute of exposure to noises at levels of 110 decibels or higher can result in permanent hearing loss. The good news is that noise-induced hearing damage can be prevented by avoiding or limiting exposure to certain noises and by wearing ear plugs when you know you’ll be in high-noise situations.

If you already have suffered noise-induced hearing loss, you have several options to help improve or restore hearing. These include amplifying systems and hearing aids. Call 904-461-6060 to schedule a consultation at St. Augustine Ear, Nose and Throat’s St. Augustine or Ponte Vedra locations.

Swimmer’s Ear – Do You Know the Symptoms?

If you and your family will spend time in the swimming pool this summer, make sure you know the symptoms and risks of swimmer's ear.

If you and your family will spend time in the swimming pool this summer, make sure you know the symptoms and risks of swimmer’s ear.

Summertime here in sunny Florida inevitably means lots of time spent in the pool, the river or the ocean. Swimming is a favorite pastime, offering a cool respite from the sweltering sun. But that relief may be short-lived if you catch a case of swimmer’s ear, say specialist at St. Augustine Ear, Nose and Throat.

Swimmer’s ear is an infection in the outer ear canal, which runs from your eardrum to the outside of your head. The most common cause is water that remains in your ear after a swim, creating a moist environment that’s prime real estate for bacterial growth. However, it also can be caused by damage to the thin layer of skin lining your ear canal, often caused by placing objects like cotton swabs, hairpins or finger tips in your ear; and by sensitivity or allergic reactions to hair product or jewelry.

Swimmer’s ear infections can range from mild cases that can be treated with drops to severe cases that can have long-term effects. Symptoms include:


  • Itching in the ear canal
  • Slight redness inside the ear
  • Mild discomfort that’s intensified by pulling on your outer ear or pushing on the tragus (that small, pointed prominence situated in front of the ear)
  • Some drainage of clear, odorless fluid


  • More intense itching
  • Increasing pain
  • More extensive redness in the ear
  • Excessive fluid drainage
  • Pus discharge
  • A sensation of fullness inside your ear and partial blockage of the ear canal by swelling, fluid and debris
  • Decreased or muffled hearing


  • Intense pain that radiates to the face, neck or side of the head
  • Complete blockage of the ear canal
  • Redness or swelling of the outer ear
  • Swelling in the lymph nodes in the neck
  • Fever

If gone untreated, swimmer’s ear can lead to complications including temporary hearing loss, bone and cartilage damage, and long-term or deep tissue infection, and potentially fatal infections that can spread to other parts of the body including the brain or nervous system. Prevent swimmer’s ear by keeping your ears dry; draining them by tipping your head to the side after swimming; swimming in well-maintained swimming pools rather than ponds, lakes or ocean spots that may have high bacterial counts; avoiding putting fingers or foreign objects in your ear; and protecting your ears from irritants like hairsprays and hair dyes.

If you or your children experience symptoms of swimmer’s ear, call 904-461-6060 to schedule a consultation at St. Augustine Ear, Nose & Throat’s St. Augustine or Ponte Vedra locations.

St. Augustine Ear, Nose & Throat’s Dr. Kalpana DePasquale Launches TV Segment

Dr. Kalpana DePasquale

Dr. Kalpana DePasquale

Recognize that face and voice on this morning’s First Coast Living on WTLV-TV? That was St. Augustine Ear, Nose & Throat founder Dr. Kalpana DePasquale. She recently launched Health Tips with Dr. DePasquale, a new regular segment of the show that will air through November.

In each 5-minute segment airing on Fridays, Dr. DePasquale will share health and wellness tips covering an array of topics including dealing with allergies, children’s health and beauty tips. Throughout June, she’ll discuss men’s ear, nose and throat, sinus and allergy issues and talk about cosmetic treatments and procedures that men increasingly are choosing for a more youthful appearance. If you’re already thinking about Father’s Day gift ideas for your husband or dad, tune in to learn about Dr. DePasquale’s proprietary line of Avanti Rx botanical skin care, moisturizing and sun protection products.

First Coast Living is a magazine style show that features local community events, businesses and personalities and airs weekdays 11 a.m.-noon. Dr. DePasquale’s upcoming segments are slated for June 12 and 19. Visit the St. Augustine Ear, Nose & Throat website regularly to find out what she’ll talk about next. And if you miss a segment, catch up on the First Coast Living website.


