Archive for April 2013

Vaccine Question and Answer

I recently had the privilege of being asked to participate in a question and answer forum concerning vaccines.  A former patient of mine who has moved out-of-state is an avid blogger at  She covers all types of topics concerning family life, adoption both international and domestic, foster parenting, and in general raising your children in the fear and admonition of the Lord.  She is a wonderfully gracious person and blog host.

I’ve posted the links to her different posts below for those that are interested.  As she says better than most, this definitely is a sensitive topic.  Sometimes friendships can be strained when we so strongly disagree.  So comments for these posts are going to be limited to preserve the peace.  As a practice if you have questions about vaccines and our vaccination policy I’d encourage you to bring them up at your visit.  Trying to work through them in a blog comment section isn’t a good idea.  Remember these blogs are for informational and educational use.  We’re not making medical recommendations here except in the general sense.  Nothing specific is intended.  I hope it is informative for you and that you see why we ultimately have developed the vaccine policy that we have as a practice.

The first two posts are from Maralee with her own thoughts on vaccines.

Vaccines- My Introductory Thoughts

Vaccines- Who Do You Trust?

These next eight posts are where I answer reader submitted questions.

Vaccination Guest Post: Did I vaccinate my kids?

Vaccination Guest Post: Ethics and Parental Rights

Vaccination Guest Post: Is there value in delaying?

Vaccination Guest Post: Whopping cough outbreak and kids with special considerations

Vaccination Guest Post: Specific vaccines and their effectiveness

Vaccination Guest Post: The flu shot

Vaccination Guest Post: What’s in our vaccines and is it causing autism?

Vaccination Guest Post: Doctor compensation and adoption issues

This last post is Maralee’s summary thoughts.

Vaccinations summary- What you do for the least of these



Recipe Review- Chicken Carbonara

Chicken Carbonara
Chicken Carbonara over Wilted Spinach and Spaghetti Squash
  • You Need per person/serving. FN= Family Number
  • 1 chicken breast or 2 thighs (xFN)
  • 2 pieces of bacon (xFN)
  • ½ of a small/medium spaghetti squash (xFN)
  • 3 ounces of spinach (xFN)
  • 3-4 stalks of asparagus (1 bunch per family)
  • 2 tablespoons parmesan (xFN- ½ cup per family of 4- optional)
  • 2 tablespoons heavy cream (xFN- ½ cup per family of 4)
  • 1 tablespoon butter
  • ¼ of an onion (xFN)
  • spices: sea salt, pepper, italian seasoning, garlic powder.
  1. Preheat the oven to 400 degrees.
  2. Scrape out the seeds and stringy parts of the spaghetti squash with a spoon and place, face down on a baking sheet or in a large baking dish with ¼ inch of water.
  3. Place in oven and cook 30 minutes or until soft when poked with a fork.
  4. While that is cooking, cut the chicken in half lengthwise to make it thinner and pound with a meat hammer or the bottom of a cast iron pan.
  5. In a large skillet, place the asparagus and about ¼ inch of water and cook over high heat until asparagus is bright green and starting to soften. The water should evaporate completely off and when it has, add 1 tablespoon butter (total, not per person) and sprinkle with some sea salt.
  6. Remove asparagus from the pan and set aside.
  7. Cook the bacon in the same pan until crispy and remove bacon.
  8. Cook chicken in the bacon grease in the same pan, and sprinkle each side with sea salt, pepper, garlic powder and italian seasoning.
  9. When chicken has cooked through, remove and set aside.
  10. Dice onion and cook in remaining bacon grease until starting to soften.
  11. Add spinach and extra butter if needed and cook until barely wilted.
  12. Add cream (if using-totally optional) and about ¼ teaspoon of the above spices.
  13. At this point, the spaghetti squash should be soft so remove from oven and scrape out insides with a fork.
  14. To serve, put spaghetti squash on a plate, top with some wilted spinach, then a piece of chicken, some crumbled bacon and the asparagus (chop into small pieces). Top with parmesan if using.


 Review: This was my husband’s favorite new dish thus far! I went a little too heavy on the salt (maybe because I had little hands helping) but less is more with the sea salt! Since, I am just starting to learn how to cook; I am slower at cutting, dicing, etc so my spaghetti squash was cold by the time I finished everything else and needed to be reheated. If you are slower like me, you may want to finish cutting and dicing before putting spaghetti squash in oven. I did not use cream this time simply because I forgot :) Let me know your thoughts if you make this! Spaghetti Squash is an awesome alternative to traditional pasta (lots of carbs and sugar, even whole grain pasta!)



