I now have an extremely cold bottom.
GP was nice but insisted on telling me about the potential complications of my inflamed pile, and examining it, she was a locum and obviously didn't read the bit in my notes labelled 'massive panic attack victim, don't give her details'. Pharmacist was male, but totally deadpan and insisted on loudly talking me through all suppository options.
So am suppositoried and suitably frozen. Apparently 48 hours should see some improvement!