Isobel did not have a good day today.

She was sick after breakfast and sick again after lunch, she kept little food down from these meals. She was given an anti vomiting injection (I forgot to ask whether this was before or after lunch).

I went in to see her at 5pm, she was asleep when I arrived. She was easy to wake a few minutes later when tea arrived. She begun eating without any difficulty, but when about two thirds of the way through the first course began retching. We paused for a few minutes and I adjusted the bed position so that she was even more upright. I was keen to finish the first course before it got cold, and Isobel indicated she was ready to go on. She finished the final part of the course without too much trouble, although we spaced the mouthfuls out. We agreed to take break before the yogurt dessert and after just a couple of minutes there were another series of retching movements but without any actual vomiting. These continued for about a quarter of an hour until Isobel fell asleep.

I let Isobel sleep for about half an hour and then woke her for dessert. She woke easily and was in good form despite the difficulties of the day. She confirmed emphatically that she did not have any pain and that she would like some of her book read to her after she had finished eating and drinking. She ate the yogurt steadily, with some long pauses after slight isolated retching movements. We took a break of about ten minutes before going on to a drink, during this time I massaged and manipulated her right arm which was again showing signs of swelling up. I moved the amaryllis from the window sill onto the chest of drawers - the heat in the room has encouraged the flower buds to burst forth from their sheath and there is no longer room for the plant behind the curtains. I expect the flowers will open tomorrow or the day after. Isobel drank a beaker of blackcurrant squash very easily without any sign of retching although her swallowing was weaker towards the end. Taking into account the loss of fluid when vomiting she has not drunk enough today, but it seemed too risky to try something else immediately as she was showing signs of tiredness from repeated swallowing. The nurses will try to get more down her later - I often find from the log that she has taken drinks very late in the evening or in the early hours of the morning.

I read a few pages from her book to Isobel, and when I felt confident she would not be sick lowered the bed most of the way to her normal sleeping position. I went on reading and Isobel fell asleep about a quarter of an hour later. I left the Centre at a quarter past eight.