posted 02-04-2014 03:02 PM               

Irwin's condition was first noted after the LM was back in lunar orbit. The flight surgeons' felt that a weightless environment was possibly the best place for a cardiac patient to be since there was less stress on his heart. Plus he was on 100% oxygen and being continuously monitored.

What possible intervention could have helped? Getting him back to a high G reentry environment sooner? That would have been a poor decision to make.

posted 02-05-2014 05:46 PM            

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Originally posted by Michael Davis:
What possible intervention could have helped?

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There was a pre-arranged code ("West Point") to alert Scott if an urgent private discussion was needed. Mission Control never used it.

One repercussion if Mission Control had alerted Scott was the potential impact on Al Worden's deep-space EVA to retrieve the SIM bay film cassettes. Struggling into a bulky spacesuit and assisting with Worden's EVA was not exactly the best treatment for a heart attack patient.

What would Scott have done if he had been alerted to Irwin's condition? Mission Control must have discussed the possibility that Scott would "play safe" by cancelling the EVA to protect his crewmember's life.

The film cassettes were important, but were they worth risking Irwin's life? And what if Irwin had suffered a more serious attack while leaning out of the open hatch?

Scott himself is in no doubt that if he had been informed of Irwin's heart issue, he would have had a full debate with the Flight Director and he, as field commander, would have made the final decision whether to go ahead with the EVA.

It was that very uncertainty which, I suggest, concerned Mission Control. That, I suggest, is why Scott was not told. Is there any other plausible reason why a crew health issue described by NASA's Chief Surgeon as "a serious situation" was not drawn (discreetly) to the attention of the mission commander?

This issue is discussed in Chapter 8 of "Footprints in the Dust" (Nebraska University Press, 2010).

posted 02-06-2014 04:51 AM            

Swap Irwin out for backup LMP Schmitt, who gets to the moon 18 months or so earlier, and without pressure from the scientific community to get him on to the last Apollo flight?

Or do you swap out the entire prime crew for Gordon, Brand and Schmitt? Unlikely given the medical precedent set by the Mattingly/Swigert swap on Apollo 13, and pretty hard to see "golden boy" Scott allowing that or, for that matter, being treated that way by management. You can imagine Scott reluctantly accepting the lesser of the two evils (Schmitt), as did Cernan, in order to preserve his chance at walking on the moon.

But if Schmitt had flown, then Engle presumably gets a clear shot at the moon on Apollo 17, with the added twist that Irwin is presumably permanently grounded and doesn't briefly join the Apollo 17 backup crew with Scott and Worden. So who would have become the first Apollo 17 backup LMP (Duke?), and what would have become of them once the stamp affair broke and Scott and Worden were removed from duty? If Duke, then presumably he would have stayed on the backup crew to be joined by the eventual backup CDR Young and CMP Roosa.

posted 02-06-2014 12:19 PM            

What has been established is that his heart went into an "abnormal" heart rhythm called bigeminy (a normal heart beat followed by a premature heart beat (PVC), a pause, another normal heart beat, another pause and so on).

Bigeminy MAY be a consequence of a heart attack but it also MAY appear during times of low magnesium and/or potassium blood levels (both Irwin and Scott had these low levels).

The presence of a bigemic heart rhythm alone is not proof of a heart attack.

posted 02-06-2014 01:31 PM            

quote:

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Originally posted by Blackarrow:
Is there any other plausible reason why a crew health issue described by NASA's Chief Surgeon as "a serious situation" was not drawn (discreetly) to the attention of the mission commander?

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posted 02-06-2014 03:16 PM            

quote:

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Originally posted by Rusty53:
I don't believe that it has ever been established that Jim Irwin suffered a heart attack during Apollo 15....Was there any post-flight evidence of a heart attack occurring during the flight?

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Again, the unanswered question: if NASA's top doctor thought a crew-member had, in effect, had a heart attack (or something similar) why was the mission commander not notified? Kraft is silent on this point.

posted 02-06-2014 06:03 PM               

Irwin was also an exceptionally fit man being continuously monitored by an outstanding team of flight surgeons.Those flight surgeons, along with the flight directors, made what was probably a difficult decision that Irwin was able to proceed normally with the remainder of the mission. That decision proved to be correct.

posted 02-06-2014 07:12 PM               

quote:

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Originally posted by Blackarrow:
On the first point, he quotes Dr. Charles Berry as saying: "It's serious. If he were on Earth, I'd have him in I.C.U. being treated for a heart attack."

