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Vital Signs with Dr. Sanjay Gupta

Astronaut Scott Kelly Spends Nearly a Year in Space; Study Conducted on Scott Kelly and Twin Mark Kelly during Space Mission. Aired 2:30-3p ET

Aired December 10, 2016 - 14:30   ET


[14:30:00] BORIS SANCHEZ, CNN ANCHOR: "Vital Signs" starts right now.

DR. SANJAY GUPTA, CNN CHIEF MEDICAL CORRESPONDENT: What if you had to live somewhere and could never go outside, never experience weather, like a rainstorm or the warm sun? And what if you had to live that way for nearly six months? Could you do it?

This is "Vital Signs." I'm Dr. Sanjay Gupta.

Six months is the usual length of time that astronauts spend living on board the International Space Station. Double that to nearly a year and you will have Scott Kelly's historic mission. It's the first step in trying to get us into deep space, Mars, maybe beyond. But the biggest variable keeping us from getting there is likely ourselves. Can humans physically and mentally handle it?

A lack of gravity is going to be one of the biggest challenges. As much as two liters of fluid shift from the legs to the head, producing changes in eyesight, while muscles and bones weaken without any force pushing down on them. With so many unknowns, it is risky, but Scott Kelly was up for it, and we went along for the ride.

More than 200 miles above the earth, whipping around at 17,000 miles an hour, Scott Kelly is on board the International Space Station.

UNIDENTIFIED MALE: Please stand by for a voice check from CNN.

GUPTA: Station, this is CNN. How do you hear me?

And we're talking to him live.

SCOTT KELLY: I hear you loud and clear. Welcome aboard the space station.

GUPTA: It is February 11th, 2016. Scott has already been in space for more than 10 months.

As you travel at a rate of five miles per second, I understand 200 miles above us, getting close to finishing a year in space. First question, how are you doing? What has surprised you most about any changes in your health?

SCOTT KELLY: I'm doing pretty good. I do feel like I've been up here for a really long time. And I kind of knew what to expect going into this because I had flown a long duration flight before. So, overall, nothing alarming.

UNIDENTIFIED MALE: And liftoff, the year in space starts now.

GUPTA: This is Scott Kelly's fourth trip to space, and by far the longest in duration. In fact, it is now the longest for any American astronaut.

UNIDENTIFIED MALE: Mikhail Kornienko now making his way into the new home that he will occupy.

GUPTA: He and Russian cosmonaut Mikhail Kornienko signed on for a year in space. Then Scott and NASA realized there was a second benefit here.

SCOTT KELLY: I'm adjusting to life back on earth pretty well. I've only been wearing these pants for a month.

GUPTA: You see, Scott Kelly is an identical twin. His brother, Mark, shares the same DNA. And like Scott, Mark too was an astronaut, having flown in space four times. NASA could study one twin in space while the other was back on earth. I sat down with the Kelly brothers in San Diego this summer for their first television interview since Scott's return.

Mark, what was it, do you think, that attracted you to this sort of work? Was it the adventure, the science? What was it initially do you think?

MARK KELLY: Certainly, the excitement. Also, being able to serve my country in a different way than I had before. I was in the Navy for about 10 years before. Both of us applied to be astronauts. I think I've always -- our parents were police officers. Public service was kind of in our family.

GUPTA: Scott and Mark grew up in New Jersey. As kids, they were always active and, in their father's word, a bit rambunctious.

We had a chance to talk to your father. He said if you guys were outside playing and he went to go look for you that he was unlikely to find you. You were sort of looking out. He would have to look somewhere specific.

SCOTT KELLY: Like on the roof of the building?

GUPTA: On the roof of the building.

SCOTT KELLY: That is true.

GUPTA: You guys were always playing on the roof?

SCOTT KELLY: This isn't recently. This is when we were kids.

