- I remember one of my test pilot friends
was really feeling sick, but did not want to go
to the doctor cause he didn't want to be grounded.
He finally couldn't take it.
He collapsed on the way to the doctor's office.
This is not a good idea, kids.
If you're sick, go see the doctor.
I'm Mike Massimino and this is how health
is different in space.
I was an astronaut for 18 years.
I flew in space two times,
two missions on the space shuttle.
Health is really important for astronauts.
There are a whole list of things that can
have you become disqualified from going to space.
Typically, you want to try to be as healthy as you can
and you want to have a healthy heart,
you want to be as fit as you possibly can,
you wanna eat right and take care of yourself,
and if you don't and you fall out of the standards
that you're supposed to be within, it could mean
you're not going to get a chance to fly in space.
You don't have to be an Olympic athlete,
but they want to make sure that you're healthy enough to do
the job, which means they don't want to be worried about
a medical situation when you're in space.
If you have a propensity toward kidney stones, for example,
that was a disqualifying thing.
They don't want you having a kidney stone develop
while you're in space.
The medical situation on Earth is bad enough,
but it space, it's really bad.
So, they want to make sure that people they're putting into
space are not going to have a problem once they're in space.
Exercise is important for all of us.
Before I became an astronaut,
I generally did sports for recreation,
riding my bike for fun or maybe going for a run,
things like that.
Once I became an astronaut,
it became a little more structured.
I felt like, I was getting ready for somewhat of
an athletic event because spacewalking did require exertion
and you needed it to move around almost constantly
and you had to manipulate this suit that you were wearing.
So, the better shape you could be in,
the better off you were gonna perform.
I was in the best physical shape of my life
before each one of my space flights
and that was, I was older.
I was 39 on my first flight and then,
46 on my second flight,
but I was in better shape than I ever was
as a high school athlete or any other time in my life.
Exercise in space is a little bit different.
Because you're in zero gravity, you're floating.
So, it's as if you're on bed rest, but even worse than that
as far as physical conditioning goes.
You're laying around, you're not exerting yourself,
you're just floating around and even doing things
like just walking or even sitting on Earth,
you're fighting against gravity.
In space, you're floating the whole time.
So, it's no load on your bones or on your muscles
and if you don't exercise in space
for a prolonged period of time,
you can lose bone mass and you can lose muscle mass
and your heart, which is a muscle, it'll shrink
and that's not a good thing.
So, the way we prevent these bad things
from happening is by exercising.
Weights aren't going to work very well in space.
You can take an object that weighs 600 pounds
and pick it up with one finger
cause everything's floating, it's weightless.
So, you want to be pulling against something
for a resistive exercise workout,
like a spring or something that has some resistance to it
cause that works just fine in space
but actual weights won't.
There is a two-hour exercise period set up,
six days a week for astronauts who are on the space station
and it's a combination of cardio,
which is riding an exercise bike or a treadmill.
The CEVIS, the bike,
Cycle Ergometer Vibration Isolation System.
The Vibration Isolation part of it is pretty important
because when you're working out,
you're gonna cause vibration
and the advantage that you have on a space station
for science is that you're in zero gravity
and if you start shaking and vibrating,
that compromises the microgravity environment,
you're going to disturb the experiments that are using the
micro gravity to zero gravity environment for the science,
but start shaking it up a little bit
and you're going to hear about it.
So, these engineers who have developed these machines,
probably don't get as much credit as they deserve
because they are not only keeping astronauts healthy,
but they're isolating the vibrations
associated with doing that sort of work out
to those machines and not spreading it around
to compromise the integrity of
the zero gravity experiments on board,
but that's the way you can get cardio exercise in space.
For resistive exercise, Advanced Resistive Exercise Device,
ARED, which is a pretty high-tech piece of equipment
that works on pulleys and springs
and you can do a variety of exercises with that.
You can even do squats.
You can do leg presses.
You can do curls.
