Logfile from Nerak

OOC: Sudanna says "Alright.. my disclaimer.. No idling.. that equals no credit.. Ask questions, pose out note-taking.. show me you are here.. Also I log.. And as much as I love 'lizards.. No disruptions in the class..

"Grab your klah and tea now and settle in!" Sudanna says, "Well, thank you all for being here.. the class tonight is Orthopedics or Bonehealing..It's in two parts.. first the diagnosis and then the treatment." Sudanna says, "First let me say this..Bones are one of the most important organs of the human body, their major and primary function being to give shape to and support the rest of the body, and thus require special attention and consideration when treating injuries of bones."

Nerak writes 'diagnosis' on the top of the page, just below the title of the class. she then starts taking notes about the bones…

Kiriya scribbles. Bones... support... body. That's why she doesn't look like a little puddle of skin, blood, water, and bodily organs right now. Bones are organs? She didn't know that... Sip of klah, refocus, re-ink stylus. Looks almost... routine.

Kendrala absorbs the serious atmosphere that has descended on the gathered apprentices. As Sudanna begins to speak, her attention is riveted on the journeywoman presiding over the group. She takes thoughtful notes, leaving room to add additional information when the need arises.

Nodding, Kerali scribbles down Sudanna's words, in her own way. She absentmindedly reaches up to scritch Zoar, then writes again.

Magen is awed by the opening statement of Journeywoman Sudanna. Notation...Bones are one of the most important organs.

Sudanna says, "So, first is diagnosis. Bones are divided into two major groups, long bones and short bones. Long bones are those bones in the upper and lower arms and upper and lower legs, whereas short bones are those of fingers, toes,etc. Breaks in either group, however, are generally diagnosed by the same symptoms but are treated differently."

Krysa shifts her weight easily from one leg to the other, almost as if she was still on board the Flying Cloud. Approvingly, she smiles at how attentive the apprentices are and is pleased that Sudanna will have such a contientious group to teach. Kiriya scribbles. Long bones=limbs and stuff, short bones=fingers, toes, etc. Acknowledging nod is given to Krysa in the corner before she turns back to her studies. Krysa and Sudanna are her favorite journeymen. :)

Nerak writes long bones ... short bones ... breaks treated differently. Sounds fascinating!

Kerali writes some more notes, then idly thinks 'the heel bone's connected to the shin bone..the shin bone's connected to the knee bone...'.

Sudanna looks at her studious students.. "Anyone want to guess the symptoms of a /simple/ broken bone?

You say, "Shock and immediate bruising?"

Kendrala unconsciously feels the bone in her shin, her fingers traveling up and down. A definite long bone. Then the ankle bone grabs her attention - short bone? Or round bone? Her attention comes back to Sudanna when Sudanna presents a question for their consideration.

Kerali says, "pain. Bad pain."

Kiriya nods. "Shock, definitely. Bruising, fatigue, and maybe some swelling around the area. Definitely pain..."

Magen shakes her head. "Pain, swelling?"

Kendrala says, "Very localized pain, especially when the area is touched."

Sudanna says, "Okay, /maybe/ shock, but the others are a sure thing. And if it's the ankle, mostlikely the patient couldn't stand or walk on it. Sometimes, with a simple fracture in the leg a person will walk on it."

Nerak erks, the person could still walk on it if it was broken? OUCH! and writes down this information.

Kiriya winces, and jots down this information. Rather disgusting in ways, but true, evidently…

Kerali winces at that thought. She waves quickly to the newly arrived Appies, then turns her attention back to her book.

Sudanna says, "More symptoms include point tenderness, swelling around the area of the break, possible deformity, and the inability to move the limb without extreme pain. "

Kendrala continues to add information to the 'Bonehealing' pages, especially noting that sometimes a person can walk with a simple fracture of the long bone in the leg.

