I went in to see Isobel at a quarter to five. She was half asleep but woke up when I manipulated her right arm. I left finger manipulation until later. The neck was about the same as yesterday. Isobel ate a couple of squares of chocolate.

I read a few pages of Isobel's book to her, we chatted about it but Isobel talked much less than yesterday, most of her responses were single words. For tea Isobel had ham sandwiches and fed herself the first three, holding the sandwich in her left hand. I fed her the fourth sandwich as her hand seemed to be getting tired. I also fed her trifle and cream for desert. She had some tea to drink, she needed reminding to swallow it, and then had a couple more squares of chocolate. After a couple more minutes Isobel had a sip of tea. When she had another sip she started to choke and to my surprise coughed a large amount of chocolate that she had been holding in her mouth over herself and the bedclothes. It appears that although the chocolate had been eaten several minutes earlier, Isobel had not swallowed it. After I had cleaned up Isobel she finished drinking her tea but needed reminding to swallow each mouthful. Then we watched the second half of the African Cup of Nations. Isobel was very passive and said little although she seemed to vaguely follow the game and my comments.

Dallas and Mike dropped in at a quarter past six, on the way home after a visit to the Victoria and Albert museum. While we chatted, Isobel said nothing despite our attempts to include her in the conversation. I thought Isobel seemed much worse than usual, but Dallas said that she had been even less responsive the last time they had seen her. Mike kindly got involved in re-configuring my mobile 'phone and it was I think after half seven before they left. Isobel had her evening mug of tea just after they left, I gave it to her using the spout on the beaker, she needed reminding to swallow after every mouthful but no problems arose.

Isobel did not want me to read any more of her book. I spent some time manipulating her arm, then I fed her some grapes. I worked for some time on her hand and fingers. Eventually I managed to fully straighten the second finger. Once it had been straightened, it became much easier to move and after a lot of manipulation the whole hand seemed to be less swollen (I don't know if this was self deception on my part). Isobel drank almost a full glass of blackcurrant cordial using a straw. The first two thirds were drunk very quickly, at the speed I would have expected a few weeks ago. The final third took five minutes. The doctor is seeing Isobel at about 3pm tomorrow. I finally left at almost half past eight, Isobel was very tired and probably fell asleep quickly.

Keith and Liz went in to see Isobel just after lunch. She was awake when they arrived, no doubt because she had just eaten. They sat and chatted to her, but were uncertain how closely she was following their conversation as she did not make a lot of responses (I suspect she was listening, I find when reading to her that she may seem as if she is not listening and may even shut her eyes and appear to be asleep, but can usually answer questions about the text I have read to her). They noted the swollen right arm and neck which they had not seen before. They also confirmed something which has only shown up in the past few days, that Isobel's eyes do not seem to focus on what she is looking at. They have not seen Isobel for several weeks and felt that her condition was noticeably worse. Isobel did not want anything to eat or drink while Keith and Liz were there. They stayed until 1.35pm.

At 2.10pm I arrived with Jackie Manhire who had come up from the isle of Wight. Jackie used to work with us in the tax office at the Elephant. She has known Isobel for thirty five years and this is probably the last time she will see her.

When we arrived Isobel was fast asleep. I spent a few minutes manipulating her right arm. The arm was very much the same as yesterday apart from a little more swelling on the hand, the second finger was very swollen indeed. When I was moving the arm, lifting it and flexing it at the elbow, Isobel did not wake. She woke when I massaged the hand and tried to gently straighten the fingers apart from the second one. When she was awake we talked about trying to straighten the second finger, but it was so painful that I did not persist with attempts to straighten it.

We chatted for a bit and Isobel's speech was almost inaudible unless she was reminded to try and speak up. We talked about the old times and mutual friends; Isobel listened, but did not say a lot herself. Isobel ate a banana and drank her mid-afternoon tea. There is no doubt in my mind that she is finding drinking more difficult, when using a straw she needs reminding to suck the drink up. There was a stain on her top where tea had been spilt earlier today.

I left Jackie talking to Isobel and had a chat with the nurses and carers. They agree drinking is more difficult but don't think Isobel is having trouble swallowing. They are inclined to feel that the reason eating and drinking is taking longer is because Isobel is sleepy and takes a long time to wake up for meals.

Isobel's neck was much the same as yesterday, with rotation better than a few days ago. Jackie fed Isobel some grapes. Iona joined us at about ten to four. Iona helped Isobel drink a beaker of blackcurrant squash, she used the spout and not a straw and had no difficulty with it. By the time Iona arrived Isobel was showing signs of being tired, not surprising as with lunch and visitors she had only a half hour break between about a quarter to twelve and four o'clock. We still stayed chatting for another half hour and although tired Isobel had no difficulty staying awake. We all left at half four.

I went in to see Isobel today just before five o'clock. The nurses said that there had not been much change but they were using a pillow to slightly elevate the right arm and ensure it did not lie below the body.

