Back to school

Back-to-School Immunizations

We’ve heard a lot about the COVID-19 vaccine lately, but less attention has been paid to the broader vaccines children need to attend school.

Idaho’s School Immunization Law requires that children be up-to-date on their immunizations in order to prevent diseases like measles and whooping cough that spread quickly in group settings. Children need to be protected before they enter school, and generally need a booster shot before kindergarten. This handy chart from the State of Idaho offers guidance around which vaccines are needed and by when.

Children age 12 and older are now able to receive the COVID-19 vaccination.

Generally, all vaccines offer full protection after two to four weeks, so plan in advance to vaccinate your children for this school year. If you have questions about vaccinating your child or want to make an appointment, set up an appointment by calling us at 208-620-5250.

To prevent COVID-19 and other diseases, including colds and the flu, children should be encouraged to wash their hands, practice good hygiene and cover all coughs and sneezes. If a child is sick, please keep them home and do not expose the school community.


Immunization Requirements by Grade
Cooking for One

Cooking for One

By Emily Maus

Heritage Health
University of Idaho - Student Intern


Emily MausI find great satisfaction and joy in cooking. As a child, I would plan and make ‘fancy’ meals for my family. As I ventured into living on my own cooking became more of a hassle. I began eating the same meals over and over. I love cooking, but I do not always love cooking for just myself.

Cooking for one offers many challenges from food waste to lack of variety. With practice, cooking for myself has grown to be one of my favorite moments. Cooking for myself has exposed many perks over the years including eating what I want without having to consider others’ cravings, improved cooking skills without fear of failure, and getting extra creative with what I have on hand. Let’s not forget…dibs on all delicious leftovers.

Here are some tips I have learned to make cooking for one fun, easy, and affordable:

  1. Plan ahead. This feels obvious, but let’s just say it can be challenging! I notice when I take initiative to plan meals or recipes ahead of time. I reduce the risk of eating the same meal day after day. I also prevent food waste by planning and preparing leftovers I will actually want to eat… or freeze. Setting aside time to prepare fresh meals fuels my body with nutrients and saves me money because I am not tempted to grab take-out. I challenge myself to pick 1-2 specific recipes each week and keep staples on hand for easy throw-together meals.
  2. Utilize the freezer. The freezer has become my best friend! It allows me to have a wide variety of food on hand without fear of food waste. I load it with ingredients I can utilize quickly like fruit, vegetables, bread, and pre-cooked meats. Those leftovers I mentioned above…the freezer is a perfect spot to keep them until you want it again… hello variety! I also keep baked goods in the freezer to prevent impulse buys and fill my cravings when they hit.
  3. Pick and choose. When it comes to fresh produce, choose only 2-4 new fruits and vegetables each week. The amount you choose will be varied on how much you really can eat in a week. When I first was cooking for myself, I wanted everything fresh, but I noticed the abundance of produce I was choosing was going bad before I could get through it. Now I typically will choose 2 fresh fruits and 2 fresh vegetables each week. The other fruits and vegetables I use are stored in the freezer!
  4. Make leftovers into a new creation. Cooking alone means there is more room for experimenting, there is no one to judge you on what you make or the flavors you choose. Some of my favorite meals I make are clean-out the fridge creations. Reinventing leftovers will minimize repetition and keep cooking and eating fun! For example, if you make chicken fajitas one night, reinvent leftovers into scrambled eggs, pasta, or a warmed sandwich. Turn curry into a burrito or throw leftover pasta on top of a green salad. Get innovative and have fun!
  5. Utilize single-serve recipes. Sometimes my freezer is just plain full or I know I want a specific food only one time. This is the moment I utilize single-serve recipes or scale back on recipes I would previously make for a larger crowd. Yes… this can take some math, but you can do it (or google can help)! Choosing ingredients for these recipes can exhibit its own challenges such as being left with a full box of that special ingredient with only 1 tablespoon missing. This is when the bulk bins or deli counters at your local grocery stores will benefit greatly. Pull out your calculator and a ramekin and get cooking!

Cooking and eating should bring joy and satisfaction. I hope these tips make preparing food for one exciting, easy, and affordable!

Emily is a member of the University of Idaho Coordinated Dietetic Program Class of 2021.

Zoom Zoom

Kickstart your daily exercise routine now!

Working from home and Zoom meetings became part of the new routine for many Americans during the global coronavirus pandemic.

Combine that with social distancing and avoiding large gatherings of people and it means COVID-19 may be the least of our worries.

“I think a big concern is people being less active and gaining weight,” says Dr. Anthony Rehil-Crest, Vice President of Medical Services at Heritage Health. “Many of us are working from home or not working at all and for many people, their job is their primary source of activity. It’s important to make yourself aware of changes in your activity.”

