Incontinence

You have difficulty controlling when or how your body voids your bladder or colon. When you feel the urge, you have 1d4 ÷ (IE) minutes, after which you must succeed on a DC 8 + (IE) Strength saving throw to prevent the release every round, the DC increasing +1 cumulatively per round. If this is a triggered trait, typical triggers include active movement (actions requiring a physical ability check), coughing and sneezing, or taking damage.

Real-world Examples

Pregnancy, Menopause, Multiple Sclerosis, Diabetes, Pelvic Floor Disorders, Enlarged Prostate

Assistive Options

Scheduling regular “timed voidings” and urinating before physical activities can keep your bladder empty enough to avoid leakage.




Constipation

You have ongoing difficulty passing stool. Every three days, you must succeed on a DC 8 + (IE) Strength check during a rest to do so effectively or experience either IE 1 abdominal Cramps or Nausea until making a successful check, which can be attempted during every rest.

Real-world Examples

Hypothyroidism, Diabetes, Uremia, Hypercalcemia, Irritable Bowel Syndrome, Diverticular Disease, Spinal Cord Injury, Multiple Sclerosis, Parkinson’s Disease, Lazy Bowel Syndrome, Amyloidosis, Lupus, Scleroderma

Assistive Options

A steady diet of high-fiber, low fat foods for the entire three-day duration beforehand gives a +1 bonus to the Strength saving throw.




Paresthesia & Phantom Pain

You experience stimulation unrelated to external stimuli in your extremities, even those you don’t have, such as an amputated limb or wings. This may manifest as tingling all the way to sharp pain. Whenever you experience this while you are concentrating on a spell, you must succeed on a DC 8 + (IE) Constitution saving throw to maintain your concentration.

Real-world Examples

Radiculopathy, Neuropathy, Diabetes, Multiple Sclerosis, Phantom Pain Syndrome

Assistive Options

Taking at least (IE) short rests each day (spread evenly throughout the day) will reduce Paresthesia by 1 IE until the next needed short rest.




Immunocompromised

You have a −(IE) penalty on all saving throws against disease.

Real-world Examples

Addison Disease, Celiac Disease, Dermatomyositis, Graves Disease, Hashimoto Thyroiditis, Multiple Sclerosis, Myasthenia Gravis, Pernicious Anemia, Reactive Arthritis, Rheumatoid Arthritis, Sjögren Syndrome, Systemic Lupus Erythematosus, Diabetes, Down Syndrome

Assistive Options

This is managed by avoiding diseases when possible.

Magical Assistance

Magic that cures diseases can cure a disease once infection happens but cannot be used proactively.




Hiccups

You get hiccups (IE)d4 times per day. You don’t know when to expect them, and they’re painful and last (IE)d10 minutes. (The GM should roll at the beginning of the day and roll or choose random times throughout the upcoming day.) During a bout of hiccups, you must succeed on a DC 10 + (IE) Constitution check to successfully cast a spell with a verbal component. On failure, the spell fails, but the spell slot is not used. Because of the painful distraction, you must also succeed on a DC 8 + (IE) Constitution saving throw to maintain concentration each round on an applicable spell. You also have a −(IE) penalty on Charisma (Persuasion) and Charisma (Intimidation) checks during a bout of hiccups. If a bout of hiccups occurs during a long rest, it will disrupt the benefits of the rest, depending on when the bout starts and how long it lasts.

Real-world Examples

Traumatic Brain Injury, Multiple Sclerosis, Diabetes, Kidney Disease, Anxiety

Assistive Options

Common treatments for hiccups don’t help with chronic hiccups. A successful DC 5 + (IE) Wisdom (Medicine) check by a trained practitioner after a one-hour acupuncture treatment will reduce the IE by 1 for the rest of the day.




Gross Motor Control Loss

You have trouble with larger body movements, such as jumping, throwing, walking, running, and maintaining balance. You have a −(IE) penalty on all melee attack rolls to hit and Strength (Athletics) and Dexterity (Acrobatics) checks and Dexterity saving throws. Spells with somatic components usually need to be modified to work within your physical range, requiring (IE) days for every hour normally needed to inscribe into your spellbook and double the cost due to experimentation materials. You may replace one of your other traits with Muscle Control & Gait Difference.

