LAS VEGAS (AP) — Justin Gauger can remember almost everything from the day that changed his life.

He was on a family fishing trip near Woods Canyon Lake in Arizona in August 2014 when lightning struck his back, propelling him 50 feet sideways until he landed face-first in a pile of rocks.

Gauger, now 46, recalls that the sound of the strike was deafening, as loud as the blasts he heard while serving in the U.S. Marine Corps. He briefly saw a white glow around him, “like a ball of light.” Then everything went dark. When he came to, he felt pain throughout his body,  and he was paralyzed from the waist down – temporarily, as it turned out.

Lightning injuries are rarer in the United States today than ever before. The average American has a 1-in-15,300 chance of getting struck during their lifetime, according to the National Weather Service.

In Nevada, no one has been fatally struck by lightning since 2006, when a 16-year-old in Tonopah died, according to the National Weather Service in Las Vegas. But popular outdoor destinations bordering Nevada, including the Grand Canyon and Zion national parks, report lightning strikes from time to time. Arizona is tied for fourth among states with the most lightning fatalities between 2009 and 2018, the National Weather Service reports.

“Arizona gets more lightning in general because they have a better monsoon season,” says Caleb Steele, a meteorologist with the weather service in Las Vegas. “Utah is kind of the same way.”

Lightning deaths and injuries often make the local news, but what happens to victims afterward rarely gets much attention. And while some medical progress has been made on recognizing and treating lightning injuries, they remain poorly understood in general.

Though lightning strikes kill more humans annually than hurricanes, volcanoes and earthquakes combined, about 90% of victims survive, according to research done by lightning injury expert Mary Ann Cooper.

Many survivors are left with physical disabilities and/or psychological impacts, however, including memory loss, depression, anxiety and PTSD, explains Cooper, a physician and former professor at the University of Illinois at Chicago.

“As a result, sometimes people can’t go back to work,” Cooper said. “They may lose their homes. They may lose their jobs. They may lose their families.”

Lightning strike survivor Sydney Copeland said the doctors she has seen have been “somewhat confused” by her symptoms and experience.

“They find it hard to give me a definitive answer to my questions about it,” says Copeland, who has declined to see specialists because of the cost.

Although strikes are sometimes avoidable, Gauger’s experience shows how quickly it can happen. He was fishing with his family when it suddenly started raining and hailing. As he was making his way to his truck, the lightning bolt struck him, burning all his clothes and literally knocking off his socks and shoes.

When Gauger arrived at a hospital in Payson, Arizona, the doctor who treated him was in disbelief.

“The doctor was like, ‘I can’t believe you’re here with us. You shouldn’t be here with us with the injuries that you have,’” Gauger said.

First-, second- and third-degree burns covered half his body, so the hospital sent him to a burn center in Phoenix. He had a pin-size hole in his back where the lightning had entered, along with two holes in his left foot and one in his right foot, where the lightning exited his body. He couldn’t walk for six months without help from his wife, children or others.

Lightning strike survivor Justin Hofer, who spent 10 days at University Medical Center in Las Vegas after he was struck in Utah in 2018, recovered more quickly but continues to experience similar lasting symptoms, including memory problems, PTSD, nerve pain and general fatigue, he says.

Hofer was golfing in St. George on a cloudy day when it suddenly started hailing. “We were sitting in our golf carts and thinking, ‘Oh, this is interesting. This never happens,’” said Hofer, then 38.

He was on the green when a bolt of lightning struck his back, exiting through his lower extremities and shoes. He remembers an unusual sensation as if he were “frozen in time” during the strike, as well as a smell he likens to burning rubber.

“The feeling is just incapacitating. It hits you and you can’t move, you can’t scream, you can’t think,” he says. “I remember that energy, and I remember falling to the ground.”

Witnesses told him he was conscious for about seven minutes before falling out of consciousness, blood coming out his mouth, ears and burn wounds. He was quickly transported to the Las Vegas hospital.

“I just remember being perplexed,” Hofer says. “It seemed like that was weeks ago that I was golfing with those guys, but then I didn’t have any memories in between that, and there I was.”

His condition has improved, but he says he still experiences bouts of nerve pain in certain areas of his lower back, and his left leg and foot remain partially numb.

“It’s definitely something that affects you for the rest of your life,” Hofer said. “It’s kind of your new normal.”

Lightning strikes cause neurological injuries, Cooper says. As a result, victims most commonly deal with chronic pain symptoms due to nerve damage, along with impacts to the brain comparable to post-concussive syndrome in football players. Memory deficits, learning problems, irritability and distractibility are common, she says.

“Eventually, many, many people get to the acceptance level,” Cooper says. “They say, ‘I know I got this, but I can take care of it.’ I think those are the people that get better. They accept it; they work with the limitations.”

Copeland, then 23, had relatively manageable physical impacts right after she was struck while rock climbing near Devil’s Head Mountain south of Denver on June 29, 2019. Immediately after the strike, she felt “numb and fuzzy” but experienced hardly any pain.

“Everything went white and I remember the universe being so incredibly loud, like the sound of standing next to a train and a city of screaming people,” she says.

She was treated with steroids and has been giving her injured wrist plenty of rest. But she still suffers from severe anxiety that’s most acute during thunderstorms.

“I’ve had nightmares. For several months after, I would sometimes see flashes of white light randomly,” Copeland says. “Occasionally when I blink or something moves quickly (through) my peripherals, I will still see these blinding flashes.”

Hofer continues to experience bouts of chronic pain and fatigue after prolonged activity, along with what he calls an “irrational fear of weather” and PTSD-like symptoms, particularly during storms. His eyesight is different, too. Sometimes images “linger” in his frame of vision longer than they should, he says.

Hofer describes himself as more risk-averse now than he was before, but says he feels lucky and grateful to have lived through an event that arguably should have killed him.

“It was really significant to me and pretty life-changing, pretty faith-building and an almost spiritual and emotional experience,” he says.

Cooper has noticed a commonality among the hundreds to thousands of lightning strike survivors with whom she has spoken: a feeling of having survived something extraordinary.

Realizing they could have easily died, they feel they have a chance to “revisit what is really important to them,” she said.

Written by MIRANDA WILSON, Las Vegas Sun via the Associated Press.

Copyright 2022 The Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.