Donor 4871 - Medical Profile

This donor is a healthy carrier for a genetic disease.
Please see his Genetic Testing Summary and Acknowledgment of Genetic Risk for details

Personal Behavior History

Question	Response
Current alcohol use: If yes, oz./week and type of alcohol:	Frequently - 24 oz. beer/week
Have you or any of your family members been diagnosed with alcoholism or drug addiction? If yes, relation and age affected:	No
Tobacco use: Do you smoke? If yes, #/day and for how long:	No
If you did smoke but quit, when did you last smoke?	N/A
For how many years?	0
Do you sleep well?	Yes
Do you exercise on regular basis?	Yes
Is your diet well balanced? If no, explain:	Yes
Are you a vegetarian?	No
Any dietary restrictions? If yes, explain:	No

Sexual History

Have you ever had sex with:

Question	Response
A partner whose sexual background you are unsure of in the past 12 months?	No
Another man anal or oral, even once, since 1977?	No

Donor Genetic History

Question	Response
Were you or any family members born with any birth defects? If yes, explain:	No
Have you been tested for Cystic Fibrosis? If yes, the result:	Yes - Non-carrier by gene sequencing
Karyotype? If yes, the result:	Yes - Normal karyotype
Spinal Muscular Atrophy (SMA)? If yes, the result:	Non Carrier - Standard donor screening
Tay Sachs? If yes, the result:	Carrier - by enzyme analysis (not DNA)

Ancestry

Question	Response
Are you of Jewish ancestry? If yes, please note: Ashkenazi, Sephardi, or Other	No

If you are of Jewish ancestry, have you been tested as a carrier of any of the following diseases?

Question	Response
Tay Sachs: If yes, result(s):	Yes - Carrier by enzyme analysis only; not DNA
Gaucher: If yes, result(s):	Yes - Non-carrier by gene sequencing
Canavan: If yes, result(s):	Yes - Non-carrier by gene sequencing
Fanconi Anemia Type C: If yes, result(s):	Yes - Non-carrier by gene sequencing
Niemann-Pick Type A: If yes, result(s):	Yes - Non-carrier by gene sequencing
Bloom Syndrome: If yes, result(s):	Yes - Non-carrier by gene sequencing
Familial Dysautonomia: If yes, result(s):	Yes - Non-carrier by gene sequencing
Mucolipidosis IV: If yes, result(s):	Yes - Non-carrier by gene sequencing
Maple Syrup Urine Disease 1B: If yes, result(s):	Yes - Non-carrier by gene sequencing
Usher Syndrome III & 1F: If yes, result(s):	Yes - Non-carrier by gene sequencing
Glycogen Storage Disease 1A: If yes, result(s):	Yes - Non-carrier by gene sequencing
ABCC8-Related Hyperinsulinism: If yes, result(s):	Yes - Non-carrier by gene sequencing
BRCA1/BRCA2: If yes, result(s):	No
Lipoamide Dehydrogenase Deficiency: If yes, result(s):	Yes - Non-carrier by gene sequencing

Ancestry

Question	Response
Are you of African ancestry?	No
If yes, have you been tested as a carrier of sickle cell anemia?	Yes
If yes, result:	Non Carrier - by gene sequencing
Are you of Mediterranean, Greek or Italian ancestry?	No
If yes, have you been tested as a carrier of beta thalassemia?	Yes
If yes, result:	Non Carrier - by gene sequencing

Have you or any member of your family had, currently have or been diagnosed with any of the following conditions? If yes, please list the affected individual(s), mother or father's side, age at onset, treatment and any other pertinent information.

Heart attack	Mother - age 50; Grandparents - Maternal grandmother, age 75
Congenital heart disease	None
Hemophilia/bleeding problem	None
Emphysema	None
Cystic Fibrosis	None
Alpha-1 Antitrypsin Deficiency	None
Pyloric stenosis	None
Colon cancer	Grandparent - Maternal grandfather, age 81, cause of death
Inflammatory bowel disease	None
Irritable Bowel Syndrome	None
Diabetes mellitus requiring insulin therapy	Grandparent - Maternal grandfather, age 60
Diabetes mellitus not requiring insulin therapy	None
PKU or inherited metabolism disorder	None
Progressive kidney disease	None
Polycystic kidney disease	None
Miscarriages or stillborn	Sibling - Sister #1, age 27
Herpes simplex virus, genital	None
Migraines	None
Mental retardation	None
Senility or mental deterioration before age 60	None
Epilepsy/seizures	None
Neural tube defects - open spine or hydrocephalus/water on the brain	None
Huntington's disease	None
Tuberous sclerosis	None
Neurofibromatosis	None
Parkinson's disease	None
Down Syndrome	None
Autism	None
Autism Spectrum Disorder	None
Pervasive Developmental Delay (PDD)	None
Asperger's Syndrome	None
Schizophrenia	None
Bipolar (manic depressive psychosis)	None
Attention Deficit Disorder (ADD)	None
Attention Deficit Hyperactivity Disorder (ADHD)	None
Muscular Dystrophy	None
Loss of muscle coordination	None
Rheumatoid Arthritis	Aunt/Uncle - Paternal aunt #2, age 32
Reiter's Disease	None
Club foot	None
Deafness before age of 60	None
Cataracts before age of 60	None
Blindness in both eyes before age of 60	None
Glaucoma	None
Macular Degeneration	None
Acne	None
Psoriasis	None
Albinism	None
More than 5 purple or coffee-colored spots on the skin-1.5 cm (1/2 inch) or larger	None
Drug abuse, misuse, or addiction	None
Cleft palate or cleft lip	None
Serious birth defects	None
Inguinal hernia	None
Premature degeneration of any organ system	None
The same cancer in more than one family member	None