Real-world Examples

Dyspraxia, Friedreich’s Ataxia, Wilson’s Disease, Parkinson’s Disease, Multiple Sclerosis, Cerebral Palsy, Paraneoplastic Syndromes, Neuropathy, Spinal Injuries

Assistive Options

Leg braces, crutches, walkers, rollators, and canes can reduce the IE penalty by 1 for Dexterity checks and saving throws. Braces take one minute to put on and cannot be worn while sleeping, and the others, unless designed for use as weapons, require one hand to be used for balance.




Fine Motor Control Loss

You have trouble making precise movements, especially with your hands and arms. You have a −(IE) penalty on all Dexterity (Sleight of Hand) checks, Dexterity checks to write, or other attempts to use precision with your hands such as playing a musical instrument. Spells with somatic components usually need to be modified to work within your physical range, requiring (IE) days for every hour normally needed to inscribe into your spellbook and double the cost due to experimentation materials. Transcribing spells with only verbal components into your spellbook takes (IE) × 4 times as long as usual.

Real-world Examples

Dyspraxia, Friedreich’s Ataxia, Wilson’s Disease, Parkinson’s Disease, Multiple Sclerosis, Cerebral Palsy, Paraneoplastic Syndromes, Neuropathy, Spinal Injuries

Assistive Options

Assistance for fine motor control loss takes the form of adapting the space around you to your needs and allowing extra time for anything requiring fine motor movements.




Seizures

Limitless Heroics Cover: As our heroes fight the hydra, we see just some of the variety of symptoms represented in this book. The paladin has a prosthetic arm to assist with their amputation. The barbarian rages from their wheelchair, providing mobility for their paralyzed legs. The ranger, whose body is more accustomed to an aquatic environment just as someone in the real world may be more comfortable in a quieter or darker sensory environment, finds ways to compensate and keep fighting. The wizard’s vitiligo may not be thought of as a disability, nor should it be, yet many in the real world experience severe discrimination due to unusual skin pigment — how many celebrities, corporate executives, or politicians do you know with visibly irregular skin?

You experience seizures. Choose or roll on the following table. If you remain aware and conscious during a seizure, you must succeed on a DC 8 + (IE) Constitution check to maintain concentration if needed.

function generateSeizure() { const rand = Math.floor(Math.random() * 100) + 1; let seizureType;

if (rand <= 40) { seizureType = "Focal Aware Seizures"; } else if (rand <= 60) { seizureType = "Focal Impaired Awareness Seizures"; } else if (rand <= 67) { seizureType = "Absence Seizures"; } else if (rand <= 77) { seizureType = "Myoclonic Seizures"; } else if (rand <= 82) { seizureType = "Clonic Seizures"; } else if (rand <= 88) { seizureType = "Tonic Seizures"; } else if (rand <= 93) { seizureType = "Atonic Seizures"; } else { seizureType = "Tonic Clonic Seizures"; } document.getElementById("seizureType").innerHTML = "Seizure Type: " + seizureType; }

