Donor 4552 - Summary Profile

Physical

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 History
See list of questions asked 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
Health Problem	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
Health Problem	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

Height: 5'10" (177 cm)	Weight: 147 lb (66 kg)	Eye Color: Blue	Hair: Brown/ Straight	Skin Tone: Medium Light	Ancestry: Caucasian
	Blood Type: A+	Ethnic Background: Norwegian-Polish/English-Irish-Scottish
	Education: AA/Theater		Occupation: Audience Services Rep.
Interests:	Act, Play Chess, Read, Write

Faith	Other
Denomination	Agnostic

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.

Donor Number: 4552

Physical

Medical

Family Medical History
See list of questions asked here

Religion:

Updates to Profile

Donor Number: 4552

Physical

Medical

Family Medical HistorySee list of questions asked here

Religion:

Updates to Profile

Family Medical History
See list of questions asked here