You can do bench press and so, combining that with
the cardio devices, you get a pretty good workout.
We also had TheraBands, these elastic bands that
we would use, they'd give you some resistance
and we have astronauts coming back in sometimes
better shape than they were when they left.
The way we prevent sickness in space is by putting you,
the astronaut, into a quarantine ahead of time,
so you're not bringing germs to space.
The spacecraft should be perfectly clean.
There should not be bacteria in the spacecraft.
So, what we do is, we enter a quarantine period
about a week before the flight,
and you're in, what we call it is health stabilization.
The only people that are allowed to be around you
have to be screened and approved by the flight surgeon.
There was an age limit that changed
for kids to be around you.
My first flight, my children were too young to be near me.
My second fight, they were both teenagers,
so they were able to come visit me.
Food poisoning is probably not going to be happening
cause that's all controlled on what goes on board.
Your water is clean water.
I think we could treat it as well with iodine, if needed.
Iodine leaves a certain taste,
so there was another filtration system we had
to remove the iodine out of the water.
So, they really wanted to make sure your water was clean.
So, you're in a pretty much a germ-free environment.
On Earth, when you're not feeling well,
you can go to the doctor.
Sometimes, you might take care of it yourself
in some ways, some medicine or aspirin
or whatever you have available to you,
but eventually, if you're feeling sick,
you can go to the doctor and get checked.
When you apply to be an astronaut,
if you get far enough along in the selection process,
that you're a finalist and typically there's
about 100, 120 finalists for each astronaut class
and then, they'll pick however many they need,
your selection interview is not just an interview
but it's also a lot of medical exams
and you get checked out pretty much from top to bottom.
It's a really extensive medical exam that you go through
that takes a few days and they'll check you out
and make sure that you're healthy.
I still go for an annual physical every year
as part of like a long-range health data
collection that NASA does,
but in space, your medical care is a little bit different.
We had a full set of medicine in our medical kit
for just about every kind of ailment imaginable
and we had to make sure we didn't have
any allergic reactions to those medicines.
So, we got a drug testing kit.
We were supposed to take one of these,
they would tell you how many you're supposed to take
and every day pretty much, we tested something different,
whether it's an antibiotic or sleep medicine
or painkiller or whatever it was.
We always had someone who was our main
medical officer on the flight.
Sometimes that was a doctor.
I never flew with an MD.
I did fly with a veterinarian and he became a medical doctor
but someone needs to work on that person as well.
So, they have another person
who is kind of like the assistant.
So, you always have at least two or sometimes,
three people who were trained to be medical officers.
We get CPR training, we get basic first aid,
so we can help each other that way
but some of us get the more extensive
medical officer training, which is kind of like
the equivalent to being an EMT.
You also are in close contact with the flight surgeon.
So, flight surgeons are medical doctors
who have this special certification that allows them
to deal with aviation space medical issues.
All flight surgeons are also aware of things
that can happen in zero gravity
and the ill effects of zero gravity, human bone loss
and muscle loss and other issues that might arise
because of the space suit, causing of injuries
and so on, for the job we have.
So, if you have a problem in space,
there is a first aid kit, there's a medical kit
that you can do basic things with.
You can do things like suture up a cut if needed.
Surgery is a bit of a problem.
I think at first in the space station program,
they thought that they would be able to do surgeries.
It really is not practical to be able
to do any major invasive operation.
If someone needed something like that,
they would de-orbit them and bring them home.
It's easier to do that, take care of that on Earth.
That's not going to be the case
when we go further away from the planet.
We're going to be have to,
you can't fly people back from Mars that easily.
You're gonna have to be able to deal with things
en route or once you get to that new place.
So, right now, the luxury of being close to the ground
helps with lot of major medical IMS.
We've never had anything that we've had do that for,
we've never had to de-orbit for a medical issue.
If you need help from the ground and on the space station
or on the space shuttle, we were able to call the ground
and see if there was help.
