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Healthy Idaho | November '15

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BOUNTY—This month, we turn our attention to life. To blessings. To gratitude, and to recognizing the bounty in life. Hopefully, the overall message is about joy, happiness, and hope for a better, more enriching life, whatever life opportunities you must embrace.

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Facebook.com/HealthyIdaho November 2015 1

2 HEALTHY IDAHO Healthy-Idaho.com208-895-0888 westidahoorthopedics.com

Offices in Caldwell - MeridianSatellite offices in Fruitland - Emmett

Charles P. Schneider, M.D. George A. Nicola, M.D.

John Q. Smith, M.D.Robert G. Hansen, M.D.Michael T. Daines, M.D. Michael J. Shevlin, M.D.Jonathon C. Wolf, M.D.Craig R. Jamison, PA-C

Hodaka Abe, PA-CThomas W. Tryon, PA-C

Bryce Wikfors, PA-C

Largest Independent(non-hospital)

Orthopedic Groupin the Treasure

Valley

Established in 1960• Reconstructive Hip and Knee Surgery• Total Hip and Knee Replacement• Knee Resurfacing• Computer Assisted Surgery• Minimally Invasive Surgery• Arthroscopic Surgery of All Major Joints• Surgery of the Upper Extremity• Sports Medicine• Fracture Treatment• Musculoskeletal Trauma• Independent Medical Evaluations• Surgery of the Foot and Ankle• Surgery of the Hand

BOARD CERTIFIED ORTHOPEDIC SURGEONS IN GENERAL ORTHOPEDICS WITH SUB-SPECIALTIES IN THE FOLLOWING:

URGENT & SAME DAY APPOINTMENTS

with Idaho’s Premier Orthopedic Clinic

John Q. Smith, MDDr. Smith is board certified and trained at the St. Louis University School of Medicine.  He is experienced at diagnosing and treating, sports injuries, fractures and surgically repairing major joints. 

Dr. Smith specializes in major joint repairs along with arthroscopy of the hip, shoulder, knee and ankle. He offers surgical and non-surgical treatment of musculoskeletal issues involving bones and muscles and is 100% dedicated to getting his patients back to an active lifestyle.

Dr. Smith is very passionate about his hobbies, that include:  Outdoor photography  - Backpacking   - Hiking  Mountain Biking   - Adventure Motorcycles

MEDICAL EDUCATION & TRAINING:Medical School:   St. Louis University School of MedicineInternship:  University of Texas Health Sciences CenterResidencies:   Department of Orthopedic Surgery – University of Texas Health Sciences Center

BOARD CERTIFICATION:• American Board of Orthopaedic Surgery• Fellows of American Academy of Orthopaedic Surgery

SOCIETY MEMBERSHIPS:• Idaho Medical Association• American Academy of Orthopaedic Surgeons• Idaho Orthopedic Association• Western Orthopedic Society• Alamo Orthopedic Society• Ada County Medical Society

HOSPITAL AFFILIATIONS:• West Valley Medical Center, Caldwell• St. Luke’s Regional Medical Center, Meridian• Valor Health, Emmett• Saint Alphonsus Nampa• Treasure Valley Hospital Boise

MEET OUR DOCTORS

Facebook.com/HealthyIdaho November 2015 3

BE YOUR CHILD’S HERO!You can be a hero by keeping your child healthy, happy, and strong. Vaccinating your child protects him against preventable diseases like pertussis (whooping cough), measles, meningitis, and chicken pox. Be a hero and get your child immunized.

CHOOSE TO IMMUNIZE!

It’s the powerful defense that’s safe, proven, and effective.

ImmunizeIdaho.com

208-895-0888 westidahoorthopedics.com

Offices in Caldwell - MeridianSatellite offices in Fruitland - Emmett

Charles P. Schneider, M.D. George A. Nicola, M.D.

John Q. Smith, M.D.Robert G. Hansen, M.D.Michael T. Daines, M.D. Michael J. Shevlin, M.D.Jonathon C. Wolf, M.D.Craig R. Jamison, PA-C

Hodaka Abe, PA-CThomas W. Tryon, PA-C

Bryce Wikfors, PA-C

Largest Independent(non-hospital)

Orthopedic Groupin the Treasure

Valley

Established in 1960• Reconstructive Hip and Knee Surgery• Total Hip and Knee Replacement• Knee Resurfacing• Computer Assisted Surgery• Minimally Invasive Surgery• Arthroscopic Surgery of All Major Joints• Surgery of the Upper Extremity• Sports Medicine• Fracture Treatment• Musculoskeletal Trauma• Independent Medical Evaluations• Surgery of the Foot and Ankle• Surgery of the Hand

BOARD CERTIFIED ORTHOPEDIC SURGEONS IN GENERAL ORTHOPEDICS WITH SUB-SPECIALTIES IN THE FOLLOWING:

URGENT & SAME DAY APPOINTMENTS

with Idaho’s Premier Orthopedic Clinic

John Q. Smith, MDDr. Smith is board certified and trained at the St. Louis University School of Medicine.  He is experienced at diagnosing and treating, sports injuries, fractures and surgically repairing major joints. 

Dr. Smith specializes in major joint repairs along with arthroscopy of the hip, shoulder, knee and ankle. He offers surgical and non-surgical treatment of musculoskeletal issues involving bones and muscles and is 100% dedicated to getting his patients back to an active lifestyle.

Dr. Smith is very passionate about his hobbies, that include:  Outdoor photography  - Backpacking   - Hiking  Mountain Biking   - Adventure Motorcycles

MEDICAL EDUCATION & TRAINING:Medical School:   St. Louis University School of MedicineInternship:  University of Texas Health Sciences CenterResidencies:   Department of Orthopedic Surgery – University of Texas Health Sciences Center

BOARD CERTIFICATION:• American Board of Orthopaedic Surgery• Fellows of American Academy of Orthopaedic Surgery

SOCIETY MEMBERSHIPS:• Idaho Medical Association• American Academy of Orthopaedic Surgeons• Idaho Orthopedic Association• Western Orthopedic Society• Alamo Orthopedic Society• Ada County Medical Society

HOSPITAL AFFILIATIONS:• West Valley Medical Center, Caldwell• St. Luke’s Regional Medical Center, Meridian• Valor Health, Emmett• Saint Alphonsus Nampa• Treasure Valley Hospital Boise

MEET OUR DOCTORS

4 HEALTHY IDAHO Healthy-Idaho.com

Small steps add up to big strides.

The first five minutes of a workout are the worst. Ten minutes in? You’re feeling pretty good. Afterward? Fantastic.

It all starts with one good choice.

©2014 SelectHealth. All rights reserved. 3648 11/14

3648 One Good Choice Print Ad_Utah.indd 2 11/6/2014 2:11:05 PM

Facebook.com/HealthyIdaho November 2015 5

Small steps add up to big strides.

The first five minutes of a workout are the worst. Ten minutes in? You’re feeling pretty good. Afterward? Fantastic.

It all starts with one good choice.

©2014 SelectHealth. All rights reserved. 3648 11/14

3648 One Good Choice Print Ad_Utah.indd 2 11/6/2014 2:11:05 PM

6 HEALTHY IDAHO Healthy-Idaho.com

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6 HEALTHY IDAHO Healthy-Idaho.com

NOV.

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Wellness

12 A CHILD ASTRAYParents of wayward children wonder if residential treatment or wilderness programs are options worth considering. Here is a guide.

16ARE YOU A NARCISSIST?We’ve all caught ourselves being selfish at some point, but for some, it’s an actual personality disorder that needs attention.

30HAPPY “THANKSFORGIVING”The holidays seem to be a particularly vulnerable time for old scars and delicate hearts. It is during these times of joy and giving, that we need to also be generous when it comes to forgiving.

Fitness

22THE DEFINITION OF FITNESSKnowing what you’re striving for is a good way to begin. This knowledge will also come in handy down the road when you’re setting goals, measuring your progress, and trying to get motivated again after a backslide.

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8 HEALTHY IDAHO Healthy-Idaho.com

NOVEMBER 2015VOLUME VII, № 11

EDITOR-IN-CHIEF | PUBLISHERJohn A. Anderson | [email protected]

CHIEF INFORMATION OFFICER Kenneth J. Shepherd | [email protected]

SALES AND MARKETING Julie Guyer 208.371.4533 Steve Wallace 208.850.4983 [email protected]

DESIGN EDITORPhillip Chadwick | [email protected]

MANAGING EDITORMichael Richardson | [email protected]

MAGA ZINE EDITOR Kristen Soelberg | [email protected]

DIREC TOR OF OPERATIONS Marlo Anderson | [email protected]

CONTRIBUTING WRITERS

Caitlin Schille, Angela Silva, Megan Moore, David Joachim, Mark Saunders

CIRCULATIONHealthy Idaho Magazine is printed monthly and delivered extensively throughout Boise and surrounding areas—direct mailed to doctors, dentists, practitioners, health clinics, banks and other businesses and subscribers and is made available for pick up at hundreds of loca-tions. If you would like to have Healthy Idaho Magazine delivered for distribution in your place of business, please contact us.

HEALTHY IDAHO MAGA [email protected]

866.884.3258

PLEASE NOTE: The content in this publication is meant to increase reader awareness of developments in the health and medical field and should not be construed as medical advice or instruction on individual health matters, which should be obtained directly from a health professional. The opinions expressed by the authors and advertisers are not necessarily those of the publisher. Call for reprint permission. All photography courtesy of Shutterstock.com unless otherwise noted.

