Electrical Burns: A New Take on an Old Injury
by Chris Gilyard, MA
Imagine lightening striking a tree. Often times the blast from the lightening will start a fire and even blast limbs free. Obviously, damage is done to the outside of the tree, but less obvious is the harm done to the inside. Sap heats to the point of boiling. Possible harm is done to the tree roots. It may take weeks or even months to begin to see the extent to which the tree was damaged—to see leaves fall off, limbs begin to die, and basic functions of tree life drastically impaired.
Imagine now, not lightening, but electricity “striking” a person. For some survivors, those with a higher voltage injury (for instance, someone who comes in contact with a highline wire), the power from the electricity usually causes an entrance and exit wound. Just like the tree, there are visible wounds, such as burned and damaged skin and tissue, and possibly even amputations. Of course, there can be internal damage as well—heart problems, nerve damage, memory loss, cataracts, and chronic pain to name a few. While the injury is not strictly thermal in nature, the energy behind the electricity causes burns all the same. Some electrical injury (EI) survivors deal with issues similar to those who experience thermal burn injuries.
A second group of EI survivors who have only recently begun to be identified are those who make contact with a lower electrical current, such as a household appliance. Usually these kinds of injuries do not leave external burns, but the energy that enters the body sometimes causes devastating, though unseen, damage, similar to the damage done to the inside of the tree. This group of low-voltage survivors report symptoms such as memory loss, joint pain, skin sensitivity, change in body temperature (cold and hot), headaches, and sensitivity to light.
Many people have had the experience of plugging in a small appliance cord and getting a shock. You can’t let go. The few seconds of contact feels like minutes. You can vividly hear your thoughts during the shock. Finally you let go—rattled, but unharmed. Now let’s imagine that after you finally let go, you are more than rattled. You experience incredible pain. The next day you have no memory of anything since the shock. Your short-term memory is completely gone. Or maybe after shopping, you park your car in the driveway, leaving the car door wide open, engine running for hours before a neighbor notices and comes to tell you. You have absolutely no memory of it. Or your sense of smell is magnified— everything you smell is 100% stronger than before and very nauseating. You can tell what shampoo someone has used when you walk by. Perfume gags you. Public interactions become a nightmare.
Or perhaps your body temperature has increased so dramatically that you sweat profusely, causing sweatbands and towels to be your constant companions. Or maybe your skin develops a sensitivity that cannot bear to be touched—the slightest pressure causes unbelievable pain. Clothing becomes an issue, causing pain by its mere presence. And then there’s the joint pain, neck or backaches, headaches that last for months, and sensitivity to light, causing the need for sunglasses even in the burn center clinic with its, what seems like, incredibly bright lights.
No, not every EI survivor will have symptoms as dramatic as these, but most EI survivors, both high and low voltage, internal and external burns, have had their bodies damaged and compromised by the energy and heat of electricity. Sometimes the burns are outside, sometimes they are not. Sometimes they are just an inside-out burn. And, as always, the road to recovery is paved with issues that affect the physical, psychological, emotional, relational, spiritual, and financial aspects of life.
Another visual that helps to describe an electrical injury is to picture a house being struck by lightening. The energy travels through the electrical lines in the home, with no predictions of where the damage will occur, which appliances will be affected, where a fire might start, which outlets will be ruined. Such is the reality of the damage sometimes done to the human body by electrical current: the symptoms that result are as varied and unpredictable as in the house struck by lightening. Those living in the home may have feelings of confusion, fear, helplessness, vulnerability, lack of control, and anger.
It is not only the homeowners who feel overwhelmed and frustrated when the home is struck by lightening, it is also the professionals called in to repair the damage to the house who sometimes feel unsure of the problem and remedy. The same can be said for the professionals who treat EI survivors. The electrical injury field is in the throws of redefining the issues and solutions associated with the treatment of electrical injuries. It is common for EI survivors to be misdiagnosed, misunderstood or mis-referred for follow-up care. Oftentimes even professionals don’t know what to do with the survivor and their problems.
