Parkbench Interview with Dr. DePasquale

Meet Dr. Kalpana S. DePasquale, DO at Avanti Medical Spa

Are you looking to combat the aging process of Mother Nature? If so, then you are at the right place. Avanti Medical Spa can help you reverse the hands of time and enhance your natural beauty. To revitalize your appearance, we offer the following cosmetic procedures:
Facials & Peels
Dermal Fillers
Visia Skin Analysis
Facial Waxing
To learn more about our spa services, contact us at 904.461.6797, or better yet come see us:
In St. Augustine, Monday thru Friday between 8:30 AM to 4:30 PM (NOTE: Office is closed for lunch from 12 PM – 1:15 PM). Avanti Medical Spa St. Augustine is located on Anastasia Island, 1.5 miles east of Flagler Hospital at 1301 Plantation Island Dr, Suite 401A, St. Augustine, FL.

What do you love most about the neighborhood?

There are so many different people constantly moving into this area so I feel like we’re in a small, big town. I meet people from Europe, people who are on vacation who come to me with a specific problem sometimes, or people who’ve recently moved from the North or West Coast. I just love the melting pot of all kinds of people from diverse backgrounds–I think that’s my favorite thing!

The Entrepreneurial Life Chose Me

I was trained  to be an Ear, Nose, and Throat physician, but the life of an entrepreneur chose me.
My employee mindset changed as a result of an interview during residency. The interview was with a private practice physician, who I had known during my training. He had first-hand knowledge of my assets as a physician: surgical skill, sound judgment, physician-patient rapport and superb communication skills. Despite my positive attributes, his job offer for my annual salary was significantly less than the price of the Porsche 911 he was driving and much less than the MGMA (Medical Group Management Association) standard for physician compensation. MGMA is the resource leader for healthcare salary compensation.
This experience left me baffled and humiliated but I realized something very important… I didn’t have the employee mindset that most physicians do.  I wanted the freedom  to create and design my own practice and there was no reason I couldn’t do that. I thrived on risk to experience a greater reward. I despise rules, structure and predictability. I wanted to change the world, not just have a job. Failures in my mind were setbacks and an opportunity to learn. Despite all the challenges I have faced over the years, starting my own practice was the best decision of my life. I was able to build a team and office culture of stellar employees.  I was able to tailor my practice to the aspects of ENT that I enjoyed most – minimally invasive procedures to treat chronic sinusitis and improve nasal obstruction. My patients are so thankful to be offered minimally invasive solutions to avoid the downtime, healing, and expense of more aggressive surgical alternatives.
Once my ENT practice was successful, my next venture was adding a Medical Spa to my practice. So many patients would not consider cosmetic rejuvenation procedures because of artificial and unnatural looking results. My goal was to achieve a well- rested youthful appearance without the obvious tell-tale signs that a procedure was performed. This difference in approach allowed me to attract patients that were looking for intervention that appeared natural, not artificial.
Things were going so well for me until I was diagnosed and treated for Thyroid cancer at the age of 34.  I had surgery to remove my entire thyroid gland and I had radioactive iodine treatment. Because the exact cause of thyroid cancer is unknown, I suspected that my diet and choice of personal care products I used could be a contributing factor.  I decided to detox my life by eating better quality food and avoiding pesticides. I reviewed my personal care products that I was using; like shampoos, lotions, deodorants; and eliminated chemicals as much as possible.
I reviewed the ingredients in the skin care products I was recommending to my Medical Spa clients and I was appalled that some products didn’t clearly list their ingredients and all of them contained chemicals that I didn’t approve of.  I was appalled when I found out that there is no federal regulation of ingredients to protect the consumer from dangerous chemicals.
From my frustration with the cosmetic industry, my next entrepreneurial venture was born.
I set out to create a skincare line that addressed common anti-aging issues such as dark spots, loss of elasticity, blemishes and more. The ingredients would be plant and mineral based, contain no harsh ingredients or chemical preservatives. The ingredients needed to work synergistically to provide superior results. KalVera Skincare was created to provide consumers with healthy skin care and to support my mission to educate consumers about hazardous ingredients found in personal care products and empower them to make safer choices.
My journey as an Entrepreneur has been euphoric but it is not the lifestyle for everyone. Entrepreneurship is often a lonely, risky, anxiety-provoking and ever humbling expedition. It can also be addictive. Although KalVera Skincare is my most recent creation, I doubt it will be my last entrepreneurial endeavor.
-Dr. D

