NASA’s stranded astronauts are finally set to come home after spending more than nine months on the International Space Station (ISS).
During the unprecedented amount of time that Sunita Williams, 59, and Barry Wilmore, 61, have spent in space, their bodies endured the harmful effects of microgravity, extreme levels of space radiation and the mental toll of isolation.
Doctors told DailyMail.com that when they emerge from the SpaceX Dragon capsule, which is scheduled to splash down off the coast of Florida at approximately 5:57pm ET Tuesday, the pair won’t even be able to walk on their own.
Health experts have already noticed physical signs of deterioration Williams and Wilmore, including rapid weight loss. When they splash down on Tuesday, the frail duo will be placed on stretchers and immediately taken for medical evaluations.
Dr Vinay Gupta, a pulmonologist and Air Force veteran said the astronauts could need up to six weeks of rehabilitation to regain their strength, which will include guided exercise and a nutritional plan.
The crew will begin their rehabilitation program the very same day they return to Earth, with the first phase focusing on walking, flexibility and muscle strengthening.
And because of the amount of radiation they have been exposed to, Dr Gupta said: ‘If I was their physician, I would think about a more proactive strategy for cancer screening.’
In just one week on the ISS, astronauts are exposed to the equivalent of one year’s exposure on Earth. This may increase their risk of developing cancer, central nervous system damage, bone loss and some cardiovascular diseases, according to NASA.
Doctors told DailyMail.com that NASA astronauts Sunita Williams and Barry Wilmore will face a grueling road to recovery after spending more than nine months on the ISS
‘We want to take a different approach here, given that they had such a unique exposure history,’ Gupta said.
Williams and Wilmore were only supposed to spend eight days on the International Space Station (ISS) when they blasted off on June 5.
But a scourge of technical issues with their spacecraft, Boeing’s Starliner, ultimately drove NASA to delay their return until they could hitch a ride home on a safer ship.
In November, Dr Gupta raised concerns about Williams’ health aboard the ISS when a ‘gaunt’ photo of her taken in September surfaced online.
In the photo, Williams can be seen tucking into a pepperoni pizza and chips while surrounded by condiments and other treats.
‘What you’re seeing there in that picture is somebody that I think is experiencing the natural stresses of living at a very high altitude, even in a pressurized cabin, for extended periods,’ he said at the time.
‘Her cheeks appear a bit sunken – and usually it happens when you’ve had sort of total body weight loss,’ Dr Gupta added.
‘I think what I can discern by her face and her cheeks being sunken in is that [she] has probably been at a significant [calorie] deficit for a while.’
Doctors first raised health concerns about Williams when a photo from September appeared to show her with a ‘gaunt’ face and thinner frame
NASA astronaut Sunita Williams on June 5 before the mission (left) and in December as she prepared to spend Christmas in space
The body burns more calories in space as it adjusts to the changes in gravity and tries to maintain its body temperature in cold, harsh conditions.
And to prevent muscle and bone loss, astronauts exercise about 2.5 hours a day, which burns even more calories.
Astronauts are encouraged to consume up to 3,500 calories per day while in space to prevent the body from breaking down.
But Dr Gupta said: ‘Your metabolism [in space] fundamentally requires you to burn way more energy than you’re intaking, even if you’re intaking pepperoni slices.’
A NASA source then told the New York Post that the agency was scrambling to ‘stabilize the weight loss and hopefully reverse it.’
The unnamed employee who is ‘directly involved with the mission’ said that Williams has been ‘unable to keep up with the high-caloric diets that astronauts must consume’ while on the ISS.
‘The pounds have melted off her and she’s now skin and bones. So it’s a priority to help her stabilize the weight loss and hopefully reverse it,’ the NASA source told the New York Post.
Later that month, Williams hit back at the weight loss ‘rumors’ in a live video published by NASA, claiming that she has actually put on muscle.
Just a day after Williams’ comments, another unnamed NASA employee told the New York Post that the agency was monitoring Wilmore’s weight loss too
‘My thighs are a little bit bigger, my butt is a little bit bigger. We do a lot of squats,’ she said.
She added that she is the same weight as when she launched to the ISS in June, and bizarrely claimed the apparent change in her appearance was due to ‘fluid shift.’
During spaceflight, weightlessness instantly shifts blood and fluids from the lower portion of the body to the upper areas, which can sometimes result in a puffy pace and thinner legs.
But Dr David Shaker, an internist at Holy Name Physicians in Hackensack, New Jersey, told DailyMail.com that fluid shift likely wouldn’t result in the ‘decreased nutritional appearance’ shown in photos of Williams.
Just a day after Williams’ comments, another unnamed NASA employee told the New York Post that the agency was monitoring Wilmore’s weight loss too.
That source said that while his weight loss did not appear as pronounced as Williams’ ‘gaunt’ look, doctors were taking precautions to ensure he doesn’t reach a tipping point.
At the start of the mission, six-foot-tall Wilmore weighed more than 210 pounds, the source said. It’s unclear how much weight he’s lost since boarding the ISS.