Isobel was asleep when I arrived and I decided to wake her by gently manipulating and lifting her right arm. I did this for a few minutes without any problems, the shoulder and elbow were completely free, just a bit of stiffness in the wrist. When I moved onto the hand it was clear that as well as stiffness (the fingers are curled into a sort of claw configuration) it is uncomfortable for Isobel to have the fingers straightened. There was not much of a problem with the thumb, third and fourth fingers. The index and second fingers were a different matter and Isobel woke fully as I attempted to gently manipulate them. Straightening the index finger only took a few seconds, but the second finger needed several progressive attempts with rests in between. Isobel confirmed that the only really bad pain was from the second finger but she was prepared for me to have a final attempt - she was not able to move the fingers at all herself apart from a slight movement of the thumb. I was not quite able to fully straighten the second finger but it was very close. The swelling of the arm itself seems to have decreased - but there does not seem to be any logic to how it varies. There is a little more freedom of movement in the neck. Isobel confirmed that apart from the right arm and neck she did not have any pain and when lying still was not in any discomfort at all.

I read a few more pages from Isobel's book to her. Isobel had eaten all her lunch of fish and chips followed by rice pudding. I fed her tea consisting of ham omelette followed by arctic roll and cream. Then we watched "Eggheads" and chatted while Isobel ate two biscuits and the last of the old grapes and finished a beaker of fruit juice. I manipulated her arm again for a few minutes (but felt she had put up with enough already from the fingers).

I then read some more of her book to her while she ate a banana and a few of a new bunch of grapes and drunk a beaker of water. Isobel's speech was once again rather restricted and tended to be inaudible at times, although as usual she would speak louder when asked. She was rather tired by the time I left at a quarter past seven and I suspect she was soon asleep.

I went in to see Isobel at a quarter to five. She was asleep when I arrived but soon surfaced when I begun to manipulate her right arm, which was not as badly swollen as earlier in the week. There is freedom of movement at the shoulder and elbow, and almost free movement at the wrist. The fingers are worse but after ten minutes gentle flexing all except the second finger could be straightened. The second finger remains the main source of pain in the arm but it became looser and I may be able to straighten it fully tomorrow or on Saturday. Her neck is still slightly swollen, freedom of movement is unchanged.

I read some more pages of "I capture the castle" to Isobel; she listened carefully and could discuss what I had just read.

Isobel's speech remains limited, that is to say that she did not talk very much in sentences although she displayed a good vocabulary. In the past week Isobel has not always finished all her food. Sometimes she has finished one course but only partly finished the other, this was not happening a couple of weeks ago. For tea today she had ham salad followed by mandarin oranges and cream, she finished this meal completely. She had a beaker of orange juice with her tea and a little later she finished off a box of chocolates left over from Christmas.

Isobel agreed that the poinsettia should be taken home, it has been on the chest of drawers where it got little natural light and has been shedding leaves continuously. On the other hand, the Guzmannia continues to thrive on the window sill.

I returned to reading Isobel's book to her, we have at last got beyond page 100, progress is slow because we spend a lot of time discussing the plot and the characters actions but I am now trying to make a real effort to press on with it. Isobel ate a huge number of grapes and then a banana. With her evening mug of tea she finished off a bar of orange and cardamon chocolate, she gave me a square and I found it delicious, the cardamon flavour was no more than a hint behind the orange. I think she was beginning to feel tired when I left for home at a quarter past eight.

Owing to car problems, I did not get in to see Isobel today. There should be a normal report tomorrow. I understand she slept most of the day.

Iona and I went in to see Isobel at twenty to four. It seemed to me that her condition was much worse. Iona said that this was how Isobel had been at the weekend, and yesterday had been unusually good.

Isobel had no ability to move her right arm at all. It was swollen like a balloon. I massaged the arm and held it up for a long time. The nurses confirmed that the doctor believes the problems are a result of tumour growth (not surprising) and that the swelling is a result of immobility. Isobel's neck was about the same as yesterday. Her speech was much reduced from yesterday, usually one or two words, rarely short sentences. She is having, I think, difficulty producing audible speech. Much of what she says is very quiet, but if asked to speak louder she is able to make the effort to do so. The doctor will see her again later today.

Iona cut her mother's fingernails and did other manicure operations. During this Isobel was unusually passive. After, Isobel ate half a dozen chocolates but did not fancy any fruit. I remembered to take the old fruit away today. She drank half a beaker of elderflower drink, I believe she is also starting to find sucking through a straw difficult.

I read a couple more pages of her book to her, she paid some attention but said little.

We sat and talked for a while before leaving at twenty to five.

I spoke by phone to June who said that her visit on Friday had been rather brief as she was running behind schedule an appointment in Dartford. She found Isobel very deeply asleep and knowing that it would take ten to fifteen minuted to rouse her, let her sleep on. She had noticed the swollen right hand.

