Tutorial Advice from a Nurse

[Uneveringslinky]

(-ing student!)

The body is very complex, all these systems and parts and pieces that make us up, but what happens when things go wrong?
Sometimes the best thing you can add to your angst plot is a sudden and dramatic illness, but does it always have to be cancer? There are plenty of other terrible awful things that can happen, and I’m here to help.

I am a Senior nursing student currently in my off semester, so to prevent my books from collecting dust I wanted to offer a kind of question and answer forum. Give me a list of symptoms you want your character to have and I can help you find an illness, treatments, and ways it would change your characters life. Tell me the traumatic event your planning and I’ll help you figure out the likelihood that your character will get out of this alive. Ask me how things really work in the hospital (because no medical shows ever really get it right). Really, I’m just looking for an excuse to lay down some medical jargon, ill try and answer any question I can.



*Please don’t give me symptoms YOU are personally having in an attempt at me diagnosing your mystery illness, I’m a future Nurse, not a doctor!

 

[Pine]

ohhhh, thanks for the thread! i majored in psych so i know that perspective of chronic illnesses (particularly development-wise) and ofc have webmd at my disposal but i think something like this thread would really help get the full picture?

recently i made a character with asthma and even less recently a character that suffers migraines. i would be interested in hearing i guess... stuff like most common triggers for these things? any trivia you might know regarding these? what can happen with an untreated asthma attack? if theres any symptoms that are 99-100% universal across everyone who suffers either from asthma or migraines? im not really sure if i have any specific questions off the top of my head, and if those two things are way too far off from the purpose of this thread (i.e. that i already have the dxs) then thats fine and you can just ignore me lol

probably more related to what you actually want to do here, i have this SUPER old character whose mom had some vague, severe difficulties with her pregnancy (and possibly ones before). i remember writing her as bedridden and semi-regularly bleeding during the pregnancy, though there was no miscarriage/termination involved, and modern day i really... don't know... how feasible that is. circumstances around this were just stress, not getting proper nutrition, and possibly being in a... stuffy environment? and generally going through her third pregnancy, probably without the leisure of modern medication/treatment so forth. so i guess im wondering how plausible that even was or if there's any other problems/specific illnesses that could happen with regards to pregnancy? could be fatal but preferably not.

and sorry if this is all just Too vague/not what you were looking for, i hope i can clarify things as needed ;;

 

[Uneveringslinky]

No no this is fine! I was a little vague about what I wanted people to ask so that I didn't block out any would be askers! I’m just going to spit out a ton of information and if you want me to hone in on any of it and explain more you let me know

So first off Asthma; there are a number of triggers, I’m sure you know; allergens, air pollution, environment, it can also have something to do with genetics and it's more common in those who are heavier set. Asthma exacerbation is most common in the early morning and late at night (its always harder to breath lying flat, that’s why we typically raise beds up in the hospital and try to have patients sleep that way. People with asthma might sleep better in a reclined but not flat position!) An untreated asthma attack is no good, Status Asthmaticus is a prolonged (>30min) asthma attack which could lead to death. Typically, patients come in with this saying that their meds weren’t working (well really a friend/family would be saying it the patient would just be gasping and crying) in this case we start by giving Epinephrine (Epi) which will get your lungs open enough for us to be able to place a tracheostomy (a tube into your lungs to help you breath). We can also give you Heliox a mixture of helium and oxygen (helium is like a smaller molecule, so it has an easier time getting into the constricted lungs.)

All asthma patients need a short-acting (rescue) drug and a long-acting (maintenance) drug. Typically we have SABA/LABA, albuterol, and corticosteroids. If drug therapy is going well the patient should not have to use their rescue.


As for Migraines, there are so many things that can cause or trigger a migraine, there are some people who get chronic migraines that are unprovoked. Some medications that dilate blood vessels may cause them, some people get them after drinking or skipping a meal, some people have congested sinuses that cause an increase in intracranial pressure that cause them. There is no right answer for migraines, you could tell me that dogs cause migraines and I think I would have to believe you. The reason there are so many causes are in part because the exact etiology (cause) of a migraine is unknown (though its currently believed to be an overexcitability in parts of the brain (mainly the occipital).

As for more interesting information on migraines, there are actually some people who have what’s called an Aura, they essentially have a feeling a migraine is going to happen (this only happens in about 10% of those affected). There are also vision changes that can be associated with migraines. An Ocular Migraine may actually cause blindness in one eye for a short time (typically for only a few minutes (but a terrifying few minutes)). This blindness can come hand in hand with a headache or could occur after its over but it will always only affect ONE eye.
Since we don’t know exactly what causes them we don’t know exactly how to fix them either, we typically just say pop a few pain pills (Excedrin is particularly good because of the caffeine in them) and go sit in a dark corner for a little while. Decrease the stimulation and wait for the storm to pass. Which stinks but it's all you can really do.



