Physical
Medical
Family Medical History
Religion
Updates to ProfileThis donor is a healthy carrier for a genetic disease.
Please see his Genetic Testing Summary and Acknowledgment of Genetic Risk for details
Please see his Genetic Testing Summary and Acknowledgment of Genetic Risk for details
Physical
|
Height:
5'10"
(177 cm) |
Weight:
150 lb
(68 kg) |
Eye Color:
Brown
|
Hair:
Brown/
Wavy |
Skin Tone:
Medium Light
|
Ancestry:
Caucasian
|
|
Blood Type:
A+
|
Ethnic Background:
German-Lithuanian/English-French-Dutch-Irish
|
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|
Education:
MS/Geography
|
Occupation:
Teaching Assistant
|
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Interests:
|
Guitar, Hiking, Yoga
|
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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? | No |
| Allergies (medicines, food, pollens)? If yes, please list substance and reaction caused: | No |
| 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 | 70 |
| 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 | 68 |
| Living / Dead | Living |
| Cause of death and any treatment prior to death | N/A |
Health Problems
Disease
Age Diagnosed
Treatment For Condition
Prostate cancer
67
Radiation
Your Mother's Father
| Question | Response |
| Current age or age at death | 70 |
| Living / Dead | Dead |
| Cause of death and any treatment prior to death | Heart failure |
Health Problems
Healthy
Your Mother's Mother
| Question | Response |
| Current age or age at death | 90 |
| Living / Dead | Dead |
| Cause of death and any treatment prior to death | Brain cancer |
Health Problems
Disease
Age Diagnosed
Treatment For Condition
Brain cancer
90
Fatal, diagnosed at late stage
Your Mother's Sisters 1
| Question | Response |
| Current age or age at death | 73 |
| 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 | 91 |
| Living / Dead | Dead |
| Cause of death and any treatment prior to death | Pneumonia, Grief (died shortly after death of wife) |
Health Problems
Disease
Age Diagnosed
Treatment For Condition
Pneumonia
91
Fatal
Your Father's Mother
| Question | Response |
| Current age or age at death | 90 |
| Living / Dead | Dead |
| Cause of death and any treatment prior to death | Leukemia |
Health Problems
Disease
Age Diagnosed
Treatment For Condition
Leukemia
90
Fatal, diagnosed at death
Your Father's Sisters 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
Disease
Age Diagnosed
Treatment For Condition
Breast cancer
62
Chemotherapy
Religion:
| Faith | Other |
| Denomination | Buddhist |
Updates to Profile
| Update Available | Yes |
| Updates - Personal | No change to donor Personal Profile: October 2020. Update received June 2021: Occupation has changed to writer. ***Update received February 2023: Donor has agreed to allow the Cryobank to release their identifying information to adult offspring 18 and older who complete the ID donor Contact request process. Please contact Fairfax Cryobank for details.*** |
| Updates - Medical | No change to donor Medical Profile: October 2020, June 2021. |
| Updates - Family Medical History | Update received October 2020: Donor's Father now in remission from prostate cancer. No change to donor Family Medical History: June 2021. |