Today was a busy day for Isobel. I went into the Centre at a quarter to twelve, June had said she was going in at about that time as well. Isobel was asleep but woke up fairly quickly. She confirmed she was comfortable and not in any pain. I massaged her right arm but the swelling was not too bad, the fingers are locked and I did not to to free them. Her speech was again largely restricted to single words. I read a little of her book to her before lunch arrived. June also arrived, having been held up at a tutorial session.

Isobel ate the main course of her lunch fairly quickly and easily. June thickened her tea to an appropriate thickness and Isobel began to take the tea as well as her desert, yogurt. The Ellenor nurse, Bev, popped in to see how things were going and we discussed the rapid decline in Isobel's condition. After Bev had left we continued with lunch, but a strange phenomena occurred, the tea became thin again, reverting from custard thickness to somewhere between syrup consistency and that of unthickened tea. This was very odd as the only variable that was changing was the temperature of the tea, and this might have been expected to increase the viscosity ot the tea, not decrease it. Isobel ate all of her yogurt but we left the last third of the tea. For additional fluid intake, Isobel had 200ml of water mixed with her paracetemol.

When Bev returned with Dawn Dark, the Ellenor specialist, June left. We had an in depth conversation, Isobel, I, Bev, Dawn and Rose - Isobel's nurse. It was agreed that Isobel's dexamethasone (steroid) level should be jumped up from 4mg a day to 12mg a day, specifically to try and give her a period of better quality life. The steroids should roll back some of the symptoms in the way that they did when she was on 12mg a day at Kings College Hospital at the start of January 2008. Dawn thought that this might give Isobel a better power of speech which would make life better for her as she will be able to make her wishes known without relying on our attempts at interpretation. Dawn will liaise with Dr Sahota later today and the increased dose should be implemented tomorrow. Dark will come back lunchtime on Friday to check on the effect of the increased dose. (When Isobel was at Kings College it took about three days for the steroids to have a marked effect.)

After Bev and Dawn left, I read some more to Isobel from her book, but there was a constant stream of callers, delivering washed clothes, checking for missing nightdresses and delivering post. Then Luisa from school arrived and stayed for about half an hour.

I settled down to read some more to Isobel, but she was tired and soon fell asleep. I sat with her for a while and then went home at just after 4pm.