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Out-of-this-world medical challenges

Anemia, vertigo, atrophied muscles, lowered cardiac output and reduced bone mass. Symptoms of a very sick patient? On Earth, perhaps. But in space, it's pretty normal. For help with these conditions, astronauts turn to experts such as Gregg A. Bendrick, MD, chief medical officer and senior flight surgeon for NASA Dryden Flight Research Center at California's Edwards Air Force Base in the Mojave Desert.

In a Sept. 20 lecture in Harvey Morse Auditorium, sponsored by the Cedars-Sinai Alumni Association, Bendrick described the "tremendous physiological assaults" that humans endure while exploring the universe, as well as the sometimes stormy "marriage" between astronauts and the flight surgeons (the military's term for flight medicine physicians) who work with them. His lecture was followed by a screening of the 1995 movie "Apollo 13," which portrays the medical and technical challenges that plagued the aborted 1970 lunar mission.

In the early days of the U.S. space program, when some flight surgeons came to view astronauts as research subjects and "completely forgot that they were human," their relationship deteriorated, Bendrick said. Project Mercury astronaut Walter Schirra once described the rigorous array of physical and psychological exams that astronauts underwent as "an embarrassment, a degrading experience."

Overall, though, physicians and space pilots build a bond like a family relationship, said Bendrick, who coordinated medical crews for five space shuttle landings at Edwards. Astronauts, he said in an interview after his lecture, are physically gifted, very intelligent and accustomed to dealing with high risk.

"You don't tell the astronauts what to do," he said. "You clarify the risks, not only for them, but for their families and the program."

Fortunately, many physical changes associated with space travel are temporary. Traceable to microgravity, commonly called weightlessness, such effects tend to gradually dissipate after return to Earth. Aboard the International Space Station, astronauts rely on special equipment, such as treadmills rigged to simulate the pull of gravity, to help counter effects of prolonged weightlessness.

"Space travel has shown us the amazing resiliency of the human body," said Bendrick, a U.S. Air Force veteran who is board-certified in aerospace medicine.

But some medical issues may be longer term. Astronauts, especially at higher altitudes, are exposed to levels of ionizing radiation that exceed federal safety standards, Bendrick said Such exposures may raise their risks of developing cataracts or even cancer, he explained.

Rapid bone loss is another troublesome issue. While in space, people may lose up to 2 percent of their bone mass each month, which could pose a significant obstacle to future interplanetary trips requiring long journeys.

As it turns out, though, one of the greatest medical challenges for space travelers may be mental health, Bendrick said. To help reduce the stress of lengthy deployments, NASA offers regular private family conferences, in which astronauts visit with their Earth-bound families through video conferencing.

In introducing Bendrick at the alumni presentation, the group's events director, Yzhar Charuzi, MD, noted that the retired U.S. space shuttle Endeavour, riding atop a modified Boeing 747, would make a celebrated flyover in Southern California the next day. Endeavour later will be exhibited at the California Science Center in Los Angeles. Although NASA ended the space shuttle program last year, it is developing plans to return U.S. astronauts to space in the future.

Photos: Gregg A. Bendrick, MD, chief medical officer and senior flight surgeon for NASA Dryden Flight Research Center at California's Edwards Air Force Base, discussing the history of flight surgeons, their stormy "marriage" with astronauts and the medical challenges of space exploration at a lecture sponsored by the Cedars-Sinai Alumni Association.