Going to your old OC with the pregnancy, just for warning I have a special interest in obstetrics so I have a lot to say on the matter! There are so, so many things that can go wrong with a pregnancy. I wouldn’t even begin to know where to start on a specific problem, but what you have written here still happens!

A Threatened Abortion involves bleeding and typically requires 24 to 48-hour bed rest (with bathroom privileges!). Their baby can still be born because the cervix is closed (if the cervix were to open this results in a miscarriage or “inevitable abortion” but that's something totally different). This bed rest isn’t for the mother though, the mother is typically feeling fine the bed rest is recommended to decrease any unwanted stimulation and reduced the likelihood of miscarriage. We have in our modern time a high-risk mother-baby unit in where some mothers can live for months out of their pregnancy. I met a nice woman on a shadow day in that unit, this was her third pregnancy and she was going to have twins (many mothers with twins end up with problems like oligohydramnios and leaking amniotic fluid) so she was staying at the hospital, this is in case her membranes break she can be seen immediately and hopefully save the babies.

She may also have a much less frightening case of Placenta Previa, this is where the placenta implants closer to the cervix and in some cases covers it. Just by being close to the cervix it can often result in bleeding because the placenta is a very vascular thing and bleeds a ton. This bleeding is painless, and we also ask for these moms to be on bed rest. The placenta can also cover the cervix either a little or completely, this is where modern medicine helps because these babies HAVE to be CESARIAN. Otherwise, the placenta is born first, and the baby suffocates long before its born.

These are both conditions that just sort of happen on their own because making babies is actually a lot more complicated than we tend to think. Stress can be a major indication of problems, and improper nutrition (especially in the first 8-weeks) can lead to really bad problems for baby.

Pregnancy problems are most common in first-time pregnancies and especially for those of young or advanced age but can happen at any pregnancy and any time.

Hopefully, this is somewhat what you were looking for! If not let me know and I can look at something else!

 

[Pine]

omg i love you SO so much right now, thank you SO much for all the information! this has been SUPER helpful omg. i think this is exactly the kind of stuff i needed to know before even being a little confident about my representation of these things LMFAO. i'll need to process this, think it over and read over again a few times, but i'll definitely let you know if i have any further questions/inquiries (provided your thread will still be open)! wow i just really can't express enough gratitude, thank you. ;; (i should extend a similar offer if u ever want some hot tips on mental illness stuff, though i might be too rusty rn to go too too in depth.)

 

[chainsmokes]

I don’t really have any questions but just dropped by to say that I think this is a good idea for a thread. A lot of times when people include illnesses - be it mental or physical, they get something wrong because all that isn’t as simple as it seems, or how you see it on TV, lol. Or just something a person wouldn’t know without studying nursing, or similar.

I’m a nursing student too so that catches my eye pretty quickly haha.

 

[Abendrot]

First, thank you for doing this

So, I've entertained the thought of writing a character with epilepsy, and I was wondering if you had any tips so that I can portray it accurately. Are there any misconceptions that should be cleared up? Is there anything that could trigger a seizure aside from flashing lights? What might a seizure feel like?

 

[Uneveringslinky]

I don’t really have any questions but just dropped by to say that I think this is a good idea for a thread. A lot of times when people include illnesses - be it mental or physical, they get something wrong because all that isn’t as simple as it seems, or how you see it on TV, lol. Or just something a person wouldn’t know without studying nursing, or similar.

I’m a nursing student too so that catches my eye pretty quickly haha.

Thank you! Yeah, I used to be the biggest offender in high school when I had no idea how this stuff worked. I love well educated and researched RP stuff but medicine can be really confusing and I felt like this would be a good way to help out

 

[Uneveringslinky]

First, thank you for doing this

So, I've entertained the thought of writing a character with epilepsy, and I was wondering if you had any tips so that I can portray it accurately. Are there any misconceptions that should be cleared up? Is there anything that could trigger a seizure aside from flashing lights? What might a seizure feel like?

So first off what we typically think of as a seizure is called a Grand Mal Seizure or Generalized Seizure, this is the one movies love where the character thrashes and shakes. But there are a number of other less dramatic types of seizures (let me know if you want me to hit on any of those, there are a ton and I have a feeling you’re interested in Grand Mal so I’m going to focus on that).

Let me start with seizures biggest misconception, DO NOT PUT ANYTHING IN THE MOUTH. While it is true we used to do this, times have changed there’s a bigger risk of the patient biting your fingers off on accident than biting their tongue off, and often the things people try to put in there are huge hazards as well (I was told a story in where someone placed a phone inside their friends mouth, needless to say, the phone and the person’s mouth got fairly destroyed). If you're doing an Rp that is placed some time ago by all means put something in the mouth because that used to be our first instinct, just please don't do it now!