To discuss Stardocs creative, design, writing, websites, online marketing services, or even creating your

custom publication, call us at 801.369.6139.

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published by Stardocs media

Copyright © 2015 Stardocs, LLC. All rights reserved. [email protected] www.Stardocs.com

801.369.6139

EDITOR'S NOTE

For any who have lived with, or cared for someone with some type of disability, you know and understand how difficult, and also how rewarding that can be. Not easy, yet enriching in peculiar ways. My oldest brother and his wife have cared for their beautiful, mentally disabled, though highly capable daughter, Candace, for over thirty years. She's brought so much unique joy to our entire family. I have a very active cousin who became completely disabled from the neck down within weeks of getting married in his 20's. It was tragic and unbearable. And amazing, as Jeremy Chatelain has gone on to become a father, a teacher, and a PhD. Through his extremity has come glorious capability and inspiration. I have another cousin who was highly intelligent, artistically inclined, with impressive scholarships to Stanford University. He suffered from mental illness and tragically took his very promising life. That was challenging to understand. I have witnessed and feebly consoled other close family members who have struggled to have children, and/or whom have lost children at birth. Infertility and child loss are two very heartbreaking issues that further highlight the fragile nature of life. As the saying goes, 'Whether it be a grain of sand or a rock, in water they sink the same.' No matter how big or small the trial, it's never easy to handle. But, it can be rewarding. Each of these personal life challenges I mention seemed to be offset by an increase of love and understanding, of closeness and caring that, perhaps, would not have been there without the pain and setback. Maybe, like the body itself, tragedy finds its own way of healing and harmonizing. So, this month, we turn our attention to life. To blessings. To gratitude, and to recognizing the bounty in life. Hopefully, the overall message is about joy, happiness, and hope for a better, more enriching life, whatever life opportunities you must embrace.

O ne thing is clear to me. Life is precious. And fleeting. And more valuable the older we grow. Still, life is only as

valuable as we make it. I recently met with my financial planner to review our retirement plan, consider a health savings plan, and talk life insurance. From a legal, life-insurance perspective, the value of life is interesting. Am I worth a few thousand dollars, or a few million? Depends on how much I want to pay each month, apparently! Insuring 'life' is an ironic concept. Any insurance agent can tell you what the no-fault payout for killing someone in a car accident is. But, ask a war casualty's widow or parents what they are paid when a military member is killed, and what they would pay to have them back. Monetizing the value of an irreplaceable life is an intriguing disparity. When I hold a baby, I marvel. An infant truly is a priceless miracle. A healthy infant, even more so. When you think of all the systems at play in making a human body function properly—eyes, ears, lungs, bone structure, brain, etc.—it truly is a wonder that any of it goes right at all. And yet, it does most of the time. Except, when it doesn't. Life comes and goes. We win, and we lose. We experience highs and lows, joys and sorrows, disappointment and fulfillment. Opposition in all things is clearly part of the mortal plan.

BountyP

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JOHN A. ANDERSON,

EDITOR- IN-CHIEF@JOHN_A_ANDERSON

8 HEALTHY IDAHO Healthy-Idaho.com

Facebook.com/HealthyIdaho November 2015 9

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Join us for the FitOne Expo, 5K, 10K and Half Marathon: September 22-24, 2016

A S

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TO:

FITO

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Congratulations to all our FitOne Corporate Challenge Team Winners!

Small Company X-Large CompanyX-Small Company XX-Large CompanyMedium Company Large Company

Heather Hill - Executive Director, Alissa McKinley - Race & Events Director, Lynn Neil - Expo &Programs Director, Keni Durfee - All-Around Utility Player, Christina Chiaberta - Volunteer Coordinator,

Samantha Vella - Summer/Fall Intern, Bailey Helvie - Summer Intern

2015 FITONE LOCAL ORGANIZING COMMITTEEAlicia PonceBart DavisBecky DelanaBen QuintanaBob KohnkeChristy NeuhoffCory ComptonDaniel MooreDave DrakeDeb DrakeDebbie KushlanDennis MesarosElsa CervantesForrest PechaJeff CrossJim WhithamKeith HughesKrystelle PuleLinda Gibbs

Linda HandlosMaralee CrossMedalist SportsMelanie JamesMichael Curtin, M.D.Mike ShumanNickole OneidaPam McEwanShaun FreeShirley KochSteve DrakeTanda WeeksTrish GallagherVickie Whitham

2015 FITONE EVENT COMMITTEEAbbey AbbondandoloAda County Highway DistrictAmanda HartmanAnne Scott

Boise Police DepartmentCentral District Health DepartmentChris WhithamChristine JohnsonChuck DarbyCity of BoiseGail SchenckHome Depot-Federal Way StoreJeff BurnsJeff LeanJenny SchenckJoan TruxalJohn McKinleyKelly LimKit ShumanKyle ChristensenLeah WhithamLiz GlasgowMac MacEwanMadison SimboliMark Van Gulik

Mary Pat MurphyMary ScottMelanie SimboliMichele RobinsonMickey FernstromRich FuhrimanRizen CreativeRobin ZadzoraRuss DunnSheryl ColthorpSt. Luke's Sports Medicine/Lost River Cycling ClubSyscoTraci HeckVector TimingVicki Flume

ST. LUKE'S LEAD COMMITTEEAmy PorterAmy StahlBeth Gray

Beth ToalBrent BoyerJean MutchieKirsten TeegardenKristin ArmstrongLisa GonserLori UriaMarcia GronsdahlRoya CampSandra WurdemannTerri LandaTheresa McLeodTim Marsano

And thank you to those of you we may have missed, for your generosity and support.

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Linda Handlos Boise Police Department

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Value In-Kind Sponsors

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To allparticipants,

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helped make healthand fitness

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Thank you!

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SLHS06394 - Healthy Idaho 2015 - FINAL.pdf 1 10/26/15 10:49 AM

10 HEALTHY IDAHO Healthy-Idaho.com

208-338-8900NOW ACCEPTING NEW PATIENTS

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Find Us Online: WomensHealthBoise.com

Our Hours Monday - Thursday 8 - 4 • Friday 8 - 3 • Closed Weekends

St Luke’s Medical Office Plaza • 333 North 1st, Suite 240 • Boise ID 83702

Dr. Hudson received her B.S. from King College (Bristol, TN), her medical degree from Edward Via Virginia College of Osteopathic Medicine (Blacksburg, VA) and completed residency training in

OBGYN at Wright State University/ Wright-Patterson AFB (Dayton, OH) in 2011. She recently fulfilled a 12-year military commitment,

spending the last four years at Mountain Home Air Force Base. Dr. Hudson received her Board Certification in OBGYN in 2012.

Interests include: general obstetrics and natural birth, lactation, ultrasound, nutrition, infertility, Polycystic Ovary Syndrome,

and menstrual disorders.

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Find Us Online: WomensHealthBoise.com

Our Hours Monday - Thursday 8 - 4 • Friday 8 - 3 • Closed Weekends

St Luke’s Medical Office Plaza • 333 North 1st, Suite 240 • Boise ID 83702

Dr. Hudson received her B.S. from King College (Bristol, TN), her medical degree from Edward Via Virginia College of Osteopathic Medicine (Blacksburg, VA) and completed residency training in

OBGYN at Wright State University/ Wright-Patterson AFB (Dayton, OH) in 2011. She recently fulfilled a 12-year military commitment,

spending the last four years at Mountain Home Air Force Base. Dr. Hudson received her Board Certification in OBGYN in 2012.

Interests include: general obstetrics and natural birth, lactation, ultrasound, nutrition, infertility, Polycystic Ovary Syndrome,

and menstrual disorders.

12 HEALTHY IDAHO Healthy-Idaho.com

Eventually, parents of these children will consider outside intervention. They’ll hear about some book, therapist, wilderness program or residential center for teens, and will begin to investigate.

Sending adolescents to a residential treatment center or wilderness program should be a last resort for parents and professionals. Therapy, an accurate diagnosis, medication and less aggressive treatments should be the first approaches when a child is slipping out of control. Many parents haven’t considered that their child may be suffering from mental health problems or learning disabilities, and this is an important first step toward resolution and successful treatment, even if it is in a residential treatment center, according to Teri Brister, PhD, the Director of Programs for Young Families for the National Alliance on Mental Illness (NAMI).

“The reality is that mental health conditions in children usually present themselves as behavioral problems,” she says. “The majority of the time when you have the behavioral issues going on with kids where every intervention under the sun has been tried and it just doesn’t work, there

PERHAPS NOTHING CUTS DEEPER THAN WATCHING YOUR OWN FLESH AND BLOOD MAKE IRRATIONAL, DAMAGING DECISIONS, AND THEN WATCHING THEM SUFFER THE CONSEQUENCES. There is a feeling of helplessness, mental exhaustion, and despair that mothers and fathers feel watching their adolescent drop into bad habits, academic decline, substance abuse, self-harm and rebellion. For many, advice, punishment, rewards and every other normal parenting tactic seem useless as the child sinks further into a downward spiral.

WELLNESSResidential Treatment is typically considered as option of last resort only after community-based mental health resources have been exhausted and have not successfully addressed the child’s needs. This treatment option may be appropri-ate for a child whose behavioral problems require a 24-hour environment to keep him/her safe. However, specialized care and research needs to be considered in choosing an appropri-ate program which utilizes a standard of care treatment specific to the child’s needs.

Amy Thompson, LMSWManager of Clinic Operations and ProgramsWarm Springs Counseling Center in Boise

Facebook.com/HealthyIdaho November 2015 13

almost always is an underlying mental illness.”