‘He had a lot more mass at the start, so it’s not as big of a deal,’ the employee told the New York Post in November.
At the start of the mission, six-foot-tall Wilmore weighed more than 210 pounds, the source said. It’s unclear how much weight he’s lost since boarding the ISS
‘But it’s happening, and it’s being monitored. Any changes in the astronauts’ bodies are being noted. And his mass seems to have gone down.’
Amid these concerns, NASA’s chief health and medical officer Dr JD Polk told DailyMail.com: ‘All NASA astronauts aboard the International Space Station are in good health. It’s unfortunate that rumors persist otherwise.’
‘NASA and our partners have safely conducted long-duration missions aboard the orbital laboratory for decades, studying the effects of space on the human body as we prepare for exploration farther into the solar system.’
‘Crew health is regularly monitored by dedicated flight surgeons on Earth, and they have an individual diet and fitness regime to ensure they remain healthy throughout their expeditions.’
Astronauts don’t just lose fat while living on the ISS. Spending that much time in low gravity causes their muscles and bones to rapidly deteriorate too.
They can lose up to 20 percent of their muscle mass after just five days in low gravity, and weight-bearing bones lose between one percent and 1.5 percent of their density per month during four-to-six-month ISS missions, according to NASA.
Research has shown that a 30 to 50 year old astronaut who spends six months in space loses about half their strength.
This not only leaves them physically debilitated when they return to Earth, but puts them at greater risk of bone fracture and premature osteoporosis, a disease that weakens bones as people age.
In December, biomedical engineer Dr John Jaquish told DailyMail.com: ‘By the time they get back to Earth, they will be at extreme risk of fragility fracture.
‘They probably will not be able to walk under their own power. They will probably leave the space vehicle on a stretcher, and it will take them months to recondition their bodies.’
That’s because ‘when you remove gravitational pull, the body doesn’t see a reason to maintain bone density and muscle mass, so it starts to break down very quickly,’ Dr Jaquish explained.
Severe muscle loss also increases the risk of organ failure and can be detrimental to cardiovascular health, he added.
There are things ISS astronauts can do to mitigate some of these risks, such as sticking to a rigorous exercise routine. But although exercise can slow deterioration, spaceflight conditions still wreak havoc on the human body, Dr Jaquish said.
‘They would need to put very heavy loads to the body on a very regular basis to even just maintain any sort of strength or bone density,’ he said, adding that the exercise equipment available on the ISS is not designed for that level of conditioning.
What’s more, NASA research has shown that daily exercise is not sufficient to counteract the effects of spaceflight on the heart, such as arterial stiffening and thickening of the artery walls, which can increase the risk of heart attack and stroke.
In January, Williams admitted to the impact that her extended ISS mission has had on her body.
NASA astronaut Tom Marshburn also could not walk on his own after he returned from a 176-day stay on the ISS, splashing down on May 6, 2022
NASA astronaut Raja Chari performs strengthening exercises after returning from a 177-day-long ISS mission. Williams and Wilmore will face weeks of rehab after their mission
‘I’ve been up here long enough, right now I’ve been trying to remember what it’s like to walk. I haven’t walked. I haven’t sat down. I haven’t laid down,’ she said during a video call with students at Needham High School in Massachusetts.
To regain their strength and cardiovascular endurance, Williams and Wilmore will need to stick to an intense rehabilitation program once they’re back on Earth.
NASA astronauts who return from long ISS missions complete a 45 day rehabilitation program that consists of three phases.
After regaining some of their strength, flexibility and their ability to walk during phase one, the astronauts move onto phase two, which adds proprioceptive exercises and cardio reconditioning.
Proprioceptive exercises strengthen the body and improve the mind’s perception of its movement and position.
Phase three, the longest phase, focuses on returning the astronaut to their optimal level of physical performance through functional development training.
Most astronauts return to their re-mission fitness level after the 45 days, according to NASA. But it can take months or even years for some to recover, and research has shown that many astronauts never fully restore their bone density.
Williams and Wilmore could have a particularly difficult time rehabilitating from their longer-than-usual ISS mission.
Earlier this month, Dr. Jaquish said they could still recover their pre-flight bone density if they use osteogenic loading, but it won’t be easy.
Osteogenic loading involves exercises that strengthen bones by putting stress on them, such as squats, lunges or jumping.
But to actually stimulate bone growth, the astronauts’ bones will have to bear a load 4.2 times their body weight, Dr. Jaquish said.
For reference, ‘the world record squat is only four times body weight, so the minimum [weight] you need is more load than the world record holders,’ he said.
In addition to reconditioning their bodies, Williams and Wilmore may need to rehabilitate their minds, according to psychiatrist Dr Carole Lieberman.
She recently told DailyMail.com that the astronauts will need to process intense emotions they may have been feeling during their time on the ISS, such as fear of dying and frustration with having to stay in space longer than they planned.
While Williams and Wilmore have repeatedly stated that they have not been stranded or abandoned, Dr Liberman said: ‘This may be partly true, but surely both astronauts will at least have some feelings of betrayal, resentment, anger that they either denied or actively hid from anyone on Earth.’
