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Alright. I came up with the entire projected plot line for this, which I will post here in case anyone is ever interested in having this be a part of their own game. Major spoilers ahoy.

I might use that for an npc rather than party member but I had been wondering the same as you in regards to Lamashtu and how to make a fuller use of her in the campaign. Then I read somewhere that she has seven daughters....there are also seven runelords all of whom have great power but will be weak initially on their return.

Not fleshed it out in full yet but obviously this then helps tie in why Nualia is working for both Lamashtu and the Runelords as her goddess wants the runelords to be awakened so they can then be killed and replaced by her daughters....

If you want the NPCs to shine, wait 'til the giants are going to assault Sandpoint. Then have them be part of a layered defense. Thus you can let the NPCs strut their stuff and yet still have the PCs be an effective force.

late to the party as always but i used the goblin attack to sort of do this but as background colour. During the fighting they would look up and see a couple of goblins running from an angry Hosk wielding one of their dog-slicers and so on as they moved from encounter to encounter. That way it did not seem like they were the only one's fighting but were clearly the one's doing the most to repel the enemy while others were defending themselves. Added a bit more colour and the respect from those they saw in action felt a bit more meaningful

Tangent101 wrote:

lots of awesome stuff

That is entirely true, I guess what I mean is that I'd have preferred it if there was a bit of foreshadowing in the AP before they spring the sanatorium on the party - like I said, the sanatorium (and especially Caizarlu) can feel a little out of place.

I'm taking some steps to rectify that on my second GM'ing of the same AP - For instance, I decided that Bruthazmus traded some captives for the Robe of Bones from Caizarlu, and it still has his Maker's Mark on it. After some research the party have found out that there's a nefarious necromancer in the area who bought a wand of Gentle Repose a few months back.

At the moment it's a red herring (they think the necromancer is responsible for the goblin raid because of the skeletons in the crypt and the theft of the cleric's remains), but I find it helps build the setting somewhat. When the party encounters the necromancer down the line it's more of a "so this is where he was hiding all along" instead of a "so why is there a random necromancer in the asylum"-moment.

Probably no longer relevant but I plan on spacing out the times a bit more so that Caizarlu and his information on the ghouls act as a bit of a foreshadowing and a blind away from the more obvious Aldern or even the link to how he became infected. Not sure if anyone else has done this and would be interested in how it worked out