Esme’s Adventure with Foxgloves

Updated 24/10/2020

I’ve struggled with whether or not to write this; there are already so many things for parents to fear, I don’t want to be responsible for adding another. But then I thought, given how rare it is, perhaps placing the possibility in people’s minds, could help a child one day, and so decided to tell my story.

It was a clear October day, we’re country folk, it was a Saturday, and we needed to get some wood for the log burner. We own a field with trees in it next to the house, there was a pile of cut wood, seasoned and ready to be stacked. We packed four bundled-up children into the car, attached the trailer, and off we went.

The youngest was only a baby, and it was his nap time, so we left him to sleep in the car. The three others; my nine year old son, my older daughter who was six and Esme who had just turned two, were exploring.

I did a quick risk assessment; no water to fall in, no drops to fall from, no people to worry about. They were in an open field and having a lovely time well within view, so we started loading up the wood, keeping an eye on them as they frolicked and went on epic adventures, the way only children can.

We were getting to the end of our collecting, the nine year old had gone for a wander to the farthest corner of the field – probably battling orcs – whilst the two girls sat chatting and laughing about twenty yards away.

I remember looking over at them and smiling, thinking how lovely they all were, and how I remembered wood-collecting expeditions from my youth. I remembered how connected I’d felt on those days, all of us together without distractions.

It must have happened when I turned away, because neither I nor my husband, Andy, saw a thing. Then we were done. That was it. There was no dramatic crescendo or eerie music. Everything was painfully normal – better than normal, it was what I would have classed as a lovely, productive day away from the strains of technology and everyday life. Just a moment; all of us out in nature – well almost all of us, we’d not persuaded the teenager from his room.

I drove the car home whilst Andy walked the short distance back with the other four. He then took them all inside to give them some lunch. It’d been a good start to the day.

I began unloading and stacking some wood, and then decided that the overgrown garden needed sorting whilst I was in a productive mood.

There wouldn’t be that many dry days between now and Winter. It felt like a good time to get things tidied up. After another hour’s work, I staggered through the door, bone tired and filthy, dreaming about a long shower and a mug of hot chocolate.

There was a strange smell in the kitchen, but I was too exhausted to work out what it was.

Then Andy came downstairs. He said that Esme had been sick, he had a bowl in his hands. He said that it looked like she’d been eating something weird and he’d brought them down to show me. There were mulched leaves in there.

Just by luck he’d made tuna and sweetcorn sandwiches for lunch and not ham and lettuce. Perhaps we wouldn’t have noticed if she’d recently eaten lettuce.

The adrenalin started at this point.

I called to my older daughter who was sat playing with her brother in the living room. I asked her if she’d seen Esme eat anything,

“She ate a couple of Dock leaves,” she said matter of factly. They know what Dock leaves are because they are the magical cure to Nettle stings.

I whipped out my phone and looked them up. I had never heard of them being poisonous, but you never know. I was quickly assured that Dock leaves were fine, not particularly edible, but not harmful either.

I felt my shoulders sag with relief, they were probably inedible enough to make her sick and now she’d be fine. She was going to be ok. I started upstairs to go and check on her, and if all was well, hop in the shower.

I was covered in bits of sawdust and greenery and filled with exhaustion. A shower sounded like the most wonderful thing in the world at that moment.

As I put my foot on the stairs a thought popped into my head, “Foxglove leaves look like Dock leaves when the plants are young and haven’t yet flowered.”

I went back to the living room, feeling a bit surreal and Columbo-esque, with my, “Just one more thing… the Dock leaves, were they the smooth shiny sort, or the furry, fuzzy kind?” I didn’t want to worry her or plant any ideas in her head, I just wanted to know for sure that everything was okay.

“They were furry,” she said with complete certainty, and turned back to playing.

“How much did she eat?”

“Only a couple of leaves.”

That was the point I stopped thinking and started acting. I called my eldest son down from the deep darkness of his teenage bedroom, and shouted for Andy. My parents were already due to visit that afternoon; it was the Rugby World Cup, Wales were playing Australia, we’re Welsh – it was compulsory viewing and worth a family event.