Kiriya oohs. Deformity. That's probable. She's seen people like that. Extreme pain? Oh yes. She's broken her leg a few times to know that…

Kendrala writes 'point tenderness' near her jotting of 'very localized pain'. Best to make the connections.

Nerak adds the list of symptoms into her notebook. Has seen deformed bones, but the child had those from birth.

Kesara whips out her pen and scribbles down, furiously, in order to get it /all/ down.

Kiriya jots down more symptoms. Note taking... fun, fun, fun. Attentively, she waits for more information from Journeyman Danna, and in the meantime, sketches little pictures of the symptoms beside the notes, or at least she sketches them as she interprets them.

Krysa realizes that she can't quite hear the responses from Danna's students so she moves a little closer and sits down in the last row of the classroom.

Sudanna says, "Okay, treatment.. First, there are two types of breaks, compound and plain breaks. Compound breaks involve a bone that has broken through the skin and are much more threatening than plain breaks due to the higher risk for infection. "

Kendrala draws a line down the middle of the top portion of the page, writing simple (plain) breaks on the left side of the line, and compound breaks on the other.

Magen screws up her face at the thought of a compound break. "Ouch!"

Kiriya scribbles, and momentarily looks at her FA1 notes. Yup, she has something about compound and simple breaks in there. She supplements those notes with little side-points about the risks of each. Figure that the compound list'll be longer than the simple…

Nerak writes 'treatment' then the two kinds of breaks. Would hate to see a bone broken through the skin - yech, would make me hurt just seeing it! She remembers learning about the breaks in First Aid, and is eager to learn more…

Nan puts in a cross reference to her earlier notes on puncture wounds, of which compound fractures are a cause.

Kendrala writes the word 'infection' on the compound side of the page and draws a distinct box around it, to make it stand out from the rest of the information already written there.

Krysa shudders once when she thinks of the first compound break she had ever seen and is grateful that she hasn't seen to many.

Sudanna says, "A plain break is any broken bone that does /not/ pierce the skin. To treat a plain break, the first thing that needs to be done is to make sure the bone is straight, end to end, or the bone will heal crookedly and cause more problems in the future." Eyes Nerak and nods another point for her braces.. "And that is one thing everyone wants to avoid. Remember, these injuries are best left to be treated by journeymen, but in emergencies, it is /never/ a bad thing to know."

Kiriya smiles. Emergencies. Good times for apprentices to practices if they're /really/ needed. A smirk crosses her face as she writes down a point or two about setting bones, and puts down a little side notes about apprentices needing to know these things in case journeymen aren't available…

Kesara shudders slightly, remembering her own broken leg as a child. /ouch/ she keeps scribbling, and making small diagrams in the margins of her paper. Stretching slightly, she sits up straight in her chair, and takes a deep breath, to stay focused and alert.

Kendrala makes a star to indicate that these types of injuries should be treated by journeymen. But, given the unexpected nature of some injuries, knowing what will be done for treatment can make a big difference in the long of it.

Nerak jots down the notes about the plain break, and the *great* reason to have Sudanna's brace as a treatment tool! "This is where you pull on the bone to get it lined up correctly before you immobilize it, right? Definately sounds like a time to knock out the patient first!"

Kiriya nudges Nerak. "No knocking out unless really necessary, i think... isn't that what numbweed's for?"

Finally slowing enough to take a breath, Nan envisions putting the bones back together, lining it up like a broken stick.

Magen raises her hand. "Is there anything that can be used for the pain?"

Nerak whispers to Kiri "I'd certainly want to be knocked out if that was going to happen to me!"

Kiriya takes a small twig in her satchel, and cracks it in half, then lining up the pieces to look like a well-set broken bone. It's... a well-set broken twig. Anyway. She scribbles down 'Nerak would certainly want to be knocked out if her bones were being set like that' and gets back to the topic.

