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Vital Signs with Dr. Sanjay Gupta

Scientific Advances In Health And Medicine Made On International Space Station Explored. Aired 2:30-3P ET

Aired June 13, 2015 - 14:30   ET


[14:31:25] DR. SANJAY GUPTA, CNN CHIEF MEDICAL CORRESPONDENT: Imagine a science laboratory that teaches us more than we've ever known about disease, muscle and bone health, and eyesight, a lab with a unique environment that affects the human body in ways we've never seen before. In fact there's no place like it in the entire world. That's because this lab doesn't exist on earth.

This is VITAL SIGNS. I'm Dr. Sanjay Gupta.

The lab we're talking about is the International Space Station. When we say this is a mobile lab, we really mean it. The ISS is orbiting around the earth at a speed of 32,000 kilometers an hour. That's more than 30 times faster than a commercial jet. With near zero gravity conditions, special diets, and modified exercise, it's the perfect place for experimenting on the human body.

Space was once called the final frontier, and now for medicine it's a new beginning. Nearly 400 kilometers above the earth's surface, the International Space Station continues its orbit where it has been every day for the last 16 years. A six-person crew lives onboard. Their official titles are astronaut or cosmonaut, but their day job is really scientist.

And its core the ISS is a science laboratory. There are experiments that help us understand earth and space, of course, but also the human body and medicine.

UNIDENTIFIED MALE: There are parts of the vibration isolation stabilization system. They're kind of little shock absorbers.

GUPTA: I've come to Houston, Texas, at NASA's Johnson Space Center to learn how the science of space is helping to improve our health, to see how NASA trains its astronauts to test the limits of human endurance and push the boundaries of science and medicine. Julie Robinson is the chief scientist for the International Space Station and our guide through this training mock-up of the ISS.

How realistic is this?

JULIE ROBINSON, CHIEF SCIENTIST, INTERNATIONAL SPACE STATION: It's exactly the same size as things are in space. It's much less cluttered. There aren't bags of things everywhere, because on the space station we bring cargo up and have to hold everything until we use it. This is really the size of a four bedroom house, except it's a laboratory. GUPTA: A floating laboratory, where for six months at a time crew

members eat, sleep, exercise, work, and live. In 1998, the station began an on orbit assembly, meaning it was built in space and was only recently completed.

[14:35:00] Since the first crew arrived in November of 2000, more than 200 astronauts from 15 different countries have visited the station.

When people say this still, you know, is it worth the cost.

ROBINSON: All the technologies that we've pushed that then turn around and become amazing new things back here on earth because we're trying to work in an environment where our engineering assumptions are wrong, so we have to be innovative, we have to solve problems we would never dream of, and that generates all these new technologies. So you have to put all of that in the queue of benefit side of that equation. And then on top of that are the research discoveries themselves, which are almost endless.

GUPTA: Endless because there really isn't anywhere else that can simulate the effects of space, particularly on the human body. And crucially what we're learning out there is benefitting us back here on earth.

ROBINSON: That effect of floating around causes changes in the body that look a lot like all the bad things that happen as you get older. Your bones start breaking down, your muscles start breaking down, your heart shrinks, fluids shift around in your body.

GUPTA: That's fascinating. It sounds like what you're saying is this environment kind of accelerates aging for a period of time. It can be reversed when you get back down to earth, but the idea that you can accelerate aging, you can test things and see them more quickly?

ROBINSON: Yes. And then you can see them naturally reverse.

GUPTA: Many times necessity is the mother of invention, especially in space. A long way from the nearest hospital, NASA discovered a way to do long distance ultrasound.

ROBINSON: On the space station, the crew members have to take care of each other and we don't always have a doctor on board, and we don't have an x-ray machine, but we do have an ultrasound. And so a group from Henry Ford Health System developed a feedback system on cd that would help show them the image, and a trained sonographer could guide them verbally from the ground. That opens up ultrasound to be a non- specialist activity.

So they have taken that technology and they put it on ambulances. And what I really like about it is they have been using it for prenatal care in remote areas.

GUPTA: The space station is a science lab. But it's also a home. So we couldn't leave the mock-up without having a look around.

ROBINSON: Here's the U.S. lab. GUPTA: I love it.

The station itself has about 935 cubic meters of livable space, though it might not always feel like it.

ROBINSON: Watch your head, especially right here.

GUPTA: Right.

ROBINSON: These are -- these are the sleep quarters. So this is your personal space.

GUPTA: This is it?

ROBINSON: This is it. And they get decorated, so they get personalized inside. You've got some real nice fans blowing on you at nice so you don't suffocate.

GUPTA: Can I step in here?

ROBINSON: Yes. Don't tell anyone.

GUPTA: I'll try it out. It could be pretty relaxing. Do you strap in then?

ROBINSON: So basically you have a sleeping bag that's Velcroed to the wall. You also have a head strap because having your head float when your body is strapped in is very creepy to a lot of people, so they like having their head strapped down to the pillow. The pillow is real thin. And this is your personal space.

GUPTA: That's my personal space. It's not big, but it will do.


GUPTA: And just float out of there when you're done?

