Dopamine, poverty, and pain: the lighter side

Executive decisions are made in the forebrain. The information that goes into them comes from the sensory cortex (nearby) and the hypothalamus (back in the dark heart of the brain.) The execution of those decisions happens in the pituitary, among other places. In short, there’s a lot of nerve-impulse mileage laid down between the moment you feel the itch in your armpit, check your surroundings for privacy, scratch away, and give a happy little sigh of relief. Lots of neurotransmission there.

Dopamine is the neurotransmitter of executive decisions. It’s a daughter chemical of adrenaline, and your adrenal glands share blood supply with your kidneys; interestingly, Chinese medicine views the need to make too many decisions as being hard on the kidneys. Makes perfect sense to me. But that’s a red herring.

The key is, without dopamine, the decision can’t get from the frontal lobe to the action parts of the brain. Dopamine levels can be knocked back by pain, drugs (including the prescribed ones), depression, poor diet, and — of course — overuse.

People who have crippling pain have to make exponentially more decisions than those who don’t. Every action is measured against an internal set of standards that don’t exist for normos: how much pain will lifting that cost me? That car door — which way should I turn my hand to minimize damage when I pull it? How many function-dollars do I have left in my body’s account — enough to do laundry _and_ shower? Or should I do just one? If so, which one is more necessary?

Poor people have a similar ceaseless train of calculations running in their heads, but with different parameters. Can I get a little meat this week? What are my produce options, since there’s no good market in this area? Which neighborhood’s market has the best prices? Have I got the bus fare? Will I get into trouble over there? How do I blend in? Can I call in a favor to get some Tylenol too? These headaches are killing me.

As a poor person with pain, I figure I make easily 20 times as many decisions — on a slow day — as a normal person my age. When I was still overmedicated, I used to feel like a loser for not making 100% perfect decisions 100% of the time; in fact, I occasionally just goofed. And the trouble with living within such narrow parameters of function and finance is, the occasional goof can put you behindhand for a very long time.

It’s easy to sneer at those who make weird decisions like paying for a flat-screen TV instead of a semester of junior college. But try wringing out your dopamine every single blessed day, week after month after year, and see how well you do. These people don’t have decision-making disorders, so much as decision-making overload.

If you’re poor or in pain, take some credit for getting through the day. Cut yourself a little slack. Take a moment to rest and relax. See, it’s easier already.

Being hypercritical just uses up your dopamine faster. Why? Because criticism is the result of long strings of decisions. It’s very dopamine-expensive. (Ever wonder why hypercritical people don’t seem very happy? Now you know.)

Take a moment to be happy, to notice what’s good. Those moments rebuild your store of decision-making, anti-depressant dopamine. Each natural, happy little sigh is a shot of the stuff.

Sniff that flower one more time. Scratch where it itches (preferably in private.) Feel the sun warming your head. Laugh with your friends. There’s a reason why it feels so good. It really does make you stronger. It freely gives back what life makes you use. And it’s not too hard to find a reason to be happy.

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Chalk boored: cortisol and dentition

My teeth were crumbling. I thought that was churlish of them, especially since I was moving at the time and had quite enough going on.

My naturopath has gotten them back to something more toothlike and durable, but the thing about tooth chips — like stretch marks — is that there’s no undoing them.

Another blow to my vanity, or what’s left of it.

I’m told this churlish chalkification was due to the effects of the cortisol my body now has again — and responds far too strenuously to. This makes sense at a basic level, since mineralization is one of the things cortisol affects. I haven’t looked into the specific science but, since I can chew without fearing for my molars now, I’ll accept the explanation and keep going.

I’m glad my teeth are stronger. I can probably live without using them for pulling needles and trimming cuticles, but I was stumped for ways to chew my food without them. As it is, I suspect beef jerky and rock cakes are entirely in my past.

Think I’ll have an apple for breakfast. Wonderful thought. It really is the simple things that make life sweet.

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Expected vs. Actual: planning for WC settlement

The lawyers have finally agreed that it’s time to put this turkey of a Worker’s Comp case to bed.

My lawyer said that, for one thing, I get a mathematically-determined
“apportionment” for being 30% disabled (yes, the Governator thinks I can do 70% of the work I was trained for — writing and patient care — with no freakin’ hands!) The amount would buy a midrange car, but not insurance or gas.

In addition to that, I can either continue fighting with them for every scrap of care my doctors are willing to go to bat for, or hold them up for cash on the barrelhead in return for letting them off the hook in future.

My lawyer figured they might be persuaded to give me the equivalent of another midrange car. This adds up to roughly the cost of a moderately tricked-out Tesla Roadster.

That’s not chump change, but put this in the tailpipe and smoke it …
I suggested plotting out future expenses and seeing how close that amount (the Tesla) would come to meeting the need. So I did.

Turns out that, after writing the check for the Roadster, they’d still
have to move the decimal one place to the right. And that’s for basic lifetime care — nothing fancy, no further disasters or complications. Just regular doctor visits, generic meds, some minor surgery (although
with CRPS there’s really no such thing), and acupuncture at about the same rate they’ve allowed so far. Over a million dollars.

Think they’ll move that decimal point?

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