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Had it happened on Earth, yes they would have put him in the hospital and ran tests on him to see if he had had a heart attack. The fact that his post flight exam did not turn up any evidence of a heart attack, it's likely that he didn't have one, in my opinion.

posted 02-07-2014 03:36 PM               

quote:

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Originally posted by alanh_7:
I asked [Scott] if he thought Irwin's heart issues later in life had been caused by the moonwalk. Without hesitation Dave Scott said "It is not something you will hear NASA say officially, but yes I suspect it was."

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posted 02-07-2014 03:59 PM               

They did not give the reasoning but mission control asked Irwin, and I think Scott as well, to keep their heart monitors on for their return home. But as I said, the book "Falling to Earth" goes into this in more detail.

posted 02-08-2014 05:01 PM            

quote:

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Originally posted by Michael Davis:
Irwin was also an exceptionally fit man being continuously monitored by an outstanding team of flight surgeons. Those flight surgeons, along with the flight directors, made what was probably a difficult decision that Irwin was able to proceed normally with the remainder of the mission. That decision proved to be correct.

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It is irrelevant what was concluded AFTER the mission. During the mission, Dr. Berry would have treated Irwin as if he had suffered a heart attack. Berry's concerns are recorded in the accounts by Chris Kraft and Gene Kranz.

You state that the doctors and flight directors made "a difficult decision that Irwin was able to proceed normally with the remainder of the mission." That decision definitely should have been made in consultation with the mission commander. I have already suggested in my first post why Scott was probably not made aware of the problem.

posted 02-08-2014 05:11 PM               

quote:

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Originally posted by Blackarrow:
During the mission, Dr. Berry would have treated Irwin as if he had suffered a heart attack. Berry's concerns are recorded in the accounts by Chris Kraft and Gene Kranz.

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Instead, per Kranz, Berry waited until afterwards to inform Lunney (and Kranz) of the situation.

posted 02-09-2014 08:40 AM               

quote:

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Originally posted by Blackarrow:
You are arguing with the benefit of 20:20 hindsight knowledge that simply wasn't available at the crucial time.

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During a particular grueling day he went through a combination of an EVA, a preparation for and return to lunar orbit, and a problematic docking with the CM. Also during that period he displayed an irregular heart beat. That irregularity went away with rest.There was never any indication during the flight that Irwin suffered a myocardial infarction (heart attack).

And Irwin and Scott were in fact monitored continuously. The flight surgeons requested that they continue to wear their monitors for the rest of the mission as a precaution. Skin irritation aside.

A very experienced team of flight surgeons were monitoring all of this and made the determination that it was not serious enough to alter the mission. The mission continued as planned and Irwin displayed no further symptoms of a heart condition. These are facts and on the record as told in hundreds of sources you can readily research.

Most of the remainder of this thread is 20-20 hindsight. For instance, knowing that Irwin would suffer a heart attack 2 years after the Apollo 15 mission might have altered the decision of the flight surgeons.

posted 02-09-2014 08:59 PM            

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Originally posted by Robert Pearlman:
Berry (and the other flight surgeons) could have called an end to the third EVA, or as Kranz writes, could have at least had Lunney give the crew an extra rest period. He didn't, which speaks volumes.

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However, I refer you to NASA SP-368 ("Biomedical Results of Apollo") which gives an account of this issue at pp 71-73. Jim Irwin did not display any heart irregularities during his time on the Moon which were any different to irregularities noted during his training on Earth, and even once 41 minutes before launch. There was no reason for Dr. Berry to advise any curtailment of the third EVA.

The cardiac event at 179:07 GET (in lunar orbit) was far more significant. If you, or others, choose not to believe Chris Kraft when he quotes Dr. Berry ("It's serious. If he were on Earth I'd have him in ICU being treated for a heart attack") then that's a matter for you.

You argue that Berry didn't treat Irwin as if he was having a heart attack and chose to keep Irwin's condition private. Apart from the obvious fact that his "patient" was a quarter of a million miles away, it was not up to Berry to make decisions, merely to advise and warn. This he did.

But it was ultimately the Flight Director's responsibility to make decisions. It is clear that all the senior NASA personnel were "in the loop": Lunney (outgoing FD); Kranz (incoming FD); Slayton, Kraft and Gilruth. Whatever decisions were made, whatever reasoning was employed, the one thing they certainly should have done was to inform the mission commander.

