Archive for December 2013

Coffee Talk

Save the Date for “Coffee Talk


Coffee Talk is a monthly educational series open to Trinity patients, the community, and VitalSigns members. It meets the first Thursday of every month at 10:30am-11:30am at our VitalSigns facility in Hardin Valley. A great cup of coffee is provided by our neighbor, Cozy Joes. Feel free to bring a friend or family member—we love to have visitors! See our Coffee Talk schedule below for our Winter/Spring series. We are collaborating with AARP for a driving course for our seniors—watch upcoming information and for dates and registration.

We are proud of our facility at Hardin Valley and would love to give you a tour when you attend Coffee Talk and tell you about programs we offer such as Silver Sneakers®.  Silver Sneakers® is a national program for members of some Medicare Advantage Care supplement plans.  You may be eligible for this free membership and we are happy to assist you in checking eligibility. Many people are not aware they have this wonderful benefit that offers a free gym membership. Let us check it out for you (or your parents.)

Coffee Talk 2014 Schedule

January 2—“-Blood Pressure Checks”   (Terri Stewart RN, TMA staff)

February 6—-“Tips about Cholesterol” (Kyra Fowler, FNP)

March 6—-“Alter G Treadmill/Physical Therapy Information”   (Spine & Sport Physical Therapy)

April 3—-“Brain Training”   (Dr. Randy Pardue)


Our address:     VitalSigns        2531 Willow Point Way       Knoxville, Tn

Call if any questions:  865-249-7566


Flu Time

Flu Time


“It’s the most wonderful time of the year…” So states one of the frequently-heard Christmas songs. And in many ways, it can be wonderful. At the same time, from a health perspective, it’s a time to take a few extra precautions. You may notice a few extra sniffles and coughs around you. Some are more serious than others. Let’s take a few moments and look at this hairy beast called influenza, or the flu.

For most people, the flu is just a big unpleasant nuisance. But it is estimated that over 20,000 people die from the flu each year in the U.S., mostly the very young and the very old.

Far more lethal strains emerge periodically. These deadly strains produced 3 global pandemics in the last century. The worst one, called the Spanish flu, occurred in 1918 and killed an estimated 20-50 million persons world-wide, with 549,000 deaths in the United States alone. So the flu can be a huge deadly deal.

Flu symptoms are typically some combination of sore throat, congestion, cough, fever, fatigue, body aches, and headache. It is very contagious from airborne droplets and close contact and is most contagious from the day before symptoms start to a couple days after they have begun. It usually takes 1-4 days between being infected and starting to show symptoms.

Right now our area of east Tennessee is showing a substantial spike in flu illness, which is a little earlier than the typical January-February peak of illness we usually see. Also, there have been some strains of flu that actually tend to hit young and middle-aged adults the hardest.

The good news is that virtually all of the strains currently circulating are included in this year’s flu vaccine. Sometimes the makers of the vaccine guess right and sometimes they get fooled; this year they seem to have nailed it. By the way, the new quadrivalent flu vaccine (that has four instead of three strains that it covers) only offers a very slight additional advantage as the fourth viral strain has barely showed up.

The other good news is that there is almost no resistance to the commonly used antiviral medicines, Tamiflu and Relenza. However these medicines need to be started within 48-72 hours of the onset of symptoms to get much benefit; the sooner the better.

So, what’s the best approach for traversing this precarious time of the year? First of all, if you or your kids haven’t gotten the flu shot (or nasal spray where appropriate), it’s not too late, and I’d strongly recommend it, especially this year when its coverage is so good. But don’t delay, as mentioned, the wave of flu is currently breaking over east Tennessee and it takes about two weeks to achieve good immunity after vaccination.

By the way, the flu shot has no live virus so it can’t give you the flu. Nationwide, the flu shot and spray prevent hundreds of thousands of cases of flu. Of course there are other flu-like illnesses that the flu shot won’t protect against, but your odds of getting the actual flu are greatly reduced. Also, when you get a flu shot you protect those around you who you could otherwise infect if you got the flu.

