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CALIFORNIA MEDICAL ASSISTANTPublished Bi-Monthly by the California Medical Assistants Association, Inc. for Medical Office Professionals
CALIFORNIA MEDICAL ASSISTANT — MARCH/APRIL 2016 1
CM
AA
UNITY IS STRENG
TH
KNOWLEDGE
ISPO
WER
l
MARCH/APRIL2016
________________________CALIFORNIA
MEDICAL ASSISTANTSASSOCIATION, INC.
P.O. Box 5694Petaluma, CA 94954-5694Toll Free 1.888.464.2622
Fax 208.730.3763
www.cmaa-ca.orgEmail address: [email protected]
A wise woman, Marjorie Moore, isquoted as saying, “Volunteeringis the ultimate exercise indemocracy. You vote in elections
once a year, but when you volun-teer, you vote every day about the
kind of community you want to live in.”I love this quote and find that it applies tomy life in many ways no matter what‘hat’ I am wearing. I volunteer for variousthings at work because I want to be apart of solving issues, instead of exacer-bating or creating them. I support mychildren in their pursuits, whether it is attheir school or a club they are involvedwith. The payoff for me is time with mychild working toward a common purposeand that is very satisfying. Personally Idonate my time to several organizations,including CMAA.
I was first elected to the ExecutiveCommittee in 1995 and have servedover 20 years straight as an officer. Asmy term draws to a close and we elect anew Executive Committee at our AnnualMeeting next month, I am excited to seewhat direction the new leaders of CMAAwill take us in. What does the future holdfor us? Each year I have attended statemeetings and Educational Workshops andSeminars that have allowed me to see somuch of this beautiful state. I have trav-eled north to Eureka and South to SanDiego for meetings. I’ll never forget hop-ping in the car with Diane Regner as“CAC Reps” or Chapter AdvisoryCouncil Representatives all the way toTruckee. Decisions were made in a hottub on that trip! I had the pleasure ofaccompanying Susan Jauron on a visit toa CMAA meeting in Palm Springs. I willnever forget stumbling into a street fairwith her and laughing all the way back toour hotel. So many memories and somuch time spent. I can say without hesi-tation that I have given a great deal of
time and energy to this organization andI can guarantee you I have received muchmore than I invested.
I am so thankful for the friendships andprofessional connections I have madethrough this organization. I cannot tellyou how many things I have learnedover the years that I have brought rightback into my classroom to enrich thelearning experience for my students.Many times I have called upon a CMAAcolleague with a professional questionand they have been eager to help.
Lifelong friendships have been made thatI absolutely treasure. Don’t worry friends;I won’t share our silly stories from overthe years. Please just know that becauseI knew you, I have been changed forgood. (A Broadway quote ☺)
This past year has seen many changesin my life. One thing that didn’t changewas the support of my CMAA friendsand fellow Executive Committee mem-bers. The first person by my side hasbeen Sue. It doesn’t matter what I amdoing; I know I have her support. Oneof my favorite memories this year iswhen I called her and upon hearing myvoice on the phone she asked, “Whathave you gotten us into now?” I alsoknow this truth, if you want somethingdone, ask Sue!
Our one man show, Byron served uswell as Secretary/Treasurer once again.He is meticulous about his minutes andwants to make sure every detail is writ-ten down. He also created a new formatto present the budget to allow membersto see several years of history on onepage. He is always enthusiastic andready to help. He is also good for alaugh while driving in downtown SanDiego! Just ask him about it.
“Volunteering is the ultimate exercise in democracy...”
WHAT’S INSIDE� PRESIDENT’S MESSAGE .................... 1
� CMAA HEADQUARTERS:CMAA Wants to Come to You............ 2
� ANNUAL MEETING 2016:Tenative Agenda ................................. 4Registration Form ............................... 5Nominations Report ............................ 6Guest Speakers Tentative Agenda... 7
� CERTIFYING BOARD UPDATE:Newly Certified CMAs .................. 8-10
� CONTINUING EDUCATION:Understanding Asthma......................11-14Self-Assessment Test ....................... 15
� Personal Certificate ofParticipation Form............................. 16
continued on page 3
California Medical Assistant
E D I T O R
KIM JONES, CCMA-CEast Bay Region
Email: [email protected]
P U B L I C AT I O N C OMM I T T E EC H A I R M A N
THERESA HENDERSON, CCMA-ACRiverside Region
Certifying Board Administrator
C O O R D I N AT O R
VICKEY MARTINEZ, CCMA-CRiverside Region
C M A A P R E S I D E N T
SHANNON TINSLEY, CCMA-AC
Sonoma Region
Email: [email protected]
For Advertising contact:
CALIFORNIA MEDICAL ASSISTANTSASSOCIATION, INC.
at
CMAA, INC.P.O. Box 5694
Petaluma, CA 94954-5694
Toll Free: 1.888.464.2622
Fax: 208.730.3763
Email: [email protected]
Material contained herein may NOTbe used without the permission of the
California Medical Assistants Association, Inc.
ALL ITEMS FOR PUBLICATIONSHOULD BE SENT
DIRECTLY TO THE EDITOR.
2 CALIFORNIA MEDICAL ASSISTANT — MARCH/APRIL 2016
MISS ION STATEMENT
CALIFORNIA MEDICAL ASSISTANTS ASSOCIATION, INC.
The purpose of the California Medical Assistants Association, Incorporated,is to promote the professional and educational growth of medical assistants.
CM
AA
UNITY IS STRENG
TH
KNOWLEDGE
ISPO
WER
l
California Medical Assistant
— NEXT ISSUE —
May/June 2016
To submit items to be published in thisnewsletter, please mail or email:
KIM JONES, CCMA-C
Email: [email protected]
DEADLINE: April 1, 2016All materials must be submitted by the
deadline date to be included in the next issue!
