A Month in NICU
The Lads, fresh from their early arrival into this world at 32 weeks, ended up in NICU - Neo-natal Intensive Care Unit - at Luton and Dunstable Hospital. Many, if not most, twins end up there if they are born premature (and most are); usually just as a precaution, to see them through the most crucial first few days or so, but also if there are any issues that need specialist care and attention. Our Lads were healthy but small - 3lbs each - and so the incubator was their home for the first week under the watchful eye of all the NICU nurses and staff.
We weren't prepared for anything so had no idea what to expect at this stage. Seeing the little things in incubators made it all seem much worse than it was - all those tubes and bandages and blinking lights and beeping noises. They were fine, they just needed care and a gentle nudge into normality. But having been next to each other for the best part of 7 months they were now apart and although they took up a bit more space in the hospital bay than most of the other single babies it was strangely unsatisfying seeing them in their own cocoon barely visible in amongst a lake of little blankets and plasters.
We were in a little ward of about 6 babies. Mum, in a ward of her own in maternity four corridors and one floor away, had to be wheeled down each day to see them until she was well enough to walk again (it turns out that caesarians can be quite painful after the drugs wear off...). But once mobile, we were able to settle in for a month of NICU.
It was odd at first.
We had spent 7 months thinking about what it was going to be like with two babies in the house; which bedroom for the nursery, what colour to paint it, which pram/moses baskets/bouncers we'd need, food, milk, toys. But all of a sudden, there we were in a specialist hospital unit with no real idea of what was going to happen next, let alone when they would be home. Every other parent in NICU was in the same position. All of us, at first, very private and concentrated on our own babies, but slowly and surely offering a few knowing nods and words to other parents, acknowledging the shared terror, before having proper conversations over the hand washing sinks (where an inordinate amount of time is spent) or, for the mums, at the breast pump cubicles.
Now, I had never ever considered that such a thing as a breast pump existed, let alone cubicles for them. But there they were, little booths with curtains and behind them the 'hurr hurr' throbbing sound of milk being electronically extracted. It's a sound that we took home with us, as mums have to produce milk at all times of day and night. With the Lads in hospital, I was convinced we'd be able to have full nights of sleep at home, but no. Every three hours: hurr...hurr...hurr...hurr for an eternity.
In NICU, it was fascinating to watch the other parents and how they dealt with their babies. When the consultants came round every morning, as each baby was assessed the rest of us had to put in earphones and listen to music so we couldn't hear them talking. You know, like Mr and Mrs. Some of the babies there were the only survivors of a twin birth, a heart-breaking situation for the parents of course and something that we became very aware of, standing there beaming with our healthy twins. But everyone was so understanding and kind. One mum, who was there with a very tiny baby, seemed to know the staff and handled her baby with astonishing confidence. We were all picking up ours as if they might shatter into a million pieces at any second. This mum would scoop up the baby, whip off the nappy, slap on another one and put it back down all while talking on the phone. It was fantastic to watch and I commented that either she works in NICU or she's had a lot of babies. Turned out it was both.
NICU is for the care of the babies but it's also a training centre for parents. We discovered breast pumps. We learned how to feed the resulting milk to them. How to avoid falling asleep whilst holding them (not easy under the circumstances). Which of the different poos to expect and when. Getting prepared for when they go home. How to recognise serious illness and what to do about it. And, inevitably, how to put on a nappy.
A few days after arriving in NICU, one of the nurses - a tiny but spectacularly and entertainingly brusque woman from the Philippines - showed me how to put on a nappy whilst a baby is in an incubator. Sounds simple, but we had to do it all (at least at first) with our arms stuck through holes in the side of the incubator so the temperature inside didn't change. It wasn't long before the whole side of the machine could be lowered for easy access but initially it was rather awkward, and looked like those movies where scientists in secure labs test deadly viruses in sealed perspex boxes. Foil tray - check. Bottles of treated water - check. Cotton wool balls - check. Nappy - check. Unsuspecting baby - asleep. The nurse demonstrated it all to me as if I was a toddler with learning difficulties: exactly the right way, of course, since I was bloody useless at it at first. She'd seen thousands of useless parents come through NICU and knew exactly what to say for it to lodge into our addled, knackered, confused brains. She was a genius.
They all were, really. Over the course of a month you get to know them a bit, find out about their lives too. The staff in NICU are a bit different to a lot of other hospital units, I think. You REALLY have to love children to work in NICU - why would you do it otherwise? And some of the staff I talked to had multiple children of their own, which meant they were getting up in the morning, looking after their 5 children, going to work for a 12 hour shift to look after other people's children, and then going home to look after their 5 children again. Astonishing. The love and care we received there was amazing, putting up with our ignorance and inexperience and panic and worry and embarrassing emotion.
