Physical
Medical
Family Medical History
Religion
Updates to ProfilePhysical
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Height:
6'2"
(187 cm) |
Weight:
210 lb
(95 kg) |
Eye Color:
Green
|
Hair:
Brown/
Wavy |
Skin Tone:
Light
|
Ancestry:
Caucasian
|
|
Blood Type:
A-
|
Ethnic Background:
Polish/Irish-Polish
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Education:
BS/Criminal Justice
|
Occupation:
Social Worker
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Interests:
|
Exercise, Friends, Reading, Swimming, Video games, Working on cars, Writing
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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: | Yes - Pollen: Causes runny nose, itchy eyes |
| 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 | 52 |
| Living / Dead | Living |
| Cause of death and any treatment prior to death | N/A |
Health Problems
Disease
Age Diagnosed
Treatment For Condition
Migraines
18
Over-the-counter medication
Atrial fibrillation
52
Over-the-counter medication
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
Disease
Age Diagnosed
Treatment For Condition
Kidney stones (passed naturally)
18
None
Sisters
Your Sister 1
| 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
Daughters
Your Daughter 1
| Question | Response |
| Current age or age at death | 6 |
| Living / Dead | Living |
Health Problems
Healthy
Your Mother's Father
| Question | Response |
| Current age or age at death | 86 |
| Living / Dead | Dead |
| Cause of death and any treatment prior to death | Heart failure |
Health Problems
Disease
Age Diagnosed
Treatment For Condition
Alzheimer's
82
Medication, Nursing home
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 | Heart failure |
Health Problems
Disease
Age Diagnosed
Treatment For Condition
Alzheimer's
83
Medication, Nursing home
Your Mother's Sisters 1
| Question | Response |
| Current age or age at death | 50 |
| 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 | 52 |
| Living / Dead | Dead |
| Cause of death and any treatment prior to death | Heart attack |
Health Problems
Disease
Age Diagnosed
Treatment For Condition
Heart attack, fatal
52
None
Your Father's Father
| Question | Response |
| Current age or age at death | 80 |
| Living / Dead | Dead |
| Cause of death and any treatment prior to death | Heart failure |
Health Problems
Healthy
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 | 55 |
| Living / Dead | Living |
| Cause of death and any treatment prior to death | N/A |
Health Problems
Disease
Age Diagnosed
Treatment For Condition
Colon cancer
55
Chemotherapy
Your Father's Brothers 1
| 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 Brothers 2
| 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
Disease
Age Diagnosed
Treatment For Condition
Kidney stones (passed naturally)
16
None
Religion:
| Faith | Other |
| Denomination | Agnostic |
Updates to Profile
| Update Available | Yes |
| Updates - Personal | No change to profile: March 2021, March 2022. Update received May 2023: Occupation has changed to Case Manager. |
| Updates - Medical | No change to profile: March 2021, March 2022. |
| Updates - Family Medical History | No change to profile: March 2021. Update received March 2022: Donor's Daughter had oral surgery to prevent crowding of adult teeth. Update April 2024: A recipeint reported a pregnancy with multiple congential anomalies, likely VACTERL syndrome. Genetic testing was negative and this is likely a sporadic (non hereditary) event. Risks to other pregnancies is very low. |