Physical
Medical
Family Medical History
Religion
Updates to ProfilePhysical
|
Height:
5'11"
(180 cm) |
Weight:
178 lb
(80 kg) |
Eye Color:
Brown
|
Hair:
Brown/
Straight |
Skin Tone:
Medium Light
|
Ancestry:
Caucasian
|
|
Blood Type:
B+
|
Ethnic Background:
English-Norwegian/English-German
|
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|
Education:
BA/Business, Exercise Science
|
Occupation:
Donor Relations Director
|
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|
Interests:
|
Family, Puzzles, Reading, Running
|
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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: | Yes - Maternal grandfather, in his 20s; Maternal uncle, in his 20s |
| 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 - Animal hair: Causes itchy eyes, sneezing; Seasonal allergies: Cause itchy eyes, sneezing |
| 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 | 56 |
| 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
45
Medication
High cholesterol
45
Medication
Gallstones
46
Surgery
Your Father
| 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
Seasonal allergies
30
Over-the-counter medication
Gout
57
Diet management
Brothers
Your Brother 1
| Question | Response |
| Current age or age at death | 32 |
| Living / Dead | Living |
| Cause of death and any treatment prior to death | N/A |
Health Problems
Healthy
Your Brother 2
| Question | Response |
| Current age or age at death | 28 |
| Living / Dead | Living |
| Cause of death and any treatment prior to death | N/A |
Health Problems
Healthy
Sons
Your Son 1
| Question | Response |
| Current age or age at death | 1 |
| Living / Dead | Living |
Health Problems
Healthy
Daughters
Your Daughter 1
| Question | Response |
| Current age or age at death | 3 |
| Living / Dead | Living |
Health Problems
Healthy
Your Mother's Father
| Question | Response |
| Current age or age at death | 77 |
| Living / Dead | Dead |
| Cause of death and any treatment prior to death | Liver disease |
Health Problems
Disease
Age Diagnosed
Treatment For Condition
Alcoholism, in his 20s
20
None
High blood pressure
50
Medication
High cholesterol
50
Medication
Heart attack
68
Surgery
Osteoporosis
70
Medication
Liver disease (alcohol-related)
73
Medication
Your Mother's Mother
| Question | Response |
| Current age or age at death | 77 |
| 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
50
Medication
High cholesterol
60
Medication
Your Mother's Brothers 1
| Question | Response |
| Current age or age at death | 30 |
| Living / Dead | Dead |
| Cause of death and any treatment prior to death | Cirrhosis of the liver |
Health Problems
Disease
Age Diagnosed
Treatment For Condition
Alcoholism, in his 20s
20
None
Cirrhosis of the liver
30
None
Your Father's Father
| Question | Response |
| Current age or age at death | 84 |
| Living / Dead | Dead |
| Cause of death and any treatment prior to death | Stroke |
Health Problems
Disease
Age Diagnosed
Treatment For Condition
High blood pressure
70
Medication
Stroke
75
Medication
Diabetes mellitus
75
Insulin
Stroke
84
Medication
Your Father's Mother
| Question | Response |
| Current age or age at death | 82 |
| 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
70
Medication
High cholesterol
70
Medication
Heart attack
70
Stent
Your Father's Sisters 1
| 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
Healthy
Your Father's Sisters 2
| 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
Healthy
Your Father's Brothers 1
| Question | Response |
| Current age or age at death | 64 |
| 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 | 62 |
| Living / Dead | Living |
| Cause of death and any treatment prior to death | N/A |
Health Problems
Healthy
Your Father's Brothers 3
| 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 Father's Brothers 4
| Question | Response |
| Current age or age at death | 54 |
| Living / Dead | Living |
| Cause of death and any treatment prior to death | N/A |
Health Problems
Healthy
Religion:
| Faith | Christian |
| Denomination | Lutheran |
Updates to Profile
| Update Available | Yes |
| Updates - Personal | Update received August 2022: Donor has earned an MBA and his occupation has changed to Executive Director. Update received August 2023: Occupation has changed to Director of Development. |
| Updates - Medical | No change to donor Medical Profile: August 2022, August 2023. |
| Updates - Family Medical History | Update received August 2022: Paternal Grandmother has died from heart disease at age 88. No change to donor Family Medical History: August 2023. |