GUPTA: Both brothers were selected for NASA's elite astronaut program after serving their country as pilots in the Navy. There was always the chance they might fly in space at the same time, but it never happened. That's OK with them. Your family, how much do they worry for you, Mark, when you are up in


[14:35:04] MARK KELLY: You know, I think our mother and father would get pretty freaked out, especially on launch day. More for me, because they liked me better.


GUPTA: I heard that. The rumors are true?

SCOTT KELLY: I don't know. I've never been told that.


SCOTT KELLY: Maybe they told him something and just kept that from me.

GUPTA: For 340 days, Scott would not be able to come home no matter what happened back on earth. It was a risk he and his family were willing to take. And it is not the only one. Scott was charting new territory. No American had ever been in space that long and no one from any country has ever been studied this closely. We have no idea how Scott's body would react to being in space for that amount of time or what could potentially develop later in life.

Here is an example of what we do know. A lack of gravity has a big impact on our bones and muscles. According to NASA, astronauts experienced up to a one-third reduction in muscle fiber size in less than two weeks on the space shuttle. To put that in context, on earth, post-menopausal women untreated for bone loss can lose one to one-and-a-half percent of their bone mass in one year but an astronaut in space can lose that same amount in a single month.

So think about what that could mean for Scott in space for a year. NASA has developed special exercise equipment to help mitigate those factors, proven effective for six months missions, but an unknown in Scott's case. He would be up there for a year.

SCOTT KELLY: My big lingering effect, my feet are still bothering me at times. I think it is probably more plantar fasciitis rather than anything just from not being on my feet for so long.

GUPTA: So not so much from the fluid shifts but more from not using your feet?

SCOTT KELLY: Not using your feet -- not using the bottom of your feet. You use the top of your feet.

GUPTA: That's interesting. So you use the top to move around.

With Scott in space for a year and Mark on earth, the idea for a twin study started to take shape. Scott would be the test subject, Mark, the control. It is a one of a kind study that could change the future of space travel.

In the meantime, Scott had to make it through the mission, not just physically but mentally.


GUPTA: By the end of the century, maybe four years from now, the United Nations projects the earth's population will top 11 billion people. Currently there are 7.3 billion living on it, and already there's a strain on resources for our planet. So where else could we go? It is certainly part of the appeal of deep space travel. Colonizing other planets like Mars has long been the stuff of science fiction, but it could become a necessity with population projections on the rise. It also means Scott Kelly's year in space is a critical first step in exploring the options of manned mission to deep space.

Year in space, 11 months in, in a place the astronauts can never leave it can be tough mentally. To keep things interesting, Scott Kelly decided to monkey around. There is no such thing as a true vacation up here, and that can take a toll. Even on a day off, without any scheduled experiments or maintenance work, the astronauts are always on alert.

SCOTT KELLY: You wake up, you are at work. You go to sleep, you are at work. You never leave. You are very busy. I think one of the underlying stressors of being up there for so long is that you are always thinking, OK, if we have a fire, if we have a depressurization, I have to be able to respond to this. And that's something that's always in the back of your mind where you never really have a minute off from those kinds of things happening.

GUPTA: In San Diego, I moderated a panel with Scott and Mark Kelly. Dr. Stevan Gilmore also joined us. He was Scott's flight surgeon for his past two missions. This lack of a mental break was one of his biggest concerns going into a year in space.

DR. STEVAN GILMORE, SCOTT KELLY'S FLIGHT SURGEON: I'd asked you or the other astronauts, if they could describe what time off would be on station. That's kind of a difficult thing to do, because for the six- month missions, you are going up there with an attitude of all the things that you want to get done and it is a very achievable thing.

GUPTA: The time away was often on Mark's mind as well. Remember, if anyone could relate to what Scott was going through, it is Mark. But sometimes he would need a little reminder.

MARK KELLY: I was on the phone with him after he had been in space about three months. And I was talking about how I had just been traveling a lot and I was walking down the street in New York City saying, yes, I'm on this trip and I'm not going to be home for like three weeks, and that's a really long time, forgetting who I was talking to.