In the article, “Electrical Injury and Electrical Shock,” Michael Morse, PhD, and Jennifer Morse, MD, refer to a low-voltage shock as diffuse electrical injury (also called by other names such as electric shock syndrome or post electric shock syndrome). They propose that low voltage injuries are becoming more recognized and documented, but say, “This injury still flies under the diagnostic radar of modern technology.” Both doctors agree that the atypical symptoms of the low voltage EI survivors are least understood and need a great deal of further study. Because EI survivors are still evaluated under the old “standards” of electrical injury treatment, which do not recognize the validity of low voltage shock, many EI survivors are labeled as crazy, lazy, milking the system, and malingering. Sadly, many “inside-out” burn survivors are left feeling isolated and lonely.
“So, why an EI survivor article in a burn survivor newsmagazine?” you may ask. (1) Many EI survivors are at treated burn centers and thereby enter the burn survivor community. However because their injuries and symptoms are different from thermal burns, they often times feel “alone in the crowd.” (2) Bringing greater awareness to EI issues will bring a greater sense of understanding and belonging to EI survivors. (3) For burn survivors who have the support and resources that are available to us today, it is both a responsibility and privilege to pass these gifts on to others.
Thirty years ago, most burn survivors were like the tree struck by lightning—alone in the middle of a field, no support, no resources, no one to help deal with the fallout of the burn injury. In 2007, as burn survivors, we are no longer in a field, but in a forest— a forest full of healing and life. Today, EI survivors often times find they are in the middle of the same old field—alone. Let us who have stood in that place of isolation, come around those who find themselves there today. Let us become their forest—full of healing, full of life.
If you or someone you care for has been affected by an electrical injury, there are resources available to you. The Phoenix Society has resources and can connect you with other survivors of electrical burns. At the 2006 World Burn Congress, four EI survivors and their spouses were sponsored to attend the conference and EI survivors are expected to attend again in 2007. Increased programming specific to electrical injuries is planned for future WBCs. “Lightning Strike & Electrical Shock Survivors International” is a website specifically for survivors of electrical shock and lightning strike. The website www.electricalinjury.com, by Michael Morse, PhD, and Jennifer Morse, MD, discusses the complexities of electrical injuries in easy-to-understand terminology. The University of Chicago Electrical Trauma Program is a group working toward a better understanding, improved diagnosis, and treatment of electrical injuries, more information on which can be found at http://etrp.bsd.uchicago.edu/mission.html
“Imagine lightening striking a tree”… with this imagery Chris Gilyard begins to paint the picture of the neuropsychological consequences that patients face with electrical injuries. This condition, like posttraumatic brain injury before it, is misunderstood as either a person’s cry for attention or, more cynically, as a way to get out of work. In a survey of psychologists in the American Board of Clinical Neuropsychology published in 2002, onefifth of patients with electrical injuries were perceived as “probably malingering” due to lack of physical findings or “implausible” self-reported symptoms. The analogies Chris uses in her article “Electrical Burns: A New Take on an Old Injury” allows patients and their families, as well as healthcare workers who are less familiar with this variable and sometimes devastating condition, a way to conceptualize a physiologic change in the body’s electrical wring in the absence of anatomic changes. The work done by the support group that Chris Gilyard has started for our Center has done more for our patients with electrical injury sequelae than all the pharmacology and neurologic testing that they have received. For many patients with this disease process, being believed and accepted is more of a treatment than we burn surgeons can offer.
—William Mohr, MD, Director Regions Hospital Burn Center
Chris Gilyard is the burn support representative on staff at Regions Hospital Burn Center in St. Paul, MN, where she offers support, coaching, education, and support groups for survivors and family members. Chris is a burn survivor.
This story is an excerpt from The Phoenix Society’s® Burn Support News, Fall Edition 2007. Burn Support News is a quarterly publication that contains articles on the emotional, psychological, and social aspects of burn recovery. All Rights Reserved.