Second off seizures don’t last long at all, typically they last a few minutes, seizures are then followed by a post-ictal phase in where the patient is sleepy and confused. Problems can arise if the seizure lasts more than thirty minutes (this includes a return to post-ictal and seizing again before this confusion wears off). This is called Stats Epilepticus and requires emergency treatment to prevent brain damage and of course death. Typically, you only ever go to the hospital if its Status, your first seizure, or you underwent some kind of harm while seizing (like if you seized at the top of the stairs and fell).
The medications they typically give include Phenobarbital, Diazepam, Ativan, Benzodiazepines, and Barbiturates. Drug therapy tends to work for most people, they still may have the occasional seizure but will seize less than if not on drugs. If the medication is not working they may move onto surgery and resection the part of the brain in where seizures are occurring most.

As for triggers; yes, flashing lights are the typical culprit but many people think you need lots of flashing where you really only need one flash. Some people have a problem in where light flashing off of water or fresh snow can cause them to seize or looking at a light through slow moving fan blades. Seizures can also be caused by fatigue, loud sudden noises, and extreme temperature changes. Every person is different and some will be triggered more easily than others (even the typical light flashing is only a trigger for some epilepsy patients).

As for what a seizure feels like as someone who hasn’t had one that’s hard to say. If your character does not have an aura (a feeling a seizure is coming on) they will likely only have feelings of drowsiness and confusion upon regaining consciousness after the seizure and may want to just nap off the feelings for a bit. Your character without an aura may also be helped by a service animal, many animals can tell when a seizure is going to happen and develop ways to tell their handlers, the animals are usually dogs, but I’ve heard they can be a variety of animals (including get this; tarantulas). If the character does have an aura this is typically described by people as a feeling of ‘spacey-ness’ or ‘being outside of my body’, some people experiences anxiety, dread, and depression, your character can hear things, see flashes, taste something (typically bitter), or smell something (typically unpleasant), auras for everyone is different but typically after your first the others will be similar. You can also sometimes have the feelings of aura without the seizure actually taking place!

Seizures aren’t always caused by Epilepsy either, Epilepsy is two or more seizures with no other causes. My older brother had an AMV (Arteriovenous Malformation) in his brain and when it bled it bled into his brain and caused an increase in pressure and made him seize. Once the issue was fixed he was seizure free. Seizures (without epilepsy) can also be caused by water poisoning, electrolyte imbalances, low blood sugar, alcohol withdrawal, dehydration, and other systemic issues.

Hopefully, this helps you out, but if you need any other information just let me know!

 

[Shuusuke]

First of all I'd like to say that this is a pretty useful thing to have in an RPing forums. There are other topics that intend to clear misconceptions but health-related ones are particularly important, so thanks for the trouble.

As a bit of a background and explanation of my interest in it, when I was a kid I had it in my head that I had arrhytmia because of am anime I watched and I just thought it was so cool because of that. In any case, despite there being few (questionable) occurences and nothing showing up in any examinations to this day, I think that condition is up there in the list of common ones people try to RP, close to asthma and epilepsy as asked above, so I wanted to use the chance to ask. I never RP'd it myself so maybe after this I'll feel more confident if I end up doing it, and it'll help other people who might be considering doing that as well.

Feel free to give it an overview, but I'll try to go for what I think are more specific RP-oriented questions:

1. If I wanted to write a character's past so that it gave hints that at a later point they'd show more severe symptoms of arrhytmia, how could that be done? Is that even possible?
2. Would it be possible for a character to suddenly "catch" arrhytmia by external means? If they had no hereditary inclinations and no malformations, could some event cause symptoms to start appearing, when otherwise they wouldn't?
3. How would a diagnosis affect a young character's daily life? I mean this as what would be the recommendations to reduce the risks to their life? If the parents were told the kid had it, what changes to a "normal" lifestyle would be neccessary? For example, things like changing eating habits, special types of education, daily monitoring, etc.
4. How plausible would it be for a character to "hide" the fact that they suffer from arrhytmia? In more strenuous situations such as during sports, would they be able to pretend nothing's wrong without anyone noticing? What signs would someone who often interacts with that character daily could pick up on? Would that act be easily "unveiled" by a routine medical exam?
5. Are there other apparently unrelated triggers to arrhytmia, other than events we'd already expect to cause a quicker heartbeat, that would be realistic to include in an RP?
6. What would be more instinctive and/or "uneducated" measures a character could take on his own to lessen the effects of arrhytmia, and their actual effectiveness? For example, avoiding leaving his house so that he doesn't run into anyone he finds attractive, therefore not risking a quicker heartbeat; or maybe avoid eating a specific type of food.