As quickly and calmly as I could, I told my eldest that he would need to watch the two older children, Andy and I were going to the hospital and would take the baby with us. He should call my mum to get her to come sooner if she could. Everything was fine, Esme would be fine,we just needed to make sure she was ok. I kept telling everyone it was fine. Perhaps that would make it true.

Esme was vomiting every fifteen minutes or so. If we hadn’t seen leaves, we would’ve assumed it was noro-virus or some other bug – it was the season after all. We would have left her in bed to sleep it off instead of running for help. We grabbed car seats, a sick bowl, a coat and ran for the car.

I sat in the back for the twenty minute drive. I remember trying to hide how much I was shaking, holding the sick bowl for her poorly body. She was alert and chatty. My head was racing with the knowledge that foxgloves were poisonous, but I didn’t have enough knowledge about how or why.

We got to the hospital, I jumped out with Esme and ran into A&E whilst Andy parked and brought the baby. There were people waiting, but when I said I thought she’d been poisoned we were rushed straight through.

She didn’t like being triaged; she objected to the stethoscope, to the ear thermometer, to being touched by strangers. She objected even more when they tried to demonstrate what they wanted to do by doing it to her penguin. How dare they try to touch her penguin?!

We were taken upstairs to the paediatric ward, and put in (what I now know to be) their high dependency room. We were asked if we knew for sure what she had eaten. We said no. We were asked if we knew how much. We only had my older daughter’s estimates. We didn’t know anything for sure.

They said they’d keep her in for 24 hours under observation, and all being well we could go home tomorrow.

There was no urgency and I wonder if anyone really believed she had eaten anything at all. I don’t blame them – they knew we hadn’t seen anything and were relying on the description of a six year old. It took a while before she was given charcoal. It was whilst I was giving it to her, and she was being sick, and I was giving her more, that she started to change.

She became very sleepy, it was all starting to take its toll. Then her heart rate started changing on the monitor; would slow right down and then pick up again a few minutes later. We didn’t know what we were looking at. Staff checked the sensor was attached properly and brushed it off.

This was a small regional hospital that has suffered cut after cut after cut, they have no resident Cardiologist, no children’s Intensive Care and poisonings like this are so rare that there was no manual on what to do.

Doctors came in and looked at her heart monitor, but we didn’t know what it was showing. A normal heart rate for a toddler is about 110 beats per minute. They said we were not to worry unless it dipped below 70 beats per minute. Then when it did, they weren’t worried unless it dipped below 60. Then when it did, they weren’t worried unless it stayed there for longer, or dipped below 50. My eyes were fixed on the monitor and the world around us slowed with her rhythm.

I made the mistake of googling at this point, I knew I shouldn’t. The first article was about a botanist who had committed suicide by eating exactly two leaves of a Foxglove plant, because he knew this was a deadly dose. It was by all accounts a horrible way to die.

I didn’t tell Andy about the article.

I knew digitalis was in Foxgloves, I knew it affected your heart, I knew it could cause heart attacks and save people from them too, but I couldn’t find the answers to whether she would be okay or not.

Esme had an ECG, her tiny body covered in sticky pads and wires placed in some mystical pattern across her torso. Blood tests showed some Digoxin in her blood, but not an enormous amount.

We were later told that it got absorbed into her fatty, toddler tissues and was then released slowly, so they couldn’t predict when it would peak. Which was lucky because it meant that she didn’t get hit by the whole dose all at once. Googling had told me that there is a point of no return. All we could do was wait for them to start dropping and hope they didn’t get too high. A wave was washing over her and if it got too high she would drown.

We were told there was an antidote, but that it came with its own risks. It was there and ready for if she needed it but they hoped she wouldn’t need it. The side effects were a vague and unclear threat. I don’t know if they were ever fully explained on that long night.

We were told that all test results were being sent to the Cardiology ward in Cardiff. They were now making the decisions remotely for Esme without ever having seen her. She was just a list of numbers and a heart beat to them and they held her life in their hands.

She was hooked up to a drip, with a cannula in each foot, one was to always be kept spare for emergency medicine. At her peak she had three in total. Her tiny limbs tide up like a puppet on strings.

At 9pm, after eight hours in hospital, we were told that the decision had been made to move her to Cardiff, a three hour drive away (on a good day). She would also be given the antidote now. If she suffered a reaction to it, they would treat that too.

We were told it would all be fine, everyone hoped it would be fine. She was gone now, fast asleep in her own world. In amongst the many poisons of the foxglove are various hallucinogens, so who knows what she really saw that night in her dazed world.

The plan was that a specialist team would drive up from Bristol – even further away than Cardiff – to take us there. They would arrive around midnight.

We’d arrived at a time when the decision had been made to stop transfers by helicopter to save money. A month earlier or a month later we would have been under specialist care a lot sooner, but we had no idea and let the world rush us on in the direction it deemed best for our little girl. That those months of spending cuts could have cost us so dearly is another thought I refuse to have.

The antidote was given and thankfully Esme didn’t react. One hurdle was over but her heart was still erratic. I now know that she was suffering from heart block. I asked a nurse friend of mine to explain it as she would a child, and she held my hand and explained complicated charts as I sent them to her. She helped me understand what was happening and why.

The digoxin works by bonding with heart cells, it interrupts the electrical current that passes from cell to cell, telling it when to pulse. It interrupts the way the heart chambers beat in turn to move the blood most efficiently. Heart block makes for lazy movement and a slow pulse, we could only hope those beats were strong enough.

My husband took the baby home to leave with my mother. I’d never left him before, she’d never had all my children at once, but there was nothing else we could do.

Enormous choices were made quickly and firmly. We would be there for Esme and bring her home safe. Andy packed a bag of clothes for the three of us and hurried back to the hospital. I would ride in the ambulance, and he would drive down and meet us there.

The team from Bristol arrived about 12.30am, a doctor and two nurses, all for us. I didn’t want to be any trouble, they were taking it all so seriously. The change in tension in the staff from when we had arrived with a chatty toddler to when we left with a silent girl was stark.

I was given a stern sheet explaining that if I were to go in the ambulance, I must stay out of the way in an emergency. I gripped it and read it slowly, digesting the judgement it made about what sort of parent I might be. I wondered what sort of people would get in the way and decided that those people in their panic probably wouldn’t listen to a piece of paper anyway.

Maybe it was just there to distract me as they strapped her bed into the back with all its machines and tubes and potions. Her heart monitor and drip were still attached. She was still vomiting and so pale and sleepy. She had a tube in her stomach to suck out any fluid, and so many gadgets around her.

I hugged my husband goodbye and cautioned him to drive slowly and sensibly. He set off on his three hour drive to Cardiff and I stood around waiting for us to be ready to leave. Her penguin was tucked under her arm and through all of it she held him tightly. I waved goodbye to her as the door closed but I don’t know if she saw me.

Then off we went.

I sat in the front with the driver. It was coming up to 2am (ish) and I still felt fiercely awake. He was lovely and told me all about his holiday home in Bulgaria as we drove through silent Welsh villages and along windy roads.

A drive usually characterised by stunning autumnal leaves and the rolling valleys of home, was all greys and blacks.

The driver told me about finding a Praying Mantis in the garden and how all the villagers owned a sheep, and there was a resident shepherd who walked around every morning collecting sheep to take to graze, and every evening he brought them home and they all toddled off to their own houses. He kept me sane with his meandering tales and fatherly advice.

It was a long journey. I started nodding at around 4am and we drove on in silence. My husband messaged that he’d arrived, found the ward, they were expecting us, and he would try to grab some sleep. We were still a long way away.

I’d been wondering why we had taken a slightly longer route down the coast, rather than the more direct route through the mountains. The ambulance driver explained that this way we would be closer to hospitals all the way down. If something happened we would drive to the nearest one for help.

There are vast swathes of mid Wales with no hospitals nearby. They’ve talked about closing our one for years. If they had, our twenty minute run to A&E would have been an hour and a half instead: all that extra time for things to go wrong.

So we moved from our cosy hospital room with the lovely local nurse, who knew my family, and held my hand, to this enormous, sterile, industrial intensive care for children with all these machines. I’m not sure if they really towered over us the way they seemed to, or if I was just so tired and shrunken by that point.

The staff everywhere were amazing; they were so caring and positive and professional, but I cursed not being allowed to take a coffee on to the ward, it had to be drunk outside in the awkward kitchen. I hadn’t realised that when I made it, so I tipped it away. It wouldn’t steal time from her bedside.

We slept for an hour on a fold out bed in a treatment room. We were told that normally they would have a bed for us, as we’d come so far, but it being the weekend, whilst there was emergency care, there were no cleaners. Although there were rooms free, they were not ready for us. They hoped they could find something, but in all honesty just somewhere to lie down for a moment was so much more than we expected.

Sunday came and went sitting at her cot-side. She was so sleepy. I was told I could hold her if I was careful of her monitors and drip. So I did and she barely awoke before cuddling in to me. It was the most amazing feeling to hold her, she felt so far away in her industrial cot.

Then as we were kicked out for the shift handover, I was finally pointed towards a shower I could use. As I undressed I realised just how much of home I had brought with me. A confetti of sawdust and leaves fell from the folds of my clothes, sprinkling the sterile floor with an alien world. I stood still in the water and washed away the dust from a million years ago.

My ridiculously active, talkative, fun two year old, was quiet and still. When she was awake she stared and retched, but mostly she slept.

Consultants came and went, they were kind and explained things again and again, but I’m not sure how much I took in.

I knew we were monitoring, I knew her heart was still not right, I knew she was very sick. We were in the intubation section of the ward, which meant they were preparing for the worst. They were waiting to see if she would have a heart attack and all we could do was wait with them.

Twice daily we were kicked off the ward for nurse changeover. I called my mother and let her know everything was fine but they wanted to keep us in a bit longer, just to make sure she was ok. I spoke to the kids, they were enjoying their impromptu sleepover. I told my older daughter that she’d done such an amazing job to remember what the plant looked like, and she agreed that she had. They felt very far away in a very different world to mine.

My eldest son wanted to know when we would be home – he adores his little sister, and she him – I said we’d been told maybe Wednesday, but there were no guarantees.

There were just no answers.

Consultants told us how rare a case like this is. Foxglove tastes horribly bitter so most children wouldn’t eat it. She’d always been such a good eater, she would eat anything; now I wished she was just a bit fussier.

As she wasn’t intubated on the Sunday, we were moved down the ward to the “awake” section of intensive care. A TV was wheeled into her line of sight and they put Peppa Pig DVDs on. She silently stared at them.

Someone had the radio playing and the song ‘Wasn’t Expecting That’ by Jamie Lawson seemed to be be playing almost constantly. I cried. I can’t hear that tune now without crying. It felt so helpless being there – I really wasn’t expecting that.

My husband found it hard to sit still, so he took on the practical things. He fed us and got us drinks, he fetched and carried, whilst I sat and watched and waited.

We watched her pulse, but I didn’t know how to see right from wrong, which bit was normal, which bit was frightening? How could I help if I didn’t know?

On Sunday night we were told they’d found a room with a single bed in it for us to sleep in in a strange empty corridor of rooms in a building not far from the ward. We were so exhausted that we climbed in together, me and my 6′ 5″ husband cuddled up on this tiny bed, and managed to get a few hours’ sleep.

I awoke early and wanted to get back to the ward before the staff changeover. I checked the clothes my husband had packed for us. They were all wrong; too hot to sit on a stuffy ward, too tight, too itchy.

I was angry at the world and looking to pick a fight about something I had some control over, so we bickered about clothes – clothes that were fine, clothes that would do perfectly well. It’s a lot easier to be cross about clothes than a sick child.

Then I was sorry and he was sorry and we hugged and went back to the exhausting horribleness of doing nothing very tensely.

Her blood tests weren’t showing a drop in the levels of poison. They started giving her antiemetics for her vomiting, she was still on a drip and hadn’t eaten or drunk anything since Saturday lunchtime.

Monday passed with Peppa bloody Pig.

With the new week we were given a double room just off the ward to sleep in. It felt like luxury.

On Tuesday morning her ECG showed more normal rhythm, so they decided we could be moved to Cardiology; this was very good news.

A friend offered to bring supplies; we’d had so many kind offers from people I hadn’t seen for decades. I agreed just so I would have a reason to make me take a break. We drank coffee and I tried not to cry. Her daughter was running around just as Esme should have been. It was so good to see her, but so hard to see such normality.

Esme’s new room was right off the nurse’s station. It had a single bed in it, so one of us could stay with her overnight, and its own bathroom. It was homely and warm and less clinical. The rules were less strict, the care was more human, this was a place to get better, not just survive.

That afternoon they did another ECG. It wasn’t such good news and we wouldn’t have been allowed to move from intensive care if her contrary heart had behaved this way earlier, but it was decided that having moved we would stay put.

That night I stayed with her and slept as much as possible in between observations. It was so nice to be near her and not be under pressure to rush back. My sleep wasn’t broken by checking my phone for missed calls from the ward for once.

My day began when I jumped at a voice in the room. The doctor had come to take another blood sample – it was a wonder she had any left; and so another day of tests and waiting loomed.

She just lay there and barely objected to the needle, the fight in her was long gone.

We found a DVD player, she cuddled up on my lap, and we watched stupid films. She still wouldn’t say much but I managed to taunt her into saying a few words by showing her photos of her siblings and saying the wrong names. Her need to correct me overcame her sickness – it was such a relief to hear her voice.

In moments, bit by bit, she was getting better; she had her first drink of milk, she tried to steal a bite of my bacon roll, but couldn’t swallow it so chewed it like a cow chewing cud.

That night my husband insisted I get some proper sleep and offered to stay with her. Having pulled promises from him that he would call me if anything changed, I reluctantly walked the long corridor back to our room alone.

I slept badly, listening blankly to comedy downloads for distraction. It was Cabin Pressure that got me through; I didn’t listen to the words, I didn’t laugh, but the familiar voices stopped my brain from whirring. I slept at some point. At six I leapt out of bed and headed back to the ward.

When I got there and asked the nurses at their station how the night has been, they paused and exchanged a glance. I ran to the door in a panic, but thankfully it was Andy who had had a rough night, not Esme.

She was getting better and had demanded to sleep in Andy’s bed with him. Which meant he’d had no sleep at all as he’d tried to keep her from falling or twisting her tubes and wires in a tiny fold down bed, his giant frame twisted to keep her safe.

Every time he’d tried to move into a more comfortable position she had sternly said, “No! Daddy, sleep!” He was a broken, but happy man. It was a good story to wake up to and I sent him off to get some rest.

She managed to drink some milk that day. All being well, we were told we might be able to go home on Friday. Another two days away.

Then came the real sign that things were on the turn; she needed another ECG, and I had learnt that ECGs were things that just appeared when you needed them, but no! We would have to take her to another section of hospital and wait with all the other routine-test people! Routine!

I don’t think I’ve ever been so happy to wait half an hour on a rickety chair, in a drab overcrowded waiting room. It was the biggest sign that she was getting better, and the marvellous NHS machine that had provided everything it could the second it was needed in an emergency, was now returning to a more normal pace.

That was the day she finally woke up. Six days of silence and then a very wobbly little girl, barely able to stand at first, demanded that her dad and I march her up and down the ward. Slowly, wobbly step by wobbly step, she pointed and we walked.

And that’s how she came back to us, all at once.

She still had heart block but there were longer periods of normality now. We were allowed home with a 48 hour ECG to monitor her. Her skin was burnt by all the chemically stickers she’d had stuck to her, her skin was pale and her muscles weak, the days had taken their toll on her, but she was back.

We drove the long journey home, through the rich Autumnal oaks of Wales. We got to see our children, and determinedly ignore the mound of washing and everyday things that desperately needed doing. We got to breathe again and sleep! Oh how I had missed my bed, my marvellous bed that is big enough for us all to snuggle in.

We were back down in Cardiff on the Monday. Blood tests showed Digoxin levels had fallen to safe levels – although zero is the normal level and anything above that is not as it should be.

Her ECG over the weekend showed she was mostly in type one heart block, with regular periods of type two (worse) and occasional periods of type three (worst), but it was confirmed that she would be an outpatient from here on in. I was happier doing six hour round trips for appointments than staying in a moment longer.

From looking at her you would never have known there was anything wrong at all. By this point our little invalid was back to tearing around the place. There was no stopping her once she’d got her strength back despite the heart block, scans had shown her heart was strong; strong enough to keep things moving even when it wasn’t dancing in time to the music.

In November we got the all clear; blood levels were finally back to zero, her heart was so nearly back to normal. It took a while to sink in; she was not only ok, but there looked to be no long term damage. She was one lucky toddler.

It’s traditional to find something deep and meaningful to focus on at times like this, something to make it all worthwhile, a message, a lesson, but all I felt was frustrated and angry. This stupid accident had happened for no reason. I’d let my baby down.

I wanted to listen to the Ambulance driver, whose sage words of, “Don’t let this change the way you parent, don’t stop her from living when she’s better,” still rang in my ears, but how could I not?

There are thousands of those leaves in the fields. It’s all organic so I couldn’t poison them if I wanted to (and I don’t want to) and there’s just no way I could dig them all up.

I would clear them from the garden, but I couldn’t clear the world. I could watch her, I could keep her close, keep her from harm, I could keep her in a push chair, instead of running in the grass, I could only go to paved areas, but even there… It’s the country, they’re in every hedgerow.

She has learnt nothing; the first time outside after it happened she reached down, picked up an oak leaf and went to put it in her mouth. It’s just who she is for now, all I can do is watch and leap. Watch and leap.

I haven’t grown as a person, I’m not more saintly, not a better mother, not a better human for sitting at her bedside. I’m a bit more traumatised, my husband and I prop each other up when need be. I’m trying not to be less optimistic – I like being optimistic.

I am so very grateful to the hospitals. I learnt that nurses REALLY like pens – buy them the nice ones in lots of colours. I learnt that often the parents’ stock of tea and coffee is bought and paid for by the nurses and other staff – so many little kindnesses that made our lives that much easier were put there by those who were already doing so much for us.

Our accommodation was charity-run, even the heart machine that she was first hooked up to was a donation. Apêl Elain was set up in the name of a little girl with heart problems. If it hadn’t been, perhaps Esme’s heart issues would have taken longer to notice. They’ve raised money for all the things we used so if you fancy making a donation to an amazing cause, please do.

Bronglais may be a small hospital, but it’s the only one in Mid-Wales, the more funding is cut for places like that? Well it doesn’t take a genius to see that people will suffer.

And us? We’re mostly back to normal. I’m not sure I’m quite back to being on top of the washing, but that’s my fault for having five children, I probably never will be.

I have so much respect and admiration for all the families we met in hospital. Those whose children would be back there, again and again. They’re not special people, they don’t have a special reserve that the rest of us don’t have to deal with the horror that is having an ill child. They take from themselves, they use energy they don’t have spare, they just keep going because they love their child and will do anything for them.

I only got a glimpse of that world, they are so incredible for doing what they do I cannot find the words. Sometimes I think it’s easier to pretend that other people are more saintly, that they have something we don’t have, because then we don’t have to think about their struggles as much. By putting them on a pedestal, we don’t appreciate the effort and stress that they go through, we don’t appreciate how hard their “normal” is, and we should, we should notice it. If we noticed it more, things like Respite Care would be funded better.

My nurse friend who had so kindly talked me through what was happening, later told me she had added Esme’s scenario to the medical training that she ran. Doctors and nurses would be faced with all the symptoms, but without a mother who could offer answers. She said that the first time she ran it, the hypothetical child survived, but everything got a lot worse before anyone thought to consider foxglove poisoning and hypothetical treatment could begin.

The reason I finally decided to write this is I started wondering and thinking about how I would have acted if I hadn’t known that Foxgloves were poisonous; if I hadn’t known what they looked like when not in flower.

Had I not known, then I would have put her to bed, I would have assumed she had a bug, I would have tried not to take her to hospital because noro-virus is so contagious. She wouldn’t have been given charcoal, she wouldn’t have been monitored, she wouldn’t have been given the antidote, she wouldn’t have been on a drip.

I couldn’t have seen her bradycardia (slow heart rate) or her heart block. Things would have gotten a lot worse before we went to hospital.

There are many poisonous plants, it’s worth knowing what they look like. It’s not about panicking anyone, just about being sensible. It’s just not worth the risk of having them in close proximity to small children. They may look stunning, but you could wait a few years before planting them in your garden, just to be safe.

If your child does vomit, and there are leaves in it, and they’ve been outside then it’s always better to be safe than sorry, but do remember that it’s very rare that any child is daft enough to keep on eating something that tastes utterly vile, it’s very rare indeed to have an Esme. And I am so very glad that we do.