CMAA WANTSTO COME TO
YOUWe need your meeting
space!
Does your company have a meeting room that couldbe used by CMAA to host an Education Day?
Would you be willing to assist our Education Chairmanwith planning a seminar in your town?
Please email Carol at CMAA Headquartersso we can schedule a date for this year.
CALIFORNIA MEDICAL ASSISTANT — MARCH/APRIL 2016 3
Our Education Chairman Kimara hasalways been a phone call or emailaway. She sets a great example for usas a leader at her job with Sutter andhas been a constant resource for us.
Debra has served as our M&M, or Mem-bership and Marketing Chairman. Iremember meeting Debra so many yearsago and she couldn’t have been kinderyet she appeared to be painfully shy. Iam fortunate to have gotten to knowDebra and some of her family over theyears. I was thrilled to see her speakfrom the heart at the conference last falland share her personal story about howCMAA has impacted her life.
Another Past President filling an officethis year, Vickey served as NominationsChairman. She has been a huge sup-port of CMAA not only this year, butfor over 20 years. She also mentoredour new CMAA publication editor toteach her the ins and outs of producingour great publication.
Speaking of our great publication, thenew Editor is Kim and she has done afantastic job despite the fact that I havebeen late on two, okay, three of mydeadlines! She has followed her checkoff lists to make sure each publicationwas full of the information required andwhen she didn’t have something, sheeither created it or found out where toget it. In addition to her efforts on the
publication, she and fellow East Baymember, Denice Eck, have been travel-ing to Sacramento to assist that Regionin the planning of the Annual Meeting.
Bailey has worn two hats for CMAA thisyear and juggled being a Mom of oneand pregnant with baby number two withserving as our Ways and Means Chair-man and Chair of our special committeeon social media. Bailey has posted toFacebook many times and shared herexcitement about CMAA as well as shar-ing pictures about items that will be avail-able for sale. She owns a craft businessand CMAA has been the recipient ofmany donated items from Bails Banners.
One of many things I will miss as thisterm draws to a close is the monthlydates I have had with Carol at CMAAHeadquarters. Living in the same townthat she does, we have had the pleasureof getting together to sign checks eachmonth instead of mailing bills back andforth. I am so grateful to Carol for hertime and efforts to market CMAA andhelp our members with their variousneeds and questions. She is, without adoubt, the voice for CMAA.
I cannot conclude my message of thankswithout including our CMAA PastPresidents. While VIckey was mentionedabove, others have come along side usand helped as well. Theresa is alwayspromoting CMAA and is currently help-
Shannon Tinsley, CCMA-ACCMAA State President
continued from page 1
Annual MeetingHOTEL OPTIONS:
Residence Inn Sacramento Downtown at Capitol Park1121 15th Street, Sacramento, CA 95814Telephone: 1-916-443-0500Toll-Free Reservation: 1-800-331-3131http://www.marriott.com/hotels/travel/sacdt-residence-inn-sacramento-downtown-at-capitol-park/
Inn Off Capitol Park1530 N. Street, Sacramento, CA 95814Reservations: 916-447-8100Fax: 916-341-0798Email: [email protected]://www.innoffcapitolpark.com/
ing the Sacramento Region in finalizingconference plans. Kate has providedconsistent encouragement to me andeven helped me draft a letter for CMAAthis year when I was at a loss for words.Kris also has been just an email awaywhen we needed her help. As I havepresided at each meeting as President Istill draw from my training and mentor-ing from Harriett and Barbara.
So, if our volunteerism is our vote, howwill you be voting for CMAA? Are youready to step up and work towardimproving our organization? I can prom-ise you that you will truly enjoy the peo-ple that you are volunteering with andyou will have great satisfaction in know-ing that you are making efforts to pro-mote the great profession of MedicalAssisting and helping others strive forexcellence by improving our knowledge.
Thank you for being a member of ourorganization. I look forward to seeing youat the Annual Meeting next month. �
March 10–13, 2016SACRAMENTO, CA
Upcoming C.M.A.A. MeetingUpcoming C.M.A.A. Meeting
4 CALIFORNIA MEDICAL ASSISTANT — MARCH/APRIL 2016
March 10-13, 2016Dignity Health — 3000 Q Street, Sacramento, CA 95816
Hosted by the Sacramento Region
C a l i f o r n i a M e d i c a l A s s i s t a n t s A s s o c i a t i o n , I n c .
~ TENTATIVE AGENDA ~THURSDAY, March 10, 2016
1:00 pm TOUR of Shriners Hospital for Children Northern Californiawith CEU Opportunity!
6:00 pm Executive Committee Meeting
FRIDAY, March 11, 20168:00 am Registration Opens
8:30 to Noon Education SessionNoon Lunch with Vendors
1:00 to 2:00 pm Education Session2:15 pm All Members Register with Credentials
2:30 pm CMAA Business Meeting with Members and Guests
2:45 pm Honoring all New CCMA’s during the Business Meeting
3:30 to 5:30 pm Education Session7:00 pm Dinner Flashback to the Past (dress representing your favorite decade)
SATURDAY, March 12, 20168:00 am Registration Opens
8:30 to 10:00 am Reference Comittees (All members are encouraged to attend!)
10:00 to 12:00 pm Education SessionNoon Lunch honoring 2015 CMAA Officers and Committee Chairmen
1:30 to 2:30 pm Education Session2:45 pm All Members Register with Credentials
3:00 pm CMAA Business Meeting continued
4:00 to 5:00 pm Election of Officers
7:00 pm Dinner with CMAA
SUNDAY, March 13, 20168:00 am Combined Executive Committee Breakfast Meeting
9:30 to 10:30 am Education Session10:45 am All Members Register with Credentials
11:00 am Closing Business Session for Members and Guests.
