Green Monster from Sesame Street

SESAME STREET – As children around the world continued to hold candlelight vigils for Cookie Monster’s health, the shocking rumors that the muppet had left Sesame Street University Hospital (SSUH) against medical advice (AMA) are true. Apparently Cookie Monster was too tempted by all the soon to be placed cookies and milk for Santa Claus this evening. Gomerblog’s anonymous source at SSUH has confirmed these reports, and this informant provided Gomerblog with an exclusive copy of Cookie Monster’s discharge summary, as below:

DISCHARGE SUMMARY:

PRINCIPAL DIAGNOSES:

Uncontrolled diabetes with ketoacidosis

Pastry dependence with withdrawal symptoms

Cookie bezoar, status-post extraction

Medical noncompliance

Borderline Personality Disorder

Morbid obesity

Peripheral aneurysm, status-post repair

Acute renal failure

Acute on chronic malignant Stage 2 hangnail exacerbation (not otherwise specified), present on admission

SUMMARY OF HOSPITALIZATION:

Mr Monster was admitted to the hospital in critical condition due to diabetic complications. The patient also was noted to have a cookie bezoar (pathology indicated the bezoar was approximately 86% chocolate chip cookie, 12% sugar cookie, & 2% unspecified) which was extracted endoscopically. Initial concern for acute coronary syndrome prompted cardiology to perform an emergent coronary angiography. The catheterization was normal and was only complicated by contrast nephropathy with acute renal failure (requiring hemodialysis initiation by nephrology) and development of an acute aneurysm at the site of vascular access, status-post emergent operative repair.

Glycemic control was compromised by significant medical noncompliance as well as his report of new allergic reactions (“me feeling very strange and itchy”) to Splenda, Equal, Stevia & Sweet’N Low. On several occasions, the patient was noted to be consuming unauthorized cookies which had been smuggled into his room by his “associates” (the manic red muppet & the depressed frog, who were escorted out by hospital security many times). Mr Monster declined diabetes education and accuchecks during the course of much of the hospitalization. Hemoglobin A1c was 74.8%, indicative of suboptimal control.

Intravenous access was difficult and required the assistance of Anesthesiology at 2am. Also, Cookie Monster’s cookie withdrawal symptoms & persistent combativeness required the use of bilateral soft wrist restraints. Psychiatry assessed the patient & recommended pastry rehabilitation, but Mr Monster declined psychiatric intake. High dose Ativan was given to the patient to alleviate withdrawal symptoms. Also, he was given high doses of Dilaudid (due to “pain everywhere” reported at “11 out of 10” on the pain scale despite Cookie Monster comfortably watching Food Network programs on his room’s television), which maintained patient satisfaction at target levels for the medical-surgical unit.