Monday 19th October - am

I had a long visit with Helen in the early morning after taking Doug to the airport and saw the psychiatrist Dr A and oncologist Dr C with her. Helen was in good form. Adjusting to her lack of hair. Slept well. Not at all manic. Eating reasonably well. Talked about all sorts of things.

Medicine wise - she is to stay on 10mg Olanzapine at night for now. Start a low dose of Epilim as a mood stabiliser and perhaps as a seizure preventer. Start 5mg Dexamethasone to minimise swelling from the radiotherapy in brain, oesophagus and bronchus. Risk of this is worsening /triggering mania - hence the decision to start the Epilim now. Also makes sense to me to do all this medicine starting, stabilising, testing while she can be monitored and hopefully they can avoid serious iatrogenic problems.

Dr C told us that the side effects of radiotherapy will actually be worse over the next few weeks - tiredness is likely to be worse. Possibility that it will be harder to swallow.

Important to eat as well as possible now. Also to try to do a little exercise and increase activity as apparently exercise is the only thing that really counters cancer related fatigue.

Sad to hear as right now I feel Mum is the best she's been since she got sick.

We still have to decide for sure about palliative chemo but are assuming we will probably try it at least. They will give her a week's break from finishing radiotx this Wed before having any chemo to allow her to recover a little - sounds like we need to keep supporting her to eat lots of yummy things.

Radiotherapy is scheduled for 1pm today - Robin will accompany her.

"Look good, Feel good" volunteer cam round to offer cosmetics and support - apparently the cosmetic companies have a "gift pack" for oncology patients.