I went in to see Isobel just before 11am. She had eaten breakfast and drunk well earlier in the day. She was very soundly asleep. I manipulated and massaged her right arm but she did not wake.

Sometime after eleven Dawn from the Ellenor arrived. We did not need to wake Isobel immediately. We discussed the changes since the steroid dose was increased last week and the lack of any significant change over the weekend. There is no doubt that the feeding is easier and the increase in the Omazaprole dose is preventing any more vomiting as a result of stomach irritation from the steroids. The anticipated improvement in speech has not taken place, it is just a little bit better than at its worst. Inability to speak or communicate her wishes easily by any other means is reducing Isobel's quality of life. She is still very sleepy for most of the day although this seems peaceful enough. The tubs of balanced dessert are going down well.

We agreed to increase the steroid dose again to 16mg daily. The Centre would store an emergency supply of injectable phenytoin substitute in case it becomes impossible to administer oral phenytoin (this drug is essential to reduce the risk of seizures). All medication is already in liquid form as Isobel's ability to take tablets became unreliable a couple of weeks ago. The present feeding regime would continue.

After Dawn had left, lunch arrived. I woke Isobel easily. She ate the first course (meat, carrots, brussel sprouts - all liquidised; and mashed potato) briskly and without difficulty. For afters she had real rice pudding (i.e. not liquidised!) which she ate a large bowl of without any problems or sign of becoming tired of swallowing. She drank a beaker of thickened blackcurrant squash and finished a tub of balanced dessert which had been started earlier in the morning. This confirmed that the improved eating performance was continuing.

We watched the news on television and talked about it, Isobel was hardly speaking at all, just the odd "yes" and "no". I sorted out some of Isobel's clothes, watered the plants and helped administer some of her medication. After, I read some of her book to her until she fell asleep. I sat with her for a while but it was clear that she was fast asleep. I left at just after half past two. On the way home I bought some more plaster as I have finished a large sack in the living room; and then went to inspect the road at the bottom of Midhurst Hill. Last night I inspected an incipient collapse of the roadway and reported it to Thames Water this morning, it had collapsed further during the day and was now about half a metre deep and coned off.