ROBINSON: Yes, exactly. Rise and shine and ready to go.

GUPTA: We're learning a lot from space through the planned experiments onboard ISS, but the space station is also inspiring new ideas and technology right here on earth. From the ISS to an operating room, technology from space is saving lives.


[14:41:47] GUPTA: The International Space Station is the most complex lab ever built. It was assembled in space piece by piece over the last 16 years. And you can thank what's called the Canada Arm-2 for that. It built the ISS while in orbit and grabs incoming spacecraft docking them to the station. There are no do-overs in space, meaning the Canada Arm-2 can't miss. So its robotics are some of the most precise and accurate technologies you can find. That same technology used on the space station was applied to a surgical robot here on earth, a robot that wants to remove the word "inoperable" from our vocabulary. Outside an operating room at Foothills Hospital in Calgary, Canada,

Dr. Garnette Sutherland preps his patient.

DR. GARNETTE SUTHERLAND, NEUROSURGEON, PROJECT NEUROARM: We've gone through everything, and you're going to have the operation on the right side.

GUPTA: Lee is 22 years old and has an aneurysm. Today he is undergoing brain surgery to remove it. But it's what's happening alongside the surgeons that makes this so unique. As Lee is being prepped, so is this machine. It's called the "NeuroArm." It's a brain surgery robot inspired by the International Space Station.

Dr. Sutherland and his team had the idea to bring an MRI machine into the operating room on a track. It cut down on the time required to move a patient to the room with the MRI in it. But the problem was even bringing the machine into the operating room still stopped down the surgery.

SUTHERLAND: To me that was a challenge because that disrupts the rhythm of surgeons. Surgeons get into a rhythm as they move through a procedure. So then from that, the idea was that we should build a robot that could access that space. So one evening we wrote a letter to MacDonald Dettwiler. I remember saying in the letter, you know, you people make robots for very unusual environments.

GUPTA: MacDonald Dettwiler and Associates knows all about building robots for extreme environments. They have worked with NASA and the Canadian space agency since the 1970s, and they built the Canada Arm- 2, the robotic arm on the International Space Station.

The aerospace engineers decided to adapt that same technology for Dr. Sutherland's surgical robot. But building a robot that could function inside an MRI machine in the operating room was a new challenge even for the space engineers.

SUTHERLAND: One of the absolute requirements was that wherever we control this robot, which we thought about outside the operating room, controlling the robot inside the operating room, that place has to recreate the sight, the sound and the touch of surgery. We want this robot to feel.

GUPTA: It took six years for the NeuroArm to come to life. This is the second generation robot that Dr. Sutherland hopes will soon be in hospitals around North America and the world.

[14:45:05] SUTHERLAND: So this is a descendant of NeuroArm, the original robot, and it has two arms. And the two arms are like surgeons. They multi articulate, and they are quite precise at the tool tip. And this robot can perform microsurgery.

GUPTA: The NeuroArm is built to increase safety and accuracy. No matter how good a surgeon is, the human hand has a natural tremor. The robot filters out the tremor for a perfectly steady tool. The precision needed for space was a good match for surgery. In the brain every tiny millimeter counts. By reducing the risk, Dr. Sutherland and NeuroArm can operate on patients he otherwise might not have. Lee's operation is another success for the NeuroArm. At the robot's workstation Dr. Sutherland removes the aneurysm from lee's brain.

SUTHERLAND: Believe it or not, it's over.

GUPTA: When the aerospace engineers first built Canada Arm-2 for the space station, they never dreamed it would help people rebuild their lives. Those unintended benefits continue to extend to our daily lives here on earth.

UNIDENTIFIED FEMALE: Just break off a piece.

GUPTA: Including what you eat, and how you exercise.

UNIDENTIFIED MALE: We use all the different surfaces of the space station, so they're in different configurations.


BUTCH WILMORE, ASTRONAUT: I'm thankful for these type of things that you dream about, literally dream about.

GUPTA: November 27th, 2014, Thanksgiving on the International Space Station. American astronaut Butch Wilmore tapes a special message posted on the NASA YouTube page.

WILMORE: And of course Thanksgiving is always about food as well. We share special meals, and this is smoked turkey, so I'm going to have some smoked turkey. This here is cornbread dressing. Rehydrate that, that's going to be mighty tasty.

GUPTA: So this is the kitchen?

MAYA COOPER, SENIOR RESEARCH SCIENTIST: This is the kitchen for space food.

[14:50:02] GUPTA: Providing that taste of home is Maya Cooper's job. As one of NASA's food scientists here at the Johnson Space Center in Houston, she spends all her days thinking about what the astronauts on ISS are eating. She invited me here to NASA's kitchen and tasting lab for a closer look at the astronauts' diets.

GUPTA: Is it more focused on health or more focused on tasting good and providing some comforts of home?

COOPER: So that's a delicate balance. And we actually really strive to do both. So there are many items that we've had on the menu that were great tasting items, but recently we've had a big sodium reduction.

GUPTA: Astronauts consume some 3,000 calories a day. That takes into account two hours a day of exercise. It's also because time spent in weightlessness requires more energy. Your body is never truly at rest.