That's what came to mind about that. There's one other thing I'm curious about though.

It's a more vague thing from what I've seen, but it seems to be referred to as "impending doom" (there are apparently bands with that name too). Is that simply hearsay? Is that presented in any way during teaching and/or in practice? What I understand is that one who is suffering from it feels that something fatal will happen to them soon. I'm curious if there's any realistic foundation to follow up on, to make that part of a character or an RP.

Thanks (again) in advance for the trouble. Wasn't sure how specific I should have been, but I thought arrhytmia and "impending doom" should be relevant subjects for the thread.

 

[Uneveringslinky]

First of all I'd like to say that this is a pretty useful thing to have in an RPing forums. There are other topics that intend to clear misconceptions but health-related ones are particularly important, so thanks for the trouble.

As a bit of a background and explanation of my interest in it, when I was a kid I had it in my head that I had arrhytmia because of am anime I watched and I just thought it was so cool because of that. In any case, despite there being few (questionable) occurences and nothing showing up in any examinations to this day, I think that condition is up there in the list of common ones people try to RP, close to asthma and epilepsy as asked above, so I wanted to use the chance to ask. I never RP'd it myself so maybe after this I'll feel more confident if I end up doing it, and it'll help other people who might be considering doing that as well.

Feel free to give it an overview, but I'll try to go for what I think are more specific RP-oriented questions:

1. If I wanted to write a character's past so that it gave hints that at a later point they'd show more severe symptoms of arrhytmia, how could that be done? Is that even possible?
2. Would it be possible for a character to suddenly "catch" arrhytmia by external means? If they had no hereditary inclinations and no malformations, could some event cause symptoms to start appearing, when otherwise they wouldn't?
3. How would a diagnosis affect a young character's daily life? I mean this as what would be the recommendations to reduce the risks to their life? If the parents were told the kid had it, what changes to a "normal" lifestyle would be neccessary? For example, things like changing eating habits, special types of education, daily monitoring, etc.
4. How plausible would it be for a character to "hide" the fact that they suffer from arrhytmia? In more strenuous situations such as during sports, would they be able to pretend nothing's wrong without anyone noticing? What signs would someone who often interacts with that character daily could pick up on? Would that act be easily "unveiled" by a routine medical exam?
5. Are there other apparently unrelated triggers to arrhytmia, other than events we'd already expect to cause a quicker heartbeat, that would be realistic to include in an RP?
6. What would be more instinctive and/or "uneducated" measures a character could take on his own to lessen the effects of arrhytmia, and their actual effectiveness? For example, avoiding leaving his house so that he doesn't run into anyone he finds attractive, therefore not risking a quicker heartbeat; or maybe avoid eating a specific type of food.

That's what came to mind about that. There's one other thing I'm curious about though.

It's a more vague thing from what I've seen, but it seems to be referred to as "impending doom" (there are apparently bands with that name too). Is that simply hearsay? Is that presented in any way during teaching and/or in practice? What I understand is that one who is suffering from it feels that something fatal will happen to them soon. I'm curious if there's any realistic foundation to follow up on, to make that part of a character or an RP.

Thanks (again) in advance for the trouble. Wasn't sure how specific I should have been, but I thought arrhytmia and "impending doom" should be relevant subjects for the thread.

Woah can I know what anime that is? : 0

Frist off, Arrhythmia (or Dysrhythmia) is a generalized term, it refers to any non-regular heart pattern, and of course there are a ton of them, these range from ‘a minor inconvenience I never knew I had’ to ‘cardiac arrest is imminent’ with the first being more common, the treatments of these vary as well as the signs and symptoms. I’ll try and answer your questions from both perspectives if possible!

