FAMILY MEDICINE® COLUMN
By John C. Wolf, D.O.
Associate Professor of Family Medicine®
Ohio University College of Osteopathic Medicine

WANT A HOT TIME ADD SOME LIGHTNING TO YOUR LIFE

Question: I was struck by lightning while visiting in Florida during 1984 and spent six days in the intensive care unit with burns and other injuries. Since then I get short of breath before a storm and return to normal as soon as it passes. I'm not afraid of being struck again, because I know this is very, very unlikely. Why do I get short of breath?

Answer: The sensation of being short of breath is probably produced by your subconscious mind telling you to stay away from lightning. Put another way, your body knows that escaping from the "jaws of death" once is dramatic and it doesn't want a repeat performance! On an intellectual and conscious level you know that you've taken appropriate precautions as a storm approaches to avoid being struck again. Your subconscious mind doesn't listen to your conscious line of reasoning and causes the change in breathing that feeling of being short of breath. After the storm passes your subconscious mind issues an "all clear" signal and your breathing returns to normal.

Your experience with lightning reminds me that there is a need for all of us to be more knowledgeable about the possible health consequences of this natural phenomenon. While lightning strikes are very dangerous, you are quite correct in saying that they are uncommon. In the United States about 600 people are killed each year by lightning strikes and another 1800 are injured. In other words, the overall risk is a little less than one out of a 100,000.

People who stay out on the beach or golf course when a storm approaches are the most likely to be struck by lightening. You'll probably not be surprised to learn that Florida ranks number one in lightening accidents, with male visitors between the ages of 18-35 the most frequent victims.

Lightning is an electrical spark which appears to the eye to jump from the clouds to the ground. Electricity and lightning take the path of least resistance. Lightning will strike a tree on top of the hill if it is closer than the tree at the bottom of the hill, but the man on the side of the hill under his metal umbrella is the path of least resistance. That is where the lightning will strike! Metal conducts electricity better than air, so golf clubs, umbrellas and other metal products tend to attract lightning. Get under a permanent shelter or building in a storm; don't stand under your umbrella!

Question: My major injury when I was struck by lightning was burns. Is this what usually happens?

Answer: Lightning is an intense electrical spark which injures individuals by heat and by the electric current itself. Burns, as you suffered, are almost always present. At times they may be extensive, but occasionally they are minor. Any organ including the heart, lungs and kidneys can be damaged by lightning. The particular organ or organs involved and the severity of damage determine the outcome.

Muscles contract very forcefully with the massive electrical stimulation of lightning. Muscle damage can range from stiffness and soreness to total destruction. The nervous system is also frequently injured. Memory loss about the events around the time of the lightning strike are common as is a persistent ringing in the ears. More severe damage to the brain produces symptoms similar to a stroke.

The damage produced by lightning may not be totally apparent during the first few hours after the event. I am suspicious that you suffered injuries which involved more than the burns to your skin, and that is why you were in the intensive care unit for six days. Recovery from any of the injuries without any noticeable effect is uncommon. Most people have scars from burns or an arm which doesn't work "just right" from the injury to the nervous and muscle systems. The injuries from lightning are like most injuries in that they are best treated by prevention. Interrupting your day on the beach or your golf game when that little thunderstorm rolls in is the really smart thing to do!

Family Medicine® is a weekly column. To submit questions, write to John C. Wolf, D.O., Ohio University College of Osteopathic Medicine, Grosvenor Hall, Athens, Ohio 45701.