Baby Love x 8

Eight? Really? Eight babies. In one uterus.

What's happening?!

We pride ourselves here at Knifestyles on being the "Science Thursday" of the celebrity world, exploring the medical misconceptions showcased in People magazine and the like.

But now a young, six-time mother presents the taxpayers of California and Kaiser Permanente with eight premies.

Twins are the up-to-the-minute fashion accessory in celebrity circles (Angelina Jolie, Julia Roberts, Jennifer Lopez, Ricky Martin, Lisa Marie Presley, Geena Davis, Marcia Cross, Nancy Grace, Dennis Quaid, P. Diddy, Melissa Etheridge, Diana Krall, Patrick Dempsey – oops, I've run out of room). Has this engendered a public right to likewise 'put in an order' for a multiple pregnancy?

Assisted reproductive technology (ART) has come a long way since Baby Louise who just turned 30 (our first test tube baby works at the post office now).

The case of Nadya Suleman aka Doud (33) does not just raise questions, it shouts them. The only thing we know for sure is that someone's not telling the whole truth.

Q: How did she procreate so many, so often?
High tech fertility à la mode requires a lot of expertise and equipment. This was not a do-it-yourself job. It's possible that a one-time pharmaceutical hyperstimulation of the ovaries (eg, 10 day course of injected pergonal, hMG, or FSH) may have provided enough to stock the freezer. Donor-dad has only one brief performance to make, usually in the clinic restroom with the magazine of his choice. Once stockpiled, these frozen embryos can be thawed sequentially and stored indefinitely.

Q: Doesn't the biological father get a say?
Well, no, if it's done through a reputable sperm bank. But several of the previous birth certificates list the Y chromosome as belonging to "David Soloman." It's a bit queasy knowing this name translates to "Doud Suleman" in Arabic.

Q: How did a single parent of six, attending school and living with her divorced mother, afford repeated IVF pregnancies?
In California it costs about $12,500 per cycle to attempt IVF, slightly lower in areas where insurance plans cover it. Five successful transfers in six years is staying pretty busy; each pregnancy is 40 weeks in gestation plus another few weeks in pharmaceutical preparation. I'm going to hazard a guess that her egg retrieval and first five transfers were covered under her insurance and were done by-the-book. She was probably on a first-name basis in the fertility clinic. She may even have sold eggs to help defray the copays.

Only this last time was different.

Q: Why eight?
Perhaps her parents' financial underwriting was at an end: "this is your last baby and I mean it!" If she hadn't met her goal, she may have reasoned (okay, too strong a word) she could get her way by using up all her remaining frozen embryos in one fell swoop. But– eight out of eight embryos all take in one transfer? It is statistically improbable.

Q: Why would a doctor go along this?
He or she wouldn't. It's unbelievably risky for mother, babies, and physicians. The serious and sometimes lethal complications of high-order multiples are enough of a medico-legal liability to dissuade any physician from transferring so many embryos, but there are also professional guidelines.

The American Society for Reproductive Medicine (ASRM) and the Society for Assisted Reproductive Technology (SART) both call for no more than one or two embryos for a generally healthy woman under 35. Reproductive endocrinology is a small club and its members are aghast. "Anyone who transfers eight embryos should be arrested for malpractice" says bioethicist Dr. Arthur Caplan.

All of which leads me to suspect we'll find out that this last IVF was without physician involvement. Perhaps Suleman and a highly-trained technician pal made use of an employer's facility to thaw and transfer the remaining baker's dozen on their own time. I'm taking bets on it.

Q: But what about the Chukwu octuplets in Texas?
The only other live-birth octuplets in the US were delivered in 1998, the result poorly monitored fertility drug use, not IVF. The smallest died within a week and the other seven needed about $250,000 of NICU apiece just to get them healthy enough to go home.

Q: Who's going to pay for this?
Kaiser Permanente, the largest not-for-profit managed healthcare plan in the US, will likely pass along their costs to their 8.6 million members. The average price tag for just one cesearean birth is about $25,000 in California; this one took 46 doctors and nurses to deliver. NICU care is in the range of about $2,000/day/baby. The bill will be well over $2M.

Dr. Charles Sophy, medical director of Los Angeles County Department of Children and Family Services, says studies estimate the providing the bare necessities to raise a child to adulthood is $2.5 million. Or roughly $35 million for 14. The cost of services for the babies with on-going health problems and disabilities, the ones short-changed in that crowded uterus, increases that amount exponentially.

A family living on $61,742 and owing creditors $984,426 as of a year ago, is unlikely to be able to meet even a fraction of these crushing expenses. The cost will most likely fall to the state of California.

