Hi, I'm in a similar situation to your husband. I had what I thought was a bruise appear on my big toenail overnight about 6 weeks ago. I hadn't had any trauma about it but wasn't concerned so did nothing. Then about 9 days ago, I saw my consultant dermatologist for my ongoing psoriasis treatment and she noticed it and was very concerned. She told me that I need an urgent biopsy by a plastic surgeon and that she would be referring me on the 2 week cancer pathway. I have my appointment with the plastic surgeon tomorrow.I told her that I had PMI but she told me to stick with the NHS until I get a diagnosis as she suspected it would be quicker as a lot of the private clinics close for 2 weeks over Christmas and some of the private hospitals currently have reduced clinics as they are sharing premises with NHS clinics due to CoVid. Therefore it might be worth you husband getting an NHS referral too.

Hi Tracey

thank you so much for your reply. He's ringing the private insurance this morning to see what they have and if nothing soon he will also ring the nhs gp to try and get a referral. 
mite frustrating that we will have to go via dermatology first to get a referral to plastics. Did you wait long between the two referrals for your appointment? I feel it's going to be weeks before we get anywhere. Did you have to have Covid test before they booked you in for biopsy? 
 

sending lots of luck for your appointment. Really hope it's nothing serious. Please update when you can. 
 

lisa 

Ah Tracey I'm so sorry. What a waste of everyone's time and disappointing to have to wait again. Fingers crossed you get seen before January as the waiting is agonising. I was thinking they will probably have to do a Covid test a couple days  before the biopsy - isn't it an operation of sorts to remove some or all of the nail to get to the nail bed? I spoke to my dermatologist again online today (he removed a mole I had which luckily was non cancerous) he's been looking at the photo of my husbands toe.  He said that on the nhs after being seen under 2 week rule they have to start treatment within 31 days of first being seen regardless of the time of year.  He also said that although 31 days sounds a long time that biology doesn't move that quickly so not to worry if we have to wait a week or two longer than we hoped. He also said that although he can't confirm everything will be ok without a biopsy  he would be very surprised if a melonoma is diagnosed (I think because they are quite rare) 

I hope that makes you feel a bit better. It helped me tonight as I've been having anxiety attacks all day. 
we have also on his recommendation contacted the go surgery and have a telephone appointment tomorrow to ask for a 2 week rule referral on the nhs so if the private appointment is going to take a while for biopsy we have that one that might come through quicker.

this time of year is a horrible time to be waiting on tests to be done especially during Covid but I've been told to only panic when there's something to definitely panic about and without a diagnosis we don't know that there is definitely something to panic about. It's really hard advice to follow especially when you're naturally anxious anyway but I've been trying to stay occupied and keep off google. I feel a bit better tonight that things are in motion. Your appointment is too and you may get a phone call with a date in the next few days and you'll feel better having that date. 
 

keep in touch. 
 

Thanks for replying Lisa, that is reassuring. He did explain about the surgery today so I suppose that was worthwhile. I hadn't really thought much about that part as I was so disappointed! He said that as long as the rules don't change again - we are already in tier 4 - a CoVid test is not required as it is done under a local anaesthetic as a day case. They inject a number of times around the nail to numb it and then remove it. Sometimes they can tell immediately that it is nothing suspicious - if it is all on the nail and nothing on the skin - but if anything is in the skin, they will shave off some for the biopsy.

I'm glad you are feeling less anxious and I hope you can enjoy Christmas x

That doesn't sound too bad under local Tracey and you may get some reassurance immediately when they remove the nail I think today because you were psyched up to get it over with and it didn't happen it's been a huge disappointment for you. It's a shame they weren't clear before hand so you knew what to expect today. Hope you hear something this week in terms of a date for the biopsy. I'll let you know how we get on on Wednesday evening. I don't expect we will get any reassurance from the appointment but at least things are moving. Apparently the consultant also works for an nhs hospital so hoping this helps in terms of availability

