By the end of January 2026 my four months on Solaraze had proved ineffective and I therefore phoned the surgery and requested the promised Efudix.
I left my call until late morning so that the receptionist could hear me. She mentioned the third GP had now retired. On checking the notes she told me she could see the Efudix script was mentioned. She'd arrange for it to be whizzed off to the chemist.
This was wonderful news and I was so delighted. Four months getting nowhere had come to an end. At long last, hope was on the horizon. And so it was, until I collected my paper bag from the chemist and discovered it contained another tube of Solaraze to keep me going until the end of May.
Another four months of getting nowhere? Or was I going to be one of the lucky ones who eventually witnessed Solaraze treatment efficacy at the end of an eight month marathon?
There seemed to be two possible explanations for this confusing state of affairs.
Firstly, was the new Solaraze script a prescribing error? It could simply be explained by a busy receptionist in an understandable rush selecting the wrong choice from a drop-down menu, and the script being signed off by a busy clinician aware of the Solaraze protocol who saw no need to delve into the notes.
Secondly, was the new Solaraze script an intentional choice by a clinician who disagreed with a decision made by a colleague who was now retired? The protocol said eight months if necessary and that was that. Rules are rules. I was going to have to wait for my Efudix.
I decided to go with the second explanation and see what happened. It wasn't an easy decision to make. It could also have been a huge mistake that I'd come to regret for a very long time and possibly the rest of my life.
By the end of May there was still no improvement but possibly some changes. One of the lesions was noticeably bigger than the other. Both lesions appeared more substantial to the naked eye and felt slightly raised to a fingertip touch. The larger one was also painful when touched. My son could get a better view of them and was in no doubt they were both growing.
I phoned reception again, explained the Solaraze hadn't helped and I needed the script for Efudix, which my history indicated would do the job. The receptionist said she'd look into it.
Three weeks went by and still no Efudix. I no longer needed my son to confirm the lesions were getting bigger. Action was now required and it was probably time to contact the surgery and request an appointment.
However, behind the scenes things were happening. It could easily have been the bots. More likely the second nurse. Or maybe they combined forces to give the surgery the necessary message. I'll never know. And the next surprising development took place before I even had a chance to request an appointment.
In the second week of June I received a letter. It wasn't a standard NHS communication. It was a letter from the surgery. I couldn't understand this. They usually contacted me by text. But this time it was a proper letter on headed paper inviting me to attend the surgery's dermatology clinic towards the end of the month.
When I attended this appointment I met the fourth GP, who was now responsible for the skin side of things.
I'd checked the surgery's site and saw she wasn't a partner. That didn't surprise me because I guessed she could easily have been part time and wanted to focus on her chosen specialty. I thought it was quite possible she might even hold skin clinics at different surgeries. I'd known several NHS clinicians who stayed fresh and avoided burnout by working part time gigs. No surprises if that was the case.
But what did surprise me was her reaction when I walked into her office. And her eyesight. The moment she saw me appear in the doorway on the far side of a largish consulting room she immediately said: "That's not sun damage."
I was so relieved that at long last events were working for rather than against me. I wanted to give her a hug. I thought she was one of these doctors whose compassionate presence was of immediate comfort. She was obviously calm, assured and very experienced. I reckoned she could have had a good career in emergency medicine. Just the sort of face you need to see beside your trolley when you've been wheeled in to be put back together again.
She left her dermatoscope on her desk and came over to make her initial assessment. At one point she touched the larger lesion very gently and I jumped. The pain was intense. She quickly apologised. I explained that until recently I was able to touch it gently with my palm in the shower but could no longer do that. She asked if they wept. Not that I'd noticed (but that would soon change).
While her examination continued she explained exactly what she was doing and what she could see. She remarked that the larger lesion contained fluid. This appeared important. I was so impressed by her diligence and commitment to a collaborative approach.
She explained that I needed to be referred to Dermatology and photos were part of this process. I was reminded of the second nurse and thought the two of them together would have made a formidable team.
The second nurse's photo session hadn't hurt at all. But three years later things had moved on and I was in agony whenever the fourth GP's dermatoscope made contact with the larger lesion. At one point it became almost comical. I would jump and immediately apologise for doing so. She would then apologise equally quickly for hurting me. And so it went on. A bizarre game of apology ping pong. We must have said sorry to each other at least a dozen times in a couple of minutes.
I was pretty shaken by the time the photos were finished. But not too shaken to ask about Efudix. It had become a bit of a habit.
She shook her head and remarked: "They're going to want to do something about this." When she mentioned there would be a six week wait I realised it was another red flag referral.
I wouldn't say I was in denial, but I certainly hadn't caught up with reality. I'd been too obsessed with my quest for Efudix. At an earlier point it might possibly have made a difference. But not now. I was too late for that.
And yet I still wasn't giving up. As I opened the door to leave she was starting to wash her hands at the nearby basin. She smiled at me and I asked if I could please have some Efudix if they weren't going to help me. Looking back on that particular moment, I now feel quite embarrassed.
She looked directly at me and repeated: "They're going to want to do something about this."
At long last the penny dropped and I understood. I thanked her for the appointment and also for all her help. When she smiled at me again I could have burst into tears.
Although I didn't realise this at the time, the intensity of the pain I'd experienced was clinically significant. Those microscopic cells I mentioned in an earlier post were on the move and hellbent on using my nervous system as their superhighway to destruction.