Donor Medical History

Question	Response
List any operations: Age & reason:	Surgery to repair double hernia when born
Hospitalization other than surgery: Age & type of illness:	None
Have you ever had any broken bones? If yes, please give age and description:	No
Have you ever had any serious illnesses? If yes, please give age and description:	No
How many days in the past 12 months could you not work because of all illness (colds, flu, accidents, surgery, etc)? Please describe:	2 - Cold symptoms
Are you presently under a physician's care for any reason? If yes, please describe:	No
List all drugs you have taken in past 12 months (prescription, nonprescription, herbal, and sports supplements, and recreational). Include drug, frequency and duration taken, and reason:	Creatine and multivitamin, taken daily; Tylenol or ibuprofen, taken occasionally to relieve pain; Cold medicine taken for two days to decrease symptoms; Melatonin taken as needed to aid sleep
List all current medication or treatments (include vitamins, aspirin, antacids, laxatives, herbal, sports supplements, etc.) Include drug, frequency and duration taken, and reason:	Creatine and multivitamin, taken daily
Do you wear glasses or contact lenses? Are you near or far-sighted?	No
Usual weight?	185
Recent weight loss or gain? # of lbs and reason:	Yes - +5 lbs due to weight training
Allergies (medicines, food, pollens)? If yes, please list substance and reaction caused:	Yes - Pollens: Cause nasal congestion
Have you been tested for HIV (AIDS)? If yes, when:	Yes - Negative, ongoing donor screening
Sexual orientation:	Heterosexual
How many sexual partners do you currently have?	1
Have you ever had a tattoo? If yes, what year did you get the tattoo?	Yes - 2011
Have you ever had your ear(s) or body pierced? If yes, where and what year?	Yes - Ears in 2006, Tongue in 2006

Family Medical History
See list of questions asked here

Your Mother

Question	Response	Comment/Age Affected
Current age or age at death	52
Health Problem	Situational anxiety, treated with medication	43
	Situational depression, treated with medication	43
	Heart attack, treated with pacemaker and physical therapy	50
Living / Dead	Living

Your Father

Question	Response	Comment/Age Affected
Current age or age at death	54
Health Problem	High blood pressure, controlled with medication	52
Health Problem	High cholesterol, controlled with medication	52
Living / Dead	Living

Sisters

Your Sister 1

Question	Response	Comment/Age Affected
Current age or age at death	32
Health Problem	Miscarriage, no treatment, successful pregnancy post-miscarriage	27
Living / Dead	Living

Your Sister 2

Question	Response	Comment/Age Affected
Current age or age at death	24
Health Problem	Healthy
Living / Dead	Living

Sons

Your Son 1

Question	Response	Comment/Age Affected
Current age or age at death	5
Health Problem	Healthy
Living / Dead	Living

Daughters

Your Daughter 1

Question	Response	Comment/Age Affected
Current age or age at death	1
Health Problem	Healthy
Living / Dead	Living

Your Mother's Father

Question	Response	Comment/Age Affected
Current age or age at death	85
Health Problem	Diabetes mellitus requiring insulin therapy	60
	Colon cancer, attempted treatment with surgery and chemotherapy	81
	Cause of death: Colon cancer	85
Living / Dead	Dead

Your Mother's Mother

Question	Response	Comment/Age Affected
Current age or age at death	91
Health Problem	Heart attack, no treatment	75
	Heart failure	91
	Cause of death: Heart failure	91
Living / Dead	Dead

Your Mother's Sisters 1

Question	Response	Comment/Age Affected
Current age or age at death	68
Health Problem	Liver cancer, no treatment	60
Health Problem	Cause of death: Liver cancer	60
Living / Dead	Dead

Your Mother's Sisters 2

Question	Response	Comment/Age Affected
Current age or age at death	60
Health Problem	Healthy
Living / Dead	Living

Your Mother's Brothers 1

Question	Response	Comment/Age Affected
Current age or age at death	68
Health Problem	Healthy
Living / Dead	Living

Your Mother's Brothers 2

Question	Response	Comment/Age Affected
Current age or age at death	58
Health Problem	Healthy
Living / Dead	Living

Your Mother's Brothers 3

Question	Response	Comment/Age Affected
Current age or age at death	56
Health Problem	Healthy
Living / Dead	Living

Your Father's Father

Question	Response	Comment/Age Affected
Current age or age at death	85
Health Problem	Healthy
Living / Dead	Living

Your Father's Mother

Question	Response	Comment/Age Affected
Current age or age at death	83
Health Problem	Healthy
Living / Dead	Living

Your Father's Sisters 1

Question	Response	Comment/Age Affected
Current age or age at death	56
Health Problem	Healthy
Living / Dead	Living

Your Father's Sisters 2

Question	Response	Comment/Age Affected
Current age or age at death	40	Maternal half sister
Health Problem	Rheumatoid arthritis, controlled with medication	32
Living / Dead	Living

Your Father's Brothers 1

Question	Response	Comment/Age Affected
Current age or age at death	19
Health Problem	Severe trauma due to car accident, no treatment	19
Health Problem	Cause of death: Severe trauma	19
Living / Dead	Dead

Your Father's Brothers 2

Question	Response	Comment/Age Affected
Current age or age at death	51
Health Problem	Healthy
Living / Dead	Living

Your Father's Brothers 3

Question	Response	Comment/Age Affected
Current age or age at death	49
Health Problem	Healthy
Living / Dead	Living

Donor Number: 4871

Personal Behavior History

Sexual History

Donor Genetic History

Donor Medical History

Family Medical HistorySee list of questions asked here

Family Medical History
See list of questions asked here