Having a medical issue while hurtle 320 km ( 200 miles ) above Earth aboard the International Space Station ( ISS ) is not idealistic . To thrill , the astronaut in question was diagnose with a rather serious circumstance : deep vein thrombosis , a blood coagulum in the internal jugular vein of their cervix . While on Earth the discussion is rather straightforward , aboard the ISS some farseeing - distance telemedicine was in order .
" My first response when NASA reach out to me was to demand if I could chit-chat the International Space Station ( ISS ) to examine the affected role myself , " order Stephan Moll , a UNC School of Medicine stemma clot expert , in astatement . " NASA secern me they could n’t get me up to space quick enough , so I proceeded with the evaluation and treatment process from here in Chapel Hill . "
The cosmonaut was one of 11 involved in a vascular study observing physiological changes to the body in place during long - term spaceflight . The patient ’s identity is being keep individual , so entropy on when this take place has not been include in the case study . We do know that they were two calendar month into a six - month mission and they have since return to Earth .
Anultrasound examinationrevealed a left-hand internal jugular venous thrombosis . The astronaut experience no headache or facial plethora ( red face ) symptoms prior to diagnosing . Molls is a DVT expert here on Earth , but with his bid to go to the place deny , a more originative – and delicate – access was needed .
" unremarkably the communications protocol for treating a affected role with DVT would be to start them on blood thinner for at least three month to forbid the clot from getting with child and to lessen the harm it could have if it moved to a different part of the body such as the lung , " Moll said . " There is some danger when engage rakehell thinners that if an injury come , it could stimulate intimate hemorrhage that is difficult to stop . In either showcase , emergency medical attending could be needed . Knowing there are no emergency rooms in quad , we had to weigh our choice very carefully . "
To make treatment more tenuous , there are limited aesculapian supplies aboard the ISS . Molls and a squad of NASA doctors decide on the parentage thinner Enoxaparin ( Lovenox ® ) while a raw shipment of drug was air to the post . intervention started with a day-after-day injection of 1.5 milligram per kilogram of body free weight , which was boil down to 1 milligram after 33 days to extend therapy until oral apixaban could be delivered via a supply ballistic capsule . The coagulum was monitored with ego - performed sonography on the neck . At 7- to 21 - day intervals , the blood clot showed reformist reduction .
" When the astronaut called my home phone , my married woman resolve and then passed the phone to me with the comment , ' Stephan , a phone call for you from space . ' That was pretty amazing,“saidMoll . " It was incredible to get a call from an astronaut in space . They just want to talk to me as if they were one of my other patients . And amazingly the call connexion was good than when I call my family in Germany , even though the ISS zips around Earth at 17,000 mile per time of day . "
Prior to re - entry back to Earth , the spaceman stopped charter their medicament due to the demanding physical nature of the process They landed safely and while follow - up examination revealed a small residual rakehell clot 24 hours post - issue , no coagulum was found 10 days after . They required no more treatment thereafter , accord to the write up inThe New England Journal of Medicine .
The fount highlights the complexities of blank music , particularly whether the condition was exacerbated by space change of location or whether it would have take place similarly here on Earth too .
" Is this something that is more common in space ? " posed Moll . " How do you minimize risk of infection for DVT ? Should there be more medicinal drug for it kept on the ISS ? All of these questions need answering , peculiarly with the plan that astronauts will enter on longer commission to the Moon and Mars . ”
