march/april 2016 what’sinside -...

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

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KNOWLEDGE

ISPO

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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

mailto:[email protected]

http://www.cmaa-ca.org/

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


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


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

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California Medical Assistant

— NEXT ISSUE —

May/June 2016

To submit items to be published in thisnewsletter, please mail or email:

KIM JONES, CCMA-C


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.

[email protected]


http://www.cmaa-ca.org/





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

http://www.innoffcapitolpark.com/

http://www.marriott.com/hotels/travel/sacdt-residence-inn-sacramento-downtown-at-capitol-park/


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



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


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!

� � � � � � � � � � � � �

� � � � � � � � � � � � �



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


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


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



• 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


– continued from page 8 –


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


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 –


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


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


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


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




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




Read the Continuing

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UnderstandingASTHMA

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Self-Assessment Test

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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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