MARK KELLY: And he said two words. I didn't tell you what they were.

(LAUGHTER) GUPTA: If you want to eventually get to Mars, that mission would last roughly 30 months, two-and-a-half years. For the duration of Scott's year-long flight, he would have only just arrived on Mars. In addition to being able to mentally handle it, radiation would be a big concern.

Consider this. Beyond low earth orbit, the protection of the earth's atmosphere is gone. NASA says astronauts are exposed to radiation anywhere from 50 to 2,000 millisieverts. A millisieverts of radiation is equivalent to three chest x-rays. So add it all up, and that's an exposure equal to at many as 6,000 chest x-rays.

I'm curious, with all that you have learned and all you have seen, do you think Mars is feasible.

SCOTT KELLY: I think it is definitely feasible. I think there are certain challenges. The radiation environment between the earth and Mars is something that we are going to have to figure out because we get protection here on the space station, although we get a lot more radiation than you do on Earth, you get much, much more on your way to Mars. So that's a challenge.

GUPTA: Another aspect of being in space for so long, nutrition. In 2014, I visited NASA's Johnson Space Station and got to taste some of the food. I have got to tell you, it's come a long way. I tried a crab cake and some fish curry.

[14:45:00] Even so, though, I am not sure I could eat out of a bag every meal for 340 days, let alone the time it would take for a Mars mission.

For the twins study, NASA monitored everything Scott ate and drank, while Mark continued his regular diet back here on earth. They also closely monitored Scott's heart. In space, body fluids shift from the lets to the head and upper body, as much as two liters of fluid. NASA says a natural reaction to this is a decrease in the total amount of circulating blood in the body. That can result in low blood pressure. Upon reentry back to gravity, some astronauts experience fainting until their blood pressure normalizes. That reentry is the last piece of the complicated coordinated effort for safe space travel. It is the riskiest, most exciting element, and it just happens to be the final part of the mission.

UNIDENTIFIED MALE: Scott Kelly back on mother earth after 340 days in space.


GUPTA: Back in 2014 when I visited Johnson Space Center in Houston, Texas, I first met Julie Robinson. She is the chief scientist of the International Space Station with a critical hand in the science experiments happening during Scott Kelly's year in space. Another element to consider about living on the space station that long is your personal space.

JULIE ROBINSON, CHIEF SCIENTIST, INTERNATIONAL SPACE STATION: These are the sleep quarters. So this is your personal space.

GUPTA: This is it?

ROBINSON: Julie showed me around the mock-up of the station, which has 935 cubic meters of livable space.

ROBINSON: You have got some real nice fans blowing on you at night so you don't suffocate.

[14:50:00] GUPTA: Can I step in here?

ROBINSON: Yes. Don't tell anyone.

GUPTA: Scott slept in this small compartment every night.

ROBINSON: So basically you have a sleeping bag that's Velcro-ed to the wall.

GUPTA: NASA says astronauts sleep on average less than six hours a day, and before critical mission operations, it is even less. Today, I met up with Julie again, this time in San Diego, for a look at what has changed since we last saw each other.

Last time we talked, it was before this year in space. I'm just wondering, from the chief scientist perspective, what has the year been like for you?

ROBINSON: It has been an amazing year. I have never had so much public interest in what we are doing in space from people. A lot of times people don't realize that the space station is up there all the time. And suddenly everyone is aware, little kids, older ladies. I will meet someone at a party and they will say, how about Scott Kelly? So it has really caught people's imagination. But I think it helps people see how the space connection connects to mars, and it helps people see how the space station connects to health. And those themes are so important. They really capture everything we are doing on the space station.

GUPTA: A lot of times you are talking about stuff that's already in textbooks and already published. But this is happening real time.

ROBINSON: Yes, yes. We are really solving problems real time, things that we really don't know. There is no analog on earth. There is nothing that looks like the vision syndrome on earth, and so we have to solve a brand new medical problem.

GUPTA: You just have this fast laboratory where it's happening.

