In a first, NASA orders astronauts home after unspecified medical issue

"The crew is highly trained, and they came to the aid of their colleague right away."

See full article...

 

[phylo]

Someone needs to create a tool like NameGrapher to show frequencies of names in space over time. With this crew’s return (and my best wishes for them all), 2/3 of people in space are going to be named “Sergey” (unless I’m missing other missions).

 

[Chuckstar]

Not the person in question, but: As someone with constant diet stones, it's tough to specify "absolutely no spinach" as a dietary requirement to others. Essentially I have to drink a glass of milk with every meal to precipitate the oxalate in my intestines rather than my kidneys. I still typically have sediments in my renal pelvises, that I flush with a course of tamsulosin every three months to prevent them turning into problem stones. Seeing sand in the bottom of the toilet bowl is fun.

Maybe you already know this and/or maybe it doesn’t help with a case as severe as yours, but there is some evidence that supplementing citric acid intake can help block calcium oxalate crystallization.

Citric acid essentially ends up as citrate in urine, and evidence for helping reduce kidney stone risk includes that citrate reduces crystallization rates in in vitro studies, citrate levels in urine have been shown to increase during citric acid supplementation, and there’s even a randomized trial showing lower kidney stone recurrence rates among people consuming an extra 60 mL of lemon juice 2x a day. (A little more than a shot glass full 2x a day.)

The randomized trial: https://doi.org/10.1016/j.eclinm.2021.101227

The one thing everyone seems to agree on, though, is that the effect is probably not big enough to replace any other intervention someone might already be using to avoid recurrence. But especially if using lemon juice (which is low in sugar and doesn’t increase urinary oxalate*), there seems to be very little risk of downside.

*There have been studies showing that grapefruit juice might increase urinary oxalate somewhat, but the data is inconsistent. As far as sugar, 120 mL of lemon juice probably has around 50 calories of sugar.

 

[Zizy]

Someone needs to create a tool like NameGrapher to show frequencies of names in space over time. With this crew’s return (and my best wishes for them all), 2/3 of people in space are going to be named “Sergey” (unless I’m missing other missions).

Chinese space station Tiangong has 3 astronauts. I haven't checked their names but I find it unlikely any is Sergey. 2/6 isn't too bad.

 

[Ted.Starchild]

Interesting that Isaacman didn’t really answer the question about what he would “like to have” for Lunar and Martian bases’ medical equipment/suite. He just mentioned about they have a lot of equipment and capability and are constantly learning. Has there been a serious proposal for a medical “room” or suite for Lunar or Martian bases? Or, like subs, they convert one of the mess tables to an operating table (at least they did in one of the black/white WWII movies…)?
Second question would be: at what level/number of colonists/residents would it be wise to have medical staff assigned, in that role, to the mission/outpost/colony/etc?

Medical equipment for Lunar base or Martian expedition should be subject of an in-depth study. I doubt anyone can offer meaningful answer to this question in real time.

 

[MilanKraft]

When I read about this situation I keep picturing an irritable AI hologram popping up on the spacecraft and saying “Please state the nature of the medical emergency.”

Was probably on last year's list.
https://apnews.com/article/ces-worst-show-ai-0ce7fbc5aff68e8ff6d7b8e6fb7b007d

 

[Excors]

Someone needs to create a tool like NameGrapher to show frequencies of names in space over time. With this crew’s return (and my best wishes for them all), 2/3 of people in space are going to be named “Sergey” (unless I’m missing other missions).

In the crossover between Soyuz TM-2 and TM-3 on Mir, if I'm counting right, 60% of the people in space were called Aleksandr (and one was called it twice): Aleksandr Aleksandrov, Aleksandr Laveykin, and Aleksandr Viktorenko. (The others were Yuri Romanenko and Muhammed Faris.)

And it reached 75% in the crossover between TM-8 and TM-9: Aleksandr Viktorenko again, Aleksandr Serebrov, and Aleksandr Balandin (plus Anatoly Solovyev).

