Shubhanshu Shukla, the Indian Air Force Group Captain is back on Earth after spending 18 days aboard the International Space Station (ISS). What now awaits is a long list of medical examination to ensure that Shukla and the other astronauts from Poland and Hungary are in good health.

What Are The Post-flight Medical Examinations For Astronauts?

The journey back from space marks the start of a whole new phase for astronauts. Just after splashdown, Group Captain Shukla and his fellow crewmates were helped out of the capsule by SpaceX recovery teams. Once aboard the recovery vessel, they underwent initial medical checks to assess their vital signs and general health.

These immediate tests are part of a broader post-flight health monitoring protocol aimed at studying how spaceflight affects the human body. Since astronauts’ health parameters are recorded before launch, comparing them with post-landing data helps scientists understand the impact of microgravity on various body systems.

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As the pilot of the Axiom-4 mission, Shukla will undergo an extensive series of assessments — from cardiovascular and immune system checks to balance, coordination, and psychological evaluations.

Over the coming weeks, both NASA and the Indian Air Force will monitor his physical and mental recovery closely.

Readjusting to Earth’s gravity is not instant. In space, the lack of gravity leads to muscle weakening, bone density loss, and a fluid shift in the body that can affect circulation and organ function. To counter this, astronauts follow a personalized reconditioning plan designed to help their bodies re-adapt. These programmes focus not only on regaining strength but also on retraining the body’s proprioception — the sensory system that allows us to sense our position and movement, which becomes disoriented in space.

Life in Microgravity: What It Feels Like

Speaking from the International Space Station during the mission, Shukla had shared the strange feeling of disorientation he experienced during his initial days in orbit. “It’s the first time for me, so I don’t know what to expect [upon return],” he said. “The only hope is — I did have some symptoms coming up — so I am hoping that I will not have it going down. Unless and until I get the worst of both worlds and I get it both the times.”

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Many astronauts deal with “space motion sickness” during the early days of their mission. This occurs when the brain receives mixed signals from the inner ear, which is crucial for balance on Earth. Upon return, the challenge reverses — as the body tries to function under the force of gravity again, simple actions like standing or walking can temporarily become difficult.

According to official reports, Shukla and his team will soon be transported to NASA’s Johnson Space Center in Houston for further recovery and evaluation, either by sea or air.

Post-Flight Rehabilitation

As per Polash Sannigarhi, Chief Instructor, Aeromedical, Training Center, Air Force Station Hindan, Ghaziabad, there are many rounds of medical checks that an astronaut undergoes. Being a flight surgeon himself, he writes in the paper, "Post-flight rehabilitation of an astronaut after long duration mission in space: Through the eyes of a flight surgeon" published in 2023.

Post-flight Medical Evaluation

Medical assessments begin within a day of landing (R+1) and cover a wide range of investigations:

Laboratory Tests: Conducted per NASA’s MEDB guidelines to assess biochemical and physiological parameters.

Physical Examination: Daily systemic check-ups by a flight surgeon to monitor overall health.

Anthropometry: Measurement of height and body mass to assess fluid shift and skeletal changes.

Psychological Assessments: Conducted privately by a mission psychologist on R+1 and R+10.

Sensorimotor and Vestibular Tests: Includes dynamic posturography and mobility assessments to evaluate balance and spatial orientation.

Ophthalmologic and Audiological Tests: Exams such as visual acuity, contrast sensitivity, orbital MRI, and audiometry.

Cardiorespiratory Assessment: ECG post-landing and spiro-ergometry on R+5 to assess VO₂ max.

Nutritional, Radiation, and Sleep Assessments: Involves dietary surveys, urine and blood sampling, dosimeter analysis, and sleep quality tracking.

Radiological Imaging: Targeted MRIs and ultrasounds are performed based on clinical indications.

Post-flight Physical Rehabilitation

This begins as early as the first day post-landing and is tailored to individual needs. A multidisciplinary team — including a Flight Surgeon, Physiotherapist, and Exercise Specialist — oversees it.

Initial Days (R0–R+1): Massage therapy for muscle relaxation.

R+2 to R+7: Structured exercise routines, including warm-ups, back and leg activation exercises, gait training, balance drills, and posture work using equipment like resistance bands.

Hydrotherapy (Following Week): Aquatic activities like aqua jogging and ball games mimic microgravity and help recondition muscles in a low-impact environment.

Core anti-gravity muscles such as the multifidus and transversus abdominis are monitored using ultrasound to track structural recovery. Flexibility and proprioception exercises are gradually reintroduced. Astronauts avoid jumping or high-impact activities until deemed fit by the team.