Q: Can any of this possibly be in the best interests of the children?
A single parent with fourteen children under the age of eight, eight of whom are going to mature simultaneously, is quite outside the laws of human nature. I wish we could rewrite the ending of this fairytale.



Join us Thursday @ 10am to hear Anne flesh it all out with Kevyn Burger on-air. Can't make it? Use this link to find the FM107.1 audio archive of Knifestyles broadcasts by date (second hour). Step one: select the date shown on the blog posting; step two: click on Kevyn Burger; step three: click on second hour. Add your comments below.

In the News: Swayze, Jobs, Jett Travolta, First Dog

This week, we go over the medical news: Steve Jobs and Patrick Swayze share hospital beds, Jett Travolta and epilepsy, and the Obama's quest for an allergen-free White House pet.

Strange bedfellows, those two. Patrick Swayze (55) and Steve Jobs (54) were both laid low last week with complications of pancreatic cancer. Both have remained in the public eye, but with markedly differing attitudes.

The pancreas is a large gland that lies horizontally behind the stomach and supplies the body with insulin and digestive enzymes. Ninety-five percent of pancreatic tumors are adenocarcinoma. One of the most aggressive and difficult-to-treat of all cancers, fully 75% of patients die within first year after diagnosis. Famed tenor Luciano Pavarotti succumbed to it, as did actors Michael Landon, Fred Gwynne (aka Herman Munster and Harvard grad), Jack Benny, Rex Harrison, Donna Reed, Fernando Lamas, and Joan Crawford. All of Jimmy Carter's three brothers and his father died of it.

In mid-2004 the legendary head of Apple underwent treatment (most likely a Whipple procedure) for an islet cell neuroendocrine tumor– a different and very rare pancreatic cancer responsive to treatment. Approximately half recur, often spreading to liver.

Defiantly private, Jobs' increasingly cachectic appearance and failure to appear at Macworld trade show led to a sharp drop in Apple shares ($5.5 billion). Always a force to be contended with, on January 5th Jobs testily proclaimed it nothing more than a "hormonal imbalance" and shares went up. Just a week later nearly $10 billion in shareholders' market value was wiped out when the "more complex" test results came back, requiring a five month medical leave.

If Jobs' has had a recurrence of his cancer, shareholder lawsuits will likely result. A CEO's personal health is a private matter until it affects the operation of a publicly-held company. Misleading statements about such lie within the realm of securities fraud.

Voted People's sexiest man alive in 1991, Patrick Swayze is terminally ill with Stage IV pancreatic cancer and he knows it. In an extended interview with Barbara Walters (79) January 7th, Joffrey-trained Swayze credited his wife of 33 years, Lisa (51), with helping him get through "this journey....as elegantly as I have."

This from a guy who went one-on-one with Chris Farley in SNL's Chippendale's tryout skit.

Both of the women in the interview have had full facelifts, browlifts, volume added, and probably some eye work. Swayze himself has undergone some endoscopic face work, sometime early in the decade. Check out Keeping Mum (2005, a lovely film)– it's not the same face that made Baby do Dirty Dancing (1987).

The untimely death of Jett Travolta (16) on January 3rd has raised questions about how a closely supervised teenager could die of an epileptic seizure.

Seizures are often a side effect of other illnesses (eg, Sen. Ted Kennedy's event at the inaugural luncheon), but not often the cause of death. The 1% of Americans with convulsive seizure disorder have the same life expectancy as others. There is, however, a poorly understood syndrome called sudden unexpected death in epilepsy patients, or Sudep, which occurs in 10 to 15 of 10,000 patients with poorly controlled seizures.

Officially speaking for the family, lawyers Michael Ossi and Michael McDermott have added to the confusion by offering medically nonsensical statement. An exclusive interview was given to TMZ.com, the celebrity gossip site underwritten by Warner Brothers & AOL and known for a mix of salacious content and speedy posting.

The 16-year-old suffered from uncontrolled grand mal seizures after being taken off Depakote (valproate semisodium), the most prescribed anti-epileptic drug worldwide. The Travoltas, after consulting neurosurgeons, stopped administering it because they felt it had lost its effectiveness.

Scientology believes in medical intervention for physical illnesses, but does not recognize those involving the mind as such, eg, autism or psychiatric disorder, nor the use of psychotropic drugs. Based on precepts laid down by science fiction writer L. Ron Hubbard (d. 1986), its adherents view mental illness as psychosomatic and to be treated via its proprietary brand of spiritual healing, not with conventional therapies. Only when a physical (organic) cause for a "mental" disorder is proven, does it move from the field of psychiatry to the field of medicine.