2016 ANNUAL MEETING
CALIFORNIA MEDICAL ASSISTANT — MARCH/APRIL 2016 5
C a l i f o r n i a M e d i c a l A s s i s t a n t s A s s o c i a t i o n , I n c .
PLEASE TYPE OR PRINT
Name: __________________________________________
Credentials: _____________________________________
Address: ________________________________________
Telephone: ______________________________________
_________________________________________________
Email: ___________________________________________
Region: _________________________________________
**Check if first timer________
CHECK ONE:
________ Platinum Member
________ Gold Member
________ Silver Member
________ Student/Former Member
________ Guest
Professional attire is requested at allscheduled functions.
REGISTRATION DEADLINE: 03/01/2016
No refunds after March 4, 2016
Mail to: CMAA Inc.P.O. BOX 5694PETALUMA, CA 94954-5694
Please make checks payable to: CMAA
CHECK MEAL CHOICES
FRIDAY
_____ Lunch................................................................. $15.00
_____ Dinner Buffet .................................................... $20.00(Dress representing your favorite decade)
SATURDAY
_____ Lunch................................................................. $15.00
_____ Installation Banquet ........................................ $25.00
______________________________________________________
MEETING REGISTRATION FEES:
_____ Members / Students and Former Members ... $50.00
_____ Non-Member.................................................... $75.00
_____ Late Fee (after 3/1/2016).................................... $5.00
_____ Single Day Registration .................................. $25.00This option is available for Members andStudents only able to attend for one day.** If single day registration is selected,please indicate which day you will beattending here:
_____________________________________
THURSDAY
_____ Shriners Hospital for Children Tour(CEU opportunity available)
TOTAL AMOUNT ENCLOSED $________________
Important information on reverse side - please copy this form, complete and mail.
OFFICIAL REGISTRATION FORMDignity Health
3000 Q Street, Sacramento, CA 95816March 10-13, 2016
2016 ANNUAL MEETING
Additional inquiries or registration by Visa or MasterCard: Call Headquarters at 1-888-464-2622
6 CALIFORNIA MEDICAL ASSISTANT — MARCH/APRIL 2016
CMAA is currently looking for new members and new faces to step up and a volunteer a little timefor the organization. We need members to be active participants we have a few open positionsavailable:
President Elect ..............................................Open
Vice Present...................................................Megan Chieppa, CCMA-AC
Secretary &Treasurer ..................................Byron Clinton, CCMA-C
Education Chair ...........................................Open
Nominations Chairmen ................................Open
Publications Chairman ................................Kim Jones, CCMA-C
Membership & Marketing Chairman ........Debra Carpenter, CCMA-AC
Ways and Means...........................................Bailey Nelson, CCMA-AC
Please come speak with any of ourcurrent Executive Officers for informationregarding any of the positions listed atthe upcoming Annual Meeting heldMarch 10-13 at the Dignity Health at3000 Q Street in Sacramento, CA. If youare a student, new graduate, newly certifiedMedical Assistant, former or retired CMAAmember or instructor of a Medical AssistingProgram, please come out and network withus. See what CMAA has to offer. We canuse your assistance. We promise to providea fun-filled educational weekend.
CMAA NEEDS YOUR HELP
WEWANT
YOU!
� � � � � � � � � � � � �
� � � � � � � � � � � � �
CALIFORNIA MEDICAL ASSISTANT — MARCH/APRIL 2016 7
C a l i f o r n i a M e d i c a l A s s i s t a n t s A s s o c i a t i o n , I n c .
DIGNITY HEALTH3000 Q Street, Sacramento, CA 95816
March 10-13, 2016
2016 ANNUAL MEETING
JOIN CMAAFOR A GUIDED TOUR OF
SHRINERSHOSPITALSFOR CHILDREN OF
NORTHERN CALIFORNIA
THURSDAYMARCH 10TH
1 – 3 PM
2425 STOCKTON BLVDSACRAMENTO CA 95817
RESERVATIONSREQUIRED
HOSTED BYTHE
SACRAMENTOREGION
GUEST SPEAKERSTENTATIVE AGENDATHURSDAY MARCH 10Shriners Hospital Tour *
FRIDAY MARCH 11“All Things Optical”James Champlain, ABO, NCLE
“Injection Safety”Zoe Langdon, MPH – California Department of Public Health
“Seniors with Arthritis”Elizabeth Sawyer, CCMA-AC, MA
“BBP and Workplace Safety”CAL OSHA Representative
Medical Assisting “Scope of Practice”Medical Board Representative
SATURDAY MARCH 12“Headaches, Migraines and Botox”Kelly Zumot, PA, Dignity Health
“Be the Match”Paula Schwartz, ICLA Da Salva Foundation
“Maximus Healthcare”Alycia Diggs, Maximus Folsom
SUNDAY MARCH 13“Motivational Psychology”Dr. Charles M. Ware, D.H.Ed.