McDonald’s would like you to be happy

Recently I was online when the following advertisement caught my eye.


I’m fascinated by this.  I never knew McDonald’s was so interested in me being happy.

Just for kicks I went and checked out the nutritional value of happiness.  Of course happiness comes in different sizes so I decided just to keep it simple and look up the smallest chocolate size available.  If you are interested it can be found here.

mccafe 2

I just want to point out what everybody probably already knows.  McDonald’s smallest chocolate McCafe’ is equal to almost 5 chocolate chip cookies.  Combine that with taking time to relax and you really should get an advertisement like this.

mccafe edited


How’s Your Kids’ Media Diet?

How’s Your Kids’ Media Diet?

Worldwide, infectious diseases are still the number one cause of death in young children. But deaths from infectious diseases declined markedly in the United States during the 20th century and have long ago fallen out of the number one position. It is remarkable that in the U.S. in 1900, over 30% of all deaths occurred in children aged less than 5 years. Now that percentage is about 1%. The top causes of death in 1900 were pneumonia, tuberculosis (TB), diarrhea and diphtheria. Immunizations, antibiotics, and better nutrition and sanitation have been major contributors to the huge drop in these infectious diseases.

Today our kids have different battles. Yes, infectious diseases still lurk and can be serious threats. One concern in that regard is that we have been so successful that we are getting complacent about immunizations, beginning to re-open the door to diseases like whooping cough that had been nearly stamped out – but that’s for another article. In our day, one of the biggest battles involves the tsunami of media inputs washing and crashing over our kids, and us. That tsunami suddenly kills a few, shortens the life span of many more, and cripples the quality of life of countless others.

Because of all this, the discussion in my well-child visits is different from when I started practice over 20 years ago. There is more discussion about the media diet of the children I’m seeing. How many hours a day do they spend in front of a screen (television, computer, DVD, video game, smart phone, etc.)? What kind of games, shows and music are they taking in? This is not in the form of an interrogation or guilt-trip, but more to just highlight this area as a key factor in the health of the child. For example, children ages 11-14 average over five hours of screen time daily. It is no surprise that any activity that pipes content into your brain for that much time daily will have a powerful impact physically, emotionally and relationally.

For starters, a child’s (and this still applies to adults as well) media diet impacts their health physically. In the U.S., obesity has more than doubled in children and tripled in adolescents since 1980. As obesity has increased, so has diabetes. Some of this is tied into the increased time spent sitting and watching a screen rather than engaging in various types of physical exertion.

But beyond this purely physical impact, increased television viewing is also associated with a number of other negative outcomes for children. Children watching high levels of television are less likely to experience feelings of contentment, to participate in after-school activities,to engage actively in other intellectually stimulating activities,to have mostly “A” or “B” grades,and to do well on math achievement tests. Excessive television viewing at very young ages (one to three) is linked to a decreased attention span later in life and to sleep problems.

Research has also found that viewing television violence is associated with children’s aggression – no surprise. Young adults who routinely watch violent television programs as children (six- to ten-year-olds) exhibit more aggressive behaviors as young adults than their peers who watch little or no violent television. Another study finds a link between viewing violent television in adolescence, and drug dependence in later years. Still another found a 30% increased risk for adult criminal behavior for every additional hour of screen viewing on weekdays from ages 5 to 15. Those viewing more socially positive content and less violence demonstrated more socially positive characteristics over time.

Like our food diet, our media diet hugely affects our overall health and that of our children, physically, emotionally, relationally and even spiritually. Both the quantity and quality of what we view is impactful. As a physician, as well as the dad of seven kids, I’ve seen that played out over and over. It’s a tough challenge to help keep kids screen time appropriately limited and positive. And setting the right example personally is key as well. But it’s worth the effort. Just like you want your kids to have the healthiest food and to avoid toxins, help them take the best nutrients into the vital realm of their minds.

Andrew Smith, MD is board-certified in Family Medicine and practices at Trinity Medical’s Maryville office located at 1503 East Lamar Alexander Parkway. Contact him at 982-0835