When an accurate assessment is made, and less invasive interventions fail, many family health professionals will point to a wilderness or residential program that places a child in a therapeutic environment for an extended amount of time.

“The primary deciding factors for families in making the decision about residential care are usually based on their feeling that they can’t provide for the child’s safety and/or the intense level of care necessary for them to remain at home,” Brister says.

But for the majority of parents, sending a child out of the home was never in the game plan. Where to get information, where to send a child, and for how long, are questions that most parents don’t know how to answer.

SIGNS THAT AN INTERVENTION MIGHT BE NECESSARY

g Old friends are replaced by friends your child doesn’t want you to meet.

g School performance worsens and apathy increases.

g Family conflicts become persistent and worsen.

g The child engages in self-destructive behavior.

g There is trouble with law enforcement.

g Personal habits change, such as sleeping, eating, hygiene and mood.

g Drug use.

g You fear for the child’s safety.

IDENTIFYING A GOOD PROGRAM

Here lies one of the biggest problems with adolescent residential therapy and adolescent treatment in general. Reliable, informed advice is hard to come by, in part because the science and best practices are evolving, and because many who feel comfortable giving definitive advice aren’t actually qualified to do so. You’re probably familiar with a common scenario: a teen begins to use drugs, get in trouble with the law and try risky sexual behavior, and parents don’t know what to do. Their doctor throws out the name of a child therapist, a neighbor describes a wilderness therapy program that did wonders for someone else’s child, and the internet provides a fire-hydrant strength stream of choices.

The truth is that your doctor isn’t likely to know the range of options available for your child, and your neighbor less so. Do you go to your dermatologist for serious questions about your heart health? Likewise, your primary care physician shouldn’t be the primary source of advice about child behavioral or psychological problems and solutions.

A family therapist is a better place to start for accurate assessment of what a child is experiencing, and what he or she needs. Therapists may refer you to an independent educational consultant. Educational consultants are familiar with a range of out-of-home treatment options for children, and are generally best equipped to match your child with the right program.

The residential treatment program umbrella encompasses a wide variety of treatment options. Many are designed for a specific gender, others for a specific age range. Some programs are designed for specific problems, like drug abuse, depression, anxiety, etc. Others have a heavy outdoor element, and some emphasize education and relationships.

“If you’ve seen one, you’ve seen one,” Brister explains, “and that’s so scary and frustrating for parents who are trying so desperately to find out what their child needs.”

Asking a parent to choose the right program is like asking a 5-year-old to go find the right part for your car at the auto shop. It’s a new, particularly foreign world, one where a guide is vital for avoiding damaging consequences. The right program can do wonders. The wrong program can be damaging to both your child and your financial wellbeing.

But, as parents and the right professionals collaborate to find the correct program, parents do have the right and the responsibility to ask certain questions.

QUESTIONS PARENTS SHOULD ASK ABOUT RESIDENTIAL TREATMENT OR WILDERNESS PROGRAMS

g What is the treatment regimen? How often does therapy occur?

g What is your success rate? How do you define success?

g How is the family involved, and how often?

g What kind of transition plan is there for children returning home?

g Is this program a member of NATSAP (National Association of Therapeutic Schools and Programs)?*

g How are staff members chosen?

g Can I talk to some previous students/families?

*Go to www.natsap.org to see an overview of programs in your area.

These questions are based around what research suggests is the most effective approach to residential or wilderness treatment.

A SUCCESSFUL EXPERIENCE

Tim Thayne, PhD, founded a teen wilderness program and now leads an in-home therapy program focused on before and after care for those attending residential treatment. In his book Not by Chance: How Parents Boost Their Teen’s Success In and After Treatment, he explains the characteristics of a successful program.

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CONTINUED ON PAGE 15 >>>>>

“A well-crafted therapeutic milieu (social environment) supercharges the environment to enhance the likelihood and speed of change. The foundation of such an environment is the creation of a safe, relationally warm place where a young person is protected from self-destructive behavior, unburdened from the “overwhelm” of life, and immersed in a relational climate that invites introspection. Such a place enables young people to look at their choices, their personal limitations, and the outcomes of the strategies they are using, and to recognize their own contributions to their problems and unhappiness.”

14 HEALTHY IDAHO Healthy-Idaho.com

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WHEN IT COMES TO THE DIFFERENT ELEMENTS OF A PROGRAM, HE WRITES, RESEARCH POINTS TO A FEW VITAL THINGS.

g A full and balanced daily life structure and schedule. g Clinical support through individual and group therapy. g Constant exposure to positive role models and coaching

from staff. g A positive peer culture in which teens who have progressed

influence other teens in positive ways. g Clear and consistent expectations and rules. g Experiential and recreational activities. g Methods for defining and recognizing progress. g Academic programming and support. g Parent education and involvement in the treatment process.

As you do careful investigation of different programs, these are some important keys to remember.

FAMILY INVOLVEMENT IS ESSENTIAL“We know that the best prognosis is a treatment regimen that

involves working with the child and the family, together,” Brister says.

Families who think they can drop their child off and have someone else fix their problems will be sorely disappointed. Thayne describes it like this: think of your family members as pieces of a puzzle. You remove one piece of the puzzle and put it in a different environment. It changes, grows and becomes fluid, malleable. After a while, that piece comes back to the puzzle. If the slot hasn’t changed, the piece will mold into its old form.

Recidivism, or relapse back into bad behaviors, has been an Achilles heel for the adolescent treatment industry. Many children see excellent gains in a residential or wilderness program, only to lose them upon returning home. A good program will work to create change in the family system as well as in the child, which results in more lasting success, research shows.

HOW PARENTS SHOULD BEHAVE DURING THEIR CHILD’S STAY g Give input and work hard on their own assignments. g Refrain from being defensive. g Develop a clear understanding of the plan. g Value the talents and expertise of team members. g View the problem as a family system’s problem, not simply as

a teen problem. g Align goals and expectations with the program’s. g Anticipate that your child is going to try to manipulate you

into getting him or her out of the program. Removing your child too early can result in lost progress.

-Not by Chance, Tim Thayne, PhD

HE TRANSITION HOME CANNOT BE OVERLOOKEDAll of the progress your child made could be lost if the

transition to home life isn’t good. This transition period has only in the last five years or so been given the emphasis it deserves in the adolescent treatment world. Thayne and his wife saw this need, and started Homeward Bound, which works to help children move to and from these drastically different environments.

Good programs will work to teach the family how to help the teen transition, which is vital because transitions are rarely smooth, according to Thayne.

SOME PROBLEMS THAT FAMILIES SHOULD ANTICIPATE g Discordant parenting: parents sometimes struggle being on

the same page with returning children. g Emotional triggers: eye rolling, name calling, wanting to see

a certain friend, refusing to do something, taking something without asking, rudeness. These cause parents to lose control and cause family system relapses.

g Power struggles. g Giving too much freedom too soon. g Over accommodation. g Unclear expectations, no accountability. g Social vacuums: lack of positive friends. g Destructive siblings.

Sending a child to residential treatment is a difficult choice followed by an even more difficult journey. Making an informed decision for your child and being appropriately involved during and after treatment can make an enormous difference for a successful outcome.

A Child Astray - continued from page 13

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WRITTEN BY RYAN CHASE

WELLNESS

SIGNS YOU’RE IN A RELATIONSHIP

WITH A NARCISSIST

HE OR SHE:

• Dominates conversation and interrupts

• Feels entitled

• Is easily hurt by criticism

• Won’t share credit for achievement

• Ignores your problems and is absorbed by

their own

• Thinks nobody understands their

problems

• Resents you for having what they don’t

• Manipulates

16 HEALTHY IDAHO Healthy-Idaho.com

Having a relationship with narcissistic individuals may be dif-

ficult as they often will not take ownership of the problem. They believe it is the fault of

everyone and everything that surrounds them. Narcissists have a strong ability to detach themselves

and deny that they have any feelings. But, it is important to remember that, often, their behaviors are covering up significant unfulfilled longings for connection and intimacy that may be difficult for

them to achieve.

Amy Thompson, LMSWManager of Clinic Operations and Programs

Warm Springs Counseling Center in Boise

Facebook.com/HealthyIdaho November 2015 17

We’ve all experienced the frustration of dealing with self-centered individuals, and sometimes we’re the guilty party. Narcissism, which can even reach the severity of a diagnosable personality disorder,

takes selfishness to the next level: attention seeking becomes extreme, manipulation defines relationships, and empathy disappears.

The term “narcissism” comes from the Greek myth about a warrior, Narcissus, who one day saw his reflection in the water and became so infatuated with himself that he died as a result (depending on the version) by either starvation or suicide. Either way, the myth finishes with the only remains of his presence being the growth of flowers, commonly referred to as the narcissus. Even though the term “narcissist” has evolved into something much greater than self-infatuation, the definition of a narcissist is “a condition characterized by self-preoccupation, lack of empathy, and unconscious deficits.” Ever heard of anyone like this? With approximately 6.2% of the general population having Narcissistic Personality Disorder (about 60% of those are male), everyone will likely encounter a narcissist at some point, or have some narcissistic qualities.

OF THE GENERAL POPULATION WILL

HAVE NARCISSISTIC PERSONALITY DISORDER IN THEIR LIFETIME.Recognizing narcissism in our loved ones may be difficult, but these qualities are rampant in fairy tales and the intertwined moral lessons. The queen from Snow White and the Seven Dwarves is a great example of narcissism. Instead of trying to find out some viable ways to improve her kingdom, she asks her magical mirror to affirm her beauty. When she doesn’t receive the answer she anticipates, the queen goes to great lengths to kill the girl more beautiful than her just to be the “fairest one of all.” In the end, the queen dies with no avail and was far worse off than when she started.