(There was also another different Aleksandr Aleksandrov on TM-5, and Aleksandr Volkov and Aleksandr Kaleri and Aleksandr Poleshchuk and Aleksandr Lazutkin on other Mir flights. Popular name.)

 

[EllPeaTea]

Someone needs to create a tool like NameGrapher to show frequencies of names in space over time. With this crew’s return (and my best wishes for them all), 2/3 of people in space are going to be named “Sergey” (unless I’m missing other missions).

Expedition 64 in 2020 had 2 Sergey's plus Kate Rubins on the ISS.
https://en.wikipedia.org/wiki/Expedition_64

 

[Ianab]

Having read A City on Mars, there’s all sorts of unrelated questions in my mind including “How would NASA handle an unintended pregnancy in space?”

6 month mission, 9 month gestation? No problem.

 

[rschroev]

In the hypothetical case that the three remaining crew members also have to leave station for one reason or another, and the ISS is therefore unmanned, can a new crew simply dock and enter the station? Or is support from inside needed?

 

[Willie McBride]

The US public pays about $2.5 billion dollars for each crew mission to ISS. They have a right to some details on why a mission was cut short, for transparency and accountability reasons.

You already know why the mission was cut short: because a crew member suffered a medical issue that increases the risk to their health should they remain in orbit until the scheduled end of the mission. Does it really matter which of the many possible medical conditions it happened to be?

The only other information that would be relevant for the public to know is if, given what happened, anything could have been done differently during the pre-mission training and medical screenings and then during the mission itself to identify the risk of this issue occurring or to prevent it, and I'm sure when NASA will know they'll tell the public.

 

[DCStone]

That doesnt follow. We aren't talking about a regular person on a regular job.

The US public pays about $2.5 billion dollars for each crew mission to ISS. They have a right to some details on why a mission was cut short, for transparency and accountability reasons.

That can wait until the crew is safely returned, though.

I feel like the public already has the information they need to know in the interests of transparency. Just because some people want more information doesn't mean that they're entitled to it.

 

[henryhbk]

Typo: "Home Home" (presumably Come Home)

Clarification:

Spacewalk preps at the space station include a period of time breathing high concentrations of oxygen to purge nitrogen from the astronauts’ bloodstreams, a mitigation to avoid decompression sickness when crew members are sealed inside their spacesuits’ pure oxygen atmosphere.

As someone who spent a bunch of time in his early medical career studying decompression sickness, while there would be a slight increase in the gradient of N2 going between the environments, the overwhelming majority of gas exchange occurs in the lung, the suit runs at around 0.1atm. that would be a larger gradient, there is little difference between being in a room of full of oxygen (suit) and using a 100% NRB. In SCUBA diving where every 33' (~10m) is an extra atmosphere, so the nitrogen is forced into the tissue, and since nitrogen passively diffuses out of tissues it is passively carried as dissolved gases, and rising from the ocean bottom to the surface produces a massive pressure gradient, but that is unaffected by the composition of external gas (in fact people have gotten bent at shallow depths still breathing the normal oxygen/nitrogen mixture that we all breathe at sea level the entire time, despite no external atmosphere and being under an additional fraction of an atmosphere (the adage of the most dangerous place in SCUBA diving is the last 15' (~5atm) because the rate of percent change of external pressure is the most assuming a constant rate of ascent. I assume the suits are kept at a low pressure for both concerns of puncture and mobility. As someone who has done a fair bit of drysuit diving I can attest that when you fill it with air, particularly deep, the air in the suit makes it feel like a suit of armor instead of vulcanized fabric, although the reverse is true as well, suit-squeeze is awful and your suit hardens like a vacuum package (and not to kink shame, but vacuum packing your junk is quite unpleasant!).

