Donor 5017 - 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:	Yes - Maternal grandfather, alcohol abuse, in his early 30s
Any dietary restrictions? If yes, explain:	No
Do you wear glasses or contact lenses? Are you near or far-sighted?	Yes - (Right eye far-sighted, Left eye near-sighted)
Allergies (medicines, food, pollens)? If yes, please list substance and reaction caused:	Yes - Penicillin: Causes rash on skin
CMV IgG Antibody	Negative
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	64
Health Problem	Healthy
Living / Dead	Living

Your Father

Question	Response	Comment/Age Affected
Current age or age at death	66
Health Problem	Diabetes mellitus requiring insulin therapy	55
Health Problem	Heart attack, mild, treated with surgery	64
Living / Dead	Living

Sisters

Your Sister 1

Question	Response	Comment/Age Affected
Current age or age at death	34
Health Problem	Healthy
Living / Dead	Living

Sons

Your Son 1

Question	Response	Comment/Age Affected
Current age or age at death	3
Health Problem	Healthy
Living / Dead	Living

Your Son 2

Question	Response	Comment/Age Affected
Current age or age at death	1
Health Problem	Healthy
Living / Dead	Living

Your Mother's Father

Question	Response	Comment/Age Affected
Current age or age at death	69
Health Problem	Alcohol abuse, in his early 30s
	Cirrhosis, no treatment	48
	Cause of death: Cirrhosis	69
Living / Dead	Dead

Your Mother's Mother

Question	Response	Comment/Age Affected
Current age or age at death	81
Health Problem	Heart failure, no treatment	80
Health Problem	Cause of death: Heart failure	81
Living / Dead	Dead

Your Mother's Sisters 1

Question	Response	Comment/Age Affected
Current age or age at death	66
Health Problem	Healthy
Living / Dead	Living

Your Mother's Brothers 1

Question	Response	Comment/Age Affected
Current age or age at death	51
Health Problem	Healthy
Living / Dead	Living

Your Father's Father

Question	Response	Comment/Age Affected
Current age or age at death	70
Health Problem	Heart failure (sedentary lifestyle, poor diet), treated with diet change and medication	56
Health Problem	Cause of death: Heart failure	70
Living / Dead	Dead

Your Father's Mother

Question	Response	Comment/Age Affected
Current age or age at death	71
Health Problem	Heart failure, no treatment	70
Health Problem	Cause of death: Heart failure	71
Living / Dead	Dead

Your Father's Brothers 1

Question	Response	Comment/Age Affected
Current age or age at death	76
Health Problem	Healthy
Living / Dead	Living

Your Father's Brothers 2

Question	Response	Comment/Age Affected
Current age or age at death	74
Health Problem	Healthy
Living / Dead	Living

Your Father's Brothers 3

Question	Response	Comment/Age Affected
Current age or age at death	72
Health Problem	Healthy
Living / Dead	Living

Height: 5'11" (180 cm)	Weight: 190 lb (86 kg)	Eye Color: Blue	Hair: Red/ Straight	Skin Tone: Light	Ancestry: Caucasian
	Blood Type: A+	Ethnic Background: English/Polish
	Education: BS/Professional Aeronautics		Occupation: Helicopter Pilot
Interests:	Baseball, Football, Ice Hockey, Skiing, Snowboarding, Wake Boarding, Water Skiing, Weightlifting

Faith	Christian
Denomination	Church of Christ

Update Available	Yes
Updates - Personal	No change to donor Personal Profile: September 2018.
Updates - Medical	No change to donor Medical Profile: September 2018.
Updates - Family Medical History	No change to donor Family Medical History: September 2018.

Donor Number: 5017

Physical

Medical

Family Medical History
See list of questions asked here

Religion:

Updates to Profile

Donor Number: 5017

Physical

Medical

Family Medical HistorySee list of questions asked here

Religion:

Updates to Profile

Family Medical History
See list of questions asked here