• The thing about this is that there really are no advanced symptoms of Dysrhythmia (unless its an acute exacerbation and in cardiac arrest), at most you get some chest pain, fluttering, maybe some dizziness and shortness of breath. Something I could suggest however is maybe your character has dysrhythmia and knows about it does treatment, however, over time it worsens only to arrive back in the ED with Cardiomyopathy, which is where the heart muscle changes due to stresses on the heart. The muscle can grow leading to it being unable to push as much blood out. This can also be treated to an extent, but the only cure is a heart transplant (here’s looking at you character B).
• For some of the nastier dysrhythmias, there still wouldn’t be any huge change in the symptoms, your character would just feel worse and have to visit the hospital and more than likely undergo cardioversion (which is really kind of cool, they stop your heart and shock it back into a normal beat!)
• Yes! However, while people can develop an arrhythmia suddenly it can also just kind of go away on its own. Alcohol, caffeine, smoking, drugs, being electrocuted, electrolyte imbalances (especially potassium), thyroid issues, and even some cases of emotional distress can all cause dysrhythmia.
• There are a ton of heart issues children can face and an Arrhythmia is probably more on the tamer side. Depending on the type of issue would determine the extent of the treatment, if its something like Atrial Fibrillation they might be on a blood thinner (warfarin/coumadin/enoxaparin) their entire life to prevent blood clots. Parents may have to be careful about giving any Tylenol because that can also think the blood and cause a bleed. They would also have to watch the amount of Potassium the child is eating to make sure the meds will still work. If it’s something reoccurring and nasty they may consider a pacemaker. That child would have frequent check-ups and have several surgeries throughout their life to ensure it would work properly, and in some cases, they should not engage in contact sports. The kid could surely live a pretty normal life!
• Very plausible, many people can’t even tell they have an Arrhythmia. The character can brush off any dizziness and shortness of breath as just being really ‘out of shape’. A friend may notice if it's particularly bad, say you walked up half a flight and look grey now, but they would probably think heart attack before they thought Arrhythmia, and based on HIPPA law a doctor would have to ask the patient if they were okay with another in the room during the exam. The information could only really get out if you wanted it to. If the Arrhythmia is bad it could be heard during a regular exam but in many cases, it needs to be seen via ECG and those are not a routine part of a medical exam and many primary care offices don’t have them.
• Hit that one in number 2!
• This one I’m not sure of, I don’t think a lot of uneducated people know about Arrhythmia unless they were already diagnosed?

Oh yes actually! Impending doom is more related to heart attacks however than Arrhythmia. A patient can state ‘I feel like I’m dying’ and then just go and kick the bucket. Its really petty creepy, and while this doesn’t happen to everyone every time some people just know when something doesn’t feel right. That’s why nurses have to listen to a patient when they say they’re in pain. You know you better than anyone else will.

Hopefully, that helps you some!

 

[Shuusuke]

I may have worded it poorly, but the anime is Captain Tsubasa. All there was to it was a character that had a heart condition, and from how they portrayed him during football matches, I thought I had the same thing. Pretty much just a kid thing really, "I'm so like this cool character 'cause I have the same thing he does!" kind of thing. Wouldn't really recommend it nowadays though.

I don't want to derail this thread, but I played two Visual Novels that include medical-related topics, Katawa Shoujo and Kara no Shoujo. To put it shortly, the main character of the former has arrhytmia and he goes to a school for people with other kinds of conditions (total/partial loss of one of the senses, amputated limbs, and so on). The second is more oriented towards crime investigation, but among the central locations in the story are a hospital and a clinic, and medical practices such as surgery are recurrent in the story. Both have mature scenes though, so be warned. And naturally, the latter has cruelty and other impacting imagery/descriptions, and plenty of forensics. Feels like I spoke more than I should about them here, but let me know if you're interested and/or would like to hear more and if you want more information we can talk through PMs.

Back to the topic, that was very enlightening, thanks for answering the questions. What I meant by the last one is if there are any common superstitions/misconceptions about it that you're aware of. It doesn't seem like a popular target for those, so I wouldn't be surprised if there weren't. As for the impending doom thing, I see. So it's kind of a feeling that something's really wrong, and that it'll likely end with death. Thanks for clarifying, now it makes more sense. I'd heard it when someone mentioned that after receiving an incompatible blood type transfusion, people would instinctively feel that, despite not knowing the blood type was incompatible, so it felt more mysterious than that.

 

[nattaila]

Neat thread! I don't know if you can help me with my particular inquiry, but it is worth a try. I'm not sure if you're familiar with Harry Potter or not, so I'll explain my question as if you are not.

Splinching is an injury that occurs when witches and wizards apparate (teleport) from one place to another. If they are not suffienciently focused, they could end up leaving part of their body behind in the place they started. This could be as minor as losing half an eyebrow, or as extreme as losing an entire leg. I'm curious as to how such an injury would realistically heal with only non-magical medicine available to treat it. A character of mine was about two when she was apparated alongside someone else, and was splinched on the surface of her left calf, and the right side of her chest. The injury would look somewhat like this. So, kind of like someone just cut out chunks of flesh.

How would these injuries be treated in a hospital? How would it look while healing? When healed? Ten years later? How would they change as she grew, since she got them so young?

 

[Uneveringslinky]

W

Neat thread! I don't know if you can help me with my particular inquiry, but it is worth a try. I'm not sure if you're familiar with Harry Potter or not, so I'll explain my question as if you are not.

Splinching is an injury that occurs when witches and wizards apparate (teleport) from one place to another. If they are not suffienciently focused, they could end up leaving part of their body behind in the place they started. This could be as minor as losing half an eyebrow, or as extreme as losing an entire leg. I'm curious as to how such an injury would realistically heal with only non-magical medicine available to treat it. A character of mine was about two when she was apparated alongside someone else, and was splinched on the surface of her left calf, and the right side of her chest. The injury would look somewhat like this. So, kind of like someone just cut out chunks of flesh.