Weight gain can creep up on people who are not paying attention – especially if you’re wearing sweatpants all day and moving from the home office to the couch to the kitchen and back to the home office.

While no formal studies have been released, it’s a good chance the last 12 months have resulted in weight gain and diminished activity. Health care providers expect to see spikes in diabetes, heart disease, and depression in 2021.

Quarantine life

Don’t forget the extra side of pickles mom, my eight-year-old son yells as I am calling in our delivery takeout dinner for tonight. It doesn’t matter that we have a whole jar of pickles in our refrigerator already, or that we have items in our kitchen that could make the food I am ordering via the phone. 

I cannot say this was my first takeout meal since the COVID-19 restrictions began. I was asked to write about what a dietitian eats at home with her kids during this social isolation period. I immediately closed my eyes and envisioned a calm parent, dressed in a clean, decorative apron working alongside their two sons (ages 8 and 9), smiling, laughing, perfectly chopping, stirring and instructing the boys on how to prepare a dish together.

My thought comes to a screeching halt when I open my eyes and see my boys using our last roll of toilet paper to decorate the house while our sweet cocker spaniel puppy chases the tail of the toilet paper gnawing on the end of it.  

Reining in my boys during this quarantine has been exhausting. Homeschooling in addition to keeping energized children occupied while working from home has not been an easy transition for many of us! 

I am a social person who likes connecting with people on a regular basis. My family and I like to patronize local restaurants. The idea of escaping a couple of times of the month to dine at a restaurant where I do not have to mess up the kitchen, have the family mess up the kitchen or clean the mess of the family in the kitchen after working all day is a highlight, and a treat we look forward to.

Since this closure, preparing and cooking balanced meals three times a day along with planning healthy snacks is exhausting. I am not alone; however, this awful virus has affected people much worse than what I am complaining about. 

I admit, my family and I have ordered takeout food more than usual. I am not a unicorn. Dietitians do eat out. We do eat more than lettuce on top of lettuce sandwiches with a side of lettuce. I think we should give ourselves a break from this new normal without feeling guilty about eating takeout.

It is about making better choices within your budget when you eat out!

Who says you must upgrade the size of the meal you order? Who says you need to get a side of fried foods? Why does having a somewhat balanced meal go out the window when we dine in or get takeout foods?

It doesn’t.  

When my family and I dine in or get takeout, a similar rule of thumb applies as if we were eating a meal we prepared at home: select four out of the five food groups with most meals.

The five “food groups” include grains (ideally whole grains), fruit, vegetables, protein and dairy. This is the same advice I give my patients who strive to acquire a pattern for healthy eating. 

Attempt to make your plate reflective of the My Plate. Yes, you can do this when you dine out or get takeout. 

Think about this, if you order takeout and select noodles, rice, breaded protein and a side starchy fried item; how are these foods going to keep us full long term, provide adequate micronutrients and reduce inflammation? Temporary fullness yes, long term, no. Refined white grains with an extra-large serving of protein are the most overconsumed food groups when we eat out. In a recent article from Fox News Lifestyle published on April 6th, one of the most popular takeout orders from Uber Eats during this quarantine so far has been french fries and soda.

Reflecting on the guidelines of the My Plate, half you of one’s plate (ideally 9” diameter plate) should include vegetables &/or fruits. The other half should include a quarter plate full of lean protein and a quarter plate full of whole grains. The outlier includes a serving of dairy. Since an order of small fries would be considered a serving of “grains,” ordering a bun on a sandwich would overfill my grain group.

So, I would need to decide on an open-faced sandwich and fewer fries? Lettuce wrap my sandwich and still have the fries? Steal my husband’s fries? Decisions like these can prevent us from overeating empty nutrient valued foods and select higher quality foods. How can we get full without overeating fries? Order vegetables. Most take out and dine in restaurants provide an option to order a side of vegetables or salad. 

When dining in, I love ordering the bottomless salad (dressing on the side) or the bottomless vegetables. Including vegetables with any meal adds fiber, micronutrients and fullness. This can be applied to almost any takeout or dine-in meal you order.

Here is an example of how my two kids order when ordering out. 

The 9-year-old:

Grilled chicken on whole wheat bread, side salad (dressing on the side), mandarin oranges and a cup of milk. Five out of five food groups chosen! 

  • Lean Protein: Grilled chicken breast
  • Dairy: Milk
  • Whole grains: Whole wheat bread
  • Vegetables: Salad
  • Fruit: Mandarin oranges

The 8-year-old: 

Canadian bacon pizza, side of steamed vegetables (typically broccoli), apple slices and a cup of milk. Five out of five food groups chosen! 

