I went in to see Isobel at half past twelve, having been delayed en-route at the dump. Isobel was asleep when I arrived. She had eaten all her breakfast and had a pot of balanced supplement mid-morning. She had drunk well. This was a pleasant contrast to yesterday.

Lunch arrived very late, a few minutes after I got there. It did not take a lot of effort to wake Isobel although she was sleepy at first. I fed her the first course of meat and three veg, she ate slowly but steadily, and finished it completely. For dessert she had just custard, I had declined on her behalf the offer of sponge pudding! After a break of a few minutes during which she remained awake we started on the custard. Isobel was rather slow and clearly tired, but she finished it. After this she drank half of a beaker of fruit juice, getting increasingly slow until she fell asleep.

I let Isobel sleep for about forty minutes, then woke her and she finished off the juice as well as taking her medicine. I massaged and manipulated her right arm which was not at all swollen. We chatted for a bit, Isobel was able to give a few yes or no answers, but not every time one was expected. She did say "yes" once very clearly, the first word for some time that has not been badly slurred. She indicated that she liked the choice of the new book to read. She listened to the first few pages of The Hobbit but then suddenly fell asleep.

After about twenty five minutes I woke Isobel and fed her a pot of balanced supplement - she is supposed to have three a day but does not always manage this. Today she ate it without any problem. It is a thicker consistency than other food and hangs onto the spoon, making it easier to feed to her when she is tired. Her supply of pots is stacked up in the room, all of them are chocolate flavour, this does not seem a problem to Isobel. The only problem is that they are very chocolaty indeed and it ends up all over the lips and surrounding skin. After I had cleaned Isobel up, she fell asleep again.

I discussed the feeding problems with the nurses and saw for the first time a letter from the gastro-enteric consultant at Darenth Valley Hospital regarding the matter of the stomach tube. he set out the pros and cons clearly and suggested that the benefit would be outweighed by the discomfort to Isobel. Coupled with the slight risk from surgery, I don't have any problem with his provisional conclusion that it was not worth proceeding, it is just a pity that I did not see the letter at the time it was received, it would have avoided some confusion. In any case, Isobel's condition now makes anything like this impractical. I left the Centre at a quarter past four.

Isobel was much better today than she has been for some days. She was more awake than usual and kept her eyes open. The main light was on in the room and this suggests that closing her eyes is not a reaction to high light levels. I remain uncertain how much Isobel can see, probably more than you would think looking at her unfocused eyes which do not track objects. Although this was a good day for Isobel, she still sleeps most of the time.