I went in to see Isobel at a quarter past ten, having arranged to see June who would visit at about the same time. I arrived to find that Isobel had just been sick, bringing up the porridge she had eaten for breakfast at 8am. While the staff cleaned Isobel up (it still feels odd not to have to do this sort of thing for her) I met June at the entrance.

Isobel was not too bad considering that she had just been sick. Her neck was still slightly swollen but she had free movement on both sides. Her right arm was still moderately swollen, but not as bad as it had been. The fingers on the right hand were locked in a curled position but the swelling was not very bad except for the second finger. I postponed straightening the fingers until later as it causes isobel a lot of discomfort.

We sat and talked for about half an hour, although Isobel did not say a lot. She managed just a few short sentences, the rest of the time giving single word responses. She confirmed that she was not in any pain. Then the speech and language therapist arrived and June left for an appointment at Rochester Cathedral.

I can't describe in detail everything that Claire said and did, but it took an hour and a half and was most thorough. She had Isobel eating various foods and drinking while she listened to Isobel's throat with a stethoscope or felt with her hand for muscle movements in involved in swallowing. the main conclusion was that Isobel has weakness of the muscles involved in swallowing. A full mouthful is not being swallowed in one go but is taking three or four swallowings to clear. There is no sign that food is going into the lungs, Isobel still has sensitivity at the back of the mouth and this triggers coughing which warns us and her not to overload the mouth or try to swallow too much at one go. The difficulty with corned beef and chips two days ago are believed to derive from the sharpness of the chips. For the next week Isobel will have all her food liquidised and her drinks thickened to "custard" consistency. Mouthfuls will be smaller and care taken to ensure that one mouthful really had been swallowed before the next was offered. If this week goes well, Isobel will be tried on mashed food next week. A food log will be faxed through later today and Claire will return at 2pm on Tuesday the 9th of February. Claire left at about a quarter to one. I manipulated Isobel's right arm for a bit and stretched her fingers. I finished feeding Isobel some yogurt and a thickened drink; then read to her for a few minutes before leaving at a quarter past one.

I returned to the Centre just before five o'clock. I read Isobel's book to her for a quarter of an hour before tea arrived. Tea was liquified scrambled egg and liquified tomatoes, it did not look as bad as it sounds. Isobel ate it without any difficulty, then had strawberry mousse and thickened blackcurrant squash. She was not sick afterwards. We watched television for a bit and then I read a long section from her book to her before going at almost half seven to deliver some items to Iona who has been ill today.