Out of the storybooks and into a real-life situation, Joan Crawford was a narcissist who was also famous on the silver screen. In the book and film, written by Crawford’s daughter Christina, titled “Mommy Dearest,” Christina depicted the respected film actress as a vain and manipulative person who felt as though nothing was enough for her. She consistently wanted perfection and paid no attention to the abuse she dealt to others. In the end, Joan left her daughter Christina with deep resentment, as evidenced by the book.

Joan Crawford and the queen from Snow White shared some common character attributes that can enlighten one’s understanding of narcissism. First was how nothing was ever satisfactory to them, either personally or in their surroundings. Instead of trying to accept that some things are simply out of their control, these narcissists attempt to control them. That is a chief characteristic of a narcissist: control. Sure, they are infatuated with their physical traits, but the act of controlling and manipulating others boosts the narcissist’s self-esteem. Usually, those methods of control are similar to those of a psychopath, meaning they tend to manipulate others, are insecure about themselves, have impulsive behavior, and trivialize mortality.

Narcissists will try to devalue you at any means, or attempt to diminish your self-esteem, in an effort to increase themselves theirs. Whether a narcissist is aware of this or not, they will try to make others dependent on them at first, and then remove themselves from supporting those once the link of dependence is established. They will lie and cause others to question themselves, in order to manipulate the situation to their advantage. Most of the time, a narcissist will try to destroy others’ relationships to make greater dependence on the narcissist.

Another thing to realize about narcissists is how most of their friendships are fleeting. While watching the Disney rendition of Snow White, you will notice that the queen’s friends are vultures. When the queen fell off the cliff and died, her “friends” swooped down to pick at the remains. Still there are people out there who will love the narcissists, even though they may not like the narcissist.

What are the overall effects on those affiliated with a narcissist? As many narcissists will begin to shower their “friends” with attention and care, for others to establish dependence on them, they will eventually take that away, but still want their friends to depend on them. When that happens, the friends may feel like an addict going cold turkey or may experience depression. Depending on the person, they may feel angry and/or hurt. No matter the feeling a friend gets, the narcissist doesn’t care.

When addressing narcissism, you need to be able to look at yourself and address the facts. What kind of person are you? How do your actions affect others? Who are the people you find yourself with and what kind of people are they? Learn now if you are a narcissist, and make an effort to be a better person to your friends and loved ones.

Do you have a lot of friends, but slowly lose interest in them over time?

Does everything have to be the way you want it no matter what?

Do you frequently look at yourself in the mirror?

Do you show off your body?

Do you find yourself more capable than others?

Would you prefer to be a leader?

Are You A Narcissist?

If you said yes to any of these questions, find out exactly how narcissistic you are by taking this quiz: psychcentral.com/quizzes/narcissistic.htm

6.2%

November 2015 17

18 HEALTHY IDAHO Healthy-Idaho.com18 HEALTHY IDAHO Healthy-Idaho.com

If your age depresses you, here’s a scientific truth that won’t make you feel any better. By 30, most people are losing one percent of their muscle mass each year (it’s called sarcopenia).

But your fate is still in your hands. Nutritionist Mariam Nelson from Tufts University even says that a lazy 40-year-old is biologically older than a 70-year-old that works out. So whether you’re 28 or 75, eating a diet full of protein and building your muscle regularly is a must.

1. Weight LiftingBy the time we hit middle age, we should start lifting weights at least twice a week to retain our muscle. But starting early can only help, so breakout some dumbbells or strap on some ankle weights. No one is exempt.

2. Resistance TrainingWhile some prefer lifting weights, they’re not required. Body weight exercises like pushups, squats, crunches, lunges and even some yoga can be just as ef-fective. Nutrition professor Douglas Paddon-Jones from the University of Texas says that just “one to two short resistance workouts each week can improve muscle mass and strength.” So, losing sleep trying to make it to the gym every morning isn’t necessary.

3. Cardio BlastingEven though cardio isn’t purely a muscle building exercise, it’s still a good idea. It improves muscle health, encourages blood flow and helps your body repair itself. So try to jump on the trampoline or grab your bike or three times a week. But don’t stop strength training.

Exercise toPREVENTMUSCLE LOSS

Sources: WebMD, The Boston Globe, Care2, and EatingWell

WRITTEN BY LINSY HUNSAKER

FITNESS/longevity

Facebook.com/HealthyIdaho November 2015 19

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There are DSME Programs statewide.Find one near your practice:

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November 2015 19

20 HEALTHY IDAHO Healthy-Idaho.com

Change your mindset and change your life.

mentally fitF I T N E S S

THERE ARE SO MANY THINGS WE CAN’T CHANGE IN LIFE, BUT WE CAN CHANGE THE WAY WE EAT, THE WAY WE MOVE AND ESPECIALLY THE WAY WE THINK.

WAKE UP A FEW MINUTES EARLIER and squeeze in 3 minutes of your favorite exercise. Do a 360 full body workout – upper body, abs and lower body – in your bedroom in just a few minutes! Place your feet on the floor and your hands on the bed and do 10-20 pushups. This version is a little less challenging than a standard pushup since it’s on the bed. To target your mid-section, get down and do 20 sit-ups. My favorite are bicycles because they are a 360 degree workout for your abs (upper, lower and obliques). And then for lower body, there’s nothing better than squats. I like to call them, butt taps. You squat down and tap a chair or the edge of your bed. This is really great for your butt and the lower half of your body. The 360 wakeup routine is a great way to start the day!

GET OUT OF YOUR JAMMIES AS FAST AS YOU CAN and lace up those running shoes. By putting on your fitness attire right away you get psyched and motivated. Now that you’re all geared up in your workout clothes, you have to squeeze in some type of exercise. Even if it’s a quick walk!

MAKE EXERCISE ACCESSIBLE. Your muscles don’t know if you’re at a fancy gym or sitting at home watching TV, so use that extra time at your office or while you’re on the telephone to lift some light weights.

SIGN UP FOR A FITNESS PLAN to help get you started and keep you motivated. Find a great group or an online plan that gives you the tools you need to achieve your goals by combining exercise, nutrition and motivation.

PURCHASE BEAUTIFUL ACTIVEWEAR that makes you feel great and will motivate you to get moving and keep moving. Find some inspiring activewear!

NEVER, NEVER, NEVER GIVE UP on your goals or shaping your dreams. If you slip up, remember: Every day is a new beginning, take a deep breath and start again.

DENISE AUSTIN SHARES HER TOP TIPS

Facebook.com/HealthyIdaho November 2015 21

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the definition of fitnessKnowing what you’re striving for is a good way to begin. This knowledge will also come in handy down the road

when you’re setting goals, measuring your progress, and trying to get motivated again after a backslide.>>

There are several aspects to condition-

ing. One is cardiovascular fitness,

which is measured by the maximum

amount of oxygen your body can use

(known as VO2 max). This indicates the

body’s ultimate work capacity. But VO2

max cannot be measured by the average

person, and it’s not all that relevant to

daily life. Another aspect of conditioning

that has greater relevance for most of us

is functional fitness, which takes into

account your general level of health

and ability to function. A healthy

heart, lungs, muscles, and bones help

make you functionally fit. Absence of

illness and length of survival, as well

as the ability to perform daily activi-

ties without noticeable discomfort or

limitations, also factor into whether

you are functionally fit.

focus on moderate activityToday, exercise recommendations focus on

moderate activity levels aimed at achieving

functional fitness and avoiding disease. This

differs from guidelines set out in the 1970s and

1980s that emphasized high-intensity activity

directed at achieving cardiovascular fitness.

This shift took place for two reasons. First,

subsequent research found that lower levels

of activity offered substantial health benefits.

Second, public health professionals believed

that focusing on activity levels that are more

manageable for the average person might help

motivate an increasingly sedentary population.

These guidelines aren’t meant to replace the

old ones. They simply offer an alternative for

people who prefer less intense workouts.

Still, achieving cardiovascular fitness can

make a real-life difference, too. Even though

you rarely press your heart and lungs to

the utmost, the physical changes that take

place as you boost your maximum exercise

capacity help you perform your regular

activities with less effort. Why? Because the

same amount of energy output necessary

to perform a task—such as walking for a

given amount of time at 4 miles per hour—

now demands a smaller proportion of your

overall ability. Hence, work that doesn’t

push you to the max feels “easier” as your

fitness level improves. Your health benefits

also increase when you perform greater

amounts of physical activity.

>>\ /\ /F I T N E S S

22 HEALTHY IDAHO Healthy-Idaho.com

Facebook.com/HealthyIdaho November 2015 23

If time is a concern, try choosing activities that are more vigorous

and shortening the length of your workout. Just be sure that you

don’t have any health conditions that might make vigorous activity

dangerous, and gradually work up to more intense exercise.

iThe terms exercise and physical activity are often

used interchangeably, but there are important

distinctions to be made. Physical activity refers to any

movement that involves muscle contractions and an

increase in metabolism. This broad definition includes

both aerobic and anaerobic activities. Types of physical

activity are further divided into groupings based on

the reasons a person performs the activity—such as

transportation, recreation, or household chores.

exercise vs. physical activity

From the Harvard Health Publications Special Health Report, Exercise: A Program You Can Live With. Copyright 2007 by

the President and Fellows of Harvard College. Illustrations by Harriet Greenfield and Michael Linkinhoker. All rights

reserved. Written permission is required to reproduce, in any manner, in whole or in part, the material contained herein. To make a reprint request, contact Harvard Health Publications.

