milk and cookies

Update: Cookie Monster Leaves Sesame Street Hospital AMA on Christmas Eve

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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:

milk and cookiesDISCHARGE SUMMARY

Services Consulted:
– Pulmonary/Critical Care
– Cardiology
– Gastroenterology
– Endocrinology
– Nephrology
– Vascular surgery
– Anesthesiology
– Psychiatry

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 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 Accu-Cheks 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 2 a.m.  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.

On the night of discharge, the patient left the hospital AMA with intravenous access still in place.  The Sesame Street Police Department was immediately notified about his breach in security.  Officers located Mr. Monster in an alley 2 blocks from Sesame Street University Hospital attempting to inject cookie dough into his external jugular venous access, with the assistance of a confrontational, disheveled homeless green muppet who had apparently been living in a trash can.  Mr. Monster was brought back to the SSUH emergency department for access removal.  He was offered readmission to the hospital, to which he angrily replied “ME WOULD RATHER EAT CARROTS THAN BE HERE!!!  ME GOING TO SUE EVERYBODY!”

Condition at Time of Discharge:
Guarded, with suboptimal control and inadequate discharge compliance

Patient left AMA

As tolerated

2000 calorie diabetic recommended, but patient indicated that “Cookies give me wings!” He was advised to chew his cookies more slowly to avoid further aspiration events.

No primary care physician

Discharge Medications:
The only new prescription issued (in order to improve patient satisfaction scores) was Percocet 5/325 1-2 tabs po q4h prn pain (#100 tabs, 2 refills).

Please note that this discharge required 42 minutes & 17 seconds to complete.

Sri-Sheshadariprativadibayankaram, MD, JD, MBA, FACP, FCCP

  • Show Comments

  • Avatar
    Peggy Buck

    Saw the movies, never read the books. Obviously I didn’t retain that reference…..too current!!

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    Jennifer Christian Moeller

    Everyone who’s read Harry Potter, for starters…

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    PJ Dew

    Just gotta take some Novolog with it! I’m a T1 and my last A1C was 5.6% (yeah, that’s right!!! 5.6% baby!!) and I eat chocolate and cookies all the time! The only thing a diabetic cannot eat is poison and cookies made with poison!!!

  • Avatar

    “: #Diabetes #Diabetic_Complications #Diabetic_Meddications” @truly_tracy @trinhing

  • Avatar
    Julie Miller

    Jeff Miller

  • Avatar
    Ann-Marie Ferrara Hosey

    He came to my house!

  • Avatar

    here @alexa_poderosa

  • Avatar
    Kelly Hemken

    “Me going to sue everybody!” LMAO :)

  • Avatar

    Cookie Monster is a Honda

    Non Compliant

  • Avatar
    Ashley Willhoite

    Bryan Fleck Rachel Ranz

  • Avatar
    Elise Sadoun

    Phil Thrush this makes me think of you

  • Avatar
    Peggy Buck

    Just wondering how many people know the word “bezoar”. One of my faves from nursing school 45 years ago!

  • Avatar
    Debbie Sheffield

    Sherry Macfarlane

  • Avatar
    Derek Seib

    hgba1c: 74.8%, bahaha

  • Avatar
    Iris Rivera

    Jejejje Yaris N Ortiz Colon

  • Avatar
    Conni Errickson Miller

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