Feeling Dizzy? It May Signal Meniere’s Disease

The source of your dizzy spells may be an inner ear condition called Meniere's Disease.

The source of your dizzy spells may be an inner ear condition called Meniere’s Disease.

If you’re prone to experiencing dizzy spells, it may be a sign of an inner ear disorder called Meniere’s disease. Named for the French physician Prosper Ménière, who, in an article published in 1861, first reported that vertigo was caused by inner ear disorders, the condition can cause any of these primary symptoms:

  • Vertigo: Spontaneous and recurring episodes of vertigo, a sensation similar to that of spinning around quickly several times, then stopping suddenly, are a common and troubling symptom of Meniere’s Disease. You may feel as if the room is still spinning and possibly lose your balance. These episodes come on without warning and typically last between 20 minutes and two hours, though they can persist up to 24 hours. Severe vertigo can cause nausea and vomiting.
  • Hearing loss: In the early stages of the disease, hearing loss may fluctuate. But most victims eventually experience some degree of permanent hearing loss.
  • Tinnitus: Tinnitus is the perception of a ringing, buzzing, roaring, whistling or hissing sound in your ear.
  • Fullness or pressure: Those with Meniere’s disease often feel aural fullness or increased pressure in the ear.

Meniere’s Disease is thought to be caused by an imbalance of the volume, pressure and chemical composition of fluid in the ear. Factors that can alter the properties of inner ear fluid and may trigger the disease include migraine headaches, trauma to the head, allergies, an abnormal immune response, a viral infection or improper fluid draining, typically caused by a blockage or anatomic abnormality.

Of all the symptoms, vertigo arguably is the most debilitating, as it can cause a victim to lose time from work, family, social and other obligations. It also boosts the risk of potentially dangerous falls, accidents while driving or operating heavy machinery and bouts of emotional stress, depression or anxiety.

Meniere’s Disease primarily affects people in their 40s and 50s, but it can strike at any age, even during childhood. Although it’s considered a chronic disease, it can be treated. Specialists at St. Augustine Ear, Nose & Throat can develop a customized treatment plan designed to relieve symptoms and minimize long-term impact of the condition on your daily life. If you or your dependent suffer any of the symptoms men tioned, call 904-461-6060 and schedule a consultation.

Dr. Kalpana DePasquale to Host Outreach Program on Sinus Conditions, Treatments

Flu allergy. Sick girl sneezing in tissue. Health

In support of National Sinus Pain Awareness Month, St. Augustine Ear, Nose & Throat and Avanti Medical Spa founder Dr. Kalpana DePasquale will host an outreach program designed to educate patients about treatment options in otolaryngology, ear, nose, and throat care. Slated for March 31, 6pm in Flagler Hospital’s Osceola Conference Room, this interactive program details all the latest innovations in treating chronic sinusitis for those with sinus disease, allergies, and related illnesses.

Research by the National Institutes of Health shows that sinus problems are are among the leading causes for children and adults to stay home from school or work. Consider these statistics:

  • Upward of 28.5 million adults in the United States are diagnosed with sinusitis each year – a figure that represents nearly 13 percent of the nation’s adult population.
  • Some 11.7 million visits to physician’s offices result in a primary diagnosis of chronic sinusitis each year.
    In 2012, 17.6 million US adults (7.5 percent) and 6.6 million children (9 percent) were diagnosed with hay fever.
  • That same year 7.8 million children (10.6 percent) suffered respiratory allergies.
  • Worldwide, sensitization rates to one or more common allergens among school children are currently approaching 50 percent.

Dr. DePasquale specializes in technologically-advanced procedures for treating sinusitis and related conditions, including Balloon Sinuplasty™, a minimally-invasive endoscopic procedure that accomplishes the same results as traditional surgery without requiring an incision; and PROPEL®, a dissolvable, spring-like steroid-releasing implant designed to prop open the sinuses after surgery. She is a sought-after speaker on a myriad of ear, nose and throat issues, plus skin care topics. She speaks on behalf of multiple medical device manufacturers, is an expert for the American Osteopathic Association and serves as a faculty member at The Sinus Forum, a series of conference-style events featuring otolaryngologists from across the nation.

