After nine grueling months aboard the International Space Station (ISS), NASA astronauts Barry “Butch” Wilmore and Sunita “Suni” Williams returned to Earth on March 18 via SpaceX’s Dragon spacecraft. Upon landing off the Gulf Coast, both were taken out on stretchers, unable to walk—an expected result after months in microgravity.

Back on solid ground, their bodies are readjusting to Earth’s gravity. Experts point to health risks including muscle loss, fluid buildup in the head, and blurred vision from Spaceflight Associated Neuro-Ocular Syndrome (SANS). “Some side effects could be permanent,” NASA warns.

Photos taken before and after the mission show visible changes. Some observers noted they looked gaunt, possibly due to weight loss and muscle atrophy. “You feel dizzy, a bit nauseous,” said retired astronaut Tim Peake. “It’ll take them a couple of days to get over that.”

Despite daily exercise and a high-calorie diet, microgravity impacts bones, muscles, and even cognition. NASA says most astronauts recover within 45 days—though full recovery can take months or more.