Another thing that is often misunderstood, leaving aside the issue of Apollo 1 like fire, why not use 100% FiO2 all the time? Well oxygen is obviously critical for life, but pure oxygen tends to do a fair amount of oxidative damage inside the body, and produces free radicals, which can do a lot of intracellular damage. The body has a means of scavenging those radicals, but why stress it. For short periods it's fine but they are living on the station of months-years, so that would do bad things. You also might wonder about 100% FiO2 for divers, and the prebreathing has been looked at, but since most divers just breathe air (saturation divers often breathe weird mixes like heli-hydr-ox) but 100% FiO2 is lethal below about +1atm so that is never safe. The other edge case is fighter pilots who face a similar situation to our space-walkers except with zero prep-time since if the jet is on fire it's time to leave! And you instantly go from 1 atm to like .1 at altitude and would instantly get bent (similar to rapidly opening a soda bottle) so they on some jets get high-pressure (>1atm) pure oxygen as they both have the problem of bends and at 1atm of O2 at those altitudes the partial pressure is insufficient. Some newer jets use extreme pressures to also assist the pilot with g-forces and can go many atmospheres positive pressure in the airway of pure O2 (I asked one of the flight surgeons about that, with an obvious concern, what happens when the g-forces lift and the pilot now has 9x the volume of O2 in their lungs, the answer was "flying fighters is dangerous business" Uh, nope!

 

[Fred Duck]

Should that be turn off?

Find out next time here on Big Brother: NASA.

TBF, I also had a difficult time determining the difference when I was reading online dating profiles.

 

[wourm]

As someone who suffers from the dammed things (enough so that Social Security eventually admitted I was disabled due to them) my guess is they don't work much differently in space than they do on Earth. The primary reason they move inside the ureter, causing massive amounts of pain, is due to urine flow. I believe that works the same way in space, or at least I've never heard of it acting significantly different.

As to forming stones in the first place, I don't know if being in space has any impact on that or not. Given how horrifically painful stones are, I'm pretty sure we'd have heard about it long ago if being in space significantly increased the risk of stone formation. Astronauts are tough, but stone pain can cripple the toughest of the tough with ease.

I recall being in the ER years ago for an ankle sprain listening to a poor guy pass a kidney stone, groaning in agony the whole time. I forgot I even had an ankle.

Here's hoping you never have another one!

 

[Earthmapper]

Interesting that Isaacman didn’t really answer the question about what he would “like to have” for Lunar and Martian bases’ medical equipment/suite. He just mentioned about they have a lot of equipment and capability and are constantly learning. Has there been a serious proposal for a medical “room” or suite for Lunar or Martian bases? Or, like subs, they convert one of the mess tables to an operating table (at least they did in one of the black/white WWII movies…)?
Second question would be: at what level/number of colonists/residents would it be wise to have medical staff assigned, in that role, to the mission/outpost/colony/etc?

I wish the rest of the administration had that sort of discretion.

 

[bone_collector]

hey Claude take the distance between the two futhest habital areas of the iss, and calculate how much energy would be required to generate an acceleration of 0.1g for the iss. could it be done by a docker dragon capsule, and then reversed? as an experiment for low g

Hey lucinius, the next time you’re tempted to post some AI slop here, do us all a favor and stop at the prompt. We can non-deterministically approximate the rest of the comment if we’re so inclined.

 

[Res-Ipsa-Loquitur]

Unrelated, but now I'm wondering how kidney stones work in space...

Salyut 7 - Anatoly Berezovoy had a particularly unpleasant kidney stone issue about 6 months into his mission, but given there have been a number of UTI related infections in Astronauts/Cosmonauts disclosed over the years, I suspect more have probably 'boldly gone' through this

Seems like an unfortunate combo of factors from longer term spaceflight would all converge for these types of issues - hygiene challenges of space 'toilet' systems; bone demineralisation and calcium, etc being lost/excreted; fluid shift in the body/dehydration; accelerated growth of certain bacterias.

 

[redtomato]

Maybe you already know this and/or maybe it doesn’t help with a case as severe as yours, but there is some evidence that supplementing citric acid intake can help block calcium oxalate crystallization.

[…]

*There have been studies showing that grapefruit juice might increase urinary oxalate somewhat, but the data is inconsistent.

Secondary risk: grapefruit juice is known to seriously impact a wide range of medications. Makes some more potent and others less effective. Someone taking medication for kidney stones is likely to also be on other medication.

Just flagging this risk for anyone considering regularly quaffing some delicious grapefruit juice.