d100 Seizure Type
1–40 Focal Aware Seizures
41–60 Focal Impaired Awareness Seizures
61–67 Absence Seizures
68–77 Myoclonic Seizures
78–82 Clonic Seizures
83–88 Tonic Seizures
89–93 Atonic Seizures
94–100 Tonic Clonic Seizures
  • Focal Aware Seizures. You have a strange feeling for (IE)d20 seconds resulting in one of the following experiences.
    d8 Experience
    1 Nausea
    2 Unusual smell or taste: You smell or taste something with no known source. You have a −(IE) penalty on all Wisdom (Perception) checks related to smell and taste for the duration.
    3 Amplified Emotion (both kinds equally likely)
    4 Myoclonic Seizure in one random arm
    5 Numbness in one random limb
    6 Feeling like one random limb is larger or smaller than it actually is: you have a −(IE) penalty on all Dexterity attack rolls, ability checks, and saving throws with that limb for the duration.
    7 Perception of colored or flashing lights: You have a −(IE) penalty on all Wisdom (Perception) checks involving vision
    8 Hallucinations
  • Focal Impaired Awareness Seizures. You become confused as if under the Confusion spell for (IE)d4 minutes.
  • Absence Seizures. You become stunned and unaware of your surroundings for (IE)d4 seconds. You may carry on simple actions like walking, but you are unconscious as far as your mind and senses go.
  • Myoclonic Seizures. Your muscles jerk (IE)d4 times, once every round. You have a −(IE) penalty on all Strength or Dexterity attack rolls, ability checks, and saving throws during a seizure and must succeed on a DC 5 + (IE) Dexterity saving throw or drop anything you’re holding in your hands. Any spell that you attempt to cast with a somatic component will fail but will not use your spell slot.
  • Clonic Seizures. Your muscles have spasms that make your face, neck, and arm muscles jerk rhythmically. During this seizure, you have a −(IE × 2) penalty on all actions requiring the use of your arms and cannot cast spells requiring a somatic component. Casting a spell with a verbal component requires a successful DC 10 + (IE) Constitution check. Failure results in the spell failing, but it does not use a spell slot. Clonic Seizures last (IE)d6 rounds.
  • Tonic Seizures. The muscles in your arms, legs, or trunk tense up. When this seizure begins, you must succeed on a DC 10 + (IE) Dexterity saving throw or become prone. On success, you must continue this check each round for the duration of the seizure. Your movement during the seizure is divided by the IE. Tonic Seizures last (IE)d4 rounds.
  • Atonic Seizures. Your muscles suddenly become paralyzed, and you become prone. You must succeed on a DC 10 + (IE) Wisdom (Perception) saving throw to notice the onset of the seizure and to use an action to intentionally become prone. Failure results in falling and taking 2 (1d4) bludgeoning damage unless wearing a helmet. The seizure lasts (IE)d4 seconds, but you get (IE)d4 of them in a row with 1d4 rounds in between each of them.
  • Tonic Clonic Seizures. Your body stiffens, jerks, and shakes, and you become unconscious. Sometimes you lose control of your bladder or bowels. This seizure lasts 1d(IE) × 2 minutes.
Real-world Examples

Epilepsy, Gray Matter Heterotopia, Traumatic Brain Injury, Lupus, Multiple Sclerosis

Assistive Options

Those with seizures benefit from someone watching them for the onset. A friend or ally nearby at the onset can use their action to help you, giving you advantage on checks against falling, bumping into something harmful, and other physical effects. You may also consult the section on Service Animals.




Fatigue

half-orc asleep at a desk, a glass of water spilled

You are nearly always tired. After every long rest, you must succeed on a DC 8 + (IE) Constitution saving throw, or you do not benefit from the rest, regardless of the amount of rest you get. Spending an entire day resting will automatically give you advantage on the Constitution saving throw.

Real-world Examples

Chronic Fatigue Syndrome, Lyme Disease, Fibromyalgia, Lupus, Hypothyroidism, Multiple Sclerosis, Insomnia, Postural Orthostatic Tachycardia Syndrome

Assistive Options

Beginning a long rest three days in a row at roughly the same time grants a +1 bonus to the Constitution saving throws, keeping the pattern adding an additional +1 bonus cumulatively to a maximum of +5. Keeping a diet for at least seven days of fish, vegetables, and nuts gives a +1 bonus to the Constitution saving throw. Drinking more alcohol than (Constitution Bonus) drinks will negate this bonus. A weighted blanket during a short rest also gives a +1 bonus to the Constitution saving throw. Such a blanket can be made from two large animal pelts for a medium humanoid or two medium animal pelts for a small humanoid plus enough sand to make the total weight 10 percent of your body weight. The cost of fabrication is 20 gp.

Magical Assistance

If the fatigue is caused by Insomnia, a Sleep spell or other effect that mimics it will assist in getting to sleep during a long rest and will reduce the IE by 1 Extent until the next long rest.




Brain Fog

You experience mental fatigue that affects your memory, ability to concentrate and think clearly, and focus. You have a −(IE) penalty on concentration saving throws, and when you need to make an Intelligence check to remember something, you have a −(IE) penalty on the check unless you take 1 + (IE) times as long to think about it.

Real-world Examples

Autism, Attention Deficit Hyperactivity Disorder, Chronic Stress, Sleep Disorders, Menopause, Anemia, Depression, Diabetes, Sjögren Syndrome, Migraine, Dementia, Hypothyroidism, Lupus, Arthritis, Multiple Sclerosis, Dehydration, COVID-19

Assistive Options

Regular sleep and exercise and a balanced diet may help. A rest will relieve Brain Fog for 1d6 hours. Keeping a journal, calendar, task list, or other notes can compensate for memory challenges.