Medical History

For the lifestyle questionnaire, see http://trentdonor.org/screening
For STD results and Physical Exam Results, see http://trentdonor.org/std

Below is a questionnaire and information regarding Trent's medical history and may be reviewed by a recipient and their physician:

List significant medical surgeries and diseases since childhood:

Age Event
 Age 0  Appendectomy (see Dr's report)
 Age 5  Chicken Pox (varicella-zoster virus) contracted with typical recovery.
 Age 8  Fractured right tibia (broken leg ice skating).
 Age 13  Began orthodontics program to treat crowding of upper teeth.
 Age 17  Wisdom teeth extraction.

 

Have you or anyone in immediate family been diagnosed with any of the following?:

Trent's Answer  
_ YES      NO  Autism
_ YES      NO Allergies of any type, including dust, pets, pollen, mold
_ YES      NO ADHD
_ YES      NO Alzheimer's disease
_ YES      NO Asthma
_ YES      NO Chronic Depression
_ YES      NO Chronic Fatigue
_ YES      NO Crohn's Disease
_ YES      NO Diabetes
_ YES      NO Hypertension

 

Yourself or any immediate family members known to have any of the following genetically inherited disorders?:

Trent's Answer  
_ YES      NO Down Syndrome
_ YES      NO Spina bifida
_ YES      NO Anencephaly (born without a skull or partial skull)
_ YES      NO Bleeding disorders, hemophilia
_ YES      NO Cystic fibrosis
_ YES      NO MS
_ YES      NO Sickle cell anemia
_ YES      NO Heart defect at birth
_ YES      NO Tay Sachs diease
_ YES      NO Huntington's Disease
_ YES      NO Cystic Fibrosis

 

Are you aware of any of the following birth related conditions occurring with immediate family members:

Trent's Answer  
_ YES      NO Stillbirth
_ YES      NO Prematurity
Additional Comments:

"Mother gave birth to all three children at exactly 9 months through vaginal delivery, with each child weighing between 8-10 lbs.  There have been twins boys in Trent's extended family."

 

Please list any additional known health conditions family members who have died:

   Trent's Answers
  "Maternal grandfather survived a heart attack in his 50's and possibly sustained a heart attack when drowning in his 70's"

 

For Latest Physical Exam, See the STD Results Page Fitness Profile Page 1  Fitness Profile Page 2   Fitness Profile Page 3  Fitness Profile Page 4  Fitness Profile - All 4 Pages
      PDF File (Pages 1-4) 

(administered by an NASM Certified Personal Trainer)

 

ECG and Echocardiograms:

Date Test Ejection Fraction (EF) Fractional Shortening (FS) JPG Source PDF Source
05-Oct-2006 Echocardiogram (ECHO) 72% 42%

Echo - Page 1              Echo Page 2
 

Echo -  PDF File (2 pages)
05-Oct-2010 Echocardiogram (ECHO) 71% 40%

Echo - Page 1              Echo Page 2
 

Echo - PDF File (2 pages)
01-Oct-2010 Electrocardiogram (ECG) - -
ECG   Pg 1 of 1
ECG - PDF File (1 page)

 

Vision Exam:

PDF

Articles

Article Quote
Understanding Ejection Fraction - Barnes Jewish Hospital
  • "A healthy heart has an EF between 50 to 75 percent. This indicates that the heart is pumping well and able to deliver an adequate supply of blood to the body and brain."
  • "An EF is a percentage of blood that is pumped out of the heart during each beat." "Keep in mind that a healthy heart does not pump 100 percent of the blood out during each beat. Some blood always remains in the heart."
  • "If your EF falls below 50%, this means your heart is no longer pumping efficiently to meet the body's needs and indicates a weakened heart muscle."
  • "Poor pumping and a low EF can occur if the heart muscle has been damaged due to a heart attack, a diseased heart valve or Heart Failure."
  • "Ejection fraction is a key indicator of heart health."
Ventricle (Heart) - Wikipedia
  • "Fractional shortening (FS) is the fraction of any diastolic dimension that is lost in systole"
  • "a range from 30 to 42% is considered normal with 26 to 30% representing a mild decrease in function"