A medical update has been received. Check the Summary Profile Update Section

Personal Behavior History

Question Response
Current alcohol use:
If yes, oz./week and type of alcohol:
Frequently - 36 oz. beer/week
Have you or any of your family members been diagnosed with alcoholism or drug addiction?
If yes, relation and age affected:
No
Tobacco use: Do you smoke?
If yes, #/day and for how long:
No
If you did smoke but quit, when did you last smoke?17 months ago
For how many years?1.2
Do you sleep well?Yes
Do you exercise on regular basis?Yes
Is your diet well balanced?
If no, explain:
Yes
Are you a vegetarian?No
Any dietary restrictions?
If yes, explain:
Yes - Kosher

Sexual History

Question Response
A partner whose sexual background you are unsure of in the past 12 months?No
Another man anal or oral, even once, since 1977?No

Donor Genetic History

Question Response
Were you or any family members born with any birth defects?
If yes, explain:
No
Have you been tested for Cystic Fibrosis?
If yes, the result:
Yes - Non-carrier for the 99 mutations tested
Karyotype?
If yes, the result:
Yes - Normal karyotype
Spinal Muscular Atrophy (SMA)?
If yes, the result:
Non Carrier - Standard donor screening
Tay Sachs?
If yes, the result:
Non Carrier - for mutations tested
Question Response
Are you of Jewish ancestry?
If yes, please note: Ashkenazi, Sephardi, or Other
Yes - Ashkenazi
Question Response
Tay Sachs:
If yes, result(s):
Yes - Non-carrier
Gaucher:
If yes, result(s):
Yes - Non-carrier
Canavan:
If yes, result(s):
Yes - Non-carrier
Fanconi Anemia Type C:
If yes, result(s):
Yes - Non-carrier
Niemann-Pick Type A:
If yes, result(s):
Yes - Non-carrier
Bloom Syndrome:
If yes, result(s):
Yes - Non-carrier
Familial Dysautonomia:
If yes, result(s):
Yes - Non-carrier
Mucolipidosis IV:
If yes, result(s):
Yes - Non-carrier
Maple Syrup Urine Disease 1B:
If yes, result(s):
Yes - Non-carrier
Usher Syndrome III & 1F:
If yes, result(s):
Yes - Non-carrier
Glycogen Storage Disease 1A:
If yes, result(s):
Yes - Non-carrier
ABCC8-Related Hyperinsulinism:
If yes, result(s):
Yes - Non-carrier
BRCA1/BRCA2:
If yes, result(s):
No
Lipoamide Dehydrogenase Deficiency:
If yes, result(s):
N/A
Question Response
Are you of African ancestry?No
If yes, have you been tested as a carrier of sickle cell anemia?Yes - Standard donor screening
If yes, result:Non Carrier
Are you of Mediterranean, Greek or Italian ancestry?Yes
If yes, have you been tested as a carrier of beta thalassemia?Yes - Standard donor screening
If yes, result:Non Carrier
Heart attackGrandparent - Maternal grandfather, age 41 (no treatment); Paternal grandfather, age 70 (surgery); Aunt/Uncle - Maternal aunt, age 53 (no treatment)
Congenital heart diseaseNone
Hemophilia/bleeding problemNone
EmphysemaNone
Cystic FibrosisNone
Alpha-1 Antitrypsin DeficiencyNone
Pyloric stenosisNone
Colon cancerAunt/Uncle - Paternal uncle #2, age 55 (treated with surgery)
Inflammatory bowel diseaseNone
Irritable Bowel SyndromeNone
Diabetes mellitus requiring insulin therapyNone
Diabetes mellitus not requiring insulin therapyNone
PKU or inherited metabolism disorderNone
Progressive kidney diseaseNone
Polycystic kidney diseaseNone
Miscarriages or stillbornNone
Herpes simplex virus, genitalNone
MigrainesMother - age 30 (treated with medication)
Mental retardationNone
Senility or mental deterioration before age 60None
Epilepsy/seizuresMother - age 30 (treated with medication)
Neural tube defects - open spine or hydrocephalus/water on the brainNone
Huntington's diseaseNone
Tuberous sclerosisNone
NeurofibromatosisNone
Parkinson's diseaseNone
Down SyndromeNone
AutismNone
Autism Spectrum DisorderNone
Pervasive Developmental Delay (PDD)None
Asperger's SyndromeNone
SchizophreniaNone
Bipolar (manic depressive psychosis)None
Attention Deficit Disorder (ADD)None
Attention Deficit Hyperactivity Disorder (ADHD)None
Muscular DystrophyNone
Loss of muscle coordinationNone
Rheumatoid ArthritisNone
Reiter's DiseaseNone
Club footNone
Deafness before age of 60None
Cataracts before age of 60None
Blindness in both eyes before age of 60None
GlaucomaNone
Macular DegenerationNone
AcneFather - age 16 (no treatment)
PsoriasisNone
AlbinismNone
More than 5 purple or coffee-colored spots on the skin-1.5 cm (1/2 inch) or largerNone
Drug abuse, misuse, or addictionSibling - Brother, age 25 (Methamphetamine abuse)
Cleft palate or cleft lipNone
Serious birth defectsNone
Inguinal herniaNone
Premature degeneration of any organ systemNone
The same cancer in more than one family memberNone