ROBINSON: Right. You've got these incredibly healthy people that don't have other diseases and they have this problem, and then it reverses. So the power of things like, the twin studies, if you can understand the genetics that was turning that problem on and turning it back off, then you have suddenly got a window into health on earth that you wouldn't get anywhere else.

GUPTA: The twin study is really the crown jewel of this mission. Ten studies with ten different groups of researchers are happening almost simultaneously, using the samples from Scott in space and Mark on earth.


GUPTA: Dr. Andrew Feinberg is a researcher with Johns Hopkins and also one of the principle investigators of the twin study. His focus is genetics.

FEINBERG: If you think about the area that the twin study was involved in, things like, say, identifying what might be the epigenetic damage to the genome that might precede the development of mutations, it could lead to cancer that might open the door with way to mitigate that damage. That has practical applications for here on earth.

GUPTA: By studying Scott and Mark, scientists will be able to identify any links between the environment and human health. But there is another down side in addition to the potential long-term health impacts for Scott. Because genetic information is a part of this study, privacy could be an issue for the Kelly twins and their families. So before anything is published, they will have the option of withholding certain information.

Your study is going to become a well-known study. This data is going to be out there. And obviously people are going to know it is you two because you are the only twins that have been in a study like this at that time. Privacy, the security of that information, just the privacy of it, how much are you worried about?

SCOTT KELLY: I am not worried about it for me. I am worried about it more for my kids. They could potentially see I'm susceptible to having this disease and based upon the person and what kind of person they are, that could have a significant effect on them or not. Maybe they would just like to know.

GUPTA: Did you have any reservations, Mark, about being in a study like this?

MARK KELLY: I realize the significance of putting that information out there. In flying in the space shuttle, there is a lot of risks involved, and it's a risk versus reward thing. And the reward is really for our country and for our nation. So same thing with the science. There might be a little bit of a downside for us. But the benefit to the space program and to the American people is enough to make it a pretty obvious decision.

UNIDENTIFIED MALE: Getting ready to department the International Space Station again, wrapping up 340 days on board the orbiting laboratory.

GUPTA: As Scott's mission in space came to a close, there was one big part left -- reentry.

UNIDENTIFIED MALE: And undocking has occurred. GUPTA: Perhaps the riskiest part of space flight happens at the very


You described it as going over Niagara Falls in a barrel that also happens to be on fire.


GUPTA: That's pretty scary. I watched the video and, first of all, you seem remarkably composed.

SCOTT KELLY: You actually think about it, so I have made it all the way through this whole year, the launch, spacewalks, the risk of being up there for a really long time. And I'll tell you what, one of the riskiest parts is at the very end when you come blasting back into the atmosphere and you're relying on this parachute to open in this Russian Soyuz, and everything goes well when there is stuff flying by and hitting the windows, part of the insulation that comes off and it gets hot inside.

[14:55:09] Then as soon as the chute opens and the motions stop and you realize it didn't kill you, it's the most fun you have ever had in your life.

UNIDENTIFIED MALE: Scott Kelly, back on mother earth after 340 days in space.

SCOTT KELLY: I said, even if I hated being up there for six months, maybe not a year, but even if I hated being on the space station for six months, I would do it all over again for the last 20 minutes. It's a wild ride.

GUPTA: When it was all said and done, Scott Kelly spent 340 consecutive days in space, from March 27th, 2015 to March 2nd, 2016, the most of any American astronaut. He traveled more than 143 million miles and saw nearly 11,000 sun rises and sun sets. In that same time period, you and I saw just 684. He also returned home five milliseconds younger and two inches taller, though gravity soon weighed in to shrink him back down to normal. And he shared it all with us along the way through these stunning photos in social media. And he's going to continue to share with a book coming out next year.

The results of the twin studies will begin coming out early next year as well, and then we will truly begin to see the impact that this historic mission could have on all of us.

For "Vital Signs," I'm Dr. Sanjay Gupta.