Sudanna says, "To do this, be sure the area around where the break is located is thoroughly lathered with numbweed to ease as much discomfort as possible. Fellis may also be given if warranted. But.. "eyes the entire class as she speaks.. "Only by a Master. So if there isn't one, you /must/ make do with willowsalic and numbweed. Then run a hand gently over the area to determine if the bone is straight on not." Sudanna says, "Don't jump ahead Nerak.. several steps before you pull on anything.." Grins at her enthusiasm.. "But eventually we will get there.."

Nerak watches as Kiri breaks the stick and puts it back together... good demonstration.. writes down the info on the herbs. Good to know! "So if the bone was not straight, you'd feel a lump still?"

Kendrala feels as if the facts about fellis are embroidered on the backs of her hands. Only a Master.

Kendrala underlines willowsalic and numbweed. Notes that the bone needs to be straight and can be checked by running a hand over the area.

Nerak blushes "Sorry!" as she puts all of her concentration into writing in her notebook so the others won't notice her *red* face…

Kiriya scribbles down, in letters bolder than the rest of her notes, 'Never Give Fellis 'Til You're A Master!' Makes perfect sense. The stuff can kill if taken wrong. Willowsalic and numbweed... good substitutes. Though numbweed /stinks/ when being made…

Sudanna says, "You would feel a lump, it may be hot at the break sight, and if it's drastic enough, the limb may be at an odd angle. So, you need to straighten it. First, numbweed it to death... And since the skin /isn't/ broken, you don't need redwort.. then assuming that it is not straight, place one hand directly over the break and hold while gently, yet firmly pulling the limb with your free hand toward the lower end of the cot until the break is felt to be straight. Again, assuming the patient is on a cot. I also recommend you don't try this if there is no help to hold the patient still."

Nan follows along, wondering in which class she'll learn about willowsalic and numbweed. Prohibitions against fellis must have a reason, too.

Kerali winces again...doesn't sound like this would be a fun thing to experience... either as a healer or as a patient, especially!! She makes a mental note...if you're gonna break a leg, make sure there's a Master nearby to administer fellis!

Nerak writes down the many steps *before* pulling on the bone... and make sure to have someone *sit* on the patient while you pull it…

Kendrala makes careful notations about straightening a limb, adding that an assistant is essential to keep the patient still. She also boxes the words "lots of numbweed" to emphasize the importance of slathering the area of the break.

Kiriya scribbles again. Hold down the patient. Yeah, so they don't scream... heh heh heh. Ok, no redwort needed for simple breaks, gotcha. Lumps, heat... odd angle, even. Sounds typical for a broken bone…

Krysa brings her hand up to shield her face and her grin. These apprentices are handling the class much better then she did when she took it a turn or so ago.

Sudanna says, "Now, this is what we currently do for a broken bone.. but hopefully, this will change.. Once sure the bone is straight, place two, long sticks, one on either side of the limb sandwiching the break, and wrap it securely with clean cloths to form a splint. A layer of cloths soaked in numbweed may also be wrapped around the limb first, to help with long term pain control. Are there any questions to this point?"

Kendrala raises her hand with a question. "Given that we can only feel the area of the break, how can we be sure that we have straightened the bone appropriately, Journeywoman Sudanna?"

Magen writes 'Plain Break'. And underneath she writes, in an abbreviated form. 1. Determine whether the bone is broken. 2. Numbweed for pain. 3. Set the bone. 4. Immobilize (castings/splints).

Nan nods, holding up a hand. "And, what if there aren't any sticks long enough available?"

Sudanna says, "If you keep one hand on the area of the break and the other does the strong tug, you should be able to feel the bone slip, with some effort and grinding, back into place."

Nerak writes *lots* of numbweed! and brace it with /sticks/? The brace idea is *much* better! She hopes these will be available *soon*!! wrap with clean cloths... "When you wrap with the clean cloths, are you tying them in place like strips? Or is it wrapped around like when you wrap a wound?"

Underlining the word /splint/, Kerali looks up and nods a bit at 'Drala's question.

Magen nods. "Good question Kendrala." Winces at the journeywoman's answer!