Each day concludes with team reviews to adapt the next day’s plan based on physical response. The program’s primary goal is to return astronauts to their pre-flight physical condition safely, without overexertion or injury.

This year, Nick Jonas has completed 20 years with type 1 diabetes. This is also the same year when his band, the Jonas Brothers have also hit the mark of 20th anniversary. Speaking to Healthline, Jonas said, "It is crazy hpw it lined up. It has been a wild journey in both... in the Brothers sense, it's been the ride of a lifetime, and we have been so fortunate to be able to do this for 20 years now and to have the support of the world's greatest fans."

He also revealed that he had great and some tough times too living with diabetes. There had been struggles of managing his low, however, he revealed that being the spokesperson of Dexcom, a healthcare company known for its glucose monitoring system, and through his own non-profit initiative Beyond Type 1, he has been joyful. “Overall, I’m really grateful to have been able to be transparent about [type 1] and to connect with all these wonderful people from all regions of the world who are experiencing their own diabetes journey, and it’s a really big thing to feel like you’re a little less alone in it,” said Jonas.

On World Diabetes Day, which was on November 14, Jonas took to the stage during a Jonas Brothers concert and shared the audience his A1C. This is a test that measures one's average blood sugar over the past 2 to 3 months. This number shows how well diabetes has been managed. He shared an inspiring message of hope, while giving a shoutout to his A1C. The concert was attended by Dexcom Warrior community, which makes more than 30,000 people who have been diagnosed with diabetes and may share the same experiences. “It was really special for me to get to use the Jonas Brothers’ platform as a place to speak about something that’s obviously very personal to me and on World Diabetes Day, I think it’s natural to get reflective and to tap into kind of what life looks like for me as a now 33-year-old person living with this disease,” he said.

He also dedicated the song 'A Little Bit Longer', that he had written very early on in his career during his diabetes journey. “It’s a really important time for me to get to speak on stage like that and play a song that I wrote about these experiences when I was 14 and to see the impact it still has to this day with the fan base,” he said.

Living With Type 1 Diabetes

Here are some strategies Jonas uses that helped him manage his diabetes. First off the list is to take the pressure off. “You’re never going to have the perfect day living with this disease and even if you’re super on top of your diabetes management, there are just things that are a little out of your control and being able to take a deep breath, reset, and know that it’s going to be OK on the other side is really important,” he said.

It may seem hard, but he said learning it in the beginning of his diagnosis helped him manage his diabetes. Then comes the care. He has focused on taking vitamins, caring for his skin, and most importantly, staying hydrated. “It’s a simple thing, but the more water I drink, my glucose levels are better. I don’t know exactly why, but I just find that hydrating has a lot of health benefits,” said Jonas. “I didn’t put as much focus on it earlier in my life as I do now, and it’s been really beneficial.”

Physical activity is a must. He walks for 30 minutes daily, or sometimes longer for his physical, mental, and emotional health. “It really centers me and even when it’s cold out, getting out in the fresh air is really important when a lot of my day too, is spent indoors for hours at venue or on a film set or something,” he said.

His focus on self, he says is the most important as he says he relies on his therapist from time to time. "I think it is really important to do that self-work". Lastly, he says everyone who has been diagnosed with diabetes, must take part in the community. “There will be good days, there will be tough days, but you can climb this mountain, and there’s some incredible people out there whose stories will really inspire anybody that’s going through tough moments,” said Jonas.

People prescribed venlafaxine are being urged to stay alert to certain symptoms and side effects that may require medical advice from NHS 111 or their GP. Venlafaxine is a widely used SNRI antidepressant. It is mainly prescribed for depression, but doctors may also recommend it for anxiety disorders and panic attacks.

What Is Venlafaxine?

Venlafaxine, sold under brand names such as Effexor and Effexor XR, is a prescription antidepressant classified as a serotonin-norepinephrine reuptake inhibitor. It helps regulate mood by raising levels of serotonin and norepinephrine in the brain, chemicals that play a key role in emotional balance and mental stability.

Doctors Warn People Taking Venlafaxine

The medicine is usually taken as a tablet or capsule. It works by increasing levels of serotonin and noradrenaline in the brain, chemicals that help regulate mood. According to NHS guidance, venlafaxine tends to cause fewer side effects than older antidepressants. That said, it is not completely free of risks.

Most people begin to notice some improvement within one to two weeks, although it can take four to six weeks for the drug to have its full effect.

Venlafaxine Side Effects

Common side effects listed by the NHS include sweating, nausea, a dry mouth, and headaches. These are generally mild and often ease as the body adjusts to the medication.