Motion sickness happens to most people, it happened to me.
My first day in space, I didn't feel very well.
It's a conflict between our vestibular system
and our eyesight.
That conflict can lead to a little bit of stomach awareness.
You're moving around the cabin, let's say with your eyes
but your inner ear is telling you you're perfectly still
and it does not feel good.
I was not used to it, my first day in space, of course
and I ended up throwing up at the end of the day
and the next day, I was fine
and on my second flight, I was fine.
Your brain doesn't know what's going on at first
and it reacts a certain way, but then it learns
and you don't have a problem.
So, it's an adaptation as opposed to a real sickness.
- How do you throw up if you get sick in space?
Ooh, the Sun's starting to come up.
So, here's an astronaut barf bag, right here.
- Puking works just like it does on Earth,
in that, stuff will come out of your mouth, right,
from your stomach, like a projectile.
Now, the difference is that, if you do that on Earth,
it's probably going to land somewhere.
In space, it's going to come out and float around,
which is not a good situation, it'll get everybody sick.
So, we want to use our vomit bag
and we have really good vomit bags,
emises bags is what they call them.
I guess emises is a fancy word for vomit.
You would vomit into those and they're really well made.
They're cloth on the outside, plastic on the inside.
[mumbles into hand]
poof, so everything will go inside of this bag
and then, once you're done, you can seal it off,
roll it up, compact it and then, get another one ready.
I was very concerned about this on my first flight.
I had two on me all the time that first day
and after the first day, I was fine, I didn't need one.
But you want them handy when you first get to space.
I think in everyday life, we realize
the importance of mental health
and trying to keep ourselves mentally healthy
and NASA is the same way.
So, there was always help available if you needed to speak
to someone about whatever issue you might be having
and they were very open to that.
It was just like anything else,
if you were sick, you went to go see the doctor
and if you weren't feeling well and felt like
you needed to speak to a mental health professional,
that was available for you as well
and you were expected to go see one
if you weren't feeling well.
- So, if you just remember those two exercises
and keep your breathing paced,
you should be okay in this test.
- So, they were very open to that and it was very important
and I appreciated that, I think most of us did.
In space, I think what NASA has realized over the years,
in particular for long duration flights
or even short flights, there could be
some extra mental stressors put on the astronauts.
It could be stressful.
You're worried about your physical well-being.
So, there's stress associated with that.
Also, performance of your job.
You want to do a good job and you might
feel the pressure that way too.
Also you're away from home,
you might not get as much sleep as you like.
It's a new environment.
There may be family issues happening.
All these things might be happening
that could also affect your performance.
We have a whole program associated with,
what we call psychological support
and psychological support is there to help astronauts
feel good and that all involves contact with home.
So, we have email, we have capability of calling our family
and friends from space through an Internet Protocol phone,
the possibility to Skype with your family is there as well.
Keeping in contact with Earth
is really important for psychological support.
It's not just being nice, but it's also to, for performance,
a happy crew member is a productive crew member.
What I've seen come though sometimes is that,
an event happens on Earth.
We had a crew on board space station
when we had the Columbia accident
and we need to get the word up to those guys
that we had this accident and the crew was lost
and the accident was a time where
mental health was really stressed.
In fact, it was required that all of us
go check in with the psychiatrist.
When a traumatic event like that happens,
like a loss of life, bad news happened on Earth
for directly affecting the personal life
of the crew member in space, that's when you sometimes
need some psychological support, right.
So, I think that comes in different forms,
sometimes it's a crew member, a good friend,
a member of the clergy, a spouse, a brother,
whoever, they try to get that person on the phone.
So, then your flight is over and you return to Earth.
So, once you come back and you land,
the biggest difference that you'll notice
is gravity has kicked back in.
Those changes to your body that occurred
because you went to zero gravity
and some of those are physical changes,
they revert back to the way it was
when gravity is encountered again.