Retail Madness

The National Retail Federation forecasts a 3.7 percent increase in holiday sales this year with U.S. spending at more than $630 billion or approximately $800 per person.  This is significantly higher than the 10 year average of 2.5 percent.  Additionally, close to 136 million Americans planned to shop on Thanksgiving weekend.  This year, I got an early start to my holiday shopping so that I could avoid the crowds.   I figured I could accomplish more in a shorter period of time without the mass crowds of shoppers.  Much to my dismay, the retail madness had already started.  There was no parking, plus huge crowds and lines made the experience intolerable. Unfortunately, I was too late to avoid it all.
I grew up in a different era.  Holidays were about spending quality time with family and life was simple.  The holiday season started with watching the Thanksgiving Day parade on television and making a turkey figure using a paper bag stuffed with newspapers for the body, a toilet paper roll for the neck, and balled up newspapers for the head.  Construction paper was cleverly utilized for feathers, wings, and other important turkey parts.  After that, we had a nice family dinner.  There was no television turned on to watch football and there was definitely No Shopping!
I am no opponent of capitalism and I certainly understand the retail industry’s desire to maximize the holiday season.  I also understand the excitement of consumers to get great deals on gifts and household purchases for themselves and their families.  It is important to realize there is a hidden cost to retail madness.  Close, personal family contact and unity can become eroded and replaced by the desire to accumulate material objects.  I am not sure if this is a cost that America can afford.  
I personally support the retailers who refuse to open on Thanksgiving Day – so their employees can have time off with family and friends.  Let’s think about the real meaning of the holidays…the spirit of love and kindness and generosity.  

Does Your Spouse Have Selective Hearing?

I just love when my patients tell me they have “selective hearing” as if it is a real medical condition. Although the medical literature doesn’t recognize selective hearing as a condition, the Urban Dictionary defines it as the ability that humans have (mostly males) to selectively hear what serves their interests.
Patients will state that they “don’t have hearing loss” and that they can “hear what they want to hear”. Apparently, being deaf is a choice. They can turn it on and off like a light switch. People with “selective hearing” are in denial about the real problem – hearing loss.  
Twenty percent of adults (48 million) in the United States report some degree of hearing loss. At age 65, one in three adults with hearing loss are in the work force or in an educational setting. They have many excuses about why they can’t hear:

  • Women speak too softly
  • Their grand kids mumble
  • They can hear if you talk loud enough (you need to scream)
  • The TV is on too loud because no one speaks clearly anymore

Studies show that seniors are three times more likely to have a cosmetic procedure performed than seek treatment for hearing loss.  A hearing test is as popular as a colonoscopy when it comes to routine health checks.
Why are seniors in denial about their hearing loss?

  • They don’t think their hearing is bad enough to warrant hearing aids
  • It’s part of aging  and not life threatening, so it’s no big deal
  • They don’t want to look old
  • They lack trust in hearing aids because they know people who have had poor experiences.

Seniors don’t realize how much hearing loss adversely affects their quality of life.  It results in depression, isolation, anger, and cognitive decline. They avoid people they can’t hear and situations in which they can’t hear.
As an Otolaryngologist, wife, and mother, I find this denial concerning. Hearing loss needs to be identified and treated.  The stigma of hearing aids needs to be removed because they are helpful when fitted and adjusted properly. Modern hearing aids are small and discreet.  They are actually less noticeable than glasses!
If you know someone that who has “selective hearing”, urge them to see an Otolaryngologist and obtain a hearing test. The proper diagnosis and treatment plan, in addition to the right physician, can significantly improve their quality of life and yours.

That Time I Became a Car Racing Enthusiast

My husband is a car enthusiast. He has been this way since the day I met him 25 years ago. He drove a Plymouth Sundance Turbo with a modified exhaust which made the car sound like a hot rod.
He has collected Car and Driver and Motor Trend magazines since 1993, and he knows everything about cars – how they work, how to make them look, sound and drive better, and how to fix them. Horsepower, torque, and stance used to be foreign terms to me, but now they are common household conversation amongst our two sons.  Although my husband can’t remember names of people he has met, he can remember everything about them once he knows the car they drive.
Throughout my life, I have been drawn to car enthusiasts. Two of my best friends in medical school were wired the same way – obsessed with cars.  Needless to say, they got along great with my husband. I could not understand the obsession, so I thought it was silly. I was everything but supportive.  
My friends finally persuaded my husband to go to the track so that he could drive in a safe manner. They assured me that this would reduce his erratic driving on public highways. It seemed counterintuitive – how could driving on a track with a bunch of testosterone crazed men trying to one-up each other be safe?
One day, I finally decided to see what the hype was all about.  I went to a track event in Georgia, only to find that the drivers were considerate and most weren’t there for their ego but to fuel a passion.  The drivers were required to point by to allow a faster driver/vehicle to pass, and the point by’s were mandatory.  
Driving on the track isn’t as much about speed as it is finesse.  There is a driving line for the track that you must learn to properly execute each turn safely and efficiently.  Until this is mastered, you cannot increase speed safely.  
I took it a step farther and signed up for a track event where I drove.  The atmosphere was exhilarating; hearing the sounds of the race cars, and the visceral sensation of executing each turn properly was intoxicating.  The weekend was full of nonstop excitement.  Even though, I was exhausted from all the focus and adrenaline, I was hooked and signed up for another weekend.  
I think I finally understand what all the hype was about.

Love Your Shoes!