I went in today to see Isobel just before 1pm. She was awake and had just finished her dinner. We sat and chatted for a while, she was in good humour and said that she had no pain. Her right arm was still rather swollen. It appeared as if she had little control over it and was not able to lift it when asked. There is full free movement at the shoulder and elbow. Isobel has some movement of the wrist but it is painful if flexed either forwards or backwards by a significant mount. There is free movement of the thumb, third and little fingers; and some movement of the index finger. very little movement of the second finger is possible without causing Isobel pain. These range of movements were tested by providing the force to lift or flex Isobel's fingers and arm, she was not able to make any of these movements herself. The neck swelling has decreased but is still present. She can turn her head on the left hand side herself. With assistance her head can be turned partly to the right without causing her discomfort. The range of head movement possible is greater than for most of last week, but is still well short of a normal range.

I spent a long time reading to Isobel from Jessica's book, "I capture the castle" by Dodie Smith. Isobel seemed to follow the reading and made appropriate comments relating to the text when prompted. We read until just after half past two.

I spent about a quarter of an hour watering plants and reorganising things in the room, Isobel stayed awake during this time. I appear to have left behind the time expired bananas and grapes I intended to take home. Isobel ate a huge number of grapes.

By ten past three Isobel was tired and slipped into a light sleep. I woke her at about 3.25 for a mug of tea and two slices of cake. As I was waking her, Iona arrived from her hospital appointment, she has her twelve week scan tomorrow. We sat and chatted for a while and I checked Isobel's neck and arm movement again. Iona and I left a couple of minutes before four o'clock, Isobel was still awake and alert.

Iona and Euan went in to see Isobel today.

Iona found her mother somewhat improved again. The neck swelling is greatly reduced and rotation of the head is much better. The swelling of the right hand had greatly increased however. This is all rather odd, but Isobel seems to suffer no discomfort. Iona found Isobel's speech improved, with more use of complete sentences although a tendency to mumble at times.

Euan had not seen his mother for a while and noticed a decline since Christmas.

It appears that Mike and Dallas visited today and I expect June visited on Friday but as I returned very late tonight from Wales I have not got details of their visits.

I did not see Isobel today. Iona went in to see her this evening and reported that she seemed better overall.

She was awake when Iona arrived, and cheerful. The right hand movement was still limited, the arm is tending to fall to the side of the bed, and as it hangs Isobel does not try to move it. There was still a slight swelling of the right hand. Her head movement was better again today, although the neck swelling remains. isobel is comfortable and had no pain.

Iona just sat and chatted with Isobel, although Isobel did not do much of the talking herself. She did not want anything more to eat or drink. As it was getting fairly late in the evening, after half past eight, Iona was not surprised when her mother began to show signs of tiredness. She settled Isobel down and went home.

The next blog will be on Sunday night or Monday morning.

Iona had not got in to see Isobel last night but we went in together today at about 1pm. Isobel was awake and cheerful.

She had been eating one of the little Thornton's chocolate bars sent by Rhoda when I was in yesterday; I noticed it was still out on her table today and no more had been eaten. Isobel explained that she did not like it, this seemed odd so Iona and I each tasted a square, it was truly disgusting. It was described as chocolate with Tonka bean (see http://www.chocablog.com/reviews/thorntons-milk-chocolate-with-tonka-bean/ ) It is the foulest chocolate I have ever tasted, Iona agrees; this demonstrates isobel has not lost her sense of taste. We compensated for this unpleasant experience by finishing at last the tin of shortbread biscuits, they have been being eaten since Christmas. I have put another packet of biscuits into the shortbread tin and left it out with her chocolate and fruit, visitors can help themselves and of course help Isobel to eat some. Today she was able to eat shortbread biscuits without much trouble, using her left hand. Isobel had a few sensible chocolates after, but did not want any fruit. She now usally has porridge for breakfast; Iona checked the food intake record, Isobel is still eating everything put in front of her.

Isobel's neck was still swollen but she seemed to have more movement of the head and no discomfort. The right hand was still slightly swollen. She was able to lift the right arm slowly, with some difficulty. Her overall condition seems a little bit better, but these are concerning symptoms. I do get the general impression that since Christmas she has less control of her muscles.

After we had been some time with Isobel, Helena arrived to visit. She is the young girl who shared the final room Isobel had in Kings College Hospital when she was recovering from her operation in January 2008. Helena has now finished her training as a nurse and will be starting work as a chemotherapy nurse at Darenth Hospital. The four of us sat around chatting for a long time, although Isobel did not say much, merely responding to direct questions. It was 3pm by the time we all left.

There will not be any blog on Friday or Saturday nights as I am going to Aberystwyth early on Friday morning and returning on Sunday night. Iona will go in to see Isobel and I hope to post a report of the weekend on Sunday night, or failing that Monday morning.

I went in to see Isobel with Derek and Jane at 10am. Derek is a sensible person and took his magazines in and sat quietly in the corner of the room reading them after the first few minutes of the visit. Isobel was awake when we arrived.