So, some of the physical changes for example,
is in space, our spine grows a bit
because our spine is held into place by gravity
to some extent and in zero gravity, the spine elongates.
So, my space walking suit was actually sized
an inch and a half higher in the waist
to accommodate spinal growth than what I wore into space
or I would wear when I practiced
in the pool for my spacewalks.
You had a little bit of discomfort in the back
when that happens in space, you feel it, little back pain,
but then it goes away.
When you come back to Earth,
your spine is settling again immediately.
So, you have to be really careful,
no abrupt movements with your head.
We've had some astronauts hurt their backs,
particularly in their neck by doing something quick motion
or something like this, before things have settled,
can hurt themselves.
You're not supposed to pick up anything.
Your kids are usually the biggest hazard
cause you want to hold them and pick them up.
If they're a baby, that's not a problem.
If they're a teenager, they're too big to do that.
But you're somewhere in between,
you want to be careful with that.
So, lifting things as soon as you get back are an issue
because you want your spine to
kind of settle where it's supposed to
and the other thing that is a physical change
is the fluid in your body in space,
when you're in zero gravity tends
to pull in your upper extremities.
What that could mean, is when you get back to Earth
and gravity sets and the fluid redistributes,
you could get lightheaded, your blood pressure
could go down, you could pass out.
So, one of the things we do to help prevent against that
before we enter, we go through fluid loading,
where before you enter, we have lots of drink bags
and is a prescription you get based on your body weight
of what you're supposed to drink.
It could be salt tablets with water
or a chicken consomme or there was this thing
we called Astro-Ade, which was kind of like,
not really Gatorade, but we had a drink a lot
to try to get those bodily fluids there,
so that when you got back to one gravity,
you didn't have this bigger orthostatic problem
when you tried to stand up.
Bigger issue may be, or the thing that's more prominent
is the, what's going on in your head
because now gravity is there again
and that vestibular system that was silent
for all those days or however long you were in space
is now excited again, and it's getting input like crazy
and the brain is saying, what the heck is this,
what's going on here.
You want to move slowly.
I felt like I needed to walk with my legs wide apart
cause I felt like I was going to
fall over to keep my balance.
I didn't want to turn my head very much
to excite my vestibular system as much
and after a couple days, you're fine,
but you're instructed not to drive a car
or fly an airplane or lift anything heavy
or do anything like that until you're approved
for those activities by the flight surgeon.
- [Space Crew Member] Final farewells and handshakes
all the way around before they make their way through that
hatch way behind peek into the Soyuz TMA-19M spacecraft.
- One of our biggest concerns for astronaut health
in space is radiation exposure.
We have to be careful about that here on Earth as well.
When we're out in the Sun, we want to wear sunscreen.
Protects us from the harmful effects of the Sun.
In space, we don't have an atmosphere or a magnetic field
which also protects us from radiation here on Earth.
If you're above that, you're going to be exposed
and that we're very concerned with.
So, we try to do whatever we can to shield the astronauts
from radiation and we do that in the spacecraft,
for example, by using certain materials and shielding
that will protect them from radiation.
NASA does monitor that.
We have a device called a dosimeter,
which is more or less, looks like a piece of plastic
that can measure the amount of radiation you have taken
and is placed in your launch suit,
and then, you hand that in at the end of the mission
and they read it to see how much radiation
you've been exposed to.
As we go further and further away,
we get further from Earth.
Radiation exposure could be the most important issue
that needs to be solved or prevented against if we're
going to be traveling further and further into space.
Something we don't always think about.
Radiation exposures can be very harmful
and it's a real challenge for space travel.
One thing to remember is you want to enter
your space flight in as best shape as possible.
It's hard to make up for a lack of exercise
while you're in space, but it is much easier
to be able to maintain where you are
and maybe get a little better if you enter the flight,
if you launch in pretty good physical condition.
For now, the best way to stay healthy
in a zero gravity environment is to exercise.
[gentle music]