Today was not a good day for Isobel.

She ate her breakfast but was sick some time after. She was also sick at lunchtime. She became very soundly asleep as a result of the exertion and could not be roused for tea. She had an anti-vomiting injection administered.

I had intended to reach the Centre before 5pm but an accident (supposedly at the Dartford Tunnel) had caused jams on many roads including the A2. I ended up going via Bexley, Swanley and Farningham, taking an hour and not reaching the Centre until a quarter to six. I found Pat and Den Ball had arrived five minutes before me. They had also had a slow journey but had come over Dartford Heath by a more direct route which I had avoided in the light of previous hold ups there, today it seemed Dartford Heath had not jammed solid. Isobel did not look very good. She was awake but not very responsive, she had a red flush over her arms, shoulders and face. The nurse said that the anti-vomiting injection would not take effect until 6pm, after then Isobel could try a pot of balanced supplement. We talked long after 6pm, with Isobel apparently listening but not able to make any comment. Pat and Den left at half six.

Isobel had very little to drink during the day and had lost fluid when she was sick, so we started with a beaker of blackcurrant squash. Isobel did not have any problem with this and we moved on immediately to a pot of balanced supplement; this did not cause cause her any problem either, but she was tired and fell asleep after.

I let Isobel sleep until 8pm. While she was asleep the appearance of her skin became more normal. I massaged and manipulated her right arm which was not very swollen; Pat and Den had noticed this earlier and commented on how much better it looked. When I tried to wake her, she woke easily and drank a beaker of orange squash. Then Isobel ate another pot of balanced supplement before dozing off again. Although she was tired, she seemed quite happy when awake and made a few replies to questions. I had put a football match on the television as Isobel has enjoyed watching it for the past year or so, but she did not watch in any meaningful sense.

I let Isobel sleep until just after 9pm. I was keen to get her to drink another 200ml beaker of squash before I left, she would probably have another beaker at some time during the night and this would set her up for the next morning despite the difficult day she had endured. She drank another beaker of blackcurrant squash very easily, then fell asleep. I left her propped up in bed as an anti-vomiting measure, the carers had said they would be along to get her ready for the night in a few minutes. I left at twenty to ten.

This morning I had another phone call from Claire, the speech and language therapist. She had phoned yesterday to say that she would no longer be looking after Isobel's swallowing problems. She works for Medway pct and her services are bought in for the Dartford area, now the contract has changed and someone else would take over. We had a long discussion yesterday and she 'phoned back today just to discuss the consistency used for Isobel's squash drinks. Although Isobel has seen her only three or four times, her detailed advice has been very useful.