Donor 7128 - 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

Updated medical information on the donor and his family (if applicable) will be included at the bottom of the Summary Profile

Personal Behavior History

Question	Response
Current alcohol use: If yes, oz./week and type of alcohol:	Never
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:	Wisdom teeth removal - Age 18
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:	Protein, Creatine - 3-4x per week; 12 months; General Health
Do you wear glasses or contact lenses? Are you near or far-sighted?	Yes - Far-sighted, 20/30
Birth weight lbs	7
Birth weight ozs	8
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?	1
Have you ever had a tattoo?	Yes - 2, right leg and left arm
Have you ever had your ear(s) or body pierced?	Yes - Both ears

Family Medical History
See list of questions asked here

Mother's Father Ethnic Origins	Portuguese
Mother's Mother Ethnic Origins	Portuguese
Father's Father Ethnic Origins	Cape Verdean
Father's Mother Ethnic Origin	Cape Verdean
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	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	56
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	26
Living / Dead	Living
Cause of death and any treatment prior to death	N/A

Health Problems

Healthy

Your Brother 2

Question	Response
Current age or age at death	23
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	35
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	21
Living / Dead	Living
Cause of death and any treatment prior to death	N/A

Health Problems

Healthy

Sons

Your Son 1

Question	Response
Current age or age at death	1
Living / Dead	Living

Health Problems

Healthy

Your Mother's Father

Question	Response
Current age or age at death	98
Living / Dead	Living
Cause of death and any treatment prior to death	N/A

Health Problems

Healthy

Your Mother's Mother

Question	Response
Current age or age at death	99
Living / Dead	Dead
Cause of death and any treatment prior to death	Old Age (died in sleep, specific cause unknown)

Health Problems

Disease

Age Diagnosed

Treatment For Condition

Other

No diagnosed health problems at time of death

Your Mother's Sisters 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

Healthy

Your Mother's Sisters 2

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 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

Your Mother's Sisters 4

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 5

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 Mother's Brothers 1

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 Brothers 2

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's Father

Question	Response
Current age or age at death	69
Living / Dead	Dead
Cause of death and any treatment prior to death	Stroke

Health Problems

Disease

Age Diagnosed

Treatment For Condition

Diabetes mellitus not requiring insulin therapy

Medication

Your Father's Mother

Question	Response
Current age or age at death	78
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	39
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	49
Living / Dead	Living
Cause of death and any treatment prior to death	N/A

Health Problems

Healthy

Donor Number: 7128

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