Physical
Medical
Family Medical History
Religion
Updates to ProfilePhysical
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Height:
6'1"
(185 cm) |
Weight:
192 lb
(87 kg) |
Eye Color:
Blue
|
Hair:
Brown/
Wavy |
Skin Tone:
Medium
|
Ancestry:
Caucasian
|
|
Blood Type:
A+
|
Ethnic Background:
German/German-Polish
|
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Education:
MSN/Family Nurse Practitioner
|
Occupation:
Registered Nurse
|
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Interests:
|
Photography, Running, Volleyball
|
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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: | No |
| Do you wear glasses or contact lenses? Are you near or far-sighted? | Yes - Near-sighted, started wearing at age 18 |
| Allergies (medicines, food, pollens)? If yes, please list substance and reaction caused: | Yes - Cats, age 12 (runny nose and itchy eyes); Seasonal allergies, age 17. Both treated with over the counter medication |
| CMV IgG Antibody | Negative |
| CMV IgM Antibody | Negative |
| Note any comments regarding above items: | N/A |
Family Medical HistorySee list of questions asked here
Your Mother
| Question | Response |
| Current age or age at death | 59 |
| Living / Dead | Living |
| Cause of death and any treatment prior to death | N/A |
Health Problems
Healthy
Your Father
| Question | Response |
| Current age or age at death | 65 |
| Living / Dead | Living |
| Cause of death and any treatment prior to death | N/A |
Health Problems
Healthy
Brothers
Your Brother 1
| Question | Response |
| Current age or age at death | 40 - 1/2 Paternal |
| Living / Dead | Living |
| Cause of death and any treatment prior to death | N/A |
Health Problems
Healthy
Sisters
Your Sister 1
| Question | Response |
| Current age or age at death | 34 |
| Living / Dead | Living |
| Cause of death and any treatment prior to death | N/A |
Health Problems
Disease
Age Diagnosed
Treatment For Condition
Seasonal allergies
15
Over the counter medication
Cat allergies
15
Over the counter medication
Your Sister 2
| Question | Response |
| Current age or age at death | 32 |
| Living / Dead | Living |
| Cause of death and any treatment prior to death | N/A |
Health Problems
Healthy
Your Mother's Father
| Question | Response |
| Current age or age at death | 81 |
| Living / Dead | Dead |
| Cause of death and any treatment prior to death | Heart failure |
Health Problems
Disease
Age Diagnosed
Treatment For Condition
Heart failure
81
None; passed away in sleep
Your Mother's Mother
| Question | Response |
| Current age or age at death | 86 |
| Living / Dead | Dead |
| Cause of death and any treatment prior to death | Natural, dementia related |
Health Problems
Disease
Age Diagnosed
Treatment For Condition
Dementia
80
Medication controlled
Your Mother's Sisters 1
| Question | Response |
| Current age or age at death | 65 |
| Living / Dead | Living |
| Cause of death and any treatment prior to death | N/A |
Health Problems
Healthy
Your Mother's Sisters 2
| Question | Response |
| Current age or age at death | 62 |
| Living / Dead | Living |
| Cause of death and any treatment prior to death | N/A |
Health Problems
Healthy
Your Mother's Brothers 1
| Question | Response |
| Current age or age at death | 65 |
| Living / Dead | Living |
| Cause of death and any treatment prior to death | N/A |
Health Problems
Healthy
Your Father's Father
| Question | Response |
| Current age or age at death | 65 |
| Living / Dead | Dead |
| Cause of death and any treatment prior to death | Car accident |
Health Problems
Disease
Age Diagnosed
Treatment For Condition
Car accident
65
No treatment, immediately fatal
Your Father's Mother
| Question | Response |
| Current age or age at death | 87 |
| Living / Dead | Dead |
| Cause of death and any treatment prior to death | Respiratory failure |
Health Problems
Disease
Age Diagnosed
Treatment For Condition
Respiratory failure
87
None
Your Father's Sisters 1
| Question | Response |
| Current age or age at death | 66 |
| Living / Dead | Living |
| Cause of death and any treatment prior to death | N/A |
Health Problems
Healthy
Your Father's Sisters 2
| Question | Response |
| Current age or age at death | 63 |
| Living / Dead | Living |
| Cause of death and any treatment prior to death | N/A |
Health Problems
Healthy
Your Father's Sisters 3
| Question | Response |
| Current age or age at death | 58 |
| Living / Dead | Living |
| Cause of death and any treatment prior to death | N/A |
Health Problems
Healthy
Your Father's Brothers 1
| Question | Response |
| Current age or age at death | 67 |
| Living / Dead | Living |
| Cause of death and any treatment prior to death | N/A |
Health Problems
Disease
Age Diagnosed
Treatment For Condition
Pacemaker
60
NA
Heart transplant
65
NA
Your Father's Brothers 2
| Question | Response |
| Current age or age at death | 62 |
| Living / Dead | Living |
| Cause of death and any treatment prior to death | N/A |
Health Problems
Healthy
Religion:
| Faith | Christian |
| Denomination | Lutheran |
Updates to Profile
| Update Available | Yes |
| Updates - Personal | Update received September 2025: Occupation has changed to Nurse Practitioner; Donor reports that he is now married. |
| Updates - Medical | No change to profile: September 2025. |
| Updates - Family Medical History | Update recevied September 2020: Donor's Maternal grandfather was diagnosed with macular degeneration in his 60's, eventually resulting in blindness. This grandfather passed away at age 81 of heart failure, as mentioned in the family history. No change to profile: September 2025. |