Lisa 

Good luck to your husband for Wednesday. Please report back x

Hi Tracey

just a quick reply being Xmas Eve but my husbands appointment with the private consultant went well. He came away reassured for now. He doesn't think that it's melanoma as it starts half way up the toenail and doesn't follow the classic direction or shape of melanoma. He had a really good look with magnifying equipment and said he isn't concerned. He's asked us to measure it / photograph and he will see him again in 3 months. He said he is expecting it to grow out as the nail grows but if it starts to grow outwards in a linear direction to ring him and he will get hiM straight in to have it checked.  He didn't want to rush in with a biopsy for worry of damaging the nail plate unnecessarily when he didn't feel it was worrisome. He said if it turns out to be melanoma it's been caught extremely early and being monitored. Although we will feel more reassured if it starts to grow out and we see this for ourselves, we feel reassured enough now to enjoy Xmas and see what the new year brings. We have a 2 week rule appointment on 6th jan on nhs with a dermatologist if anything else  happens / changes and feel confident knowing we can ring up and go back if anything changes.  The derm seemed really knowledgeable and reeked off so many things it could be and he said he's seen hundreds of nails over the years with different diagnoses so we feel reassured that he's experienced and that this has only appeared in the last 2-3 weeks and doesn't look alarming at the minute. Happy to monitor and won't hesitate to ask for biopsy if anything changes.  I hope that you are doing ok and manage to have a nice Christmas. Keep us posted how it goes with the biopsy. 
 

Lisa x

Hi Tracey

ooh defo look at some new PJs then and some pampery stuff. I hear great reviews about mindfulness and calm apps on your phone too for trying to focus on the now and not panic thinking too far ahead before you actually know if there's even something to worry about. It's good news that there's been no change. We were told that if it was melanoma it would be really early stage and the fact that he's not following it up for 3 months is reassuring. The other derm also said that biology tends to move slowly. On the rare chance that you do have melanoma it sounds like it's being biopsied in the early stages which is great when you consider that for many they don't get picked up till sometimes 2 years down the line. We were also told that they tend to keep growing outwards in a linear direction. It's positive that it hasn't changed in 8 weeks.  Try and keep positive mental attitude, ring the hospital tomorrow for an update and if they have no appointment yet ask them to contact you ASAP so you can at least stop worrying about when the appointment will be. I think once you get a date you'll feel less anxious.  If you want to chat just message any time. 
Lisa x 

Hi Lisa, so pleased that the appointment went well and you were reassured. I've been quite good over Christmas and haven't thought about it much but my husband and boys have gone back to work today so I'm home alone and it's all I can think about. I just wish I had a date for the biopsy so I would at least have something to aim for. Feeling very low today. Hope you're both doing ok x

Hi Tracey

I was wondering how you were getting on. I'm pleased you were able to enjoy Christmas and at least put it to the back of your mind for a few days. Distraction and being around people definitely helps shift the focus away from the worry. With today being a Bank Holiday you may not hear today but tomorrow lots of people are back in work as usual so you may get a phone call with a date for early January for the biopsy. The NHS seem to ring with appointments in urgent cases (They gave us our two week rule appt the day they received the referral but thats just to see the dermatologist).  You cant control when the appointmnet will be but what about doing something you can control about the biopsy?  Looking online today and treating yourself some nice new slippers or PJs to wear after the op? You Could also ring the hospital department tomorrow to ask if they have a date for you yet as the not knowing when is making you anxious?   Also I keep telling myself that subungal melanoma is rare. Have you noticed any changes in the mark? - Has it improved any? Grown in size etc? Changes in the nail etc?  

Hi Lisa

Some online shopping sounds like a great distraction. I received some new slippers and dressing gown for Xmas but some new PJs sounds ideal!

I think I will call them tomorrow afternoon if I haven't heard anything just to reassure myself that they have my details.

No changes to the toenail at all. I've worked out that I've had it about 8 weeks now and it hasn't got any bigger or grown up with the nail at all. I haven't got the typical straight line but the discolouration starts at the nail bed on the right side of the nail and goes halfway across  and up with an irregular edge.  It's not painful either but don't know if that's a positive or not!

Thanks for replying. It's nice to chat.

