This is the continuation of the account of yesterdays meeting with Dr Sadler at Maidstone Hospital.

In answer to Iona's question, Dr Sadler said that she attributed the decrease in active tumour to continued cancer cell death after radiotherapy and chemotherapy last year. On the basis of the scan alone, she would not have expected any significant worsening of symptoms. Dr Sadler wondered whether small scale fitting was occurring and checked the current phenytoin dose. I confirmed that there had been nothing observed to suggest fitting. After further discussion it was agreed that there did not seem to be an obvious explanation for the recent changes in intensity of symptoms. Dr Sadler suspected something other than the effect of the tumour was playing a part and will arrange for one of her colleagues, a neurologist, to take a look at Isobel (the appointment will be notified by post). Before leaving we arranged the next oncology appointment for the 29th September (at 9-30 am, that will be a challenge!); we will come back for blood tests next week, probably on Wednesday and fit them in before the neurological psysiotherapy appointment at Queen Mary's at 2-30pm. This meeting had a result none of us expected and it does not help at all with planning for the weeks ahead. There is no doubt about the results of the scans, I looked at them closely and checked that they were labelled with Isobel's name. Maybe I was tired, but it was difficult to see continuity between the March and June scans.

We only stopped for a few minutes at Iona's house on the way back. For dinner Isobel had cheese and bacon flan. Isobel was very tired and lay down on the bed while I was at the shops. The end of the evening was dominated by bed cleaning and washing; Isobel slept in the spare back bedroom tonight.