It may seem trivial and superficial, but women typically bond over shoes, while men bond over cars. Women will usually go out of their way to compliment another woman’s shoes. I have to admit it is a great feeling when a stranger compliments your shoes.  
Now, you may think because I am a doctor that I have a closet full of Prada, Gucci, and Louboutins; however, that is not the case.  Of course, these shoes are beautiful, but I refuse to pay over a $1000 to be uncomfortable, despite their beauty.  I like shoes that are unique (most of the high-end brands have shoes that look too similar for my taste) and comfortable.
While on a trip to San Francisco, I stumbled upon a brand that was unique and comfortable – a dream come true! John Fluevog is a Canadian shoe designer noted for his progressive art deco styles with messages engraved on each sole. I was concerned that the styles might be too edgy, and not professional enough for my Saint Augustine clientele, but I bought them anyway.
These shoes really reflected my style perfectly. Almost every female patient would exclaim “I love your shoes!” as soon as I walked in the door. The shoes seem to be an immediate ice breaker with any patient, new or established. They immediately felt less anxious about seeing me, the doctor, because we talked about shoes for a few minutes before we began the medical portion of the visit.
One patient declared that if the surgery fixed the problem that she has had for 30 years, she would put a “statue of me outside of her house….with those shoes on!” Contrary to what you may think, I have had my fair share of conversations with men that start off the same way.  
I learned a valuable lesson from the internal conflict I faced when buying those shoes in San Francisco.  If you remain true to yourself, your style, and your personality, you can never go wrong.

Should You Get the Flu Vaccine?

Every year, the influenza epidemic results in significant morbidity and mortality, as well as a significant economic cost to society. An estimated 200,000 excess hospitalizations and 36,000 deaths occur each year due to influenza and its complications. Influenza kills more Americans than any other disease that can be prevented by a vaccine. Therefore, physicians and the CDC (Center for Disease Control) urge Americans to get their flu vaccine, but each year, Americans hesitate to get the vaccine for many reasons.

  • The flu vaccine doesn’t work. Flu shots are at best 50-60% effective at preventing lab confirmed influenza requiring medical care. Despite this shortcoming, the CDC still recommends the vaccination as it prevents some infections with the currently circulating influenza virus and can prevent serious influenza-related complications. Each year medical researchers do their best to determine which strain of the influenza virus will likely hit each season, and they prepare the vaccine accordingly.
  • I will get the flu if I get the vaccine. There has been some speculation that live virus vaccines can potentially transmit influenza, but the consensus is that this is unlikely, unless you are immunocompromised or allergic to the vaccine.
  • I don’t need it because I don’t get sick. Getting vaccinated not only protects you, but it also helps others who may not be able to fight off an illness as well as you can.
  • The vaccine has side effects. The side effects are usually mild, including redness and soreness surrounding the area of the shot or mild body aches. Gillian Barre syndrome is a rapid onset muscle weakness caused by the immune system damaging the peripheral nervous system. It is a well recognized side effect of the influenza vaccine, but there are only 1.7 cases per 1 million people vaccinated.
  • It’s too late to get the vaccine now. Flu activity usually peaks in January and February, and in some cases, the season can last until May.

Keep in mind that there are also other ways of preventing against the flu, including optimizing Vitamin D levels, eating a proper diet avoiding sugar and processed foods, getting plenty of sleep, minimizing stress, and of course, frequent hand washing.
Medical professionals have not come to a consensus on the flu vaccine, but there are more doctors in favor of it than not. The biggest debate is whether influenza is too much of a low-risk disease to vaccinate against, but since there is a large number of people that are hospitalized and even killed by influenza-related complications, the answer seems obvious.

Cold Weather Skin Tips

Winter is upon us, at least for those of you who don’t live here in Florida. However, even for us Floridians, the cold weather depletes our skin of moisture causing dullness, dryness and even itching.  
Luckily, this is an easy problem to solve. Simple adjustments to your skin care routine can help minimize these issues.  
Some like it hot – but not your face
Limit your time in the shower and use warm water instead of hot water. If you’re using water that’s too hot, it can wipe out your skin’s natural defenses, making your skin dry out even further.
Ditch the bar
Use a cleanser for your face and a body wash for your body instead of simply using soap all over. Bar soap – even those labeled “facial soap” generally have a higher pH than cleaners made for your face. The higher pH dries out your skin further.
Pat dry
Pat your face and body dry instead of rubbing. When you rub a towel against your face, you can cause irritation and even inflammation.
Moisturize, moisturize, moisturize
Add moisturizer to your face and body liberally. If you have very dry skin, this step may need to be repeated two to three times per day.  
You must remember that moisturizers do not work by putting water into the skin, but by slowing the water loss. Look for one that is thicker for the winter and doesn’t have thick oils that can clog your pores.  
Don’t forget sunscreen
Also remember that sunscreen is still very important in winter months. If you live in a snowy climate, snow can reflect the sun and can leave you with a sunburn just as serious as any you can get in the summer.
Still not convinced? This stat might persuade you: wearing sunscreen can slow the aging process by 24 percent. To ensure you’re maximizing your effort, be sure to use sunscreen on our ears, lips and neck, as these three areas are often neglected.