I was very relieved to find that had Isobel changed little from my previous visits. The right hand was slightly swollen - it was so minor that I had to get Jane to give a second opinion. It has been noticeable over the past few weeks that Isobel has been using her right hand less. If she eats a biscuit, fruit or chocolate her natural tendency is to put the food into the left hand and raise it to her mouth. She has always been naturally right handed. I have been encouraging her to use the right hand sometimes for eating while I am with her. She has been on steroids all the time since January 2008, but there is not much sign of general body bloating as a result. She has put on a lot of weight (after losing a lot in 2007) as a result of her enhanced appetite. There is no doubt that there is swelling of the neck. She still found rotating the head to the right difficult - she was unable to turn the head very far past the straight ahead position. The swelling is no worse than it was on Sunday. The range of movement might be a little worse than Sunday. She has no problem with the right leg. I am not sure that there is any general problem with the right hand side of the body, although almost any problem could develop at this stage. Isobel said that she was not feeling any discomfort.

Isobel's speech was usually clear although she did not say much. She did not want anything to drink and ate only a token half dozen grapes. She was relaxed and had not missed the lack of visitors yesterday. She was pleased to hear about her mother's eighty first birthday yesterday.

I think we left some time after 11am. Iona was going to go in after work tonight but I have not spoken to her since.

I did not visit isobel today as a result of problems with my car, nor could Iona go in as she was working a twelve hour day.

I phoned the Centre early in the evening. They said that Isobel was unchanged apart from a possible problem with a swollen right hand. The doctor had looked at it today and was undecided (?). I will discuss this with the staff tomorrow.

I spoke to Dallas today by phone, she arrived just twenty minutes after I had left Isobel yesterday and found her much as I had.

Keith and Liz went in to see Isobel this afternoon, but my brother is too polite to wake her robustly. After trying turning the television sound up and stroking her arms and face, they sat and watched her sleep for twenty minutes. (Keith has been instructed to be more robust next time!)

Iona and I went in to see Isobel at seven o'clock. She was awake and alert. Her speech was clear and she was more inclined to talk than yesterday, although towards the end of our visit she slipped into the habit of saying things very quietly. Dallas had also commented on this. If you visit and she does this, do not hesitate to ask her to repeat what she said more loudly. If you still cannot make out what Isobel said, it is probably best to drop the conversation - sometimes this is an indication of tiredness.

Iona helped Isobel drink half a large beaker of squash. After this she had a beaker of tea and a few grapes, she did not want anything else. Isobel was still having problems moving her head to face towards the right of her body. Trying to do this caused a lot of discomfort. Iona also thought swallowing was becoming more difficult. These matters will be observed closely this week. We came home at ten to eight.

I went in to see Isobel just before four o'clock, rather later than I intended as I had to drop Euan off in Gravesend. Isobel was fast asleep and it took fifteen minutes to rouse her. She finished off a beaker of fruit squash. Once she was properly awake we chatted for a bit and then I read some of Jessica's book to her. While I was reading Isobel shut her eyes and appeared asleep but was listening as she could comment on what I had read. Isobel was alert once she had woken up and was in a good mood but did not talk a great deal.

I fed her tea consisting of a large hot dog roll with onions followed by sponge cake with cream. She did not have any difficulty eating, but was very slow to drink a beaker of tea and seemed to have a problem getting her head in a good position to drink - dribbles of tea tended to run from the left side of her lips. While she was drinking her tea, a carer appeared and said that she had noticed this morning that Isobel was apparently having trouble turning her head. She had reported this to a nurse and they had tried to encourage her to turn her head but failed. It was not clear if this was merely perhaps a stiff neck from sleeping in an unusual position or whether it was connected with the tumour progression. It has been noted for follow up. I asked Isobel to turn her head but she did not seem able to do so; she said that she had no pain or discomfort in the neck, nor any headache.

After drinking the tea, Isobel had a banana to eat. I left at twenty to six as I was teaching this evening.

Dallas was going to come in to see Isobel today, I am not certain whether she came in later.

I went in to see Isobel at five o'clock. There were still piles of ice and a little snow at the Centre but but the Bexleyheath area has no snow and just a few remnants of thawing ice. It has been a very protracted thaw, but felt very mild today. The automatic door at the Centre was playing up again and I had to hold it open while a couple of ambulance men maneuvered a returning patient inside. Isobel was just starting to be fed her tea and I took over from the carer.

For tea Isobel had two rounds of ham and tomato sandwiches followed by arctic roll and cream. I have a slight suspicion that Isobel is starting to find eating a little bit more difficult. Now that she is back on an even keel after the chest infection it is easier to make comparisons over a few days. I think she is finding it a little more difficult to bite, this shows up with a ham sandwich as the ham is left intact and the bread is pulled off it. I will watch this over the coming days. Certainly the meals are not being eaten in the couple of minutes that Isobel used to take. Immediately after tea Isobel had a couple of shortbread biscuits while drinking her tea.