This free-of-charge event is open to the public and includes light refreshments. Flagler Hospital is located at 400 Health Park Blvd.in St. Augustine. Find out more at www.saent.net or by calling 904-461-6060.

St. Augustine Ear, Nose & Throat Expands with New Ponte Vedra Beach Location

St. Augustine Ear, Nose and Throats new Ponte Vedra Beach location will open in April.

St. Augustine Ear, Nose and Throats new Ponte Vedra Beach location will open in April.

For over a decade, St. Augustine Ear, Nose and Throat has served Northeast Florida residents with management of ear, nose and throat disorders, thyroid disease, allergies and medical spa procedures. Now, the practice founded by the nationally renowned Dr. Kalpana DePasquale is expanding into the Ponte Vedra area.

Slated to open in early April, the new SAENT office space is currently undergoing a build-out in The Shoppes at St. Johns Oaks at 145 Hilden Road, Suite 123. When the construction dust settles, the space will feature spacious reception areas; separate waiting rooms and exam rooms for patients of both St. Augustine Ear, Nose and Throat and its sister firm, Avanti Medical Spa; plus procedure and treatment rooms. Patients will be welcomed via a natural stone entryway and made to feel at home in the beautifully appointed space.

Joining Dr. DePasquale at the new location are Dr. Zeeshan Aziz, MD, a board-certified ENT and thyroid specialist and aesthetic reconstructive facial plastic surgeon; and Amy Dugan, PA-C, a long-time physician assistant with experience in critical care, infectious disease and OBGYN.

Upon its early April opening, the new office will take both scheduled and walk-in appointments Monday, Tuesday, Thursday and Friday from 9am-4pm and Wednesday, 9am-noon. Services will include a range of advanced ENT and minimally-invasive cosmetic procedures. Plus, retail space will be devoted to products by Avanti Rx, Dr. DePasquale’s physician-formulated, botanical skin care line.

If you or your child suffer ear, nose or throat issues, call 904-461-6060 to schedule an appointment at our primary location at 1301 Plantation Island Drive S. in St. Augustine, or our new Ponte Vedra Beach office.

January is National Thyroid Awareness Month

Thyroid disorders can wreak havoc on your health, but are treatable.

Thyroid disorders can wreak havoc on your health, but are treatable.

By far, the most common New Year’s resolution in America and perhaps worldwide is to lose weight. But if you’ve had trouble reaching your weight loss goals year after year, it may be something other than your will power that’s to blame. January is National Thyroid Awareness Month, and a top related issue just happens to be hypothyroidism-related weight gain.

Your thyroid is a large, ductless gland in the neck that secretes hormones responsible for regulating growth and development via your metabolism rate. Two primary thyroid disorders are hypothyroidism and hyperthyroidism, both of which can affect your overall health.

Hypothyroidism occurs when the thyroid gland fails to make enough thyroid hormones, upsetting the normal balance of chemical reactions in your body. Symptoms can take years to appear and most notably include weight gain that cannot otherwise be explained. Despite cutting calories and exercising, the pounds just keep piling on. This can further compound other symptoms including depression, fatigue, constipation, hair loss, constantly feeling cold and irregular menstrual cycles in women.

The flip side of this coin is hyperthyroidism, caused by the thyroid gland producing more thyroid hormones than the body needs. Common symptoms include otherwise unexplained weight loss, diarrhea, palpitations, feeling anxious or jittery, trouble sleeping, excessive sweating, feeling hot and, as with hypothyroidism, irregular periods in women.

“Thyroid disorders are sometimes hard to diagnose, because symptoms of over-active and under-active thyroid may be similar to those associated with aging, depression or other life changing events,” said Zeeshan S. Aziz, MD, a thyroid specialist with St. Augustine Ear, Nose & Throat. He noted that women are up to five times more likely than men to have a thyroid condition.

The good news is that multiple treatment options exist for hypothyroidism and hyperthyroidism, including anti-thyroid medication, radioactive iodine and or surgery. If you’re experiencing symptoms that you suspect may be the result of a thyroid condition, call 904-461-6060 and schedule a consultation with St. Augustine Ear, Nose & Throat today.