HOUSTON -- An agonizing sensation, like a million pinpricks, spread across Jerome Serrano's skin when he awoke after another bad night's sleep. He wanted to rip off the compression gauze that covered his arms and legs. But he couldn't do it alone.

An explosive fire last year at a San Francisco Bay Area oil refinery had destroyed most of his skin, along with the soft tissue of his ears, nose, eyes and genitals. The complications of his recovery were so severe that doctors ultimately amputated his fingers down to his middle knuckles. The catastrophic incident has spurred California to change its safety regulations covering refineries, a move coming too late to protect Jerome, but one that now helps him get through tough days.