We watched the quiz programmes on TV that Isobel enjoys. Then we chatted and Isobel ate a banana and finished off the last of the grapes Carol had brought. This time she ate white grapes, they triggered a little coughing so the theory that this only happened with red grapes is discredited. We decided to leave reading from Jessica's book until the week-end. The poinsettia in Isobel's room had not lost any leaves or bracts today, the first day for a long time. The problem is overwatering caused by carers, me or other visitors assuming it has not been watered by anyone else; this week I have tried to keep it dry and it seems a lot happier. The guzmannia on the window sill is still thriving, Louisa and Toni left it on their first visit when Isobel had just arrived. By seven o'clock Isobel was showing signs of tiredness and I left her watching the snooker; I think she will have been asleep within half an hour.

I think the final departure of the snow is at hand. No snow has fallen, early this morning there was a period of heavy and extended sleet and rain. By mid morning there was only an inch of snow left and it was distinctly mild. By the evening the newer snow had mainly melted to reveal a mixture of slush and ice below. As far as I have seen all roads are clear, open fields are walkable but often wet, only pavements still need great care although they are a lot better than they were a few days ago. There is a lot of standing water, in some cases drainage is prevented by ice or frozen ground below (an unusual phenomenon in the south of England).

I went in to see Isobel at five o'clock. She was awake and in a good mood. Her speech was fairly good. I started reading to Isobel from Jessica's book but had only read two pages when tea arrived. For tea she had two rounds of ham and egg sandwiches followed by fruit salad and cream. Tea took a bit longer to eat than usual, but this was because we were chatting.

After tea Isobel watched television and talked. She confirmed that she did not have a headache and was comfortable. She added that she was happy. Isobel and I finished eating the chocolate orange we had started yesterday. Isobel then ate a banana, and a quarter of an hour later finished the red grapes that Carol had brought in. The red grapes again induced a small amount of coughing, Isobel's chest is still not completely clear. I went home at just after half six to a very tasty chilli con carne cooked by Euan. I had been unable to do justice to Keith and Liz's excellent curry last night and have been a bit below par since before Christmas with chest problems.

I went in to see Isobel at a little past five, she was just finishing her tea when I arrived. She had sausage rolls and something followed by, err, something for desert. She was fairly alert and in a good humour.

We sat and chatted and watched television. Isobel's speech was not so good as it had been for several days after thew trouble with her chest largely cleared. The chest problem has not gone completely and there was still some congestion apparent.

Isobel ate most of a chocolate orange with my assistance! She had a small drink of water , as well as the mug of tea she had just after I arrived. Isobel said that she felt tired, and she certainly looked tired. I left at half past six, I was having dinner with my brother and his wife tonight. My trip to Uxbridge tomorrow has been cancelled as Chris (I worked with him in 1971-2 when we were prospecting) is trapped in Crawley by deep snow. There was about an inch of snow overnight and another inch fell during the day but it is very wet, lying on top of old ice.

No more snow fell overnight, the thaw continues but the rate of ablation is very slow. There is still a lot of snow and ice at the Centre although around our house there is patchy coverage of an inch or so. I went in to see Isobel direct from Wickes in Erith with the car full of electrical conduits and other bits and pieces, I arrived just before five o'clock and found Iona sitting with her. Isobel was fast asleep as she had been when Iona arrived after work about a quarter of an hour earlier. Iona pointed out that the records showed Isobel had been asleep at 3pm when she was offered a drink. Iona will visit Isobel on Thursday when I am in Uxbridge - I hope a brief blog will be posted late on Thursday but it may be skipped if I get home late.

We woke Isobel, and she was still surfacing when her tea arrived. Iona fed her a strange combination of fish cakes and tomatoes, followed by chocolate blancmange and cream. She drank the mug of tea that accompanied the meal and also ate a few shortbread biscuits. We chatted until Iona went home at a quarter to six. Isobel ate a few grapes while she watched the usual television quizzes. She enjoys these although she cannot hardly answer any questions now.

At half past six I began reading a few pages from Isobel's book to her. She seemed to greatly enjoy this and I must remember to do this more regularly; a few weeks ago she used not to want this done. Isobel had a banana to eat then drank a very large beaker of orange squash. She had a few more grapes to eat before I left at a quarter past seven. The car park was still snowy, but not as spectacular as last night when a huge bonfire of wood was blazing in the grounds of the other nursing home next door.

For once there had been no snow forecast overnight - but about an inch had fallen. I was finally forced to the doctors when they opened at 8am to seek anti-biotics to clear up a chest infection which has hung around since I got rid of the swine flu, this has hampered the dusty work involved in cutting brickwork in the living room. Luckily I got an instant appointment and was home by ten past eight, greeted by Euan with the news that Iona had locked herself out of her house while Jon was already at work. I drove to Stone with her spare keys, finding the roads not too bad. Iona was sitting in her car, but had not been able to leave for work as she had not settled the dog or put all her uniform on - just as well she had a late 9am start today.