Kiriya pipes up, evidently with a question. "How long will it take for the bone to heal, and what's the general course of treatment after the bone is set into place?"

Kesara chews on her pen as she absorbs the new bit of knowledge...then scribbles down frenetically once again. She keeps banishing past memories from this part of the treatment from her mind.

Sudanna says, "Well, if you are in the infirmary, we have splints of all lengths already available. If you are in teh wild.. at least use sticks of a length that will be longer then the break area, and wrap it snuggly as possible.. Just til you get to a real infirmary."

Kendrala grits her teeth at the thought of the grinding bones. She adds the steps of the splinting procedure to her notebook. At Kerali's question about bone healing time, Kendrala looks up to be sure she catches all the important information.

Sudanna says, "That's still to come Kiriya.. let's take it in order, okay? It's a good question, but the answer is ahead.."

Magen adds the notations, then looks up at the journeywoman.

Kiriya scribbles down the answers Sudanna gives to the questions of the others. All good points made... definitely the one about the splints. Sticks - if they're strong enough - are great splints.

Nerak winces as she hears about the bones grinding... that sounds painful!

Kerali shakes her head a bit, trying to shift her focus from the former exam to bonehealing. tough! SHe writes furiously, then looks back up.

Nan twists around in her chair, trying to catch all the questions and put them with the appropriate answers.

Sudanna says, "Now we move on to compound fratures. No matter how simple the actual break itself is.. the minute the skin is broken, it becomes a compound and infinetely more work. "

Kendrala perks up when Sudanna mentions compound fractures. Not that simple breaks aren't interesting but this is where things can get complicated, especially when you consider the possibility of infection.

Kerali shifts a bit to settle herself. Compound...fractures. Underline. OOooo...more herbs will be needed with this one. Like...redwort. ;)

Sudanna says, "So.. what is the biggest concern with a compound as opposed to a simple break?"

Kerali pipes up. "Infection?"

Kendrala says, "Infection, and foreign material in the wound associated with the broken bone."

Nerak writes down the compound fracture information.... More numbweed, more redwort... "

Kiriya raises her hand and says, "Uh, it's easily infected if it breaks the skin, and it can be broken in multiple places, so it requires more setting?" Intuitive, she is…

Sudanna nods.. "infection, and not necessarily.. that could happen even with a 'simple' break.. Anyone else?"

Krysa eyes open wide as Kerali answers so quickly and as the others follow suit. Good thinking and paying attention group she thinks to herself and files away the attendence list to remember there names.

Nerak "Definately infection... If the bone pokes through the skin, it could get messy - the bone as well as the skin, with dirt from the area..."

Nerak *didnt' see the last pose as I was typing, about not necessarily infection... oops…

Nan flips back in her notebook to her previous class -it's easy to find, it's the only other one in there -and reviews the procedures.

Sudanna says, "Okay, but it could also harbor foriegn matter to the body.. And there is the possibly of serious bleeding. So, what do you do first when confronted with a bleeding compound arm with pebbles in the wound?"

Kendrala raises her hand and blurts out, "Stop the bleeding!"

Kerali pictures that gastly image. "Stop the bleeding by applying pressure above the wound."

Kiriya winces slightly. "Get the pebbles out and then stop the bleeding. Remove the foreign bodies. Definitely."

Kesara raises /her/ hand. "Clean out the wound as well? Isnt good to grind the foreign material farther into the wound..."

Nerak thinks, then says "Well, clean out the wound - and stop the bleeding by putting pressure above the wound, don't put pressure /on/ the wound if it is dirty.

Magen clasps her hands in front of her, listening to all the responses. They're all good.

Kendrala reconsiders and replies once more, "It would probably depend on the volume of the bleeding."

Sudanna says, "excellent.. remove the pebbles, stop the bleeding and /then/ set and splint the bone..But.. remember the redwort after the numbweed.. you can never use too much of either with an exposed wound."