 

[DistinctivelyCanuck]

For anyone looking for absolute accurate information on some of the medical screening that occurs prior to spaceflight, Chris Hadfield's book had almost a full chapter discussing the medical screening prior to flight. He had an intestinal issue which required intense pre-flight screening that almost took him off the flight roster.

Someone developing a medical issue on-orbit has to have developed that after going through some absolutely intense investigations and diagnostics checks.

 

[BobDole11]

*edit - read what I wrote here, and then looked at the article title. Sorry I went off on a tangent rant. I'm just genuinely in fear of the Artemis 2 crew's lives (launching in less than 1 month - maybe) and this quoted comment just set me off

"the health and well-being of our astronauts is always and will be our highest priority.”

I get that its just fluff talk, but man statements like this makes something boil in me. NASA has many times shut their eyes, stuck there head in a whole, and just rolled the dice on crew lives. They're about to do the same thing again on Artemis 2. NASA is putting 4 crew on Orion to fly 10 days out and around the moon in less than a month (as planned - who knows though).

Artemis 1 did the same flight a bit over 3 years ago, but a good chunk of it was just a boiler plate test. There has been no in space life support test. Life support isn't trivial, just look at Starliner's crew launch last year where the crew was half popsicle when they entered the ISS.

And of course there is the heat shield. First, its a heat shield material from the Apollo days when there are better alternatives like PICA used on Dragon and even the newer Mars landers. But its not the same heat shield. LockMart altered the composition because the original was wildly carcinogenic. They also broke the design apart to be more easily assembled from molded chunks. Artemis 1's heat shield we all know cracked and spalled severely. NASA very intentionally hid the heat shield reentry test result for 2 years! NASA's end solution was to alter Orion's reentry profile to reduce peak heating, to reduce the outgassing of their new resin binder of their altered Avcoat. They also have now altered the Avcoat formula AGAIN, and rolling the dice AGAIN. The new change in formulation is to make ultrasonic scanning for damage in the heatshield easier. Sounds good, but the change is said to exacerbate the thermal outgassing and spalling issue.

Orion's battery design is brand new untested, and its the 3rd completely different design. The power systems in the Artemis 1 test faulted several times in its flight. They blamed that on cosmic radiation - yes, a craft that is intended to fly outside the van allen belts is susceptible to cosmic radiation. Maybe the crew present on Artemis 2 will block enough radiation to prevent power systems faults.

There is lots more. If you haven't yet read Casey Handmer's "NASA’s Orion Space Capsule Is Flaming Garbage", its very telling. The fact that we're putting 4 lives on this $35+ Billion dollar capsule disaster, costing $4 billion more per launch, that is largely untested in space, and many things that were tested failed and have been replaced with totally new design untested systems, is hair raising to me. For another though, the Apollo craft had 2500+m/s deltaV. That is a lot of spare propellent for contingency maneuvers. Orion has enough deltaV to do a fly by obviously, but has less than 1500m/s total deltaV. Wherever it burns for, its going. There is a bare sliver of spare deltaV for any emergency. It as we all know can't even enter a traditional orbit of the moon.

We thought the Starliner crew were brave... The Artemis 2 crew? Balls of platinum

 

[KrookedRooster]

Bring back life form, priority one. All other priorities rescinded.

Crew Expendable.

 

[MJMullinII]

Better safe than sorry, although the dream of expeditions to Mars and the Moon highlights the need for medical intervention in orbit.

Indeed. This is also one reason I think before a 6-9 month trip away from Earth (speaking of beyond lunar travel, whatever the destination) is even contemplated, several equally long trips in high-Earth orbit should be completed. While nothing is quite exactly like traveling between Earth and Mars/Venus/wherever, high-Earth orbit puts you hours, maybe a day away from being able to return if something you didn't expect or predict happens, health wise to the crew.

 

[NetMage]

IV pumps are entirely standard in medical settings. Seems very unlikely that they wouldn’t be using them in space.

The ones I’m familiar with still use a drip chamber and gravity to keep air out of the feed.