I went in to see Isobel at five o'clock. There was still a great deal of snow and ice at the Centre, as it has an elevated position above the Darenth Valley, but it was thawing and everything was very wet. Isobel was awake and cheerful. Her speech was perhaps not as good as yesterday but the difference was very slight. I fed her tea consisting of ham and chips followed by pear flan. A little later she had three shortbread biscuits and a small packet of chocolate buttons. The room is still packed with boxes of biscuits and chocolates, Isobel is making slow progress through them as she has been enjoying more fruit recently. The nurses commented that they are very pleased with her eating and drinking, essentially she eats and drinks everything put in front of her. She still had some very slight phlegm on her chest. By half past six Isobel was a little tired, but still keen to watch yet another episode of Michael Portillo's train journeys across Britain. I left her watching this when I went home at twenty to seven.

As might have been expected, the promised snow entirely failed to materialise overnight.

Carol (from across the road) went in just before 1pm. She had not seen Isobel since before she went to the Centre. She found some difficulty, as might be expected, in following Isobel's conversation, but Isobel was happy enough. Isobel was watching a film on television and Carol asked her if she was following it, to which Isobel replied "No, not really"! Carol stayed for over an hour, although there were long spells when Isobel just watched television. Carol fed Isobel a few grapes before she left, noting that the red grapes seemed to make her cough a little but the white ones did not.

I went in at just after 5pm. I fed Isobel her tea of cheese salad followed by trifle and cream, with a mug of tea. Isobel could recall that she had a visitor earlier, could vaguely describe Carol but could not remember her name. We discussed the poetry of John Betjeman, Isobel had a vague memory of him. I fed Isobel a few red grapes (not yet having spoken to Carol about her earlier visit); she did cough slightly for the only time in my visit. I read a few pages of "I capture the castle" to Isobel, this is the book left for her by Jessica. Overall I thought she was about the same as yesterday. I went home at twenty to seven, noting a significant thaw was underway.

I went in to see Isobel at just before mid-day. The early visit was because of snow forecast for this afternoon and evening and also I am teaching in Petts Wood tonight. The roads were clear, there had been only a light dusting of snow overnight although 15cm to 20cm is expected tonight. A few flakes of snow were falling as I came in, but had stopped by the time I returned home.

Isobel was awake when I arrived. Her speech was as good as yesterday and there was hardly any trace of the chest problem. I fed Isobel her lunch. The first course was sausages, mashed potato, diced swede and a huge pile of cabbage which, to me, smelt disgusting but Isobel thoroughly enjoyed it. For afters there was a very large helping of sponge pudding with custard, it reminded me of school dinners but Isobel enjoyed it also. We chatted for half an hour, and Isobel ate three shortbread biscuits and a small bar of milk chocolate. Isobel was able to eat the biscuits on her own but needed to be fed the chocolate piece by piece. I read Isobel a few more pages of the book Jessica left before Christmas, she was able to explain some details of the plot which surprised and pleased me. It is clear that she is back to the condition she was in last week and the problems earlier this week were a passing phase. I went home just after 1pm.

No travel problems on the way to the Centre; virtually no snow has fallen today When I arrived at about ten past five Isobel had already finished the omelette and pudding she had for tea. She was wide awake and in very good mood. Her speech was much better, as good as it has been for several months.

We watched two quiz programmes on television and Isobel was able to talk sensibly about them. She ate a banana and some grapes. There was still some congestion on her chest which caused discomfort and coughing at times. Overall Isobel was far better than yesterday. I stayed until 6.35pm. More snow promised again tonight but I am beginning to doubt the veracity of these weather forecasts.

Light snow was falling at 9am this morning. By half nine it seemed a bit heavier and weather forecasts were promising a belt of heavy snow advancing across southern England and reaching this area in an hour or so. I decided to go into the Center this morning as it might be impossible later. As soon as I left the house the snow stopped and there were no problems on the roads, with the exception of ice beneath snow cover on the first few yards of Darenth Road South which required some care. The weather had delayed some Centre staff and they were behind schedule with their morning tasks when I arrived just after 10am, although Isobel had eaten breakfast they were about to wash and dress her. We postponed this task for half an hour until I had gone. Isobel was awake and alert. Her speech was fair, about the same as yesterday. She ate a banana , a few grapes and a large slice of cake. Just before I left at a quarter to eleven, the nurse confirmed that Boots had phoned to confirm the anti-biotic were en route from Dartford.

The promised snow again failed to arrive during the day. Keith and Liz popped in for a visit in the afternoon but found Isobel soundly asleep and gently snoring (the result of the chest infection). They only stayed for twenty minutes as they did not like to wake Isobel. (For future visits, and for other visitors, the best course is to ask the nurses if there is any reason why you should not wake Isobel. Usually it will be OK to wake her.)

I arrived again at the Centre half an hour after Keith and Liz had left. The roads were clear, even Darenth Lane South had improved. Isobel was now taking the anti-biotics and had been seen again during the afternoon by Dr Mohan; she thought that the chest was not a serious problem and the increased sleepiness was largely the result of tumour progression.

