Paradoxical excitation

Tuesday, June 29, 2021.  Three weeks out from the knee replacement surgery and generally I’m doing better.  The rash on my lower legs is gradually clearing up, particularly the blotches on the surgical leg. Still experiencing itches that wake me up at night, but nothing like last week.  Still the occasional gout attack in my left toe at 3 am, but also nothing like the first week after surgery.

Along the way I have had some interesting experiences.  Over the weekend I followed the recommendations of a number of people to take Benadryl for the itching.  It was also reported to induce drowsiness to help me sleep.  Unfortunately that’s not what happened the night that I took it.  Not only did I become very awake, the itching became worse.  When I Googled “Benadryl stimulant,” a number of responses reported that Benadryl can have this effect on certain people.  Only one scientific paper, which postulates that it may be associated “with being a CYP2D6 ultrarapid metabolizer,” whatever that means.  I was more taken by the label that some medical sites put on this reaction, “paradoxical excitation.”  I love it when professionals give a fancy name to something they can’t explain.

Yesterday, however, I experienced another kind of “paradoxical excitation.”  I have been pushing myself to walk farther and farther each day.  Getting up to the circumference of Maja Park on Sunday, with two stops to catch my breath on park benches.  Yesterday afternoon I went to my first outpatient physical therapy, at the same place where I went for treatment of shoulder impingement in 2019.  It’s about half a mile from my apartment, but I took Lyft to get there.  Unlike the gout and the rash, I was expecting the intense pain of PT after knee replacement surgery.  This session did not disappoint me.  What did surprise me was the energy I was feeling as I left PT.  I decide to try to walk back to the apartment, which I did routinely in 2019.  I made it with two bench stops, but not feeling weak as I have been doing.  Who would have thought that sharp pain could stimulate one to get out and move more?

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