Tracey x

Just had a phone call from the hospital. All surgeries including possible cancer biopsies have been cancelled due to CoVid for the foreseeable future. They have suggested I try private route as well but they are not sure if they will be booking appointments now as last time when they stopped all operations, NHS & Private combined care.  Just feel sick

Just had a phone call from the hospital. All surgeries including possible cancer biopsies have been cancelled due to CoVid for the foreseeable future. They have suggested I try private route as well but they are not sure if they will be booking appointments now as last time when they stopped all operations, NHS & Private combined care.  Just feel sick

Hi Tracey

thats awful news! It's not like it's a routine operation you were referred urgently. That's so frustrating! I would definitely go down the private route. In the first lockdown I went private for a suspicious lesion on my lip. I was referred to a dermatologist that also did plastics and he saw me for a zoom call first of all then asked me to go in to have it looked at in the private hospital. He didn't know if it was cancerous or not so he scheduled me in the following week to have it removed following a Covid test. All routine private appointments were cancelled but urgent procedures were still going ahead and I had my op in June in the private hospital during the toughest restrictions. 
if you have private healthcare I would definitely try and use it. X

Thanks. I have a list of calls to make tomorrow with AXA PPP being top of the list!

I also need to get hold of the referral letter from Dermatologist to Plastics somehow to skip that part of the process. The hospital have it but won't email to me because of GDPR! They will post tomorrow but our post is taking ages at the moment. There seems to be an obstacle every way I turn!

GP might have a copy but I've looked at my online account & nothing on there at the moment so that's another call tomorrow.

Your GP may have a copy and might emaiL it to you or let you collect a copy. Mine has done before.  The phoning around is not ideal we did it last week but hopefully they will get you seen soon. I've just had a google and it looks like some nhs patients paid privately to have urgent procedures done that were left by the nhs during the height of the first wave of Covid. A terrible situation but good that you have private healthcare and proof that private ops took place last time despite nhs cancelling them. 
good luck. I hope you get seen really soon 

Thank you. Yes very lucky to have PMI to fall back on. Just wish I had done it on 10 December when I was first referred instead of trusting in the 14 day pathway x

Hi Lisa

its been a stressful few days but I had my private consultation this morning and she did the biopsy there and then. I'm so relieved to have had it done.

I’ve got to keep it elevated for 5 days and go back next week for wound check and the following week for results. Initially she said it looked very suspicious but when she had the nail off most of the discolouration was on nail and only a little bit on skin so she is not so sure now. If it is suspicious, its not gone very deep so that’s a big positive x

Fantastic news Tracey! So pleased you got a biopsy straight away. Was it the dermatologist that did the biopsy? Or plastics? 
please keep me posted. Any idea how long you have to wait? It sounds reassuring from what you've said. 
 

my husband was due for his nhs appointment tomorrow but has cancelled it as he's being reviewed privately in 3 months. We've been monitoring the nail and it's not got any worse / bigger / darker. Still early days to see if it's growing out or not though. 
we contemplated being seen on the nhs still but it was the same clinic the private dermatologist works at so figured they would all have the same kind of ethos and thoughts over it and to monitor for now. Fingers crossed it all works out ok. 
 

lisa 

Hi Lisa

The biopsy was done by a plastic surgeon but she is also a skin cancer specialist based in London.

She is hopeful that I should have results on the 21st.

I think you are right with your husband not to attend the nhs appointment. If he does need a biopsy in the future, I would go for private as you have PMI as the results seem much quicker. The NHS plastic surgeon I saw said 4 weeks for results. 
I had mine over 8 weeks and she said she would have expected it to have start growing out by now which it hasn't. Hopefully you will see your husbands start to grow out soon.

Tracey x

Results due tomorrow ~ feeling nervous!

Hi Tracy 

so sorry for lack of response on here I got no email notification at all abs came across your message as was popping on to see if you'd had results back yet. How did it go? 
 

kind regards 

Lisa 

Hi Lisa

No suspicious cells detected!! So relieved. The plastic surgeon just wants to see me in three months to check on regrowth.

thanks for asking.

any changes to your husband's nail?

Tracey x