I woke Isobel up for her tea, this was not as difficult as the last couple of times I have done this. Isobel had two rounds of ham and cheese sandwiches followed by peaches and cream. With her mug of tea she had a banana and some grapes. Her speech was a little better than in the morning, although still not back to the standard of a couple of weeks ago. She was cheerful and alert. I felt very happy to see her so much improved in the last two days compared to the sudden deterioration in her condition at the start of the week. Isobel had a few more grapes before I left her watching television as I went home at twenty to seven.

The promises of heavy snow overnight did not come to pass here, but just over an inch caused plenty of problems on Wednesday morning. It started snowing heavily in the afternoon about half an hour before I left to see Isobel, picking up some shopping for Iona en route. The A2 was a tricky prospect and great care was needed on the road from the Bluewater turnoff to Greenhithe. It was a relief to park at Greenhithe ASDA and enter the store which had very few customers. Fifteen minutes later I came out to find that the snow had stopped falling and the roads were wet, a dramatic change. I dropped off Iona's shopping. The back road to Darenth which I had thought might be impassable was no problem at all. The heavy gritting yesterday resulted in the sloping entrance drive to the Centre being no problem at all when I arrived just afte a quarter past five.

I was pleased to find Isobel sittng up in bed watching one of the detective programmes she used to watch at home. She was cheerful and alert. She still had the congestion on her chest but anti-biotics are being delivered for her early tomorrow morning by Boots "however deep the snow is". Her speech was very much improved on the two previous days although not quiet back to normal standards.

I fed her tea consisting of scrambled eggs with tomatoes, followed by strawberry mousse. Instead of tea she had a beaker of fruit juice. We chatted for a bit and discussed the snow. Isobel had two shortbread biscuits, a banana and some grapes before I left at twenty to seven. It was a great relief to find her so much improved, even though the chest problem was still persisting. The nurses said that Isobel had still been very sleepy in the morning and had also slept for part of the afternoon but seemed better all round. On the drive home there were no problems at all with the roads. There has been no further snow up to the time this blog was written, 9pm.

I went in to see Isobel at mid-day. She was sound asleep and it took ten minutes to wake her and a further five minutes before she could give one or two word replies to questions. After this she was cheerful but spoke very little, mainly giving one or two word replies, sometimes so quietly that I could not hear them. Her mid morning tea had not been drunk, she drank a small amount of squash as soon as she was awake.

Dinner arrived and I fed Isobel. She had egg, cheese and minced beef flan with boiled potatoes, green beans and carrots. For afters she had jelly with cream, accompanied by a mug of tea. Eating dinner took about twenty minutes, with a further five minutes to finish the mug of tea after. She clearly had some congestion on her chest as this could be heard while she was eating.

After eating dinner Isobel seemed much more alert. Her speech improved, but only to the extent that she attempted some longer sentences. I could make out about half of these, words were often spoken quietly or slurred. I had a word with the nurse, he will get the doctor in to check Isobels's lungs this afternoon or tomorrow morning. I went home at a quarter past one. After her brief period of activity Isobel was showing signs of tiredness again. On the way out I passed two men shoveling a very generous amount grit onto the long sloping entrance drive.

I came back in to see Isobel at teatime, just after five o'clock. One of the carers had just woken her for her tea and I took over the feeding. The carer confirmed that for the past two days there had been the sort of difficulty rousing Isobel that I had experienced at lunchtime - it takes some time but eventually is fairly successful. For tea Isobel had two rounds of cheese and ham sandwiches followed by fruit salad and ice cream. The feeding again took about twenty minutes. During the meal Isobel had half a beaker of tea, she drank the rest fairly quickly after she had finished the food.

Isobel's speech was again very poor at the start of the meal, she did no more than give one or two word replies, and these were often mumbled or slurred. By the time Isobel had finished eating and drinking she seemed more alert. We chatted, but it was difficult to make out what she was saying and I often had to ask her to repeat what she had said. After about a quarter of an hour Isobel had some grapes and a banana, I fed these to her but she ate them quickly, more or less at the usual speed of the past month. Despite the speech problems, after the meal Isobel was cheerful and more alert. We discussed the snow forecast for overnight, Isobel understands that if the promised 60cm arrives I may not be able to get in to see her tomorrow, although at that time there did not seem much chance of anything like that depth of snow falling. For the second evening running I left shortly after half six, leaving Isobel watching Michael Portillo travel around Britain by train on television. Although she was wide awake when I left, I expect she was asleep within half an hour.

I believe that part (if not all) of Isobel's tiredness is due to a minor chest infection. I can hear that she has phlegm on her chest. On the way out I spoke to the nurse, he confirmed the doctor will see Isobel tomorrow, he is confident the Centre will not be cut off by snow!