COOPER: So we have better data in terms of how food actually impacts the body than what you'll probably get from a terrestrial study.

GUPTA: Are you ready to try this?

COOPER: Absolutely.

GUPTA: That's kind of cool.


COOPER: So here we have the Indian fish curry. There is -- yes, that's yours. Just break off a piece.

GUPTA: Crab cake?

COOPER: Crab cake.

GUPTA: You know, it seems like it would just be easier to just basically have a liquid that has all the nutrients people need and they would just have that liquid. That's what people think of when they think of space food, right?

COOPER: We've had the suggestion that people should just have a liquid, they should take a pill to consume all the vitamins and minerals that they need. The Issue with that is that really there's a psychological experience that comes with eating, and people don't want to take all their meals through a straw.

GUPTA: Psychological well-being?

COOPER: Psychological well-being. What are we trying first?

GUPTA: Let's do the goat curry -- or the fish curry, rather?

COOPER: The fish curry, OK.

GUPTA: It's good. It's got a lot of flavor to it. Now the crab cake.

COOPER: The crab cake is delicious.

GUPTA: That's really good. How do you determine these portion sizes?

COOPER: We look at calories. So we know about how many calories we want an entree to have, about how many calories we expect from a dessert and whatnot, so that all factors into how much is placed into the pouch.

GUPTA: Did you say dessert?

COOPER: Absolutely.

GUPTA: What are some common desserts?

COOPER: You can't live without dessert. It's a psychological experience.

GUPTA: I like the way you think.

There's no question that food is really important when it comes to the health of astronauts up in space, but equally, if not more important, is exercise. There's some really unique challenges when it comes to exercise in a zero gravity environment.

Thank you for having me.


GUPTA: Bruce Nieschwitz is the astronauts' strength conditioning and rehabilitation specialist. He trains the crew on how to exercise with the modified machines necessary for working out in zero gravity. Each astronaut is prescribed an exercise regimen for two hours every day. So Bruce and his team are going to put me through a normal workout to see what it's like to exercise in space.

Is there a primary objective? Is it for them to be able to do their jobs while they're up in space? Is it to prevent injury in terms of the type of exercise that you prescribe?

NIESCHWITZ: I would say it's all of the above. We have mission- specific tasks that we have to protect for, and we have our own general health that we have to protect for. We have muscle loss that we have to prevent, and we have bone loss that we have to prevent as well as any psychological benefits from exercise that we can add to our day.

GUPTA: And this is months at a time.

NIESCHWITZ: Five and a half to six months at a time, yes.

GUPTA: All right, I'm not doing that part of it, but I'll give this part a try.

NIESCHWITZ: This is our treadmill, T-2, our second generation treadmill. If you want to go ahead and stand on there.

UNIDENTIFIED FEMALE: If you can bend your knees a little. So these are bungee assemblies just like the astronauts use on ISS. They are basically rubber tubing that will keep you pulled down to the surface of the treadmill, and we can adjust that load with adding or removing clips.

GUPTA: Got it. You know what's always remarkable is how simple it is. I'm not sure what I expected, magnets on the bottom of your shoes or something to hold you down, but it's bungees and literally just removing clips or adding clips depending on your height presumably.

UNIDENTIFIED FEMALE: Do you want to give it a try?

GUPTA: Let's give it a try, yes. I thought I was going to feel more shaky or wobbly with this on here, but it's pretty good. The load seems pretty well spread out.

Cardiovascular health is important, but so is weightlifting. But space is weightless, so NASA developed a special machine to achieve the effect.

[14:55:08] All right, so what's this machine?

NIESCHWITZ: This is call ARED, the Advanced Resistance Exercise Device. Right now we're at 100 pounds, a little over. Make sure you have a nice step back so you don't hurt yourself, just give it a pull and stand up. So you can see how much more weight we've added.

GUPTA: Right. Double.

NIESCHWITZ: That's pretty good, huh?

GUPTA: That is good. They would feel that?

NIESCHWITZ: It feels just like that.

GUPTA: That's great.

The two main goals for this machine are bone and muscle health. In zero gravity there's no weight pushing down on your bones, making them weaker. The astronauts use ARED to prevent bone and muscle loss.

Are they pretty into it?

NIESCHWITZ: Most of them are very into it. They have an idea that this is what's going to keep them from becoming brittle or turning into Jell-O when they come back, so they understand the importance of these machines, all three of them, and really appreciate what we're trying to do for them.

GUPTA: Our last stop is the cycle. It's the third piece of NASA's astronaut exercise program. Of course in space it would look a little different.

I find this really fascinating. If I was doing this in space, I wouldn't need handlebars. I wouldn't need these, and I wouldn't need a seat. I just need to be clipped into these pedals.

There's just something about space that brings out the kid in all of us -- the curiosity, the possibility, the unknown. But it's what we're learning in space that might be the most exciting of all. As space technology overlaps with life here on earth and life on earth extends to space, there's no doubt that the ISS is helping us explore new ways to improve our health and better our lives. Exciting new breakthroughs only outer space can provide.

For VITAL SIGNS, I'm Dr. Sanjay Gupta.