FOR MOREINFORMATION CONTACT
CMAA HQ888-464-2622
Shriners International
* Reservations Required
JOIN CMAAFOR A GUIDED TOUR OF
SHRINERSHOSPITALSFOR CHILDREN OF
NORTHERN CALIFORNIA
THURSDAYMARCH 10TH
1 – 3 PM
2425 STOCKTON BLVDSACRAMENTO CA 95817
RESERVATIONSREQUIRED
8 CALIFORNIA MEDICAL ASSISTANT — MARCH/APRIL 2016
NAME SPECIALTY HOMETOWN
• RECERT ++ ADDING 2ND SPECIALTY
C E R T I F Y I N G B O A R D U P D A T ECongratulations to the newly California Certified Medical Assistants
Certification Codes: A = Administrative C = Clinical AC = Administrative and Clinical
NAME SPECIALTY HOMETOWN
continued on page 9
ALANIS, MICHELLE AC ROHNERT PARK
ANDERSON, JESSICA K. C REDDING
ANDREAZZI, GIANA AC ROCKLIN
ANUNCIACION, MARIZEN C DALY CITY
AQUINO JR, AMANTE A. C SAN JOSE
ARRIAGA, LORENA • C FRESNO
AUEN, RHONDA • AC LAKE HAVASU CITY
AYALA VORN, DHESSELYN • C STOCKTON
AYALA VORN, DHESSELYN • C STOCKTON
BALDONADO, MICHELLE C TUCSON AZ
BANUELOS, VANESSA MARIE C SAN JOSE
BARROW, RUTH AC SAN BRUNO
BAVINGTON, TRIANNA M. AC SAN DIEGO
BECERRA, CYNTHIA M. AC IMPERIAL
BENAVIDEZ, ANNA LIEZEL C SAN JOSE
BENTLEY, BARBARA J. AC FAIRFIELD
BERNAL, PATRICIA • C ROHNERT PARK
BERUMEN, MARIA E. • AC MODESTO
BOLING, MICHELLE C MODESTO
BOSWORTH, CASSONDRA C BURNEY
BOWMAN, AMY M. A SANTA ROSA
BRIM, CHARLOTTE ROSE AC ELK GROVE
BRISENO, MICHAEL A LANCASTER
BROWN, RISHIDA M.C. C MODESTO
BUENDIA, RUBI C LOS ANGELES
CAMACHO, MELISSA C. AC CLOVERDALE
CAMPOS RIVERA, LIVIER AC SHINGLE SPRINGS
CANDELARIO, JESSICA • C WATSONVILLE
CANELA, SOPHIA AC MANTECA
CARDENAS, CLAUDIA A RED BLUFF
CASE, AMY AC CAMINO
CASILLAS, ANA E. AC CHULA VISTA
CASTRO, DANIELA AC LODI
CASTRO, ANNJILLIAN CHRISTINE C MISSION HILLS
CASTRO, BRANDI A. C OCEANSIDE
CHAFFIN, MARTHA F. • C ARCATA
CHAN, FELICIA WAI C SACRAMENTO
CHATFIELD, MONTSERRAT D. C BEN LOMOND
CHERN`E, FRANCINE N. AC SANTA ROSA
CHERRY, LAZONIA RENA C PATTERSON
CHIQUETE, MONICA ROSE C SUNNYVALE
CHOW, MIRLA • C WATERFORD
CIRKELIS, LISETTE CHRISTINE AC SOUTH SAN FRANCISCO
CISNEROS, GRISELDA C VISALIA
COLE, BRITTANY AC REDDING
COOK, KAREN J. • C LODI
CORNEJO, ROSEMARY C INDIO
COSTON, SAMANTHA J. C BURNT RANCH
COVARRUBIAS, CECILIA C MANTECA
CRECELIUS, BETTY V. C STOCKTON
CRENSHAW, MASHA K. AC ROSEVILLE
CRUZ, ORALIA C OCEANSIDE
CUEVAS, MARCELLA A. C TUCSON
D’AGOSTINO, JENNIFER BALOLONG C SAN JOSE
D’AMICO, TIFFANI MARIE C RIVERBANK
DEGRAMMONT, TERESA A LODI
DEINES, ASHLEY RENEE C COLORADO SPRINGS
DELCOMPARE, SOHANY M. C LONG BEACH
DIAZ, JOANA ALICIA C BAY POINT
DIEMER, SERENA LYNN • C AUBURN
DOMENICHELLI, MELISSA SUE A WINDSOR
EGOAVIL CLARK, ELAINE D. C LANCASTER
ESTUDILLO, BRENDA A STOCKTON
FELDMAN, MARGARET A. AC TWENTYNINE PALMS
FERRANDO, JILL ANN AC PETALUMA
FITZPATRICK, SHELBI C TEMPLETON
FLETCHER, KRISTIN D. AC LONG BEACH
FLORES, PORTIA A. • AC TRACY
FONTENO, AUDRA D. AC PLEASANT HILL
GALLEGOS, JASMINE PATRICIA C DOWNEY
GAMEZ, ERIKA A IMPERIAL
GARCIA, CAROL M. • C PATTERSON
GARCIA, LUIS F. C PATTERSON
GARCIA, ANTHONY AC HOLLISTER
GARCIA, LORENA A PASO ROBLES
GARCIA, MARIA C SAN JOSE
GASCA, ANTHONY LEONARDO C LODI
GEVORGYAN, ANUSH C VAN NUYS
GHUMAN, PRITPAL KAUR AC BAKERSFIELD
GIACCONE, KATHRYN T. • AC JAMESTOWN
GOCHE, SHANNON A SANTEE
GOEBEL, WENDY C COTATI
GOMEZ, ARACEL GUADARRAMA AC STOCKTON
GONZALEZ, ESTRELLITA • AC OAKLAND
GONZALEZ, RAQUEL C OXNARD
GONZALEZ, DENISE ANDREIA A TRACY
GOODBRAND, AVRIL • AC RANCHO SANTA MARGARITA
GRANT, MICHELLE • AC FOLSOM
GRAY, LYNNETTE A. C MANTECA
GROVE, JENNIFER AC MARANA AZ
