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Maryland offers "The New Directions Waiver" as a means of self-directing state and federal Medicaid dollars for individuals who qualify for supports due to their disability.

This offers the disabled individual the opportunity to use those dollars to best meet their own unique needs. However, it comes with the responsibility to create a plan, a budget, and find your own resources to make the plan a reality.

No centralized source of resources exists. The purpose of this blog is to direct others to resources in our communities and to provide one example of a self-directed plan. (*Caution: The self-directed plan described at the beginning of this blog is for an individual with a 5/5 needs rating, the highest possible rating in Maryland, and therefore the highest budget possible. Most will have a lower rating and a lower budget to work with.) It is also to share firsthand knowledge of experiences that may assist others who self-direct services.

Comments are welcome. Please share your knowledge with others.

Tuesday, August 7, 2012

A Day Off of the NAC

I waited until I only had 2 doses of NAC left before ordering more. So, when the NAC shipment didn't arrive before I ran out, we had a day without any NAC. What a difference! I had wondered how much the NAC was helping before we ran out, but now I know. V was irritable from 10 am until 3pm, either acting out or laying in her bed resting or sleeping. She never had a community outing because it would have been unsafe to take her out until she was calm, and 1 mg of lorazepam (ativan) did not help her. She did better in the later afternoon and evening. We still don't have the new shipment of NAC and I am hoping it arrives today. Now I can see that she is much more relaxed with it than without, and it has reduced the need for sedatives to take the edge off of her irritability, which I don't want to use any more often than necessary for safety.

Here is a new article about NAC and explains in terms that are fairly easy to understand, why NAC may help autism symptoms.


N-acetylcysteine may hold potential for treating autism



Read more: http://www.digitaljournal.com/article/330225#ixzz22s2eOhp3



N-acetylcysteine (NAC) is an inexpensive antioxidant supplement that was recently examined for its ability to improve some aspects of autism. Significant improvements on some behaviors were observed with the use of NAC.
Dr. Hardan of the Department of Psychiatry and Behavioral Sciences at Stanford University in Stanford, California performed a randomized, placebo-controlled study of NAC in children with autism.
The children were divided into two groups, and one group received NAC, and the other received a placebo for 12 weeks. Patients who received NAC were administered 900 mg per day for four weeks, then 900 mg twice a day for four weeks, and then 900 mg three times per day for four weeks.
NAC treated patients had significant improvements in irritability compared to those on placebo. A decrease in repetitive/stereotyped behaviors was also observed, but reached statistical significance only on some subscales. Gastrointestinal side effects were observed, but NAC was generally well tolerated. The results were published in the journal Biological Psychiatry.
Autism may have several causes, and some of them include increased levels of the neurotransmitter glutamate, which is excitatory, and high oxidative stress. Researchers of the above study highlight one of the causes of the disease is disequilibrium between antioxidants and oxidants. This causes an increase in reactive oxygen species (ROS), and this causes damage to several cells and organs. Synthesis of glutathione, the body’s main antioxidant, is also perturbed.
NAC may work because it increases glutathione and beneficially modulates the release of glutamate. Whey protein can also raise glutathione levels, and other researchers have also previously found that NAC can raise glutathione.
A systematic review of research findings was carried out by Dr. Frustaci at the Unit of Clinical and Molecular Epidemiology at the Scientific Institute of Recovery and Treatment San Raffaele Pisana, Rome , which specializes in neurologic rehabilitation. Her key results recently published in the journal Free Radical Biology and Medicine shows that patients with autism have low blood levels of glutathione.
Other researchers also recently reported in the journal Current Medicinal Chemistry that glutathione levels are reduced in autism patients, and antioxidant enzymes are decreased. They stated that glutathione can protect against the inflammation and oxidative stress in autism.
Thus, by increasing glutathione levels, NAC might improve some aspects of autism. Larger randomized studies are required to evaluate the effects of NAC on the disease.


Read more: http://www.digitaljournal.com/article/330225#ixzz22s2Dz5ZD

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