Physical
Medical
Family Medical History
Religion
Updates to ProfilePhysical
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Height:
6'3"
(190 cm) |
Weight:
195 lb
(88 kg) |
Eye Color:
Blue
|
Hair:
Brown/
Wavy |
Skin Tone:
Medium Light
|
Ancestry:
Caucasian
|
|
Blood Type:
A+
|
Ethnic Background:
English-Irish/English-German
|
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Education:
MD, MPH
|
Occupation:
Physician
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Interests:
|
Clarinet, Cooking, Running, Ultimate Frisbee, Woodworking
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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 | 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 |
| Current age or age at death | 61 |
| Living / Dead | Living |
| Cause of death and any treatment prior to death | N/A |
Health Problems
Disease
Age Diagnosed
Treatment For Condition
High blood pressure
57
Medication
Emphysema
54
Smoking cessation and inhaler
Your Father
| Question | Response |
| Current age or age at death | 61 |
| Living / Dead | Living |
| Cause of death and any treatment prior to death | N/A |
Health Problems
Disease
Age Diagnosed
Treatment For Condition
High blood pressure
55
Medication
Sisters
Your Sister 1
| Question | Response |
| Current age or age at death | 36 |
| Living / Dead | Living |
| Cause of death and any treatment prior to death | N/A |
Health Problems
Disease
Age Diagnosed
Treatment For Condition
Migraines
14
Abortive therapy (Imitrex and/or ibuprofen)
Sons
Your Son 1
| Question | Response |
| Current age or age at death | 2 |
| Living / Dead | Living |
Health Problems
Healthy
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 | Complications from a stroke (heavy smoker) |
Health Problems
Disease
Age Diagnosed
Treatment For Condition
Other
No other health problems diagnosed at time of death
Your Mother's Mother
| Question | Response |
| Current age or age at death | 40 |
| Living / Dead | Dead |
| Cause of death and any treatment prior to death | Car accident |
Health Problems
Disease
Age Diagnosed
Treatment For Condition
Early death (less than age 50)
40
Fatal car accident, no treatment
Your Mother's Sisters 1
| 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
Disease
Age Diagnosed
Treatment For Condition
Other
Rosacea, no treatment
Your Mother's Sisters 2
| 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 Mother's Brothers 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
Healthy
Your Mother's Brothers 2
| 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 Father's Father
| Question | Response |
| Current age or age at death | 68 |
| Living / Dead | Dead |
| Cause of death and any treatment prior to death | Complications from war injuries (TBI, double leg amputation) |
Health Problems
Disease
Age Diagnosed
Treatment For Condition
Diabetes mellitus not requiring insulin therapy
60
Diet changes
Your Father's Mother
| Question | Response |
| Current age or age at death | 87 |
| Living / Dead | Living |
| Cause of death and any treatment prior to death | N/A |
Health Problems
Disease
Age Diagnosed
Treatment For Condition
Parkinson's disease
78
Medication
Osteoarthritis
75
Double knee replacement
Other
Second knee replacement do to allergic reaction to nickel implants
Your Father's Sisters 1
| Question | Response |
| Current age or age at death | 66 |
| 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 | 68 |
| 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 | 60 |
| Living / Dead | Living |
| Cause of death and any treatment prior to death | N/A |
Health Problems
Disease
Age Diagnosed
Treatment For Condition
High blood pressure
52
Medication and lifestyle changes
Your Father's Brothers 3
| 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
Religion:
| Faith | Other |
| Denomination | I believe in the commonalities of all religions - Raised Christian, Believe all religions have commonalities for a reason |
Updates to Profile
| Update Available | N/A |
| Updates - Personal | N/A |
| Updates - Medical | N/A |
| Updates - Family Medical History | N/A |