GUERRERO, ROSA MARIA A REDWOOD CITY
GUEVARA, BARBARA AC LOMPOC
HARDEN, TONA • AC TALMAGE
HARMON, DANA M. AC BEND OR
HARRELL, MIRANDA T. AC ANTIOCH
HARRINGTON, RAEANN • C SAN MATEO
HAWKS-GARCIA, LAURA C ROHNERT PARK
HEMPHILL, JENNIFER M. AC EL CAJON
CALIFORNIA MEDICAL ASSISTANT — MARCH/APRIL 2016 9
NAME SPECIALTY HOMETOWN
• RECERT ++ ADDING 2ND SPECIALTY continued on page 10
C E R T I F Y I N G B O A R D U P D A T E
NAME SPECIALTY HOMETOWN
– continued from page 8 –
Certification Codes: A = Administrative C = Clinical AC = Administrative and Clinical
HERNANDEZ, MARIA S. A SANTA ROSA
HERRERA, SANDY AC BAKERSFIELD
HERRERA, LOURDES C BLOOMINGTON
HESTER, LATIISHA D. C OAKLAND
HOYNAK, JOHNNA C COTO DE CAZA
HUANG, JUN NUO • C SAN LEANDRO
HUANTE, ANA CONNIE • C WATSONVILLE
HUGHES, MICHELLE C OCEANSIDE
HUGHES, KATHRYN J. C WINDSOR
IACOBITTI, ALYSSA C CLAYTON
IBANEZ, LAILANI C SIMI VALLEY
INGERSOLL, CALEB NICHOLAS AC TEHACHAPI
JACKSON, BRITTANY C REDDING
JACOBO, ELIZABETH A WATSONVILLE
JOHNSON, JANELLE RENEE AC EMERYVILLE
JOLLEY, MARISA AC LODI
JOLLY-MATTHEWS, TIFFANY A. A STOCKTON
JONES, KATRINA AC ELVERTA
JOSEPHY, ELLEN DAVENPORT AC OAKLAND
KARNO, JASMYN • C VALENCIA
KENNY, DILLAN • C PISMO BEACH
KESLINGER, ASHLEY H AC YUBA CITY
KLEIN, LESLIE PLANTING AC FREMONT
LACAP, SHEENA MANANSALA AC ANTIOCH
LAMBRETTI, STEPHANIE • C SANTA CRUZ
LEDFORD, ELIZABETH ANN A CHICO
LEON, LUCIA AC APTOS
LINDAUER, PAULA KAY • C SANTA ROSA
LOPEZ, ANTHONY D. • C MODESTO
LOPEZ, ANEL C SAN LUIS OBISPO
LOZANO, MONA LISA C LAWNDALE
LUNA, ANGELA • C MC KINLEYVILLE
LYNCH, TINA RENAE AC SMARTSVILLE
MACHAMER, MERCEDES C REDDING
MAHJOOB KHORASSANI, CHAKAVAK C CLOVIS
MAHSEN, NADIA ABDULLA • C CERES
MAIER, GARRETT M AC SANTA CRUZ
MARES, LAURA BETH • AC FREMONT
MARIANO, LAUREN RACHELLE C FREMONT
MARONE, MELAINE G. C CHULA VISTA
MCCOMBER, MANDY C BAYSIDE
McDONNELL, MAGDALENA C PASO ROBLES
MEALS, JANIS AC GRASS VALLEY
MEDINA, DIANA C OXNARD
MEDRANO, NADA JAZVAC • C ROHNERT PARK
MENDIETA, JENNIFER G. • C OAKLEY
MILLER, NIKIRAH C OAKLAND
MILLIGAN, RAQUEL C ROUND MOUNTAIN
MOHAMMED, LAUREN C BAKERSFIELD
MOJICA, MARITES S. • C FAIRFIELD
MORA-GUTIERREZ, YOSELIN C SANTA CLARA
MORALES, LISA C SAN LUIS OBISPO
MORALES, STEVE MICHAEL C MODESTO
MORALES, VANESSA C C MODESTO
MORALES, JOANNA C SAN JOSE
MORENO, MYRA • C NEWMAN
MORGAN, PAMELA C HAYWARD
MORSE, ERIN LENORE C TAHOE CITY
MOTA, SARA MARLENE AC ANAHEIM
MULLEN, CHERYL • AC SAN MATEO
MULLER, ANNA B. A CASTRO VALLEY
NARVAEZ, CELESTE GABRIELLE A DOWNEY
NAVARRETE, KRISTIN • AC ROSEVILLE
NAVARRO, BERENICE C FONTANA
NGUYEN, JULIE T. C HAYWARD
NOHRDEN, MEREDITH GAIL • C SCOTTS VALLEY
NOLEN, JEREMY BLAKE C WILLOW CREEK
ORELLANA MANZANO, LUIS A. C SAN LEANDRO
ORTIZ, OLIVIA • C WATSONVILLE
ORTIZ, NATALIE NICOLE A PETALUMA
PAPISH, GINA E. AC HUGHSON
PARKER, KATHY ANN • C MARINA
PEACOCK, KATRINA C ROUND MOUNTAIN
PEACOCK, IYESHA C BAY POINT C
PEREZ-GARDNER, ANITA C NEWARK
PESNELL, KATHRYN A GRIDLEY
PINA, STEPHANIE AC LANCASTER
PLASENSIA, RUTH • C HAYWARD
PLUMMER, LISA M C NEVADA CITY
POWERS, RENEE A. C LODI
PRIEST, KIMBERLY ANN C YUCCA VALLEY
PRIETO, ERIKA C RIPON
QUIROZ-GUTIERREZ, CARINA • C WATSONVILLE
RABY, VERGIE PALCE • AC REDWOOD VALLEY
RACHUY, REGINA AC NOVATO
RADKOVA, MIRELA • C CONCORD
RAMIREZ, RAZIEL C SOUTH GATE
RAYGOZA CARRILLO, ERIKA C SANTA ROSA
REAL, CYNTHIA MICHELLE C OCEANSIDE
REED, NICOLE LEE C BRENTWOOD
REMSBERG, TERI • AC OCEANSIDE
REYES, FRANCISCA • C THOUSAND PALMS
REYES, SAMANTHA C MILPITAS
RIOS-RIVAS, CASSANDRA ELIZABETH ++ AC SANTA CRUZ