The Obamas' dog dilemma?

That an easy one. There is no such thing as a hypoallergenic dog. The major allergen in canines is a protein that dogs excrete in sweat and shed from their skin. There are no skinless dogs!

If anything, factors related to individual dogs seem to influence the allergenicity more than breed or gender.

So here's the deal, Malia. You can have a dog on trial. The dog stays out of your bedroom, since you spend a lot of time in there. Wash your hands after you pet it. And make sure those staff keep the White House clean. But (there always is one, you know), if you have to visit the ER for asthma or you need significantly more medication, the dog has to go.



Tune in @ 10am to Anne flesh it all out with Kevyn Burger on-air. Can't make it? Use this link to find the FM107.1 audio archive of Knifestyles broadcasts by date (second hour). Step one: select the date shown on the blog posting; step two: click on Kevyn Burger; step three: click on second hour. Enjoy!

Does This Make Me Look Operated?

What do Sharon Osbourne (56), Vanessa Williams (45), Jennie Garth (36), Daisy Fuentes (42), Brooke Shields (43), Simon Crowell (49), David Hasselhof (56), Linda Evangelista (43), Janice Dickinson (53), Lisa Rinna (45), Lori Loughlin (44), and Courtney Cox (44) all have in common?

Fewer wrinkles!

It's not a coincidence that there has been a slew of Botox "confessions" from Hollywood celebrities in the last few months. It coincides with Allergan's (the manufacturer of Botox® Cosmetic aka Botulinum Toxin Type A) marketing push launched in 2007 and formatted as a hybrid public service/infomercial/giveaway featuring well-known personalities.
Olympians Mark Spitz (58) and Nadia Comaneci (47) both gave lecture tours on “Your Personal Best” this fall. Virginia Madsen (44) hawked Botox with her mother in "Freedom of Expression."

By her own admission, Madsen got the job by a slip of the tongue in an interview shortly after the surprise success of her Oscar-nominated film role in Sideways (2004).

But it is really just stating the obvious: Aging Hollywood faces have help from knives and needles.

Short of the kind of admissions currently being featured in magazines, how do you know who's telling the whole truth?

It's all in the ears.

Rhytidectomies do the heavy lifting and offer the most clues. In a traditional facelift, an incision is made in front of the ear extending up into the hairline and down around the bottom of the ear and then up behind it, usually ending in the hairline. (For an excellent pictorial tutorial of the actual surgery, go here.)

Shall we play I Spy? I spy with my little eye....operated auricles.

A pixied earlobe is the distorted result when the reattached lobule is pulled down and forward onto the cheek. A fine example is Micky Rourke's (56) left ear; both are shown. A competent facial plastic surgeon will preserve the shape of the lobe you with which you were born. Otherwise, a big earring is the answer.

Poor scar placement and poor incision planning can be covered up with hairstyling– less so if you are David Gest (55). Over time, John Cleese's (69) aging facelift has relaxed into something appearing fairly natural, but his misplaced post-auricular scar in probably still very visible. (Check out the big kiss scene in Fierce Creatures, 1997).

The pre- and post-auricular skin of the ear is specialized: it is thin and nonhair-bearing. In some (especially men) the facial skin does not match identically with the ear skin. Removing this patch of pliable, hairless skin can have unnatural results....like shaving your ear.

Perhaps more subtle is temporal hair loss or the sacrifice of the tuft of hair at the upper junction of the ear and face. As with Sophia Loren's (74) right ear, it can give a man or woman the appearance of wearing a wig.

The incision can go behind the tragus, that little cartilaginous bump in front of the ear hole, or in front of it. Female stars like Joan Rivers (75) usually opted for behind, in order to camouflage the scar. Poorly handled, the natural definition/indentation in that area is lost, blunting of the facial-ear junction.

Sometimes the tragus itself is distorted and pulled forward by the tension of the lift and/or the thickness of the redraped skin (this settles out over time as it has for Madonna, 50).

And whose operated ears do I Spy here?




After a traditional facelift, some of these stars may appear wonderful in photos, but as soon as they try to move their faces they look a bit Frankenface. The old-school operated look is something smooth and taut, but not young. The new look is all about volume, not subtraction. Volume is the very essence of facial youth and next-generation surgery is all about adding it.



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Did you miss hearing Anne flesh it all out with Kevyn Burger on-air? Use this link to find the FM107.1 audio archive of Knifestyles broadcasts by date (second hour). Step one: select the date shown on the blog posting; step two: click on Kevyn Burger; step three: click on second hour. Enjoy!

I Spy answers: