I would charge full rate at that point. You have served am snack and lunch, and run the core part of the programming in the morning. I revised my contract, so that even if I close at the 1/2 day point, I am paid about 75% of my daily rate. After that, the day is paid in full. I found I was bankrupting myself to get to an appointment, which is rediculous, as it is next to impossible to get to any appointments with a 10hr workday. My parents all understood when I revised the contract.
I too, have put my health as a second priority, as I didn't want to inconvenience parents, and now I have several things to deal with health-wise. You are human, and are entitled to do the normal appointments that people do. All of my parents do it before or after work, or on their lunchbreak, obviously we don't get that luxury of time flexibility.
Full rate, all the way!

































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