Once I got home I went to the shops and stocked up on the basis of being cut off for three days, this should ensure it will not happen. At about half ten the temperature rose and some ice crystals on the roof of my car melted. Just before 11pm it began to snow and by 11.20pm it was snowing heavily. At 11.30 the snow stopped falling, but begun again ten minutes later, less heavily. As I write this just before midnight there is an inch of wet snow lying. When I lived in Wales I was once cut off by seventeen foot deep drifts so today's snow is a bit pathetic but will probably manage to cause chaos across southern England tomorrow.

I went in to see Isobel at a quarter past five. On my way in I was intercepted by a nurse who said that they had been concerned about an increase in her sleepiness. Today they had to wake her for breakfast and for lunch. The doctor had seen her this afternoon and inquired whether she was due to see the consultant at Maidstone again - I confirmed that she would not and that from now on it was just a matter of palliative care as no further treatment was possible (I have of course advised the Centre of this before).

Isobel was sitting up in bed awake but looking rather sleepy. She did not have the television on and possibly may have been dozing and recently woken up. The most obvious change was to her speech. She spoke much less than usual and words were not well formed or clearly spoken. She seemed to have a slight cough again.

Tea soon arrived and I fed Isobel corned beef and chips followed by fruit salad and cream. Feeding tea normally takes about five minutes, it is rarely more than ten even if we chat a lot. Today it took over twenty minutes. Drinking a beaker of tea after the meal took almost ten minutes. This is very unusual. Isobel was taking much longer than usual to chew each mouthful and only took small sips of tea with long breaks between them. I think she may have a little bit of a cold that may be making things more difficult for her.

After tea we chatted for a while and Isobel's speech became noticeably better, although still much worse than the previous days. Isobel had a banana to eat. She was certainly tired and I left her soon after half six.

On the way out I had a chat with the male nurse. He has previous experience of glioblastoma patients and confirmed that there was nothing much unusual about Isobel. This fluctuation in ability from day to day may be expected to recur. Eventually the proportion of time spent sleeping will occupy all the day but before this there will be an unpredictable pattern of changing symptoms. We discussed the tumour regrowth and I confirmed again that the consultant had concluded no further treatment is possible, just palliative care. It was agreed that I would come back in just before noon tomorrow to see how Isobel was at lunchtime.

I went in to see Isobel just before 5pm. She was sitting up in bed but did not have the television on. Her speech was just a little bit better than yesterday. Isobel was alert and in a good mood. There was hardly any sign of the slight cough she had yesterday.

Tea arrived almost immediately, rather earlier than usual. I fed Isobel prawn salad consisting of a mountain of prawns with beetroot, lettuce, tomato and cucumber. For desert there was trifle with cream, accompanied by a beaker of tea.

I mentioned to Isobel that Euan had said that I would find her watching football on TV when I visited, and Isobel then said that she would like to watch this, so we watched most of the second half of the Arsenal versus West Ham game. Isobel's level of attention to the game was a little better than yesterday; she followed the exciting turnaround in the last few minutes of the game intently. This is a contrast to many occasions when she seems to have the television on just as background noise. I think in some way sport appeals to Isobel because isolated bits of action can be enjoyed without needing to follow the whole event in detail. While we were watching the football Isobel ate some grapes and drank a beaker of blackcurrant squash. I went home just before half past six; by this time Isobel was showing signs of tiredness and I would not be surprised if she dozed off after I left.

NOTE
If one, or even two, blogs do not appear on time this week, do not assume anything dramatic has happened! I may need to be away from home at short notice overnight. At the moment Isobel is very stable and I don't foresee any unpleasant developments this week.

I went in to see Isobel at ten past five. I found her alert and cheerful although later the nurse told me that she had been very sleepy earlier in the day.

I fed her tea consisting of two rounds of cheese sandwiches followed by sponge cake and cream. She drank a mug of tea with the meal. Some time after she had a banana, three shortbread biscuits and some grapes with a mug of fruit squash. Isobel's speech was unclear at times, with the wrong word being selected more often than usual. As well as the wrong words being used, at times there was a lack of clarity in the words spoken, verging on slurring at times.

We watched the second half of the Reading versus Liverpool match on television. This increased interest in sport has been apparent since the early stages of Isobel's recovery from surgery. I cannot imagine Isobel watching so much sport before she became ill. I can't say that she followed the match intently or continuously, but she paid intermittent attention and was able to discuss some facets of the game. After the football had ended we watched some World Championship darts and talked about the time when we played together in the Southwark darts team. Isobel had some more grapes to eat and I went home at twenty past seven. On the way out I discussed Isobel's slight cough with the nurse.

I went in to see Isobel at 1pm today. She had already had her New Years Day roast beef dinner followed by Christmas pudding. She was happy and alert and watching Dr Who on television. She was aware it was New Year's Day.

Her speech was rather imprecise and it took a lot of effort to clarify the subject of conversations; but this did not disturb her good mood. Isobel ate a few few shortbread biscuits followed by a fudge bar. Later on Isobel ate a banana and some grapes. We did not talk all the time, Isobel was content to just lie on the bed and watch television at times. She did not have any headache or other discomfort. I went home at just after 3pm.