Today, the 26th of June, had been awaited for some time, as we will learn the results of the latest MRI scan when we see Doctor Sadler at Maidstone Hospital this afternoon.

Morning preparations went smoothly and Isobel was taken to visit her friend Jane at about half ten. She was collected at noon and we had lunch at home before going to pick up Iona.

We only stayed a few minutes at Iona's house and then left for Maidstone Hospital. The roads were clear and we arrived early. The wheelchair was used to transpor Isobel into the hospital, on previous visits she has walked. There were very few patients as a large scale training exercise was underway and parts of the buildings and grounds were cordoned off. Dr Sadler asked Isobel to explain how things were going. Isobel only managed one or two coherent sentences before her speech became completely incoherent. At previous meetings Isobel has made a great effort to speak carefully and I think she has conveyed the impression of having less language difficulties than she actually has had. On this occasion it was clear that she was not able to describe in understandable terms most matters relating to her illness.

Iona and I described the changes in the past couple of months affecting mobility, balance, incontinence, speech and manual dexterity. It was agreed that part of these were certainly caused by the muscle wasting effects of long term steroid use, this may completely account for the manual dexterity problems and partly account for balance and mobility problems. We stressed that the rate of change seemed to be greater in the past few weeks.

Dr Sadler said that she would not have been surprised by these changes had she not examined the latest scan results. The scan showed very good progress, with the area of active tumour very greatly reduced in size. Examination of the scans showed that (after gadolinium enhancement) the part of the ring shaped tumour margin that had previously been most active (towards the front of the brain)showed almost no bright active areas. There was a small active area towards the rear, but it was much smaller than the previously active areas.

This account continues after midnight....