Kiriya nods. Redwort after numbweed, not the other way around. Redwort cancels numbweed's effects if applied first.

You paged Kiriya with: Nerak pages, "I thought the redwort was /before/ the numbwed..."

Kiriya pages, "Redwort cancels its effects. The info's on p. 87 of the Dragonlover's Guide"

Kerali marks that one down...yet again. She always mixes the redwort-after-numbweed bit up. Gah. She takes a quick sip of her now luke-warm klah.

Kendrala circles the words "numbweed then redwort" in column for compound fractures.

Sudanna says, "Once the bone is back in place, pack the wound with mosstea, then procede as before.. numbweed bandages, splints and more bandages. The patient must be seen again in a day to check healing and possibly recieve stitches of the wound at this time. "

Kiriya *hehees! The numbweed-redwort thing is on p. 87 of the Dragonlover's Guide

Magen raises her hand. "How can that be. Redwort is an antiseptic. Numbweed is for pain?"

Nerak writes the info down 'redwort *after* numbweed - that always confuses her... yeesh! Then adds the info about the mosstea, numbweed bandages, etc…

Sudanna says, "Redwort will seep through numbweed to actually disinfect, but numbweed cannot work through a layer of redwort.. so, always numbweed first.."

"Numbweed is an anaesthetic. Is this true, journeywoman Sudanna?" Nerak cringes as she remembers trying to perfect stitches in a pig foot.... smelly!

Kiriya scribbles down the info about the mosstea and numbweeded bandages. She nudges Magen a little. "Remember my nickname, Magen?" Smirk. Reminiscing back to hall basics…

Kendrala continues with her notes, - pack the wound with mosstea, numbweed bandages., splints, bandages. After a day, maybe stitches.

Nan writes down the steps again, figuring that it's better to have it more than once in the book.

Kerali chuckles and mutters 'Numby' towards Kiriya, then gets an innocent look on her face as she focuses on her notes again.

Nerak ahhs "Ok, once it is explained that the redwort can work thru numbweed, it makes more sense! I get it now! Plus you want to numb it first, then make sure it is clean."

"But numbweed is a salve, and redwort is a cleansing wash. So redwort first, numbweed second. Right?" Magen asks again. Really confused now!

Kendrala finds the information about redwort seeping through numbweed to be important.

Kerali raises one eyebrow. This is starting to sound like an herbalry class! She chuckles a bit.

Sudanna smiles at the chatter.. "Now, because we are dealing with a high source of infection, the break would need to be carefully watched, every day for the first sevenday, and then every few days for a sevenday after that. A break in a bone can take anywhere from 8 to 12 sevendays to completely heal. And you need to keep your patient from jumping right into a full schedule when the splints are finally removed. Have them speak to one of our specialists about exercises to rebuild muscle tone lost during inactivity of the limb."

Kiriya flips back to her little drawing of the 'Numbweed Girl', then goes back to her notes with a soft chuckle. Oh, those were the days, indeed... Listening to Sudanna's explanation of the interaction of redwort and numbweed, she chuckles. Oh so right. Although she's heard teachers of hers mix it up before, she knows the right way to apply it now.

Sudanna says, "No Magen.. if you redwort first, the numbweed won't work.. you must numbweed first, then redwort."

Kiriya grins. Her question is answered! She scribbles down notes about how long it takes to heal, and not to let the patient jump right into full work and stuff, let them rebuild muscle tone, etc., etc.

Kendrala whews at the next bit of information that Sudanna divulges, a real mouthful this time.

Kesara stops doodling in the margins, and snaps back to attention, yes, keep writing, you /can/ make it without another snack, despite the fact that you missed your normal meal time. Numbweed, redword, ah yes.…

Flipping yet another page, Kerali moves on, writing furiously. Eeesh. She's going to have to get a new notebook soon. Scribble scribble.

Nan scribes along. Glad /she's/ never had a broken bone. Not sure if she could hold still for 8 to 12 sevendays.