Donor Medical History

Question Response
List any operations:
Age & reason:
Tonsillectomy at age 4
Hospitalization other than surgery:
Age & type of illness:
N/A
Have you ever had any broken bones?
If yes, please give age and description:
Yes - Right thumb, wrestling with brother at age 8; Right middle finger, basketball injury at age 14; Right index finger weightlifting injury at age 17
Have you ever had any serious illnesses?
If yes, please give age and description:
No
How many days in the past 12 months could you not work because of all illness (colds, flu, accidents, surgery, etc)?
Please describe:
0
Are you presently under a physician's care for any reason?
If yes, please describe:
No
List all drugs you have taken in past 12 months (prescription, nonprescription, herbal, and sports supplements, and recreational). Include drug, frequency and duration taken, and reason:Multivitamins, taken daily for general health; Fibercon, taken daily for proper bowel movements; Ranitidine, taken daily for upset stomach
List all current medication or treatments (include vitamins, aspirin, antacids, laxatives, herbal, sports supplements, etc.) Include drug, frequency and duration taken, and reason:Multivitamins, taken daily for general health; Fibercon, taken daily for proper bowel movements
Do you wear glasses or contact lenses?
Are you near or far-sighted?
No
Usual weight?195
Recent weight loss or gain?
# of lbs and reason:
No
Allergies (medicines, food, pollens)?
If yes, please list substance and reaction caused:
No
Have you been tested for HIV (AIDS)?
If yes, when:
Yes - Negative, ongoing donor screening
Sexual orientation:Heterosexual
How many sexual partners do you currently have?0
Have you ever had a tattoo?
If yes, what year did you get the tattoo?
No
Have you ever had your ear(s) or body pierced?
If yes, where and what year?
No

Family Medical History
See list of questions asked here

Question Response Comment/Age Affected
Current age or age at death 58
Health Problem Epilepsy, treated with medication30
Migraines, treated with medication30
Hypoglycemia, treated with diet regulation40
Benign ovarian cysts, removed with surgery45
Living / DeadLiving
Question Response Comment/Age Affected
Current age or age at death 62
Health Problem Healthy 
Living / DeadLiving
Question Response Comment/Age Affected
Current age or age at death 28
Health Problem Asthma, treated with inhaler5
Hay fever, treated with medication5
Methamphetamine abuse, no treatment25
Living / DeadLiving
Question Response Comment/Age Affected
Current age or age at death 41
Health Problem Heart attack, no treatment41
Cause of death: Heart attack41
Living / DeadDead
Question Response Comment/Age Affected
Current age or age at death 86
Health Problem Lung cancer (smoker), treated with chemotherapy and radiation80
Cause of death: Lung cancer86
Living / DeadDead
Question Response Comment/Age Affected
Current age or age at death 55
Health Problem Healthy 
Living / DeadLiving
Question Response Comment/Age Affected
Current age or age at death 53
Health Problem Heart attack, no treatment53
Cause of death: Heart attack53
Living / DeadDead
Question Response Comment/Age Affected
Current age or age at death 50
Health Problem Healthy 
Living / DeadLiving
Question Response Comment/Age Affected
Current age or age at death 79
Health Problem Heart attack, treated with bypass surgery70
Stroke, intensive care treatment79
Cause of death: Stroke79
Living / DeadDead
Question Response Comment/Age Affected
Current age or age at death 89
Health Problem Stroke, no treatment89
Cause of death: Stroke89
Living / DeadDead
Question Response Comment/Age Affected
Current age or age at death 64
Health Problem Healthy 
Living / DeadLiving
Question Response Comment/Age Affected
Current age or age at death 56
Health Problem Colon cancer, treated with surgery55
Living / DeadLiving