The record for the longest space-flight is held by physician-cosmonaut Valeri Polyakov. Back in 1994-95, he spent 437 days on the Mir space station and grew 4 centimetres in height through elongation of his spine in micro-gravity. Polyakov had an uncomfortable ride back to Earth in the very precisely customised descent module. Microgravity also causes demineralization of weight-bearing bones that is faster than age-related decline. But the cosmonaut had worked out religiously for the entire mission and after his capsule parachuted to the ground he made a point of walking from it relatively unassisted. One of the main objectives of the marathon flight had been to prove that walking proudly onto the Martian surface after a 9-month journey might be possible, given it only has 37 percent the gravitational force that Earth does. But microgravity also results in adaptive plasticity of the vestibular and sensorimotor networks and deconditioning of the cardiovascular system. Indeed, several years ago there was a medical emergency aboard the international space station when an ultrasound investigation revealed thrombosis of the internal jugular vein in one astronaut. In this podcast we discuss how management of cases like this has many parallels with remote medicine on earth. Part 1 of this series examined the risks of cosmic radiation and spaceflight-associated neuro-ocular syndrome among other things. Guests Professor Gordon Cable (Australian National University; Co-founder, Human Aerospace) Dr Alicia Tucker FACEM, FAWM (Royal Hobart Hospital; University of Tasmania) Dr John Cherry DPhil. FACRRM (Deputy CMO, Australian Antarctic Division) Chapters 1:08 Bone mineral density 15:35 Circulation and a case study in remote medicine 35:04 Historic medevacs from spaceProductionProduced by Mic Cavazzini DPhil. Music licenced from Epidemic Sound includes ‘Spring Water’ By Chill Cole, ‘At the End of Nothing’ by Silver Maple and ‘Mega Woman IV’ by ELFL. Music courtesy of Free Music Archive includes ‘Snowfall’ by Kai Engel. Graphic is AI-generated and shared online with a Creative Commons licence. Editorial feedback kindly provided by members of the podcast editorial group Paul Cooper PhD, Dr Aidan Tan, Dr Rahul Barmanray, Dr Simeon Wong, Dr Fionnuala Fagan, Dr Maansi Arora, Dr Jia-Wen Chong, Dr Aafreen Khalid and Associate Professor Dr Stephen Bacchi. Please visit the Pomegranate Health web page for a transcript and supporting references.Login to MyCPD to record listening and reading as a prefilled learning activity. Subscribe to new episode email alerts or search for ‘Pomegranate Health’ in Apple Podcasts, Spotify,Castbox or any podcasting app.

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