Kendrala continues with her notes, adding the information regarding healing time after the notes about how often to check the broken bone in the first few sevendays.

Nerak sighs and remembers another of her teachers had the numbweed/redwort thing backwards... Ok, back to writing, the information about checking for infection and how often to have the patient return for checkups...

OOC: Sudanna says "Okay.. Imagine redwort is like rubbing alcohol and numbweed is similar to a thick salve.. the numbweed's property of numbing the skin takes effect before the alcohl-like property of redwort breaks down the salve.. Got it?"

OOC: Kerali chuckles. good analogy, Sudanna!

Kiriya keeps on scribbling. All this work is making her hand tired, so she shakes it out a bit, and takes a long gulp of klah. Need the energy…

Kendrala checks her notes, adding a few words here and there, completing thoughts and information that were left out due to the speed of the information being given.

Sudanna says, "And that is bonehealing. Actually doing it is a lot different the then the theory, but it essentially the entire process. So.. any questions?"

Kiriya shakes her head. "None here, Journeywoman... I believe you've answered most, if not all of mine. Thanks much for the class... have to be getting back to chores, and then bed." She gathers up her things, and then makes her way out of the classroom.

Kesara raises her hand. "Um, what do we do if we find a bone that has set and healed incorrectly...like in the wrong position?" she queries.

Krysa nods to Sudanna, oh she loves dispensing with jman titles now that she is one, and stands up. Smiling at the the backs of the apprentices and at the fine journeywoman instructor, she makes her way out the back of the classroom.

Nan skews around to look at Kesara. Now /that's/ an interesting question.

Sudanna says, "in that case, you have to determine several things.."

Magen nods. "Good question Kesara."

Kendrala looks over her notes and decides that she has a good grasp of the essentials of bonehealing. Perhaps as a journeyman she will have the opportunity to gain more knowledge in this area. She wonders if there are a greater number of fractures in any of the crafts over the others.

Nan *runner herding? good cowboy stuff.

Magen smiles at journeywoman Sudanna. "Thank you for this class. It was really interesting. I enjoyed it. I have a lot of notes to go over, before my brain cramps on me." And standing up, she gathers up her notebook and stylus…

Sudanna says, "So, how badly did the bone set? Does it interfere with the basic function of the limb? There is also the patient him/herself to consider.. would an attempt to fix it be to their benefit?"

Kerali yawns a bit, then packs up her notebook and stylus. "Thanks for the class, Journeywoman 'Danna!" She grins, then yawns again. Kerali waves to the other Appies, then heads off to...read. le sigh.

Nerak smiles at Sudanna "Yes, Journeywoman Sudanna, I really enjoyed this class! When the class is totally finished, Can you tell me more about your braces? When are you going to present them? They sound like such a good idea!"

Kendrala stands as she packs her notebook and stylus back into her carrybag. Belatedly, she remembers her klah mug lurking under her chair and retrieves it before moving too far. She listens with one ear to the final comments being made by Journeywoman Danna about the problems of poorly set bones. She hears but is not certain that she will remember, given how weary she is after her duties today.

Kendrala turns and remembers to thank Sudanna, "Thanks for the information, Journeywoman Sudanna. I learned a great deal in this class."

Sudanna says, "So.. if everyone agrees the mended break is intolerable.. and the /patient/ is willing to undergo further treatment, the limb in question /can/ be rebroken and re-set. I recommend this only if the healed break is so serious it is hindering function. And I would insist on a master being called in, fellis would definitely be called for in this case."

Nerak /is/ waiting to hear about the poorly set bones...

Kesara ahs. "I see. So if the person is not too impaired, then it would probably be better for them, if they are happy and healthy to leave the limb alone, then right?"

Nan's eyebrows raise. "So, it would have to be completely rebroken? There's not anything else that could be done?"

Kendrala continues on her way out the door, idly scratching Cerulean who was a quiet as a mouse during the entire class. Definitely a stellar firelizard!