All three crew-members were quite clear about that after the mission. See for instance "Falling to Earth" by Al Worden with Francis French (at page 206: "...the ground should have told Dave. As commander he needed all available information about his crew." Disagree with me if you want, but Al Worden actually flew on the mission.

posted 02-09-2014 09:39 PM            

quote:

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Originally posted by Michael Davis:
And Irwin and Scott were in fact monitored continuously. The flight surgeons requested that they continue to wear their monitors for the rest of the mission as a precaution. Skin irritation aside.

A very experienced team of flight surgeons were monitoring all of this and made the determination that it was not serious enough to alter the mission. The mission continued as planned and Irwin displayed no further symptoms of a heart condition. These are facts and on the record as told in hundreds of sources you can readily research...

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If you check the Apollo 15 Flight Journal, you will find that Irwin was "off sensors" and therefore NOT being monitored on several occasions between the problem in orbit and Worden's EVA. For instance, at 193:13:51 GET Scott asked Houston to allow Irwin to take a break from wearing the sensors. Houston agreed. Remarks at 197:53:01 show that Irwin was clearly "off sensors."

Again, at 214:56:36 Houston asked Irwin to put on the sensors "as per the Flight Plan" so they had clearly been off. Later, at 229:30:00 the transcript shows that only Worden was wearing sensors (and this tallies with the Flight Plan).

During the sleep period before Worden's EVA, Irwin was off the sensors. All wore them during the EVA.

There is an interesting remark at 248:24:37 GET when Capcom stated: "...as far as the medics are concerned, it's 'dealer's choice' on who wears the biomed tonight." As the Flight Plan called for Irwin to wear the biomed sensors during the following sleep period, the crew stuck to the Flight Plan. The transcript records at 249:19:15 GET "Irwin dons biomed", so clearly he was not being monitored for some time before that.

posted 02-10-2014 03:37 AM               

The Apollo 15 post flight medical report makes no mention of any heart related problems.

As far as Irwin is concerned it says that he suffered a sensation of head fullness for three days and slight giddiness. His heart rates were noticably higher whilst carrying out tasks on the lunar surface.

The only medication taken on the flight were 14 aspirin taken by Scott to relieve the pain in his right shoulder and some nose drops used by Worden prior to re-entry.

posted 02-10-2014 12:18 PM               

quote:

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Originally posted by Blackarrow:
If you check the Apollo 15 Flight Journal, you will find that Irwin was "off sensors" and therefore NOT being monitored on several occasions between the problem in orbit and Worden's EVA. For instance, at 193:13:51 GET Scott asked Houston to allow Irwin to take a break from wearing the sensors. Houston agreed. Remarks at 197:53:01 show that Irwin was clearly "off sensors."

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posted 02-10-2014 12:50 PM               

Of interest is that it says also that Scott displayed similar heart irregularities to Irwin, albeit briefly.

The report concludes that a most likely cause was potassium deficiency coupled with stress.

posted 02-11-2014 01:12 AM               

quote:

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Originally posted by Blackarrow:
Maybe a lot of things, but the one thing you must do is tell the mission commander. He has a right to know, because he needs to know how the issue might impact on overall crew safety.

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Even if he has displayed the same symptoms? Isn't the key to this is when did Berry actually make his comment and in what context?

Since neither Irwin or Scott were displaying no other indications might not the comment have been made to mean in an ideal situation we'd investigate further, but since the crew are functioning normally we'll let it pass and just monitor it. No need to alarm anyone. As the report says, Irwin was unaware that he had a heart beat irregularity.

posted 02-11-2014 06:06 AM               

quote:

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Originally posted by Blackarrow:
I have no medical training, but if it is correct (see my previous post) that Irwin recorded a blood pressure reading on the recovery ship of 275/125, that does not sit easily with Kraft's comment that "...in every test his heart was normal."

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posted 02-11-2014 05:00 PM            

quote:

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Originally posted by Robert Pearlman:
Correct me if I am wrong, but I don't believe Apollo had private two-way channels.

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posted 02-12-2014 06:16 AM               

1. Who were the flight surgeons on Apollo 15? Wouldn't it have been their call rather than Berry's? Wouldn't this make Berry's comment just that, something to note but not act on? What I'm trying to suggest is that if the flight surgeons were unconcerned, then the question of whether to tell Scott doesn't arise.

2. Wasn't it correct that post flight examinations revealed that Irwin was suffering from hypokalemia? This is a well documented cause of irregular heart beats.