If you thought it couldn't get any worse....

So maybe things can get worse. I did make a joke of my upcoming seven years of bad luck for smashing that review mirror saying that, at least now, I know, that I have seven years of SOME luck.    . Well, let the bad luck begin. On that very same day after the mirror crunch I started feeling a familiar ache in the left side of my neck, above the collarbone.   No amount of morphine relieves this pain. It's unrelenting. I have had this before, I would say on three or four occasions, where pain of this characteristic would come on suddenly.       . The first time was in september 2006.  I had stopped my ABVD chemo regimen on the basis that I had reoccured during treatment and was awaiting either a biopsy to confirm relapse or some other difinitive symptom of cancer.   . That definitive symptom, in september 2006, was left supraclavicular pain with swelling. . That symptom was enough to start inpatient chemotherapy in preparation for my first auto stem cell transplant.                             .     Imagine the fear, the paralyzing terror, that same symptom incites in me now, three years later when I have tried chemotherapy after chemotherapy, radiation, trial drugs, and a second allogenic transplant.            . When the pain started and my neck swelled in 2006 I knew I had a treatment plan in place and a doctor to swoop in and care for me.         . You would think time would improve the conditions. The same feeling of fear and horror of relapse come back. The same urge to cry in devastation. Those emotions do not change with every reoccurence. I dare say they get worse as the stakes are raised higher and your odds are circling the gutter.              . At least I can be lying in the gutter, but still staring at the stars.        .   As if having to face the very clear reality that my cancer may be rearing it's ugly head in the form of a second head in my shoulder, I have to somehow access treatment.     You would think this would be easy seeing as I have been a patient in two systems for years now.     . I called dana farber for an action plan. Melissa, my reigning np was out. I paged dr. Alyea twice to convey the urgency I felt and received a call from his right hand nurse, pat.   . The decision was made I needed to be seen. Pat would call dartmouth to arrange the appointment, I gave her four points of contacts that could guide her in getting me an appointment. She spoke to an np who said I could be seen in the afternoon. . Not long after, I received a call from the clinic and was patched through to the np I would be meeting with, or so I thought.       . I tried to be nice. I tried to be polite.I tried being extra cordial through the tears and fears of a rapidly growing and painful tumor in my neck. I understand the precariousness of the situation and that the np is probably uncomfortable receiving a high acuity patient she has never seen nor heard of before. I tried to alleviate her obvious apprehension, but somewhere somehow that went so wrong, and let's be real here, I am calling as the patient with severe cancer pain and a possible tumor growing out of my neck.        .   I think if anyone deserves to be cut some slack in the conversation, that would be me.     . NP Ratchet asked if this was an emergency. I said, no, I did not think it was an emergency, but I did think it was urgent and needed to be seen.   .   Np ratchet retorted that I should be seen in the emergency room under these conditions.        . I said I disagreed, that I had been working with both df and dhmc to have a safety net of cancer coverage since often there is a window of time when a symptom presents itself before it comes emergent and I would prefer to be treated during this period.        Really, who wants to wait around for all hell to break loose, for humpty dumpty to completely fall apart, before getting put together again.       . That's just not efficient practice.    .      At that point she asked me exactly what I wanted. I told her I was THE PATIENT and that I had been referred to her by DANA FARBER and if she wanted the treatment plan, she should probably communicate directly with them.       . This is definately where communication started to crumble. I am in pain. I am hurt. Psychologically I am in shambles thinking that my malicious hodgkins has once again foiled the little joy I'm trying to squeeze out of what is trying to be a short life and this professional Is drilling me about what I want for treatment in a condescending tone that says , " how the hell did you even get through to speak to me directly since you obviously know nothing.".      . Oh honey, if you only knew.   I hate that this happened to me, but I also hate what it represents. This represents a starch social structure in healthcare, a clear heirachy, that patients are not to disturb their providers with innane complaints such as "I have pain unrelieved by 15mg of oxycontin and 15mg of morphine that kept me up all night and swelling that is eerily similar to the growth of a tumor,". Then, we as patients are supposed to disregard their lack of empathy as the almighty care provider and say, "okay, I will now trust you with my life".   .    Being nice, patient, understanding and intelligent in a health care capacity are not mutually exclusive. A provider can be gentle and understanding while still providing effective, efficient quality care.        . There are many fabulous providers out there.   NP Ratchet had received all the information necessary to prepare herself for our meeting. She had the names and numbers of my providers. She has my records from both DHMC and Dana Farber at her disposal. She also has a specialty in cancer which will benefit me as the patient over going to an emergency department. Through the clinic she also has the access and the ability to order every test the emergency deartment does, with the same ability to ask fot it "STAT.".  Only in a clinic, I am receiving better specialized care ina safer environment that will not expose my compromised immune system to the germ fest also known as the emergency department.    . NP Ratchet was not among the empathetic helpful providers I have encountered.   I don't quite now what the problem is, but I do know, once again, I was left in tears, wondering if the quality of care I will receive will be subpar due to the NP's clear preconceived notion that I am in no way her responsibility, but if I am not her responsibility, then who is? Please keep me in your prayers as I again prepare for treatment.