RIOS-RIVAS, CASSANDRA A SANTA CRUZ
RIZO, ALICIA J. AC WATSONVILLE
ROBLES, ROCHELLE PAULINA AC HUNTINGTON BEACH
RODRIGUEZ, MATTHEW C. C BRADBURY
10 CALIFORNIA MEDICAL ASSISTANT — MARCH/APRIL 2016
Congratulationsto each of these medical assistants.From the California Certifying Board
for Medical Assistants
• RECERT ++ ADDING 2ND SPECIALTY
C E R T I F Y I N G B O A R D U P D A T E
NAME SPECIALTY HOMETOWN NAME SPECIALTY HOMETOWN
– continued from page 9 –
Certification Codes: A = Administrative C = Clinical AC = Administrative and Clinical
RODRIGUEZ, VERONICA C BAKERSFIELD
RODRIGUEZ, MARTHA C GLENDALE
RODRIGUEZ, ROBERT C SAN JOSE
ROMAN, REGINA A. C SAN LORENZO
ROMERO, CRISTINA MARGARITA AC REDWOOD CITY
ROQUE, ROMMEL L A SIMI VALLEY
ROSALES, PAOLA ALEJANDRA C PITTSBURG
ROSS, KRISTAN RAE AC CHICO
RUBIN, ELIZABETH AC MC CLOUD
RUECO, RIZA AC MILPITAS
RUVALCABA, ABRIL PRISCILLA AC SAN LORENZO
RUVALCABA, ROCIO AC SAN LORENZO
SALAS, SANDY AC PALMDALE
SALOMON, FABIOLA • C AMERICAN CANYON
SANCHEZ, DULCE JENNIFER • C PATTERSON
SANCHEZ, IVONE C SAN JOSE
SANCHEZ, MARY E C LOS ALTOS
SANCHEZ, SONIA C SAN JOSE
SANDOVAL, PRISCILLA • AC LANCASTER
SANDOVAL, SOMMER C SPRING VALLEY
SANTAMARIA, ARACELI C FRESNO
SCHWEGERL, JOLENE C FALL RIVER MILLS
SEA, KIM AC LONG BEACH
SEGLER, JARED MATTHEW C FRESNO
SHUKLA, RUPA C SANTA ROSA
SINGH, SUSHILA • A ELK GROVE
SISK, CHRISTINE • AC PASO ROBLES
SOLANO, MARTHA R. • C WINDSOR
SOLIS, LETICIA I. C DESERT HOT SPRINGS
SOUVANTHONG, NANCY • C STOCKTON
SPELLMAN, LACY C ANDERSON
SPOHN, JACKIE C WILLOW CREEK
STAMEY, LISA MARIE C NIPOMO
STARCK, ARDITH A. AC JOSHUA TREE
STELZL, EMILY ELISE AC PASO ROBLES
TAPIA, JESSICA C BAKERSFIELD
TASSO, NADJA C HIGHLAND
TAYLOR, GAIL ANN • C RED BLUFF
TERRY, DANA D. • AC VALLEJO
TISCARENO, SERENA MARISA A ONTARIO
TOLEDO, LEILA SKYE C FIREBAUGH
TORRES, LUZ M. C PITTSBURG
TORRES-MOLINA, DAMAYANTY C PETALUMA
TORREZ, LOUISE C ANTIOCH
TOWERY, MELINDA G. • AC LOWER LAKE
TREJO, KRISTAL C TUJUNGA
TROTTER, JAYLYNN SIERRA C COTTONWOOD
TROUT, SUSAN M. • C POWAY
TROUT, CHARLA C RAMONA
TRUONG, TUONG QUY THI • A FORT SAM HOUSTON
TUCKER, JUSTINA C MT SHASTA
VALDEZ, ANTHONY C ARCATA
VALDEZ-JUAREZ, VICTORIA AC FREEDOM
VAN AMBURG, JAMIE JOANNE C SAN JOSE
VASQUEZ, OLINDA A PACIFICA
VENDIL, MARIA AC SAN FRANCISCO
VILLAGRAN, MARSELA • C NEWMAN
VILMOS, ANDREA C SAN ANSELMO
WALDON, KENYA DANIELL C HANFORD
WALKER, LUCY MENCIA • C SAN DIEGO
WHITE, JUNE MARIE AC BAKERSFIELD
WHITE, JODI ELIZABETH AC CLEARLAKE
WICKS, RACHEL N. • ++ AC SAN JOSE
WILLIAMS, ELIZABETH AC SANTA ROSA
WINDORSKI, ERIKA JANNETTE AC RIPON
WOODY, LAUREEN M. • C FREMONT
YOUNG, CYNTHIA • C LA QUINTA
ZACHARIAH, REBA • C PLEASANTON
ZALLANI, FATIMA • AC TORRANCE
CALIFORNIA MEDICAL ASSISTANT — MARCH/APRIL 2016 11
Based on frequency and severity ofsymptoms asthma can be classified intothese categories:
• Mild intermittent: daytime symptomswhich occur not more than twice aweek and nighttime symptoms not morethan twice a month
Asthma is a chronic, or long-term, diseasethat inflames and narrows the airways ofthe lungs, it cannot be cured but it can bemanaged. Some people may experiencesome or all of these symptoms:
• Wheezing - A whistling sound heardwhen breathing in or out.
• Coughing - A cough that may not goaway and often occurs or worsens atnight or early morning.
• Chest Tightness - Feeling as if some-thing is squeezing or sitting on the chest
• Shortness of Breath - Feeling asthough one can’t catch their breath.