However, there are other, more serious side effects that may need prompt medical advice. While these reactions are uncommon and affect fewer than one in 100 people, the NHS advises contacting 111 or a GP if they occur.

Venlafaxine Serious Side Effects

NHS advice says you should speak to your GP if you notice unexpected weight gain or weight loss, or sudden changes to your menstrual cycle. This may include spotting, bleeding between periods, or unusually heavy periods.

Patients are also advised to contact their doctor or NHS 111 without delay if they experience any of the following symptoms while taking venlafaxine:

• Yellowing of the skin or the whites of the eyes
• Bleeding gums
• Bruising that appears without explanation or continues to spread
• Thoughts of self-harm or suicide
• Muscle pain or weakness with no clear cause
• Breathlessness, or a heartbeat that feels fast, uneven, or irregular
• Intense feelings of elation, extreme excitement, or restlessness that makes it hard to stay still
• Changes in vision, including blurred eyesight or enlarged pupils
• Coughing up blood
• Blood in urine
• Persistent headaches along with confusion, weakness, or repeated muscle cramps
• Black or red stools, or blood in vomit, which may point to internal bleeding

As adenovirus cases continue to rise globally, health professionals have noticed that this potentially serious infection is sometimes being mistaken for another illness, what many are calling the ‘super flu’.

For those unfamiliar, adenovirus is a DNA virus that gradually affects a person’s upper and lower respiratory tract, as well as other organs. This can include the eyes, digestive system, and kidneys.

Adenovirus Or Super Flu?

According to Dr. Deborah Lee at Dr Fox Online Pharmacy, who spoke to Cosmopolitan: "It spreads when someone breathes in infected droplets, touches the virus and then rubs their eyes, or through the faecal-oral route (not washing hands properly after using the toilet)."

"It moves quickly in crowded spaces where people are close together." She added, "The virus is resistant to soap and many commonly used cleaning products."

Adenovirus: What Are The Symptoms?

The reassuring news about adenovirus is that most people recover within a week or two. Its symptoms are often similar to those of a common cold.

Typical signs include fever, runny nose, sore throat, cough, shortness of breath, and swollen lymph nodes in the neck. In more severe cases, patients may also experience conjunctivitis, ear pain, diarrhea, vomiting, stomach aches, or urinary tract infections.

Certain groups are at higher risk of serious illness. Dr. Lee notes, "Babies and children under five, older adults, pregnant women, and people with weakened immune systems are the most vulnerable."

Although adenovirus symptoms often resemble those of a typical flu, it’s important to know when someone is dealing with the flu—or worse, the current ‘super flu’ that’s circulating widely.

How Does Adenovirus Differ From The 'Normal' Flu?

One way to tell the difference is by how long someone is sick. Adenovirus tends to develop gradually, whereas the ‘normal’ flu often hits suddenly, with high fever and intense symptoms within hours, Lee explains. Common flu symptoms also include a high temperature (38–40°C), severe headache, and extreme fatigue.

Other key differences: adenovirus can occur throughout the year, while flu is mostly seasonal. Adenovirus can also cause pink eye and gastrointestinal problems like vomiting or diarrhea, but it’s less likely to lead to serious complications compared to flu.

What About The 'Super Flu'?

Doctors say it’s not only the regular flu that needs to be distinguished from adenovirus, but also the current ‘super flu,’ which is causing particularly dramatic symptoms.

This infection is caused by the H3N2 virus and tends to be more severe than typical winter illnesses, especially in the UK.

"Past data shows H3N2 has been linked to more hospitalizations and deaths from flu, especially among adults over 65 and young children, compared with other flu types," Lee explained. When comparing the ‘super flu’ to adenovirus, she notes that the symptoms are very similar.

However, she stresses that the ‘super flu’ is considered much more intense. Not only can your sore throat feel agonizing, but aches and pains may be strong enough to confine you to bed.

Adenovirus vs Super Flu: Symptoms Explained

While adenovirus and the so-called ‘super flu’ can feel very similar, there are subtle differences to watch for. Adenovirus usually develops gradually, with fever, cough, sore throat, runny nose, and sometimes pink eye or digestive upset. Most healthy individuals recover within a week or two. In contrast, the ‘super flu,’ caused by the H3N2 virus, hits hard and fast—high fever, intense body aches, severe fatigue, and an agonizing sore throat are common.

Both illnesses can affect vulnerable groups such as young children, the elderly, and immunocompromised individuals, but the super flu tends to bring more extreme symptoms that may require hospitalization. Understanding these distinctions can help people recognize the illness early and seek appropriate care.