I went in to see Isobel at mid-day. I had some news to try and prime her with before Iona sees her tomorrow lunchtime. Today was Iona's twenty second birthday and she had her halfway scan early this morning before coming to see us. Her baby is coming along fine and will be a girl.

Isobel was asleep when I arrived. She had only eaten a small part of her breakfast but had eaten a pot of balanced supplement a little later. She had not vomited again. When I arrived a carer was failing to wake her, I took over and succeeded, I think I am a little more robust. I fed Isobel both parts of her lunch. We took it very slowly and she did not have any major difficulties. After lunch we sat and talked. I explained about Iona's baby and Isobel seemed pleased although I did not get any verbal response. Isobel seemed to be comfortable. Isobel slept for about half an hour, I had to wake her in order to get her to take some fluid - she had only had a few sips this morning. I got her to drink a beaker of orange squash without major problems. At difficult times squash is the best drink to try as it is very palatable when thickened and retains its texture for a long time which is essential when Isobel often takes more than half an hour to finish a drink. Two of the four flower buds on the amaryllis had opened. Isobel fell asleep before we could do any reading. I left at a quarter past two.

I returned to the Centre at just after half five having been stuck in traffic on the A2. The carer had just finished feeding her tea, which had been eaten very briskly. Isobel had however fallen asleep soundly before she could be given a drink. I let her sleep for just over half an hour before gradually wakening her. She drank a beaker of squash in less than a quarter of an hour. I told her again about Iona's baby. I then read to her from her book for quite a time before she fell asleep conveniently just at the end of the second chapter. Isobel does want the book read to her and enjoys it, but always falls asleep eventually.

Edmond the nurse said that Dawn the Ellenor palliative care manager had suggested a 2mg reduction in the steroid dose to take effect from next Monday. This was presumably based on the good stability she had until yesterday. On further discussion this would in fact be a 4mg daily reduction from 2 x 8mg daily to 2 x 6mg daily. As matters stand at the moment this might not be a good idea. I said I would see what happened over the next couple of days, then maybe talk to Dawn (I have not seen her for several weeks). I left the Centre at twenty past seven, there was still a little daylight around, the first time it has not been fully dark when I left in the evening.