Asthma is a condition of chronic inflam-mation in the airways, it is characterizedby bronchospasms or tightening andnarrowing of the airways, which isreversible. People with asthma willhave periods of time with symptomsand periods of time that are symptomfree. The airways produce a largerquantity of thicker mucus which isdifficult to move in an inflamed andnarrowed airway.
continued on page 12
CONTINUING EDUCATION
• Mild persistent: daytime symptomsoccur more than twice a week but notevery day and nighttime symptomsoccur more than twice a month
• Moderate Persistent: daytime symptomsoccur every day and nighttime symptomsmore than once a week
• Severe persistent: continuous symptoms
The causes of asthma are difficult tounderstand and determine, but the mostcommon causes are infection, exerciseand allergens. Understanding “asthma trig-gers” is key to managing the symptoms.
Pollens such as grasses, trees, and weedsare a common trigger for asthmatics,as well as molds, dust mites, animals,cockroaches and cigarette smoke mainlybecause so many asthmatic patientshave allergies as well, having the allergenexposure under control greatly helps theasthma symptoms. This involves seeing anallergy specialist possibly having skin pricktests and or blood tests done then inconjunction with the physician developinga plan to manage the symptoms andcontrol the triggers.
Understanding ASTHMA
12 CALIFORNIA MEDICAL ASSISTANT — MARCH/APRIL 2016
Childhood asthmaThe statistics are interesting boys 2-5years old are 8 times more likely tohave asthma symptoms than girls at thesame age. But by age 20 women are 3times more likely than men to havesevere asthma. Children who have oneparent with asthma have a 40% chanceof inheriting asthma, if both parentshave asthma that number goes up to70%. Hispanics and African-Americanshave a greater chance of developingasthma; also African-Americans are 3times more likely to die from asthma asCaucasians. Low birth weight, maternalsmoking and premature birth are all riskfactors for developing asthma.
There has been an increase in childrenages 0 to 4 with asthma, reasons forthis are not clear, the only reliablemarker for the child or infant at risk isthe parent, especially the mother hav-ing a history of asthma or allergies. The
CONTINUING EDUCATION
major causal factor of the onset ofsymptoms is viral URI with respiratorysyncytial virus (RSV) being the culprit.Some children develop allergic asthmaafter age 5-6, although air pollution hasbeen said to increase the risk of child-hood asthma, there is minimal data tosupport it. The fact is asthma can devel-op at any age. The diagnosis of asthmain this age group must be made basedon history and physical as well asresponse to therapy, since lung functiontests are not possible in this age group.Almost 50% of children with asthmadevelop symptoms prior to their firstyear of life. Poor growth and failure tothrive suggests another chronic disease,not asthma. Physicians say childrenwith asthma are usually the healthiestlooking babies in the waiting room.There are 3 categories of therapy for allchildren: Education, Environmental con-trol, Pharmacologic therapy or medica-tions. Administration of medications isdifficult in this age group; the best wayis inhaling usually by nebulization.Studies conducted in Europe showedthat the earlier a child is started on anti-inflammatory therapy the better theoutcome 5 years later.The study was done with inhaled corti-costeroids; however environmental con-trol is a very important part of anti-inflammatory therapy. The goal is toeducate the family so as to allow thechild to have normal growth and devel-opment, decreasing the asthmaepisodes and the need for the child tomiss out on activities.
Asthma in AdolescentsDifferent approaches to management arerequired with adolescent asthmatics; thereare an equal number of females and maleswith asthma, even though there are moremales with asthma before adolescence. Itappears that approximately 30-50% ofchildren with asthma continue to have itinto late childhood and adult life. Patients,who are not symptom free at puberty, arenot likely to outgrow their symptoms asyoung adults. There are children who out-grow their asthma in puberty, but develop
Approximately 40% of asthmatics havesymptoms only rarely and the other60% have symptoms that range from1-2 times per week to some havingsevere enough symptoms to requiredaily medication. It is important torealize asthma can be fatal; there area reported 6,000 deaths each yearworldwide. According to the AmericanMedical Association the number ofasthma cases has doubled in the last 20years. In the US that is over 17 millioncases of asthma, an estimated 2.3million people with asthma live inCalifornia, higher than any other state.The asthma related hospitalizations inCalifornia costs the state 350 million.State legislation aiming to treat asthmaas a public health problem is beingconsidered. If passed this would beadministered through the CaliforniaState Department of Health Servicesand implemented at the local level.
Understanding ASTHMA – continued from page 11
Common Triggersfor Asthmatics
molds
feathers
dust cigarette smoke
animals
pollen
certain foods
CALIFORNIA MEDICAL ASSISTANT — MARCH/APRIL 2016 13
Understanding ASTHMA – continued from page 12
CONTINUING EDUCATION
recurrent asthma later in life. We alsoknow that up to 45% of adolescents withasthma have a delayed onset of puberty.This age group is difficult to treat as theymay be resistant to taking medications;they have to be given the autonomy that isimportant to them. Compliance with amedication regimen is not easy with ado-lescents. Keep the plan simple, by takingmedications twice a day rather than 4times a day, working with a support group,peer support. Exercise induced asthma isseen in 90% of asthmatics, and the adoles-cent is the most frequently affected by it.
Nocturnal AsthmaWheezing at nighttime is a commoncomplaint, 80% of episodes occurbetween midnight and 8:00am. Thebest lung function with an asthmatic isat 4:00pm with the worst being at4:00am. There can be a 50% differ-ence in a patients lung functionbetween day and night, this is not dueto lying down. When a patient hasnighttime awakening due to asthma itindicates the asthma is not well con-trolled and a medication adjustment isneeded. Many asthmatics have GEreflux or heartburn; medications foracid reflux will help. A good measurefor nocturnal asthma is measuring peakexpiratory flow rates at bedtime duringan awakening and during the day.