 

[fe3a8b63]

That doesnt follow. We aren't talking about a regular person on a regular job.

The US public pays about $2.5 billion dollars for each crew mission to ISS. They have a right to some details on why a mission was cut short, for transparency and accountability reasons.

That can wait until the crew is safely returned, though.

Lupus, it's always lupus

 

[alisonken1]

Should that be turn off?

Actually, no.
A good portion of medical diagnosis consists of visual cues, not just what is said. Although the diagnosis may be something not visual (internal or similar), the examiner can get some cues from body language and body behavior.

Not medically trained, but have been to a lot of doctor visits as well as thinking about why I and family members have been seen by medical personnel.

EDIT: Another consideration is there is a good chance some symptoms may be skipped by the person because they thought it was unrelated. I would expect astronaut training would preclude "symptom bias" but it may be unconscious bias for some indications.

EDIT 2: An example of unrelated can be the clinical trials of viagra. Initially, the drug was designed for some other actual health issue, but since all of the male participants in clinical trials indicated raging woodies while taking the drug. If those symptoms had not been reported, then we would not have Viagra now. Doctors can and do try to find all extra symptoms regardless of whether they appear to be related because what the average person may consider unrelated may be a key indicator a doctor is trained to look for.

 

[paintivore]

Secondary risk: grapefruit juice is known to seriously impact a wide range of medications. Makes some more potent and others less effective. Someone taking medication for kidney stones is likely to also be on other medication.

Just flagging this risk for anyone considering regularly quaffing some delicious grapefruit juice.

My doctor prescribed potassium citrate for this purpose. He said it's more effective than citric acid, but it does have the downside of requiring occasional testing to make sure blood levels of potassium aren't getting elevated. I take a medication that increases risk of kidney stones so it's been tough to manage.

 

[wagnerrp]

Some newer jets use extreme pressures to also assist the pilot with g-forces and can go many atmospheres positive pressure in the airway of pure O2 (I asked one of the flight surgeons about that, with an obvious concern, what happens when the g-forces lift and the pilot now has 9x the volume of O2 in their lungs, the answer was "flying fighters is dangerous business" Uh, nope!

That doesn't make any sense. I can't believe their face masks would even survive eight atmospheres gauge, much less their pulmonary system.

 

[fl4Ksh]

Glad to see NASA make a quick decision on this medical emergency.

NASA delayed a decision on the Starliner emergency of June 2024 and has taken a lot of criticism for poor management of that crisis.

 

[Ciconia]

Have we ever had a pregnant astronaut ever?

Many have been pregnant and oddly all female astronauts. While in space, none to my limited knowledge.

 

[azazel1024]

Interesting that Isaacman didn’t really answer the question about what he would “like to have” for Lunar and Martian bases’ medical equipment/suite. He just mentioned about they have a lot of equipment and capability and are constantly learning. Has there been a serious proposal for a medical “room” or suite for Lunar or Martian bases? Or, like subs, they convert one of the mess tables to an operating table (at least they did in one of the black/white WWII movies…)?
Second question would be: at what level/number of colonists/residents would it be wise to have medical staff assigned, in that role, to the mission/outpost/colony/etc?

Some of it with equipment is you need someone trained to use it. Unless you are sending/requiring someone to have advanced medical training, there isn't much point to have the equipment. Basic EMT training is probably the best you can hope for in terms of level of training and care. I am not against such missions requiring a physician, of course there comes the question of self-treating (not that this has not come up, see the south pole medical incident where the resident doctor had to perform a biopsy on herself, IIRC).

But that is a LOT of specialized training and if their skills are need 1% of the time, what are they doing the rest of the time? I guess a question of it is makes more sense to take a physician and train them as a mission specialist, or take a mission specialist, scientist, etc. and provide them the level of training and education needed to also be a physician (at least a passable one). Not that any of this is impossible. It isn't like astronauts get 6 weeks of training and strapped into a rocket. Most have years of training and advanced degrees even going into it.