  • Lean Protein: Canadian bacon
  • Dairy: Cheese and milk
  • Grains (whole if available): Flatbread
  • Vegetables: Steamed broccoli
  • Fruit: Apple slices

Now, they may not always be full after eating the above meals, but after they eat the fruit and vegetables, the inclusion of seconds is encouraged. If we only gave our hungry, energized boys bowls of bottomless macaroni and cheese or all you can eat pizza, that is all they would eat. By including additional food groups, as small as a couple of carrot sticks with some apple slices, instills a habit of eating a variety of food and can slow the eating process down. 

Just a couple of simple changes can be made for helping our kids and ourselves be healthier while eating at home, takeout included! 

  • Include fruit and vegetables with lunch and dinner meals
  • Include fruit with breakfast
  • Change bread products from white to whole wheat
  • Change pasta items to whole grain or whole wheat pasta
  • Limit grazing on empty calories food throughout the day
  • Eat from a bowl or plate, not from the box or bag
  • Eat at a table without screen distractions

Here is an easy way to prepare a fiber-rich Macaroni and Cheese that my kids give a thumbs up to:


· 8 ounces whole wheat pasta (or whatever shape your kids prefer) 

· 2 tablespoons whole wheat pastry flour

· 1 teaspoon garlic powder

· 1 cup shredded cheese blend (we use provolone, mozzarella, and sharp cheddar)

· 1/4 cup shredded Parmesan cheese

· 1/4 teaspoon fine sea salt

· 1/8 teaspoon ground black pepper


 1) Bring a large pot of salted water to a boil

 2) Add macaroni and cook until al dente (approx. 10-12 min). Drain well

 3) While the macaroni is cooking, whisk together milk, flour and garlic powder in a large saucepan until completely blended.

 4) Cook over medium heat, stirring constantly, until thickened (approx. 6-8 min). 

 5) Add cheese and stir until gently melted. 

 6) Add drained pasta to the sauce. 

 7) Season with salt, pepper, stir well

Serve with a side of vegetables, fruit and a healthy beverage. 

Approximate Nutritional Info:

Per serving: 370 calories (100 from fat), 12g total fat, 7g saturated fat, 30mg cholesterol, 370mg sodium, 50g carbohydrates (5g dietary fiber, 3g sugar), 19g protein.

Jennifer Ramsrud is a clinical dietitian at Heritage Health, currently meeting with patients via telehealth. To schedule a dietitian, visit with Jennifer, please contact (208) 620-5212.

Sobering Realities

Al Mahoney’s life could be a novel someday.

Al’s story is one of youthful exuberance, long-term homelessness, drunken violence, near-death experiences, and ultimately redemption. By his own account, he’s lucky to be alive.

“Al is an exception to the rule,” says Two Feathers, a community outreach worker with Heritage Health. “At first, it was how many days can you be sober, then weeks and then months. We made sure to contact and support him on a daily basis. As time went by, he didn’t need as much from us. Then we started helping him with his life skills.”

For nearly 40 years alcohol dominated this man’s life. Eventually, he decided to confront alcoholism and start a new life of sobriety.

“The credit goes to Two Feathers and TJ Byrne,” says Al. “They saved my life. All of the people at Heritage Health really care.”

Heritage Health’s Street Medicine program looked after Al. Two Feathers and Byrne, a Physician Assistant, helped him stop drinking, making sure his medical and emotional needs were being met on a daily basis.

The details of Al’s life are still a little foggy. The 56-year-old Coeur d’Alene man has been battling alcoholism with repeated stints in rehabilitation centers across the country.

None of his recovery efforts or treatments worked for the fiercely independent man.

“Once I got out of rehab in Florida and within hours I was drinking again,” he says. “I couldn’t stop.”

Al is a survivor.

He was shot in the head, but he doesn’t remember why.

He points to a metal rod in his leg which had to be inserted after a car ran him over. He has been to prison too. He spent 27 months in an Iowa prison after clobbering a college student over the head with a chair during a poker game.

He’s been arrested countless times.

The common dominator in those situations has always been alcohol.

“At first, I was young and adventurous,” he says. “I just grew tired of my life. I wanted something better for myself.”

Heritage Health provided the resources to ensure he could achieve his goals – even if that meant giving him a ride to see a counselor or just helping him with day-to-day struggles.

“Heritage Health was there for me,” says Al. “They went beyond just doing their jobs. They saved my life. I am so much better off today than I was.”

Despite having long-term health issues, Al is optimistic about the future. He’s working as a janitor at a local business. He is also off the streets.

“Things are going great,” says Al. “I feel great. I am moving into a new apartment. It’s been six months since I have had a drink. That has been hard. It’s a fight for sure, but I know I can do it.”