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Astronauts have to be incredibly fit. That’s because not only does spending time in a zero-gravity environment take its toll on your physical – and emotional – health, but also because you really don’t want to get sick when you’re doing a six-month stint on the International Space Station (ISS) with limited access to medical help and supplies. But that’s exactly what happened recently, as has been revealed in a case study published in the New England Journal of Medicine.

The astronaut in question – who hasn’t been named – developed a deep vein thrombosis (DVT), or blood clot, in the jugular vein in their neck when they were just two months into their six-month mission. Apparently it’s the first time a blood clot has been found in someone in space, so there were no established treatment guidelines for treating a DVT in zero gravity. The astronaut had no symptoms, but the DVT was found while they were taking part in a research study on how body fluid is redistributed in zero gravity.

NASA has its own doctors, of course. But in this instance it called on a non-NASA expert, Dr Stephan Moll, professor of medicine at the University of North Carolina School of Medicine, who has a considerable amount of knowledge and experience of treating DVT on Earth.

“My first reaction when NASA reached out to me was to ask if I could visit the International Space Station (ISS) to examine the patient myself,” he says. Unfortunately for Dr Moll – a space enthusiast, would you believe? – NASA couldn’t get him up to space quickly enough, so he had to diagnose and treat the astronaut remotely.

“Normally the protocol for treating a patient with DVT would be to start them on blood thinners for at least three months to prevent the clot from getting bigger and to lessen the harm it could cause if it moved to a different part of the body such as the lungs,” says Dr Moll. “There is some risk when taking blood thinners that if an injury occurs, it could cause internal bleeding that is difficult to stop. In either case, emergency medical attention could be needed. Knowing there are no emergency rooms in space, we had to weigh our options very carefully.”

Dr Moll and the team of NASA physicians decided on a course of blood thinners. But the space station only had a limited amount in stock. So the astronaut was instructed to take a certain dosage of the medicine they had on board, and in the meantime NASA sent further supplies as advised by Dr Moll. The on-board medicines lasted for 40 days, but thankfully the new medicines shipped from Earth arrived on day 43. During the entire treatment period, the astronaut had to perform ultrasound tests on their neck to monitor the blood clot, with Dr Moll supervising and keeping in touch by email and phone calls.

“When the astronaut called my home phone, my wife answered and then passed the phone to me with the comment, ‘Stephan, a phone call for you from space’. That was pretty amazing,” says Moll. “It was incredible to get a call from an astronaut in space. They just wanted to talk to me as if they were one of my other patients. And amazingly the call connection was better than when I call my family in Germany, even though the ISS zips around Earth at 17,000 miles per hour.”

The astronaut’s mission is over now and they’re back on Earth, and we’re relieved to say the blood clot is no longer a problem.

Photo by NASA on Unsplash