How would these injuries be treated in a hospital? How would it look while healing? When healed? Ten years later? How would they change as she grew, since she got them so young?

Well in breaking reality there is only so much you can do, I’ll try and give you what I can but it may not fit perfectly into your story since science and magic don’t typically like one another.

If taken to the hospital there might be issues right away with child services, kids don’t usually lose chunks of flesh and hospitals are big on trying to find out what happened, so they can treat things properly, the type of treatment will also depend on the size and depth of the injury, and the amount of bleeding. Stitches are always the preferred method so if the wounds are thin enough to be stitched shut that’s likely what they would do if the wound edges are too far apart for stitches we have what’s called wound packing (based on the picture you included they may stitch the smaller cuts and then try and pack the larger wound. Wound packing involves filling the space with sterile gauze and then covering it, the gauze is removed and changed every so often based on healing (and typically they give you some meds before they start because pulling out the soiled gauze can be painful). It’s a sterile procedure and very meticulous, you have to document everything including the amount of gauze you used (otherwise there are horror stories of leaving a gauze behind and it gets a nasty infection!) If the wound is so superficial there s nothing to pack they would just cover it, like a huge band-aid.

The wound would be fleshy and red (so long as it's healthy that is) and may heal with little to no complication! If the sterile procedure is broken or your child just has a poor immune system you can develop an infection and the wound bed will be yellow or worse black! The yellow and black skin is washed out or Debrided and the wound repacked.
If the wound is super huge (which I don’t think is likely in a toddler) or gets infected often they may try a skin graft in where the skin is removed from another part of the body and placed over the missing area. In a skin graft, they either pull a small enough piece that it can then be sutured shut or they pull partial thickness or only the top layers of skin. They typically avoid skin grafts if they can help it.

Depending on how much blood was lost would determine whether they would give fluids or blood. They rather give fluids because you aren’t likely to have any terrible side effects from them. Blood is needed in serious situations. The way you describe it the wounds seem like they would be superficial so there might not be a lot of bleeding (hospitals may still put her on fluids because she’s so young and it really does not take a lot of loss to throw a toddler off balance).

Scars are also very different from a person to person basis, again it depends on how deep the wound went, the deeper the wound the more permeate the scar. A more superficial injury may heal completely or leave faint marks, your OC is a child at the time of injury and kids have an advantage of being able to heal much better than adults. So, she may have skin discoloration, if it’s a large area (or over a joint) she may have contractures where the skin tightens over the area of the injury (which can be very painful!) Your character may also suffer from Keloid or Hypertrophic scars in where the affected skin grows into large bumps (which can be itchy and unattractive but not painful).

And just an extra note when it comes to treating kids! Once the child is stabilized and if the child is going to be staying in the hospital they actually have things called Treatment Rooms! This is where anything invasive is done, like shots, wound packing, IV, anything that could be traumatic. That way the child's room can remain a safe place and the child won't develop any kind of anxiety upon sight of the nurse. Kids who are unstable are still treated in their rooms since they're...unstable. Your child though would probably be sent home (so long as things are cleared with social services) and home nursing can be used to help with the wound packing (or if mom or dad want to in some cases they can be taught and fix it up on their own).

I think that covers it! If you have any other questions or clarifications let me know!

 

[nattaila]

I think that covers it! If you have any other questions or clarifications let me know!

Thank you so much for your help! You're a saint!

 

[adrian_]

Would you say that an Ork mad dok is a good physician?

 

[Uneveringslinky]

Ork mad dok

I don't know who that is

 

[Jules8008]

For the migraine part: Migraine runs in our family, exclusively in the female sex, we are prone to migraines. The women have it until their 50s, until it suddenly stops. My mom had, my grandma, my grand-grandma, etc. Really weird.
Migraine triggers are incredibly random, as it varies from individual to individual. What causes me a migraine may not cause your character to get one. For me: Stress, not drank enough, not eaten enough, bad sleep, flashing lights. Maybe even trauma for some.
And, for me...not enough sugar in my body. Yes. Not enough sugar. Really weird. I call them "sugar migraines". I am drinking about one 300ml bottle of cola per day, as this gives me a hell lot of energy. Yeees, sugar's bad. At least en masse. But I'm here for a good life, not a long one. Whenever I feel like a migraines coming (my head starts to hurt. Left side and it starts to shuft to the right. And it starts to get hot), I am usually trying to find something sweet to prevent a migraine. Or at least make it bearable. When I have a migraine, it usually stays for about five to six hours. Time may be halved when I consume sugary treats.
Migraines appear fairly randomly. They do what they want to do and give zero shits about your plans. I don't have them on a daily basis, but instead, maybe once a month. With daily migraines I probably would have finished myself off by now. The last migraine I have had was yesterday, during an exam. I woke up already having a weird...gut feeling. I was a bit dizzy and my head was incredibly warm. I still went to write the exam. Usually, I would NOT recommend writing exams with a migraine - it's like you are having a headache while your head yells "AAAAAAAAAA", while faintly in the background, some random ass song lyrics play. Nevertheless, I still wrote it.
What helps against them? Again, varies from person to person. For some, medicine helps. For some, drinking something cold may help. For others, sleeping.
Note: Not everyone has migraines caused by not enough sugar. I think I am the first one in the family. But each migraine in our family is caused by different things, as already said. I may get a migraine from something and my mom didn't get one from it.