Used with permission of StayWell.

Exercise or exercise training is technically

a subcategory of physical activity. It refers

to a structured program of activity for

attaining physical fitness. For most people,

fitness for health reasons is of greater

concern than athletic performance,

which demands skill, speed, and agility.

The elements of health fitness include

cardiorespiratory capacity, muscle

strength and endurance, flexibility and

balance, and weight management. A

regular exercise program that incorporates

all these elements is important for a

healthy level of conditioning.

Household activities such as sweeping

or leisure pursuits like gardening can be

a good way to get moving. But there’s no

reason to stop there. Coupling this kind of

activity with regular exercise will increase

your total energy expenditure and improve

your overall conditioning.

“Runners just do it - they run for the finish

line even if someone else has reached it first.” -Reg Anderson

>>

>>

//

Facebook.com/HealthyIdaho November 2015 23

24 HEALTHY IDAHO Healthy-Idaho.com

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26 HEALTHY IDAHO Healthy-Idaho.com

High school students from all over Idaho will soon have access to the new health sciences lab that physicians and college students are using at the Idaho State University campus in Meridian.

It’s an 18,000 square foot, $6 million, state-of-the art facility. A first-of-its-kind in Idaho. A health sciences lab so high-tech it looks like it could belong in a CSI episode.

“In terms of the combination of everything that’s here, this is unique in the state,” said Bessie Katsilometes, Health Science Center Dean of Academic Programs.

Learning transcends textbooks at this lab.

The facility includes a virtual lab for anatomy and physiology equipped with 3D technology, twelve cadaver stations, and a bioskills learning lab to provide practitioners with training in new surgical procedures and continuing education.

“There is not another bioskills learning lab in the state of Idaho,” said Katsilometes.

Students will come from a number of fields from physician assistants to pharmaceutical, dentistry, speech and language.

And it’s not just those enrolled through ISU.

WRITTEN BY KIM FIELDS

Katsilometes says students from other universities and colleges in Idaho will use the lab in a cooperative effort to promote health education. “We have a huge workforce shortage in the health professions,” said Katsilometes.

Even high school students will benefit from the lab. A teacher in rural Blackfoot can show his students the effects of smoking, not by pictures in a textbook, but by logging on to a virtual cadaver lab.

“We can connect to high schools all around the state,” said Ali Crane with Idaho State University. “Every high school in this state has a classroom that has broadband connection. This gives us the opportunity to connect to them anywhere.”

“This is going to be a resource for the entire state of Idaho with a particular emphasis on the Treasure Valley,” said Katsilometes.

The $6 million lab was built through a combination of public and private money, with the Idaho Legislature appropriating $3 million toward the project.

THERE’S AN EXCITING SHIFT TAKING PLACE IN THE WAY HEALTH EDUCATION IS TAUGHT IN IDAHO.

ISU HealthSciences Lab

Facebook.com/HealthyIdaho November 2015 27

28 HEALTHY IDAHO Healthy-Idaho.com

Dr. Neetu TalrejaDr. Neetu Talreja is a Board Certified Allergist/Immunologist with The Allergy Group, which has locations in Boise, Nampa and Meridian.

Learn more from Dr. Talreja at www.theallergygroup.com or call 377-4000

ABOUT THE AUTHOR

--------------------------------

--------------------------------HEALTHY MAGAZINEADVISOR CLIENT CONTENT

Relocating?

IF YOU WERE OFFERED A JOB IN ANOTHER CITY—OR YOUR CURRENT EMPLOYER ASKED YOU TO RELOCATE—WOULD YOU MAKE THE MOVE?

There are a lot of things to consider when you decide to relocate- cost to rent, new city, new friends, etc. In addition to all these, people with allergies and asthma have to also worry about the weather and pollen in the area.

For example, if you were to move in late summer, ragweed season has started in some parts of the country. It usually starts in mid-August and peaks around early September. People with asthma and allergies, who are sensitive to ragweed, can start feeling the symptoms by late summer. Ragweed is most commonly found in Midwest and the eastern states. A single plant can produce up to 1 billion pollen grains. The pollen can travel up to 400 miles!!! Ragweed sensitive individuals notice increased sneezing, stuffy or runny nose, itchy eyes and scratchy throat, which can affect the quality of life tremendously. Asthma attacks, headaches, difficulty sleeping and chronic sinus infections can also be present in very sensitive individuals with uncontrolled allergic rhinitis patients.

Obviously, there are many other seasonal allergies to be aware of when you move out of your area.

• Familiarize yourself to the pollen/allergens present in your new area of location. Then, identify your individual sensitivity to those environmental allergens by visiting a board-certified allergist in your area. Discuss a personalized action plan. The allergist can help identify and treat symptoms, and sometimes, suggest allergen immunotherapy – such as allergy shots or under-the-tongue sublingual tablets – and medication – either oral or nasal or both routes.

• Packing and unpacking for the move can expose you to dust. Use a mask to prevent yourself the best you can. Try sinus rinse or use allergy medications (as suggested by your allergist) to help you with symptoms.

• Find out if your newly rented or owned apartment or house had any cats or dogs from the previous tenants or house owners. If you are sensitive to animal dander, this could be serious trouble for you, especially if you have asthma. It takes 4-6 months to “de-cat” or “de-dog” a house. Discuss this with your allergist so a personalized plan can keep you free of symptoms.

When faced with the prospect of relocating, it is very easy to feel overwhelmed. However, if you make a plan, write your goals and determine a timeline, it could easier for you to work towards the move.

Here are some key things to consider

CONSIDER THE FOLLOWING IF YOUR MOVE IS GOING TO TAKE YOU OUT OF STATE:

Facebook.com/HealthyIdaho November 2015 29

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HAPPY “THANKSFORGIVING”WRITTEN BY SHERLY SULAIMAN

“Sometimes in order to be happy in the present moment, you have to be willing to give up all hopes for a better past.”- Robert Holden

Facebook.com/HealthyIdaho November 2015 31

For many of us, spending time with certain family members can reopen old emotional wounds, even if we thought the scar tissues had healed for good. The holidays seem to be a particularly vulnerable time for old scars and delicate hearts. It is during these times of joy and giving, that we need to also be generous when it comes to forgiving.

Everyone has at least one person they still need to truly forgive. We may know intellectually that forgiving is ultimately better for us, but unfortunately we don’t always practice what we know to be better. While we’re constantly letting go when we excuse friends, colleagues or strangers for irritating or even offensive behaviors, when it comes to certain family members or loved ones, letting go may not come so easily.

There is an aunt in my family (I’ll call her Wendy) who “means well” when she criticizes our appearance, our significant other, our work, or other things she finds counter to her strong opinions.

HAPPY “THANKSFORGIVING”WRITTEN BY SHERLY SULAIMAN

Sherly Sulaiman is an internationally renowned clinical hypnotherapist and Neuro-Linguistic Programming (NLP) practitioner. She resides in Los Angeles and sees patients at her Santa Monica facility, New Stress Relief (www.NewStressRelief.com).

Her untimely remarks can feel like her pumpkin pies, presented as something sweet, but after several servings, we’re left with an ache and a heaviness in our belly that’s hard to digest. Many of us have an “Aunt Wendy” in our lives.

Unfortunately, it can be the actual person or simply a reminder of them that can emotionally trigger us. During holiday gatherings, we’re often exposed to other people’s issues, as well as the dynamic of various relationships, and our own issues. Now that can be a LOT of issues in one room. It’s hardly surprising that people experience so much stress, anxiety and depression during the holidays.

We need to access some mental and emotional tools to prepare us for these gatherings. Most of us know that we want to cultivate calmness, stability, detachment and healthy boundaries, especially with our families. Sometimes, we overlook that the key to unlocking the doors to these powerful tools is forgiveness. And other times, we simply resist it. Why?

THERE ARE SEVERAL POSSIBLE REASONS1. We think it means condoning the “bad” behavior that hurt us.2. We see it as a threat to our values. For example, forgiving

someone for cheating on us may unconsciously represent a compromise to the value we place on loyalty or honesty.

3. We may feel forgiveness makes us appear weak or “the loser.”4. We lose a form of protection that prevents us from being hurt

in the same way again.

None of these are true. Forgiveness sets us free emotionally and mentally. It allows us to see people for who they are and not who they were or who they remind us of. We can enjoy the present moment as it is, unburdened by fears of the past. This helps make gatherings with family and loved ones an enjoyable experience, from an authentic place. We can decide to let things go, the same way we do on a daily basis with friends, colleagues and strangers.

During challenging “forgiveness crossroads,” I tell my clients to consider

these two questions: “Is my desire for happiness and harmony stronger than my attachment to my past suffering?” And, “Is it more important for me to have peace or to be right?”

Forgiveness allows us to choose peace, happiness and harmony over resentment and fear. When we let things go from a space of love and compassion, it’s easier to understand that “Aunt Wendy” is who she is and is simply doing the best she can. We appreciate the time and effort she took to bake those pies…and we enjoy every bite.

32 HEALTHY IDAHO Healthy-Idaho.com

Thanksgiving only comes around once a year, so why not go ahead and splurge? Because gaining weight during the holiday season is a national pastime. Year after year, most of us pack on at least a pound (some gain more) during the holidays — and keep the extra weight permanently.But Thanksgiving does not have to sabotage your weight, experts say. With a little know-how, you can satisfy your desire for traditional favorites and still enjoy a guilt-free Thanksgiving feast. After all, being stuffed is a good idea only if you are a turkey!

