Donor 7502 - 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:	Rarely - Beer 12oz, Wine 5oz, Whiskey 1oz per month
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?	N/A
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

Question	Response
A partner whose sexual background you are unsure of in the past 12 months?	No

Donor Genetic History

Question	Response
Do you have a history of a speech disorder; such as a speech impediment, stuttering, delayed speech development, etc.? If yes, explain:	No
Do you have learning differences, such as dyslexia? If yes, explain:	No
Were you or any family members born with any birth defects? If yes, explain:	No

Donor Medical History

Question	Response
List any operations: Age & reason:	Tympanostomy - Infant, fluid not draining properly from ears
Hospitalization other than surgery: Age & type of illness:	N/A - N/A
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
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:	N/A - N/A; N/A; N/A
List all current medication or treatments (include vitamins, aspirin, antacids, laxatives, herbal, sports supplements, etc.) Include drug, frequency and duration taken, and reason:	N/A - N/A; N/A; N/A
Do you wear glasses or contact lenses? Are you near or far-sighted?	No
Birth weight lbs	7
Birth weight ozs	12
Recent weight loss or gain? # of lbs and reason:	No
Allergies (medicines, food, pollens)? If yes, please list substance and reaction caused:	No
How many sexual partners do you currently have?	0
Have you ever had a tattoo?	No
Have you ever had your ear(s) or body pierced?	No

Family Medical History
See list of questions asked here

Mother's Father Ethnic Origins	Irish-Italian
Mother's Mother Ethnic Origins	English
Father's Father Ethnic Origins	Irish-Italian
Father's Mother Ethnic Origin	English-German-Czech
Is anyone in your family of Ashkenazai Jewish Heritage?	No
If yes, who?	N/A

Your Mother

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

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

Brothers

Your Brother 1

Question	Response
Current age or age at death	40
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	44
Living / Dead	Living
Cause of death and any treatment prior to death	N/A

Health Problems

Healthy

Your Sister 2

Question	Response
Current age or age at death	42
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	92
Living / Dead	Living
Cause of death and any treatment prior to death	N/A

Health Problems

Disease

Age Diagnosed

Treatment For Condition

Other

Pacemaker, age of diagnosis and treatment unknown

Your Mother's Mother

Question	Response
Current age or age at death	84
Living / Dead	Dead
Cause of death and any treatment prior to death	Natural Causes

Health Problems

Disease

Age Diagnosed

Treatment For Condition

Other

Heart Attack, Treatment: Stent, age of diagnosis and treatment unknown

Your Mother's Sisters 1

Question	Response
Current age or age at death	64
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	60
Living / Dead	Living
Cause of death and any treatment prior to death	N/A

Health Problems

Healthy

Your Mother's Sisters 3

Question	Response
Current age or age at death	56
Living / Dead	Living
Cause of death and any treatment prior to death	N/A

Health Problems

Healthy

Your Mother's Sisters 4

Question	Response
Current age or age at death	52
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 Mother's Brothers 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 Mother's Brothers 3

Question	Response
Current age or age at death	55
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	62
Living / Dead	Dead
Cause of death and any treatment prior to death	Complications from surgery

Health Problems

Disease

Age Diagnosed

Treatment For Condition

Other

Ulcer, age of diagnosis and treatment unknown

Your Father's Mother

Question	Response
Current age or age at death	92
Living / Dead	Living
Cause of death and any treatment prior to death	N/A

Health Problems

Healthy

Your Father's Sisters 1

Question	Response
Current age or age at death	57
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	51
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	69
Living / Dead	Living
Cause of death and any treatment prior to death	N/A

Health Problems

Healthy

Your Father's Brothers 2

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

Healthy

Your Father's Brothers 3

Question	Response
Current age or age at death	64
Living / Dead	Living
Cause of death and any treatment prior to death	N/A

Health Problems

Healthy

Donor Number: 7502

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