I went in to see Isobel today at twenty past five, She did not have a good early morning, as she was retching without actually being sick to any extent and was unable to eat her breakfast. She did however eat a pot of balanced supplement a little later and then ate both parts of her lunch.

When I arrived she was awake and nearly finishing the main course of tea. I took over from the carer and fed her dessert of chocolate mousse which she obviously enjoyed (it has been difficult identifying the extent to which Isobel can taste as for many weeks she has approached all foods in the same way). Isobel then drank a beaker of blackcurrant squash. Her swallowing continues to be weak but she seems to come to terms with this by multiple swallowing, with occasional strong single swallows. The eating and drinking this evening was fairly brisk, with no sign of the tiring that usually happens. Isobel was relatively perky today, but her speech still only consisted of occasional single words said not very clearly.

Isobel confirmed she would like some reading and for nearly half an hour I read to her from The Hobbit. She then drank a beaker of orange squash with no problems. I spent a few minutes re-organising the room. I had brought back in the Kalanchoe that she had on the window sill when she first moved in, it has come back into bloom. The amaryllis however has faded completely and I took it home with me - these plants are spectacular but the flowers do not last long in the heat of the Centre. Isobel indicated she would like some more reading, but after just a few minutes she fell asleep.

I am reserving judgement for another couple of days on the effect of the steroid reduction, obviously it may be implicated in this mornings problems but worse occurred last week on the higher steroid dose. Overall Isobel was brighter and more with it today. A couple of letters had come to the Centre for Isobel, both related to speech and language (i.e. swallowing and other feeding problems) and the transfer of responsibilty; they added nothing to what was already known. I left at about half eight.