IMHO, a well-supplied ER room, likely with the add on of a portable X-ray and a mini-pharmacy is probably what they need for a Mars mission or Lunar base. Unless you are just existing within the ship or base, lunar or Martian excursions are going to up the risk of injury significantly compared to daily life on the ISS. And you'll be much further from treatment/evacuation. At least in theory on the Moon, you can probably be 3-4 days away from treatment for an emergent evacuation. On Mars, that isn't really possible at all. Mars more than the moon, probably needs even more than that. Develop cancer? Okay, well we can start treating it in 18 months. In some cases, the risk is the risk and there is zero you can reasonably plan for. That would likely be one of them.

IMHO, someone with at least PA level of training/background/experience and the mentioned equipment I would think would be a must for a Mars mission. For a lunar mission with temporary occupancy, what they have today for the ISS is probably fine. For long term surface missions with more than about half a dozen people, I think similar equipment and training as a Mars mission would be needed (at least one astronaut with at least PA level training).

 

[nimelennar]

In the hypothetical case that the three remaining crew members also have to leave station for one reason or another, and the ISS is therefore unmanned, can a new crew simply dock and enter the station? Or is support from inside needed?

I don't know about the international side.

On the Russian side, I presume that after a Soyuz docking, they can open the ISS hatch, because they've done it before, when they first arrived to an empty ISS. And if there's (for example) an inner hatch that can be closed and locked from the inside, there wouldn't be anyone there to do it.

 

[rhgedaly]

While there are private audio channels on the ISS for medical consultations, etc., do I understand that there are not private video channels available ... which then necessitated turning off the public broadcast. Or was it just a matter that there would be risk of unintentional chatter that would disclose private information?

 

[jock2nerd]

As someone who suffers from the dammed things (enough so that Social Security eventually admitted I was disabled due to them) my guess is they don't work much differently in space than they do on Earth. The primary reason they move inside the ureter, causing massive amounts of pain, is due to urine flow. I believe that works the same way in space, or at least I've never heard of it acting significantly different.

As to forming stones in the first place, I don't know if being in space has any impact on that or not. Given how horrifically painful stones are, I'm pretty sure we'd have heard about it long ago if being in space significantly increased the risk of stone formation. Astronauts are tough, but stone pain can cripple the toughest of the tough with ease.

Agree to the pain issue.

After I had my first kidney stone, my wife stopped telling me that I didn't understand the pain of childbirth.

Though I doubt if it is kidney stones on the ISS.

 

[azazel1024]

This is a pretty dumb take.

There is no reason at all other than satisfying morbid curiosity of internet shitposters to identify the person. Might it come out eventually? Yes, but it's not like anyone has a right or reason to know, much less any element of timeliness.

What there is at least a reason to eventually disclose is the nature of the medical condition and the how the responses were evaluated. That's at least valuable scientific information, but obviously also sensitive and could de facto identify the person. And that is why there are jobs like "medical ethicists" to help figure out what and when that type of information can be responsibly disclosed.

This. Oh I am dead curious. But I can see lots of harm in releasing it. Everything from harassment from individuals in the public, to political harassment.

If it became public, I can, absolutely imagine a situation, that was, I assume, completely out of control of the person the ground them for life. Or even get them kicked out of NASA if the wrong orange haired pressure came down. Just as one example.

It would be one thing if somehow a microgravity environment caused the condition and it could repeat, being a medical reason to ground the astronaut. But because something outside of their control happens, that isn't likely to repeat, that is an entirely different reason. And naming, and possibly shaming the astronaut is not. Just because mission or NASA staff might not do the shaming, doesn't mean there aren't plenty of trolls, including in charge of the government, who might not.

 

[EllPeaTea]

I don't know about the international side.

On the Russian side, I presume that after a Soyuz docking, they can open the ISS hatch, because they've done it before, when they first arrived to an empty ISS. And if there's (for example) an inner hatch that can be closed and locked from the inside, there wouldn't be anyone there to do it.

The PMA hatch must be openable from the outside too, as there were Shuttle missions to the ISS prior to it being crewed.

 

[DancesWithBikers]

Bring back life form, priority one. All other priorities rescinded.

So which crewmember is the perfectly humanoid robot?