We were there for most of the day, every day, for a month. Thankfully, the hospital was only a 10 minute drive from home. But, in the middle of all the joy of having the twins, I was also in the midst of a huge work project. If the Lads had arrived when they were supposed to, it would not have been an issue. But 8 weeks premature threw me into the biggest work panic I've ever experienced. For a week after they were born, the only thing to concentrate on was that. Everything else fell away. But eventually, the project hung over me like a colossus. I had a LOT of work to do and very little time in which to do it. As producer, I was preparing all the music and tech for doing a screening of The Great Escape with an orchestra playing the famous soundtrack live. That's what I do (or DID, until the pandemic wiped out all live performances for the time being). But with just a couple of weeks before the premiere, I still had a massive amount to do on the music and preparing things for the conductor, as well as getting all the music copied and printed (which takes time). So the only way to do it was to have a strict daily timetable: I got up at 4am to work until 8am, then breakfast and straight to the hospital to be with The Lads for the morning. After lunch, I came home to work, leaving mum with the babies, and came back for 6pm to pick her up, bring her home for dinner, a bit of a rest and then back to hospital from 10pm-midnight; home, bed (and the hurr...hurr of the breast pump throughout), then up at 4am again. It was tough and exhausting and, to be honest, exhilarating. And I got it all done - just. The rehearsals and premiere concert, at the Royal Festival Hall, happened while the Lads were still in NICU and the concert day was the only day where I didn't see them at all since they were born. It feels like a dream now; I was wired throughout the whole thing.
With that over, it was back to 24 hour twins. Phew.
Eventually, the Lads were allowed to sleep in the same cot together. They were tiny. But we were thrilled about this because they belonged together. They seemed to enjoy snuggling up. At this stage, they were still sleeping most of the time and, for whatever reason, they hardly made a sound for the entire time they were in NICU. This became something of a joke in the ward, since most of the other babies did scream a lot (weirdly, the smaller the baby, it seemed, the louder the scream). Ours barely mustered a small moan and I rather hoped this was a sign for the future, that they would continue in this way for, oh I dunno, another 18 years or so. Hahahaha, said everyone. They were right, of course. As soon as we got them home, the Lads miraculously found their voice. Funny that.
We then started to be prepped for Going Home. By about week three, we were desperate to get them home. But they are ready when they are ready so the staff slowly introduced us to the various things we needed before taking them home, when the time came. First up, though, we were moved into a private side room in the ward. This room was highly coveted because it meant you were nearly ready, close to getting out of there and into the big world. It was a huge relief for us. We'd had virtually no privacy since they were born but now we could talk without being overheard, mum could feed and hurr hurr pump without the need of a portable screen, and we could even play music to the Lads. This is something I had wanted to do for weeks; I was keen to introduce them to music at the earliest opportunity but in the ward it was impossible (unless you were the couple that would march in at 8pm every evening, just as the rest of us were putting our babies to sleep, and spend the entire time shouting into their phones, playing (dreadful) tinny music out of other phones and allowing their toddler to run around chatting incessantly - until I complained to the staff and they were moved). In our little room, we cradled the Lads in our arms in the evening, I put my iPhone on a table and played them a selection of music that was anything from Handel to Pink Floyd and, often, we'd all fall asleep together (not strictly allowed - a knock on the window, if we were spotted, would wake us up). Lovely.
Then the day came. Like every last day in a hospital, as each hour passes you begin to wonder if you really are going to be going home after all. But there was a lot to do. Hearing tests. Blood checks. A crash course on what to do if they stop breathing at home, using unnervingly realistic dummies. Endless forms to sign. Checks on the car seats. Final visit from the consultant to sign us off. And then waiting. And waiting. And waiting. Until someone remembered that we were due to be going home and why were we still there? Stuff packed up, Lads in their car seats.
Off we went.
In a month, we'd forged new friendships and got to know the staff - who we were likely to never see again. A whole new contingent of tiny babies and their parents had already moved in and NICU carried on; a revolving door of shock, exhaustion and emotion. The little building in our rearview mirror had been the Lads' home for a month, but they were on their way to proper home, finally.
Looking back, spending that time in NICU was a very effective way of easing ourselves into parenthood. The Lads had first class, round-the-clock care and we could go home at night and not worry. It gave us the chance to get used to the idea of being parents, particularly since we had banked on having another 6 weeks or so to prepare anyway. It was a highly professional but caring and loving environment for the Lads to be in for their first month.
Quick warning, for anyone with this ahead of you: It was always incredibly warm in NICU. Not just the usual Hospital Warm, but BLOODY BOILING; wear shorts even if it's snowing outside. Also, we washed our hands and put on that gel about 50 times every day so our skin wanted to fall off; but that now seems like it was simply a warm-up for Covid times. I honestly don't know how parents and staff are coping in NICU right now with all the virus restrictions.
Home, we got the Lads straight into their moses baskets in the corner of the lounge. Despite everything that had happened in the previous month - the surprise of their early arrival, the birth itself, the brutal timetable, the huge amount of time we spent with them in hospital - it wasn't until I saw them there, in our home, sleeping, that the enormity of what was to come finally hit me and I burst into tears. It wouldn't be the last time.