Physical
Medical
Family Medical History
Religion
Updates to ProfilePhysical
|
Altura:
177 cm
(5'10") |
Peso:
66 kg
(147 lb) |
Cor dos olhos:
Azul
|
Cabelo:
Castanho/
Liso |
Tom de Pele:
Moreno Claro
|
Ascendência:
Caucasiano
|
|
Tipo Sanguíneo:
A+
|
Etnia:
Norwegian-Polish/English-Irish-Scottish
|
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Escolaridade:
AA/Theater
|
Ocupação:
Audience Services Rep.
|
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Interesses:
|
Act, Play Chess, Read, Write
|
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Medical
| Question | Response |
| Have you or any of your family members been diagnosed with alcoholism or drug addiction? If yes, relation and age affected: | No |
| Any dietary restrictions? If yes, explain: | Yes - I try to limit carbohydrates (from grains) and dairy; (but don't necessarily need to) |
| Do you wear glasses or contact lenses? Are you near or far-sighted? | Yes - Near-sighted |
| Allergies (medicines, food, pollens)? If yes, please list substance and reaction caused: | No |
| CMV IgG Antibody | Positive |
| CMV IgM Antibody | Negative |
| Note any comments regarding above items: | N/A |
Family Medical HistoryVer lista de perguntas. here
Your Mother
| Question | Response | Comment/Age Affected |
| Current age or age at death | 54 | |
| Health Problem | Hypothyroidism, controlled with medication | 47 |
| Living / Dead | Living |
Your Father
| Question | Response | Comment/Age Affected |
| Current age or age at death | 51 | |
| Health Problem | Brain tumor, treated with surgery | 13 |
| Heart arrhythmia, no treatment | 51 | |
| Cause of death: Heart arrhythmia | 51 | |
| Living / Dead | Dead |
Brothers
Your Brother 1
| Question | Response | Comment/Age Affected |
| Current age or age at death | 20 | |
| Health Problem | Healthy | |
| Living / Dead | Living |
Sisters
Your Sister 1
| Question | Response | Comment/Age Affected |
| Current age or age at death | 25 | |
| Health Problem | Healthy | |
| Living / Dead | Living |
Your Sister 2
| Question | Response | Comment/Age Affected |
| Current age or age at death | 23 | |
| Health Problem | Healthy | |
| Living / Dead | Living |
Your Mother's Father
| Question | Response | Comment/Age Affected |
| Current age or age at death | 89 | |
| Health Problem | Heart attack, no treatment | 78 |
| Living / Dead | Living |
Your Mother's Mother
| Question | Response | Comment/Age Affected |
| Current age or age at death | 75 | |
| Health Problem | Diabetes mellitus not requiring insulin, diet-controlled | 60 |
| High blood pressure, treated with medication | 60 | |
| Living / Dead | Living |
Your Mother's Sisters 1
| Question | Response | Comment/Age Affected |
| Current age or age at death | 45 | |
| Health Problem | Healthy | |
| Living / Dead | Living |
Your Mother's Brothers 1
| Question | Response | Comment/Age Affected |
| Current age or age at death | 56 | |
| Health Problem | Healthy | |
| Living / Dead | Living |
Your Mother's Brothers 2
| Question | Response | Comment/Age Affected |
| Current age or age at death | 52 | |
| Health Problem | Healthy | |
| Living / Dead | Living |
Your Mother's Brothers 3
| Question | Response | Comment/Age Affected |
| Current age or age at death | 51 | |
| Health Problem | Healthy | |
| Living / Dead | Living |
Your Mother's Brothers 4
| Question | Response | Comment/Age Affected |
| Current age or age at death | 49 | |
| Health Problem | Red/green Color blindness, no treatment | |
| Living / Dead | Living |
Your Mother's Brothers 5
| Question | Response | Comment/Age Affected |
| Current age or age at death | 47 | |
| Health Problem | Red/green Color blindness, no treatment | |
| Living / Dead | Living |
Your Father's Father
| Question | Response | Comment/Age Affected |
| Current age or age at death | 88 | |
| Health Problem | Leukemia, attempted treatment with chemotherapy | 82 |
| Cause of death: Leukemia | 88 | |
| Living / Dead | Dead |
Your Father's Mother
| Question | Response | Comment/Age Affected |
| Current age or age at death | 95 | |
| Health Problem | Stroke, no treatment | 70 |
| Arthritis, treated with medication | 70 | |
| Osteoporosis, treated with medication | 80 | |
| Stroke, no treatment | 88 | |
| Living / Dead | Living |
Religion:
| Faith | Other |
| Denomination | Agnostic |
Updates to Profile
| Update Available | Yes |
| Updates - Personal | No change to donor Personal Profile: August 2014, October 2014. Update received July 2015: Donor has earned an AA degree in Theater; his occupation has changed from Student to Audience Services Representative. |
| Updates - Medical | No change to donor Medical Profile: August 2014, October 2014, July 2015. |
| Updates - Family Medical History | Update received August 2014: Maternal uncle #1 died at age 58 of end stage kidney failure. Update received October 2014: Maternal uncle #1 was diagnosed with depression and was treated with medication. It is believed that the medication contributed to his kidney failure. He is still alive, and is being treated with dialysis. Update received July 2015: Maternal uncle #1 was diagnosed with bipolar disorder, and it was medication for that condition that resulted in kidney failure; Maternal grandfather has been diagnosed with lactose intolerance, age unknown, controlled with diet modification; Brother has been diagnosed with hypertension at age 23, controlled with diet modification. |