GET ACTIVECreate a calorie deficit by exercising

to burn off extra calories before you

ever indulge in your favorite foods,

suggests Connie Diekman, MEd, RD,

former president of the American

Dietetic Association (ADA).

"'Eat less and exercise more' is the

winning formula to prevent weight

gain during the holidays," Diekman

says. "Increase your steps or lengthen

your fitness routine the weeks ahead

and especially the day of the feast."

Make fitness a family adventure,

recommends Susan Finn, PhD, RD, chair

of the American Council on Fitness

and Nutrition: "Take a walk early in the

day and then again after dinner. It is a

wonderful way for families to get physical

activity and enjoy the holiday together."

EAT BREAKFASTWhile you might think it makes sense

to save up calories for the big meal,

experts say eating a small meal in the

morning can give you more control

over your appetite. Start your day with

a small but satisfying breakfast — such

A THINNER THANKSGIVINGWRITTEN BY KATHLEEN M. ZELMAN, MPH, RD, LD

Facebook.com/HealthyIdaho November 2015 33

Enjoy the holiday feast without the guilt—or the weight gain.as an egg with a slice of whole-wheat

toast, or a bowl of whole-grain cereal

with low-fat milk -- so you won't

be starving when you arrive at the

gathering. Eating a nutritious meal

with protein and fiber before you arrive

takes the edge off your appetite and

allows you to be more discriminating in

your food and beverage choices.

LIGHTEN UPWhether you are hosting Thanksgiving

dinner or bringing a few dishes to

share, make your recipes healthier with

less fat, sugar, and calories.

"There is more sugar and fat in most

recipes than is needed, and no one will

notice the difference if you skim calories

by using lower calorie ingredients," says

Diekman.

HER SUGGESTIONS:

• Use fat-free chicken broth to baste the

turkey and make gravy.

• Use sugar substitutes in place of sugar and/

or fruit purees instead of oil in baked goods.

• Reduce oil and butter wherever you can.

• Try plain yogurt or fat-free sour cream

in creamy dips, mashed potatoes, and

casseroles.

POLICE YOUR PORTIONS Thanksgiving tables are bountiful and

beautiful displays of traditional family

favorites. Before you fill your plate,

survey the buffet table and decide what

you're going to choose. Then select

reasonable-sized portions of foods you

cannot live without. Don't waste your

calories on foods that you can have all

year long. Fill your plate with small

portions of holiday favorites that only

come around once a year so you can

enjoy desirable, traditional foods.

SKIP THE SECONDS.Try to resist the temptation to go back

for second helpings. Leftovers are much

better the next day, and if you limit

yourself to one plate, you are less likely

to overeat and have more room for a

delectable dessert.

CHOOSE THE BEST BUFFET BETS.While each of us has our own favorites,

keep in mind that some holiday foods are

better choices than others. White turkey

meat, plain vegetables, roasted sweet

potatoes, mashed potatoes, defatted

gravy, and pumpkin pie tend to be the

best bets because they are lower in fat and

calories. But, if you keep your portions

small, you can enjoy whatever you like.

SLOWLY SAVOREating slowly, putting your fork

down between bites, and tasting

each mouthful is one of the easiest

ways to enjoy your meal and feel

satisfied with one plate full of food,

experts say. Choosing whole grains,

fruits, vegetables, broth-based soups,

salads, and other foods with lots of

water and fiber add to the feeling of

fullness.

Spread out the food and fun all day

long. At the Finn family Thanksgiving

gathering, they schedule dessert

after a walk, while watching a movie

together.

"We eat midday, and instead of

another meal at dinnertime, we

continue the feast with dessert a

few hours after the main meal," Finn

explains.

BE REALISTICThe holiday season is a time for

celebration. With busy schedules

and so many extra temptations, this

is a good time to strive for weight

maintenance instead of weight loss.

"Shift from a mindset of weight loss

to weight maintenance," says Finn.

"You will be ahead of the game if you

can avoid gaining any weight over

the holidays."

FOCUS ON FAMILY AND FRIENDSThanksgiving is not just about the

delicious bounty of food. It's a time

to celebrate relationships with family

and friends.

"The main event should be family

and friends socializing, spending

quality time together, not just what

is on the buffet," says Finn.

DIET & WEIGHT MANAGEMENT

A THINNER THANKSGIVING

34 HEALTHY IDAHO Healthy-Idaho.com

The first Thanksgiving after Alice Bast learned she couldn’t eat gluten, she devised a strategy for the perfect family gathering—a color-coded Thanksgiving where one color of plate indicated gluten-free and another the remaining dishes.

BY EMMA PENROD

Today, when she hosts a holiday meal, everything served is free of gluten. But every family is different, she says.

What so many diverse families across America have in common, however, is a shared sense of holiday meal anxiety, the product of intense pressure to offer a picture-perfect family experience. Meal-centric holidays such as Thanksgiving can be especially frustrating for those with specific dietary needs—such as those who are diabetic or who don’t eat meat or gluten—but a little preparation can go a long way toward ensuring everyone enjoys family traditions to the fullest.

Boot the Gluten: But what about Grandma’s stuffing?Thanksgiving is a difficult holiday for the estimated three million Americans with Celiac Disease—a digestive condition that damages the intestine whenever gluten, a protein found in wheat, barley and rye, is ingested—and to those

THE MEAL ORDEAL:(

DIETARY NEEDS HOLIDAY MEALS

Facebook.com/HealthyIdaho November 2015 35

who are otherwise avoiding gluten. “You want to eat—it’s tradition,” says Bast, who after being diagnosed founded the National Foundation for Celiac Awareness". But then you turn to the dinner table. Turkey with stuffing is out. Pumpkin pie is out. The mashed potatoes are probably ok, but not with gravy.

“Gluten can be hidden,” Bast says. “Gravy may have flour in it. Serving spoons—you have to be sure they don’t get dipped in a gluten-containing dish and then back into a gluten free one.”

Those planning to travel for Thanksgiving should bring a “signature dish,” Bast recommends. It doesn’t have to be complicated, but could be as simple as a platter with veggies and hummus, or an apple crisp.

Similar rules apply for hosting gluten-free Thanksgiving meals, Bast says. Keep recipes simple, and practice cooking each dish in advance to avoid making something new for the first time. Focus on vegetable- and protein-based dishes, and consider getting a gluten-free pie crust and substituting gluten-free bread in the family’s favorite stuffing recipe. And in any situation, make family the priority.

“Instead of focusing on the food you can’t have,” Bast says, “focus on making it a fun gathering for the family.”

A Diabetes Dilemma: Turkey and four sides of carbs“One of the concerns for people with diabetes is the need to regulate their intake of carbohydrates,” says Sandy Kipp, a dietetics master’s candidate doing supervised work under registered dietician Rhonda O’Brien. The difficulty with Thanksgiving, she explains, is that most traditional components of the meal are loaded with carbs.

Rather than eliminating entire categories of food, those with diabetes need to monitor their portion sizes and carbohydrate exchanges, Kipp says. The best strategy for the 25.8 million Americans with diabetes is to prioritize which dishes they most want to try and to balance carbs with protein and fiber. Be mindful, and select a few small sides with some turkey and non-starchy vegetables.

“Observe what is in front of you, how hungry you are, and start light on the plate,” Kipp says. “Pick your very favorites, instead of having a serving of each.”

For dessert, cooks can oftentimes cut the amount of sugar in recipes by up to half, or by substituting some applesauce instead, without negatively impacting the flavor, Kipp advises. Apple pie can always be made with juice concentrate instead of sugar. But the best plan might be a slice of old-fashioned pumpkin pie.

“Pumpkin pie is actually a very healthy dessert that can be made light on sugar,” Kipp says.

THE MEAL ORDEAL:(Thanksgiving without the Turkey? Move over, Meat.For those who do not or cannot eat meat, Thanksgiving’s celebrated turkey centerpiece is problematic. However, Thanksgiving is an otherwise vegetarian-friendly holiday, according to John Cunningham, a consumer research manager at the Vegetarian Resource Group.

“Thanksgiving is one of the easy holidays because there are so many traditional side dishes,” Cunningham says. “One can focus on those side dishes and still enjoy the meal.”

In some cases, it may be best to offer to bring a dish—that might help to take some pressure off of the host, Cunningham adds. If you’re a vegetarian host, pleasing a crowd that expects a traditional centerpiece can be more difficult, especially if the rest of the family’s not sold on tofurky. But it’s nothing a little creativity can’t remedy.

“It doesn’t necessarily have to be a protein roast to bring the meal together,” Cunningham says. He suggests trying a stuffed pumpkin in the place of a stuffed turkey. “Pumpkin is an impressive vegetable, and it has a really mild flavor that most people won’t object to and that does a really good job of absorbing other flavors.”

More important, Cunningham says, “you need to focus on the people, not the plate.”

"Pumpkin pie is actually a very healthy

dessert that can be made

light on sugar"

36 HEALTHY IDAHO Healthy-Idaho.com

BATTLE PLANHOLIDAY HEALTH

cON

fIDE

NTI

AL

Facebook.com/HealthyIdaho November 2015 37

BATTLE PLAN

Holiday memories are great—except for the ones that remain in your love handles.

The holidays are about family, fun and food, and we shun anything that tries to take away from those joys. But we also worry about our weight during the festive time of the year, which can take the pleasure out of family meals. These meals should warm the heart, not make you feel guilty.