...................

This may seem random, but are there any causes for a permanent limping on a leg? Like, maybe a car accident?

 

[Darkmaster006]

Ohh, this is such a good thread!! I really like that your responses are so detailed. Do you have any advice on how to write ADHD?

 

[AdrianS]

I LOVE this thread! Just the idea of it is amazing and really, really useful, thank you for going out of your way!!! I think I want to comb through my own notes before I ask questions, though I'm definitely going to have one about intense burns/burn scars, to be sure.

Would you mind if I fashioned a similar sort of thread for my own profession, which is counseling? It never occurred to me that I could do a Q&A-style advise thread, but I don't want to detract from you in any way...

 

[Uneveringslinky]

For the migraine part: Migraine runs in our family, exclusively in the female sex, we are prone to migraines. The women have it until their 50s, until it suddenly stops. My mom had, my grandma, my grand-grandma, etc. Really weird.
Migraine triggers are incredibly random, as it varies from individual to individual. What causes me a migraine may not cause your character to get one. For me: Stress, not drank enough, not eaten enough, bad sleep, flashing lights. Maybe even trauma for some.
And, for me...not enough sugar in my body. Yes. Not enough sugar. Really weird. I call them "sugar migraines". I am drinking about one 300ml bottle of cola per day, as this gives me a hell lot of energy. Yeees, sugar's bad. At least en masse. But I'm here for a good life, not a long one. Whenever I feel like a migraines coming (my head starts to hurt. Left side and it starts to shuft to the right. And it starts to get hot), I am usually trying to find something sweet to prevent a migraine. Or at least make it bearable. When I have a migraine, it usually stays for about five to six hours. Time may be halved when I consume sugary treats.
Migraines appear fairly randomly. They do what they want to do and give zero shits about your plans. I don't have them on a daily basis, but instead, maybe once a month. With daily migraines I probably would have finished myself off by now. The last migraine I have had was yesterday, during an exam. I woke up already having a weird...gut feeling. I was a bit dizzy and my head was incredibly warm. I still went to write the exam. Usually, I would NOT recommend writing exams with a migraine - it's like you are having a headache while your head yells "AAAAAAAAAA", while faintly in the background, some random ass song lyrics play. Nevertheless, I still wrote it.
What helps against them? Again, varies from person to person. For some, medicine helps. For some, drinking something cold may help. For others, sleeping.
Note: Not everyone has migraines caused by not enough sugar. I think I am the first one in the family. But each migraine in our family is caused by different things, as already said. I may get a migraine from something and my mom didn't get one from it.

...................

This may seem random, but are there any causes for a permanent limping on a leg? Like, maybe a car accident?

There is a long list of possibilities that could potentially cause a limp, so I’ll just talk about the option you give; car accident. Yes, this is a totally probable cause of a limp that can last a lifetime; but how? In the MVA (motor vehicle accident) your character could break a bone in the leg, from the hip (it's actually almost always the femur (the long bone of the leg that breaks in a hip fracture fyi) to the metatarsals in the ankle.

One of the worst can be a patellar (knee cap) break, this happens when your knees collide with your dashboard this can be done to the driver or a passenger (I actually suffer from knee pain because I used to sit passenger side with my knees against the dash, and we were rear-ended (luckily not too badly) I don’t limp, but I do suffer knee pain). With a patellar fracture, it becomes very difficult to straighten out your leg meaning walking would be very different. This break can be treated with a cast but typically requires surgery if the bone, broke in half, shifted drastically or caused injury to the surrounding muscle.
Knee injury is really a huge cause of limping, you could break that bone, tear the surrounding ligaments (ACL/PCL) or tear the cushions (called meniscus) that cushion the tibia and femur during walking. In some cases, meniscal tears can be so painful people become confined to a wheelchair.