The managing of asthma requires regu-lar monitoring and therapy; this shouldinclude a peak flow meter. This is ahandheld device that can be used athome to measure how well air from thelungs moves out. The use of a peakflow meter can give the patient withasthma an early warning sign that asth-ma is worsening. It is advisable to keepa record of peak flows on a daily basisso you can see the variables, whichcould be due to seasons, exposure toallergens, illness etc. This type of chartcan help the physician to determine ifthe medication plan is working. A peakflow meter for an asthmatic is as impor-tant as measuring blood sugar is for adiabetic; both are trying to control their
conditions. Spirometry or pulmonaryfunction testing is done in a physician’soffice generally a specialist such as anallergist or pulmonologist. MeasuringFEV1 (forced expiratory volume in 1second) and FVC forced vital capacity)as well as the ratio of the two.
The physician should also have the patientcomplete an “asthma control test” TheAsthma Control Test is a way to help thepatient and their healthcare providerdetermine if their asthma symptoms arewell controlled. These are 5 questionsasked of the patient reflecting over thepast 4 weeks, there is a childhood versionfor ages 4-11 and the adult version ages12 and up. If your score is 19 or less,your asthma symptoms may not be as wellcontrolled as they should be.
A personal “asthma action plan” helpsboth patient and physician keep infor-mation organized and prepared, and
can be modified and changed as need-ed. It should be noted that 60% ofpeople with asthma cannot tell whentheir asthma is worse and about 15%do not know they are having an asthmaexacerbation until the time they needemergency care.
With all of these tools the physician candetermine the best course of therapy andplan of action for the patient. The medica-tion therapy is determined by severity ofasthma and the age of the patient.
Asthma medications can be classified asthose for quick relief or long term con-trol. All asthmatics will generally be pre-scribed a short acting bronchodilatorsuch as Proventil, Ventolin. These aregiven for the acute symptoms, actsquickly to relax smooth muscles, able tobe used every 4-6 hours as needed.
FEV1 / FVC Ratio
Volu
me
exha
led
1 secondTime (seconds)
FEV1
FEV1
FEV1
FVC
FVC
Normal lungs
Obstructivediseases
FVC
Restrictivediseases
continued on page 14
14 CALIFORNIA MEDICAL ASSISTANT — MARCH/APRIL 2016
CONTINUING EDUCATION
Understanding ASTHMA – continued from page 13
Read the Continuing
Medical Education Article
UnderstandingASTHMA
located on pages 11 - 14,
then complete the
Self-Assessment Test
on page 15
for CME credit.
Anti-inflammatory or inhaled corticos-teroids are given for long term control,also in recent years a combination ofcorticosteroids and long acting bron-chodilators. These medications keepairways from becoming inflamed andreduce the sensitivity to triggers, andare used daily as preventative.Examples of combination medicationsare Advair, Symbicort, and Dulera.
Anticholinergic medications decreasethe production of mucus and blockstightening of airways, these are usefulin the elderly and in COPD (chronicobstructive pulmonary disease) generallyCOPD is found in smokers. Examplesof anticholinergics are Atrovent andCombivent.
Antileukotrienes prevent the formationof leukotrienes that contribute to airwayinflammation; examples are Singulairand Zyflo these are in tablet form. Itis important that the patient knowsthese anti-inflammatory or preventativemedications are not meant for immedi-ate relief.
Prednisone an oral steroid is given intablet or liquid formulation may beneeded regularly for the most severepatient, i.e.…steroid dependent.Patients are sometimes given a shortcourse of Prednisone for an acuteasthma exacerbation.
IgE InhibitorsImmunoglobulin E, or IgE, is an anti-body in the immune system. Whenpeople with asthma are exposed toallergens, their bodies launch animmune response, producing IgE anti-bodies that can cause inflammationand a worsening of asthma symptoms.Medicines called IgE inhibitors blockthis action, helping to prevent asthmasymptoms before they occur. IgEinhibitors are typically given by injec-tion once or twice a month to peoplewhose moderate to severe persistentallergic asthma is not controlled withinhaled corticosteroids.
This is where education is the key thephysician and nurse need to explain tothe patient the differences and demon-strate the use of these medications.Patients don’t always understand whatthey are taking and how it works. Thereare so many new ways to deliver med-ications now, dry powder, breath actuat-ed devices, and the patients need to beinformed of the dangers of using themedications incorrectly. And the sideeffects that come along with the differ-ent classes of medications. For examplethe patient must always rinse the mouthafter dosing with an inhaled corticos-teroid to avoid oral candidiasis, a yeastinfection in the mouth
Although a cure for asthma is not thereyet, the future for patients is bright, newand better agents with less adverseeffects are being studied. These will bedirected towards the underlying cause ofthe problem, inflammation and not justtreating the symptoms. There are manyongoing clinical trials in allergy, asthmaand immunology. Pharmaceutical com-panies spend billions of dollars to bringthese medications to the market. A newmedication can cost up to 500 milliondollars and take over 10 years to getFDA approval. To obtain this, testingmust be done in the laboratory, inhealthy patients and then on patientswith asthma.
The end goal is for the asthmaticpatient to lead a normal life, have agood quality of life, while keeping theasthma symptoms controlled, asthmaneed not keep the patient from doingthe things they want to do. By followinga good asthma action plan with anexperienced physician asthmaticpatients can lead a normal productivelife and hopefully avoid costly hospitaladmissions and ER visits. �
___________________________________
REFERENCES:
• A Patient’s Practical Guide toAsthma and Allergies
• By California Society of Allergy,Asthma and Immunology, edited bySheldon Spector, MD
• Contributor - Bruce M. Pruner, MD
• Asthma.com about Asthma
• JAMA (Journal of the AmericanMedical Association) Vol. 307No. 4 Jan. 2012
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CALIFORNIA MEDICAL ASSISTANT — MARCH/APRIL 2016 15
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UnderstandingASTHMA – Self-Assessment Test
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