OK, what if you start getting symptoms of the flu? If the symptoms are bad, this is a time where you don’t want to just wait and see for a few days. The sooner you get in and get diagnosed and specifically treated, the greater your benefit from one of the antiviral meds, if this is indicated. Beyond this, rest, fluids and ibuprofen or acetaminophen can be helpful for substantial fever or pain. I’m a bit of a minimalist with multi-symptom over-the-counter meds since none of them directly fight the virus and some have a lot of potential for side effects, especially in younger children. Occasionally they can give a bit of relief if some symptom is particularly obnoxious.

So, as another Christmas song proclaims, “You better watch out…” We’re in the first wave of the flu season and we want this to be a wonderful rather than a miserable time of the year. In the meantime, and on a deeper level, “Do not be afraid; for behold, I bring you good news of great joy which will be for all the people; for today in the city of David there has been born for you a Savior, who is Christ the Lord.” Blessings!

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



Adolescent Obesity

Adolescent Obesity and Overweight


“That was awesome!” OK, admittedly that is not a phrase that is usually uttered as a patient exits one of my exam rooms. This was an 11 year old boy, Sam, who had just heard some very encouraging news. Some five months earlier he had come in with abdominal pain and frequent episodes of diarrhea. In the midst of examining him and working this up, several additional facts came to light. Sam was obese, being well above the 95% for BMI (body mass index) for his age. Connected to his obesity were several common complications:

  • High blood pressure
  • High cholesterol
  • High triglycerides (a fatty substance that also increases risk for heart disease)
  • Fatty liver with elevated liver enzymes in the blood indicating damage
  • A low HDL (the “good cholesterol” that helps protect against the plaque in the arteries that can lead to eventual heart attack or stroke)
  • He was not yet diabetic or pre-diabetic but certainly was at risk for this

As we reviewed this with his mom and him, they (especially his mom) registered concern.

She was well aware that Sam’s family history, besides obesity, included heart disease, stroke, diabetes, high cholesterol, high blood pressure, and several kinds of cancer. These are the very things that Sam’s obesity put him at risk for, and they were already beginning to emerge.

Childhood obesity has more than tripled in adolescents in the past 30 years, increasing from 5% to 18%. In 2010, more than one third of children and adolescents were overweight or obese. Besides the major diseases that rise with obesity, there are the stigmas and teasing and lack of energy and involvement in physically demanding activities that often are the further unwanted baggage of obesity and overweight.

We got Sam and his mom scheduled with one of our nutritional counselors as well as our wellness nurse who helps put together a lifestyle of movement and exercise that will work for a given person. Sam and his mom both got on board with a number of healthy changes. Sam had begun to get in some walking and then running, partly through school activities. He had gone from frequent giant sweet teas to less frequent small ones. He halved the portions of a lot of the carb-heavy snacks he was having. All in all he didn’t feel deprived but was learning to make better choices, and his mom was making sure that his available choices at home and in his lunch were healthy.

The result was that Sam, in four months had dropped about 18 pounds (roughly a pound a week). His liver enzymes had gone back to normal along with his triglycerides. Sam’s total cholesterol had dropped, his good cholesterol went up and his bad cholesterol went down. Blood pressure had completely normalized. Beyond that, Sam’s digestive problems had nearly resolved, his energy was back, and he felt great about it all. What’s more, he was putting in place habits that would serve him well for a lifetime.

These are some of the most satisfying visits for me as well – to identify habits that are feeding into several disease processes, especially when this can be done early on, and to then help to effect real change. We can only put tools in people’s hands; it is the Sam’s and Sam’s moms (and dads!) who do the real work of using those tools to make things happen. And of course that doesn’t always happen. But every time that it does, to quote Sam, it’s “awesome!”

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