You can also injure other parts of the leg such as the hip, hip fractures are more common in the elderly but if a piece of car smashes into your side I’m sure that would do the trick too. Typically, with a hip fracture, they will do surgery (unless surgery puts you at a higher risk of death (i.e. if you are very old and sickly) and that’s where you et screws and rods and bits of metal put in you. I’m not sure if this is likely to cause a permanent limp, however, it may cause a limp for some time but with good physical therapy you might be able to walk again nicely, but it could also develop arthritis or just cause your character enough pain to limp.

Really any fracture of the lower body can cause an issue if not treated correctly/healed wrong or may develop arthritis which can also cause pain and possibly a limp.

Your character could always lose a part of the foot, instant limp no questions asked, and in a car accident if there is substantial bleeding your body would naturally supply blood to the more important parts of the body, the brain/heart and may cut off circulation to the extremities leading to possible necrosis of part of an already injured leg?

You could also injure your back, maybe a herniated disc which could lead to nerve pain and damage below the affected area and could cause a limp for quite some time?


I’m sorry for the inexactness of this one but when it comes to limping it’s a fairly case by case judgment. Hopefully, this helps you and if not I recommend Orthoinfo.com as a nice site to maybe help you if you decide to go on with the bone stuff!

 

[Uneveringslinky]

I LOVE this thread! Just the idea of it is amazing and really, really useful, thank you for going out of your way!!! I think I want to comb through my own notes before I ask questions, though I'm definitely going to have one about intense burns/burn scars, to be sure.

Would you mind if I fashioned a similar sort of thread for my own profession, which is counseling? It never occurred to me that I could do a Q&A-style advise thread, but I don't want to detract from you in any way...

Of course!! I wanted to do this to help people since there is a lot of misconception with medicine and I know nothing about counseling so go ahead! Teach away!
Can I ask what you mean by counseling though? Like a counselor in school? mental health stuff? I'm curious.

 

[Uneveringslinky]

Ohh, this is such a good thread!! I really like that your responses are so detailed. Do you have any advice on how to write ADHD?

Thank you! I try to supply a lot of information to be able to cover all the bases and hopefully hit any future questions. I’m going to apologize in advance and be a little honest with you on your topic, however, we didn’t go over a lot of ADHD in mental health so what I’m going to give you is right from my text book (along with the bits I know and remember).

Before I talk about ADHD I wanted to add one little note about Absence Seizures which is often misdiagnosed as ADHD. Absence seizures occur during childhood and you can typically grow out of it after puberty, this is a loss of consciousness for 2 to 10 seconds that happen in clusters throughout the day, and it just kind of looks like the child is zoning out, this is seen as an inability to pay attention rather than a seizure which is why it is treated as ADHD and not a seizure. Okay, enough about that and onto what you really asked about!

Attention Deficient Hyperactivity Disorder (ADHD), this is where people show inattention, impulsiveness and hyperactivity (you can also have ADD same thing just not hyperactive). This is diagnosed by a child younger than 12 if they have these symptoms in two settings (such as at home and at school ADHD isn’t turned off when you get home). You can also be diagnosed as an adult. Kids with ADHD are also often diagnosed with other things such as oppositional defiant disorder (ODD) or conduct disorder (CD) (I think this is likely because kids with ADHD tend to frustrate easy and this leads to a build-up of anger and lashing out ODD and CD are really fancy ways of saying ‘help my kid is a jerk and won’t listen to me’. These behaviors also could be due to the fact that ADHD kids have trouble in school because of their lack of attention and have trouble maintaining relationships which can lead to frustration).

Big center stones for ADHD are; impulsiveness, distractibility, disorganization, difficulty taking turns, difficulty maintaining relationships, poor social boundaries, and frequently interrupting others. With inattentive ADHD they also may bore easily, have trouble completing long tasks and require frequent prompts to get things done.

These symptoms can be managed via medication Ritalin and Adderall are the number one drugs in treatment, they can help really fairly quickly in making sure someone focuses. There are issues however in compliance to the treatment, people with ADHD can have problems with memory which leads to a game of ‘did I take my meds???’ most mornings, there is also an issue in overtaking the medication to try and stay more focused or selling the drugs to others to help them become more task-oriented (believe it or not ADHD drugs are classified as stimulants which everybody loves to take).
Also, children who take Adderall need a ‘drug vacation’ every once in awhile because this drug interacts with growth hormones so they can be put on Strattera in the meantime so symptoms don’t get worse

Hopefully, this helps!

 

[AdrianS]

Of course!! I wanted to do this to help people since there is a lot of misconception with medicine and I know nothing about counseling so go ahead! Teach away!
Can I ask what you mean by counseling though? Like a counselor in school? mental health stuff? I'm curious.

Mental health, for my side, and I aim to make that clear when I make the topic. School counselors and mental health counselors share a lot of classes, but not all of them, and have different legal considerations. I'll also probably try to make clear the differences between counselors, psychologists, psychiatrists, and social workers. We're all related, but totally different.