The solution? Have a battle plan.

SCOUT IT OUTYes, soldier, the first step in winning any battle is to survey the field to know what you’re up against.

Upon arriving at a dinner party, pot-luck or buffet, don’t immediately attack the deliciousness in front of you. Get a drink, chat it up and inspect the table. Reconnaissance will help you avoid eating foods you don’t like, which is a big-time holiday health nemesis. Besides, it’s a big downer to fill your stomach with things you don’t really want when so many other good foods are available.

In addition, examining the table will help you avoid overloading your plate. The more we put on our plates, the more we eat. Pick and choose the foods you want in reasonable portions, remembering to be somewhat balanced nutritionally.

HOLIDAY HEALTH

HOW TO GET ON THE OFFENSIVEWHEN IT COMES TO OVEREATING

WHERE ARE THE SNIPERS?Festive foods aren’t necessarily unhealthy. Oftentimes it’s what’s on top that hurts. Gravy, cream sauce, whipped cream and things of this nature are especially unhealthy. But a family dinner without these things is certainly a drab idea, so we aren’t saying avoid them altogether. Just be aware of them and try to be reasonable. Remember that simply limiting calories may not be sufficient planning. The source of calories you get may be just as important.

SURPRISE ATTACK!You just ate an hour ago, but that toffee on the table is looking irresistible. It’s a snack attack, and you aren’t ready.We love snacking, especially during the holidays when snacks are better than any other time of year. But snacking can lead to overeating. Sometimes if we snack too much then we skip meals, going all T-Rex when we finally eat again.

Here are some solutions:

• Give away leftovers to friends and family.

• Chew gum in between meals• Put it away. Easy access to food

leads to snacking.

COUNTERATTACK: DESSERTYou’ve handled yourself well for the main course, but here comes dessert, and it has a power that may be invincible.

Some suggest eating dessert first, because it can lower the total calories taken in for the meal. It’s probably true, if you think about it. Usually we stuff our faces with the main meal, and then tack on dessert even though we’re already full. Eating dessert first can curb overeating.

Lora Erickson, a professional fitness coach in northern Utah, recommends a 90/10 rule, where 90 percent of eating is smart, and 10 percent of eating is free. Why so strict?

“It simply doesn't feel good to overindulge and the body usually rebels,” she said. “As always, it's about balance."

As a side note, remember that “lite” holiday desserts aren’t much healthier than the real thing and often taste much worse.

ON YOUR FEET, SOLDIERHoliday pounds often come not just from food, but from being sedentary. Whether it’s the football game or a long fireside chat, we spend extensive amounts of time on our bottoms.

It’s a smart idea to get the family out the door after or before meals. Take a stroll to find the prettiest fall-colored trees, build a snowman, or do one of a hundred other things to counterbalance the diet that comes with festivities. At night, have a family dance or play an active game.

Maybe we will never call the holiday diet “healthy,” but with a little organization and planning, the long-term effects of holiday eating become insignificant, especially if the focus on good diet is year-round.

38 HEALTHY IDAHO Healthy-Idaho.com

Chickpea & Rice Soup with a Little KaleSERVES 6

3⁄4 cup cashews, soaked in water for 2 hours or overnight 2 tablespoons olive oil

1 medium-size yellow onion, thinly sliced

3 cloves garlic, minced

1 teaspoon dried rosemary

3⁄4 teaspoon dried thyme

1 teaspoon salt

Freshly ground black pepper

3⁄4 cup uncooked rice, rinsed

3 ribs celery, thinly sliced

1 cup carrot, diced chunky

5 cups vegan vegetable broth

1 (24-ounce) can chickpeas, drained and rinsed (about 3 cups)

4 cups chopped kale

Thinly sliced green onion, for garnish

1. Drain the cashews and place them in a blender or food processor with 1 cup of fresh water. Blend until completely smooth, scraping the sides with a spatula occasionally to make sure you get everything. This could take 1 to 5 minutes, depending on the strength of your blender.

2. Heat a stockpot over medium heat. Sauté the onion in the olive oil, with a pinch of salt, for about 5 minutes, until translucent. Add the garlic, rosemary, thyme, salt, and pepper and sauté for a minute more.

3. Add the rice, celery, and carrot and then pour in the broth. Cover and bring to a boil. Once boiling, bring the heat down to a simmer, add the chickpeas, and let cook for about 15 more minutes, until the rice is cooked and the carrot is tender.

4. Add the cashew cream and kale and simmer until the kale is wilted, 3 to 5 more minutes. You may need to add water to thin the soup if it seems too thick. Taste for salt and seasonings and let sit for 10 minutes or so to allow the flavors to marry. Serve topped with green onions.

This soup thickens as it cools, so if you have leftovers, just thin with a little water when you reheat.

Invite a friend over, break some bread (olive sourdough spoken here), and inhale big bowlfuls of comfort like this one: chewy rice and succulent chickpeas, fragranced with rosemary, thyme, and celery, pulled together by luscious cashew cream. And, of course, I throw in a little kale at the end for good measure. Lacinato holds its bite, but you can use whatever kale tickles your fancy.

eat right new & easy

Facebook.com/HealthyIdaho November 2015 39

Fresh Corn FrittersMAKES 15 FRITTERS

6 ounces extra-firm silken tofu (1⁄2 package of the vacuum-packed kind)

1 tablespoon pure maple syrup

2 tablespoons unsweetened almond milk (or preferred nondairy milk)

1⁄4 cup all-purpose flour

3 ears corn, kernels cut from the cob (about 11⁄2 cups) (see “Fizzle says”)

1⁄4 teaspoon salt

A few dashes of freshly ground black pepper

1 jalapeño pepper, seeded and very finely chopped

1⁄4 cup red bell pepper, very finely chopped

Refined coconut oil for frying

INSTRUCTIONS

In a blender or food processor, whiz the tofu, maple syrup, milk, and flour, scraping down the sides often with a rubber spatula, until everything is smooth. Add half of the corn (3⁄4 cup) and pulse so that the mixture is blended but still a bit chunky. Transfer to a bowl and add the remaining corn, salt, black pepper, jalapeño, and bell pepper, and combine well.

Heat a thin layer of oil in a heavy skillet over medium-high heat. Drop the batter by tablespoonfuls into the skillet. Flatten a little with the back of the spoon (wet the spoon first to avoid sticking). Cook in batches, 21⁄2 to 3 minutes on each side, until lightly browned. When done, transfer to a brown paper bag or paper towels to drain the oil.

TIPTo cut the corn from the cob, place the shucked corn pointy side up on a kitchen or paper towel. Take a chef’s knife and cut downward, as close as you can to the cob. The towel will keep the corn kernels from bouncing everywhere and also makes a handy vehicle for transporting them to the mixing bowl.

http://www.amazon.com/Vegan-Vengeance-10th-Anniversary-Edition/dp/0738218332

These are really fast and yummy. The jalapeño and red pepper make the pancakes colorful and add just a little spice. Serve with salsa or as a breakfast side dish in place of potatoes. A cast-iron skillet works best for even frying.

40 HEALTHY IDAHO Healthy-Idaho.com40 HEALTHY IDAHO Healthy-Idaho.com

Turkey is a given. Not only is it great for Thanksgiving, but it’s great for your health, and as such it’s fortunate that

turkey is part of America’s year-round cuisine. But some of turkey’s fruit and vegetable companions are often neglected,

despite their healthy potential.

Here we’ve listed some of the best foods from holiday traditions all across America,

along with their suggested uses, both traditional and year-round.

PumpkinPumpkin pie is far from the most sinful dessert available. On the contrary, pumpkin is one of the most nutritious foods available, being an excellent source of vitamins A, B, C and E, iron, potassium, thiamin, folate, and riboflavin, among other nutrients. And raw pumpkin offers all this for only 30 calories per each fat-free, cup-sized serving.

Of course, pumpkin can be served without the added sugars and fats that

come along with most pie recipes. Instead of pie, try serving it as an appetizer as a

warm cup of pumpkin soup.

At many grocery stores, small raw pumpkins are often sold alongside other varieties of winter squash, and they can be served the same way. Leftovers can be turned into a puree, which can in turn be used to fill ravioli, mixed into a soup, or added to breads. In Thai cuisine, it’s even served in curry.

TRADITIONAL FOODS

WORTH REVISITINGYEAR-ROUND

40 HEALTHY IDAHO Healthy-Idaho.com

Facebook.com/HealthyIdaho November 2015 41

Turnips & RutabagasThough the specific name for rutabaga varies from region to region, this peculiar, pale vegetable is a frequent—and remarkably healthy—addition to many holiday meals, particularly in the eastern United States. Here you will find vitamins B and C, Thiamin, Calcium and fiber, and less than 50 calories per cup.

For Thanksgiving, turnips are generally served boiled and mashed, like potatoes, and mixed with apples and brown sugar for a sweeter dish or with other root vegetables, rosemary and butter. But they also make for wholesome, cheap ingredients year-round: in the fall, baked in a variety of gratins or added to potato soup, or sliced and served raw over salad for summer.

Another under utilized root vegetable worth trying, to throw something new into the mix, is celeriac, also known as celery root for its similar taste to the more familiar vegetable. Both celery and celery root boast high quantities of vitamins C and K, fiber and potassium, for a minimal number of calories.

