Physical
Medical
Family Medical History
Religion
Updates to ProfilePhysical
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Height:
6'0"
(182 cm) |
Weight:
215 lb
(97 kg) |
Eye Color:
Hazel
|
Hair:
Brown/
Curly |
Skin Tone:
Light
|
Ancestry:
Caucasian
|
|
Blood Type:
A+
|
Ethnic Background:
Irish-Norwegian-Swedish/French Canadian
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Education:
DDS/Dentistry
|
Occupation:
Dental Student
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Interests:
|
Model kit building, Painting, Reading, Volunteering
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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 |
| 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 HistorySee list of questions asked here
Your Mother
| Question | Response | Comment/Age Affected |
| Current age or age at death | 51 | |
| Health Problem | Pre-cancerous cervical cells, removed with surgery | 47 |
| Living / Dead | Living |
Your Father
| Question | Response | Comment/Age Affected |
| Current age or age at death | 59 | |
| Health Problem | Healthy | |
| Living / Dead | Living |
Brothers
Your Brother 1
| Question | Response | Comment/Age Affected |
| Current age or age at death | 24 | |
| Health Problem | Healthy | |
| Living / Dead | Living |
Your Mother's Father
| Question | Response | Comment/Age Affected |
| Current age or age at death | 94 | |
| Health Problem | High blood pressure, controlled with medication | 65 |
| Diabetes mellitus requiring insulin therapy | 70 | |
| Basal cell carcinoma on left temple, removed with surgery | 85 | |
| Living / Dead | Living |
Your Mother's Mother
| Question | Response | Comment/Age Affected |
| Current age or age at death | 84 | |
| Health Problem | Anxiety, no treatment | 70 |
| Diabetes mellitus requiring insulin therapy | 70 | |
| Heart disease, controlled with medication and oxygen therapy | 70 | |
| Heart failure, no treatment | 84 | |
| Cause of death: Heart failure | 84 | |
| Living / Dead | Dead |
Your Mother's Sisters 1
| Question | Response | Comment/Age Affected |
| Current age or age at death | 62 | |
| Health Problem | Strawberry allergy, treated with over-the-counter medication (since childhood) | 5 |
| Knee replacement | 60 | |
| Living / Dead | Living |
Your Mother's Sisters 2
| Question | Response | Comment/Age Affected |
| Current age or age at death | 58 | |
| Health Problem | Basal cell carcinoma on nose, removed with surgery | 57 |
| Living / Dead | Living |
Your Mother's Brothers 1
| Question | Response | Comment/Age Affected |
| Current age or age at death | 65 | |
| Health Problem | Double hernia, treated with surgery | 35 |
| Living / Dead | Living |
Your Mother's Brothers 2
| Question | Response | Comment/Age Affected |
| Current age or age at death | 59 | |
| 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 | 65 | |
| Health Problem | High blood pressure, controlled with medication | 63 |
| Heart attack, no treatment | 65 | |
| Cause of death: Heart attack | 65 | |
| Living / Dead | Dead |
Your Father's Mother
| Question | Response | Comment/Age Affected |
| Current age or age at death | 81 | |
| Health Problem | High blood pressure, controlled with medication | 75 |
| Living / Dead | Living |
Your Father's Sisters 1
| Question | Response | Comment/Age Affected |
| Current age or age at death | 57 | |
| Health Problem | Healthy | |
| Living / Dead | Living |
Your Father's Brothers 1
| Question | Response | Comment/Age Affected |
| Current age or age at death | 30 | |
| Health Problem | Germ cell cancer, attempted treatment with surgery, chemotherapy and radiation | 30 |
| Cause of death: Germ cell cancer | 30 | |
| Living / Dead | Dead |
Your Father's Brothers 2
| Question | Response | Comment/Age Affected |
| Current age or age at death | 61 | |
| Health Problem | Bipolar disorder, treated with routine doctor's office visits | 53 |
| Living / Dead | Living |
Your Father's Brothers 3
| Question | Response | Comment/Age Affected |
| Current age or age at death | 56 | |
| Health Problem | Diabetes mellitus requiring insulin therapy | 56 |
| Living / Dead | Living |
Religion:
| Faith | Christian |
| Denomination | Catholic |
Updates to Profile
| Update Available | Yes |
| Updates - Personal | Update received May 2015: Donor has completed his Bachelor's degree in Biology and is pursuing a degree in Dentistry. No change to donor Personal Profile: July 2016, August 2018, June 2019. |
| Updates - Medical | No change to donor Medical Profile: May 2015, July 2016, August 2018, June 2019. |
| Updates - Family Medical History | No change to donor Family Medical History: May 2015, July 2016. Update received August 2018: Maternal grandfather has died at age 98, his cause of death was not reported. No change to donor Family Medical History: June 2019. |