Sweet PotatoesSweet potatoes are usually reserved for casseroles served Thanksgiving Day. Recently, however, they have begun making perennial appearances in popular American cuisine, and for good reason: sweet potatoes pack an extremely high amount of vitamin A—nearly 400% the average daily requirement—plus fiber and potassium. Traditionally, they’re served with brown sugar and butter, or, more recently, fried, though neither of these is the best option, since raw sweet potato alone is relatively high in calories, with more than 100 per cup serving. But sweet potatoes are just as good as russets when baked or mashed and served with a light topping like chives. Still more interesting combinations can be found if you’re willing to be creative. For example, ginger and soy will offer an unexpected Asian twist.

PlumsPlums make an annual appearance around Christmas, usually in the shape of puddings, pies and pastries. But for less than 80 calories per cup-sized serving, plums bring vitamins A, C and K into your diet. They don’t have to be baked or sweetened, but serve can serve instead as a base for marinades on chicken or pork.

November 2015 41

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Butternut SquashLike pumpkin—perhaps because they are so closely related—butternut squash offers a plethora of nutrients for minimal calories, only 63 per one-cup servings. This squash is packed with vitamins A, B, C and E, plus potassium, fiber, calcium and others. Around the holidays, it’s usually served pureed, with warm flavors such as brown sugar and nutmeg. But there’s no reason to avoid butternut squash year-round. In the summer, it can be served grilled, or cubed and served with Provençal flavors such as garlic, parsley and oil.

PersimmonsHere’s an unusual fruit for those looking to spice up their traditions with something new. The persimmon is more popular in Japan, but it has found a niche market in Indiana, where it is frequently served as persimmon pudding for Thanksgiving. High in both vitamin C and iron, with only 30 calories per cup, this is worth a second glance.

It should be noted that there are two major categories of persimmons—a sweet kind, and another that is intensely bitter. Persimmons are best when soft, so plan on making time for them to ripen up. In fact, some unripe persimmons are inedible.

In America, persimmons are used almost exclusively in baked goods such as cakes, cookies and pies, but in Japan, they are often eaten raw, or dried. In the case of the former, the top is cut off, and the insides scooped out with a spoon. A few modern salad recipes call for persimmon.

CranberriesIf you avoid the sugary, jellied variety, the vitamin C content of cranberries alone makes these

worthwhile. In addition to more than 14 mg of vitamin C per serving, cranberries also

offer high quantities of fiber, plus vitamins E and K. But naturally, cranberries are exceptionally bitter, so they can be difficult to eat raw. Nonetheless, with a little sugar, they blend nicely with oranges, apples and pomegranate. Year round, try them baked into breads and muffins with orange or lemon zest.

44 HEALTHY IDAHO Healthy-Idaho.com44 HEALTHY IDAHO Healthy-Idaho.com

WRITTEN BY ASHLEY EVANSON

T H E P O W E R O F

RELIGION HAS LONG EMBRACED THE CONCEPT OF GRATITUDE, AND THE HAPPINESS AND HEALTH THAT FLOURISH AS A RESULT. BUT NOW SCIENCE HAS ACCEPTED AND PROVEN GRATITUDE TO BE A POSITIVE FORCE. SO WHEN IT GETS DOWN TO IT, THE REPETITIVE, TIME-CONSUMING TASK OF WRITING THANK-YOU LETTERS IS ACTUALLY GOOD FOR YOU!

Facebook.com/HealthyIdaho November 2015 45

Robert Emmons, professor of psychology at the University of California, Davis, and author of Thanks! How the New Science of Gratitude Can Make You Happier, is a

forerunner in gratitude research. He conducts experiments that measure the physical and emotional results of gratitude and ingratitude—and they truly do have a direct effect on your body and spirit.

BENEFITS OF EXPRESSING GRATITUDEFor example, Emmons’ ground-breaking research has proven that people who are grateful have higher levels of positive emotions like love, optimism, joy, enthusiasm, and happiness.

“The practice of gratitude as a discipline protects a person from the destructive impulses of envy, resentment, greed, and bitterness,” Emmons says.

He also states that those who are grateful are able to cope better with stress, they sleep better and have more energy, and they even have more resilience toward illness and have greater physical health.

“Gratitude works because, as a way of perceiving and interpreting life, it recruits other positive emotions—like joy, contentment, and hope—that have direct physical benefits, most likely through the immune system or endocrine system,” Emmons says. “We have also found that when people experience gratitude, they feel more loving, more forgiving, and closer to God.”

On the flip side, ingratitude can have the opposite effect. Those who are ungrateful show signs of loneliness, increased depression, and lack of meaning in life. Like gratitude, it too has a direct effect on your body’s health.

“If ingratitude is combined with hostility, resentment, or cynicism—as it often is—then the cardiovascular disease risk is increased,” Emmons says. “Ungrateful people may also be at greater risk from stress-related diseases because they handle stress more poorly than do the grateful people.”

So how do you show gratitude? You can always “count your many blessings,” which has proven to be a great help. But here’s where the thank-you letter comes into play. Emmons says that by sharing gratitude, all of the above benefits are amplified. So expressing thanks to someone else doubles your joy.

Emmons recalls a study done in 2005 that examined what happened to people when they wrote a thank-you letter to someone they felt they had never properly thanked. They delivered the letter and personally read it to the person, nothing more. After having completed the assignment, the letter-givers were happier and more content. They went in for follow-ups one week, one month, and even three months later, and most still showed signs of increased happiness.

EMMONS BELIEVES THE POWER OF A THANK-YOU NOTE IS INCREDIBLE, AND THAT THERE ARE THREE MAIN BENEFITS:

1. Expressing emotions magnifies the feeling, so expressing thanks makes our gratitude stronger.

2. Expressing thanks builds and strengthens relationships. Gratitude is the relationship-building emotion, so not only do we benefit on an individual level, but we create better bonds with others.

3. It humbles us. The natural man has a self-serving bias and the tendency to take sole credit for everything positive. Acknowledging that something good is a result of someone else provides us with a humbling experience.

THANK-YOU NOTE BASICSSo how does one write a proper thank-you letter, making sure to express sincere gratitude for another person? A lot of people don’t write thank-you notes because they either don’t know what to say, feel like they can only write generic, impersonal things, or they’ve forgotten and it’s too late to send one now. Don’t let these stop you. Remember, silent gratitude benefits no one.

The key is to focus on the giver. What does the gift mean to you? How does it make you feel that the giver acknowledged you? Try to concentrate more on the person than the gift, although mentioning the specific gift is a must.

OUTLINING A TYPICAL THANK-YOU LETTER:

1. Greeting: “Dear Johnny,” or more personal, “Hey Johnny!”

2. Thank them for the gift, and be specific: “Thank you so much for the lovely pearl bracelet.”

3. Mention something about the gift, why you like it, and/or how you are planning to use it: “It is absolutely stunning, and I feel so beautiful when I wear it.”

4. Express gratitude for the time, effort, and thought the giver put into the gift: “It was so nice of you to think of me, and you knew exactly what I would love.”

5. Mention a brief personal comment about the giver, like the next time you plan to see them, mention their family, or express feelings about your relationship: “You are such an amazing person, and I feel so lucky to be your friend.”

6. Sign off with “Love,” “Sincerely,” “Thanks again,” etc., and sign your name.

It’s that simple! You can elaborate and, of course, add more than one sentence to any or all of these steps, making it as short or long as you feel appropriate. Writing an uncomplicated letter like this can mean the world to someone, and make a tremendous difference in your relationship with them.

An easy way to get your thank-you notes written quickly is to have envelopes already

stamped and labeled with your return address, and to always have stationary on hand. Make it a goal to immediately sit down and write a quick note as soon as you receive a gift. Think of it as the quicker you write a thank-you, the more grateful you are.

Also, you should never feel indebted. There is a crucial difference between indebtedness and gratitude. If you feel like you have to repay the debt or have a sense of obligation to the person, no good will come of your thank-you. True gratitude is where we are glad to be indebted to the person, truly happy to give thanks.

Just remember in your thank-you writing endeavors, any letter is better than no letter, so despite tardiness or embarrassment of poor writing skills, or whatever is keeping you from the task. Just do it—your happiness depends on it!

THANK-YOU NOTE ETIQUETTEThe website thank-you-note-samples.com lists common mistakes made in thank-you notes. Make sure you don’t do one of the following:

• Don’t talk about yourself—the point of the letter is the gift, not you.

• When thanking someone for money, don’t mention the amount in the note.

• Don’t print out a thank-you card. Take the time to write a hand-written letter. After all, they took the time (and money) to buy the gift.

• Don’t include fewer than three sentences.

• Don’t write a thank-you note for receiving a thank-you note. It gets too confusing and isn’t necessary.

• Don’t wait more than two weeks to write a thank-you, and don’t wait a year to mail letters for wedding gifts.

• Don’t get personal with a business letter. It’s best to just stick with thanking them.

• Don’t email thank-you letters. Unless you know them really well and speak with them often, email is too impersonal.

Thank-you Writing for KidsGetting your kids to be as enthusiastic about writing a thank-you letter as they were about receiving the gift can be a challenge. But it’s a good habit to develop early on and kids should know that gratitude is important. Here are some ways to get your kids excited about writing a thank-you note.

• Make their own stationary: pull out the crafts and let them color, paint, sticker and design their own personal cards. They can even make a stockpile for the future.

• Give them their own address book: help them fill out an address book of their own that they can take with them on vacations or to summer camp.

• Take a picture thank-you card: if your child is too young to write a letter, take a picture of them with their gift and have them sign their name on it.

Create a drawing thank-you letter: again, if they’re too young to write, have your kids draw a picture of themselves with their gift.

46 HEALTHY IDAHO Healthy-Idaho.com

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