On a Sunday afternoon in April, Adiel Nájera’s world turned upside down.
The 25-year-old University of Kentucky doctoral student knew something was wrong. Earlier that week, he experienced exhaustion, chest pains and trouble driving. On this spring weekend in 2022, he slept through his alarm, missed church, then found himself disoriented and barely able to move.
Weak and unable to leave his apartment, Nájera FaceTimed his parents, who quickly knew the situation was dire because of his slurred speech and confusion.
‘The biggest steps of my life’
Music — and the trumpet in particular — are in Nájera’s DNA. He’s a trumpet performance major in the UK College of Fine Arts and his father, Paul, is a retired band director and trumpet player himself who still gives lessons to musicians. Adiel’s brother, Johniel, is a music education major at Baylor University in the family’s home state of Texas.
In early April, Paul and Johniel competed in the National Trumpet Competition in Delaware. Adiel surprised them by showing up unannounced to cheer them on, along with his competing UK colleagues.
Afterward, Adiel and the other UK students drove back to Lexington. That’s when his symptoms began.
They dropped me off at my apartment. It’s only two steps I have to take to get up on the level to my apartment, and I just remember those two steps feeling like the biggest steps of my life.”
Adiel Nájera, University of Kentucky doctoral student
In the days that followed, Adiel grew more out of sorts.
On the Sunday he phoned his family, his father was so worried that he called Adiel’s band director, Professor Cody Birdwell, D.M.A. Birdwell along with three of Adiel’s classmates hurried over to Adiel’s apartment to check on him.
“My couch to my door was about five steps,” Adiel said. “I was on FaceTime with my dad and he said, ‘Go open the door now, son.’ He was pretty forward about it.”
However, Adiel remained sitting as he felt unable to stand up.
“My father almost called the police to just force their way in. It took all my willpower to get up and take those few steps to open the door. That’s one of the last things I remember.”
Soon after the door opened, Adiel’s friends and Birdwell rushed him to UK Good Samaritan Hospital.
‘It looked like fireworks in his brain’
Doctors at Good Samaritan determined Adiel had experienced multiple strokes and sent him to UK HealthCare’s Kentucky Neuroscience Institute. Adiel’s parents and brother booked the first possible flight from Texas to Lexington.
Before Adiel underwent emergency brain surgery, his family was able to briefly visit him along with his priest.
“Having a priest there was important to us,” said Paul, who feared his son might not make it out of surgery.
Paul recalls examining Adiel’s CT scan.
“It looked like fireworks in his brain,” Paul said. “It was a three-hour surgery, and it was the longest three hours of my life.”
Adiel’s family held vigil in the days that followed.
“I left at midnight every day and went to Adiel’s apartment and pretended to sleep,” Paul recalled. “I came back at six in the morning to relieve his mother and brother, then they went and pretended to sleep.”
Rest and relief finally came when Adiel improved enough to be sent to Cardinal Hill Rehabilitation Hospital two weeks later. It took extraordinary work by neurologist David Dornbos, M.D. and Adiel’s neurosurgery team at the Kentucky Neuroscience Institute to get him to that point.
‘He truly saved our son’s life’
Adiel’s most dangerous stroke occurred in his cerebellum, the part of the brain at the base of the skull that is important to movement, balance and motor function.
“The problem there is you get a lot of swelling, which starts to push on the brain stem,” Dornbos said. “If we had done nothing, he probably would have passed away from it.”
To relieve the pressure and give Adiel’s brain room to swell and recover, Dornbos removed part of his skull — as well as portions of dead brain tissue.
“After we got that bone off, the surgery went fine,” Dornbos said. “He did really well with it.”
A second procedure, involving the insertion of a catheter into an artery, was performed to prevent secondary strokes and to plug a major clot in Adiel’s arterial artery.
Dornbos says it is uncommon for people in their 20s and 30s to suffer strokes. However, he and the other providers at Kentucky Neuroscience Institute have dealt with enough such cases that they’re prepared to meet the moment when it occurs. Even if, as in Adiel’s case, the cause of a stroke is unclear.
“We’re a very high-volume referral center for vascular neurosurgery, so we get a lot of (experience),” Dornbos said. “You always have to be very conscientious about each individual patient. But when you do it that many times over and over again, you definitely have better outcomes.”
Adiel’s family is grateful for their experience.
“At the end of this surgery where they removed part of Adiel’s brain, we had this amazing human being of a doctor come in and talk to us,” said Adiel’s mother, Johjania, of Dornbos. “He was so caring, yet so professional, so approachable and kind. It made a world of difference to us. The confidence that we knew he truly cared, it wasn't just a job.
“He truly saved our son's life,” Johjania said. “His hands, his knowledge, his caring just saved him. And we're forever grateful.”
Paul praised Dornbos and Adiel’s health care team for their life-saving care, as well as their compassion toward the family at a frightening time.
“That man is my new hero,” Paul said. “He tolerated my questions and was very gracious. I owe these people more than I can ever give them.”
‘He’s a pretty remarkable guy’
Adiel has worked hard through occupational, speech, and physical therapy to reach his pre-stroke level of motor and musical skills. It has been a frustrating road at times. But through dedicated practice with the help of his father, his brother, and UK trumpet Associate Professor Jason Dovel, D.M.A., Adiel’s trumpet skills are improving every day. Dornbos says Adiel’s family has played a major role in his rapid recovery.
“His family is awesome,” Dornbos said. “He’s a pretty remarkable guy, and he has really good family support. Those two things make a big difference.”
Dornbos expects Adiel to make a near-complete recovery and says he’s at fairly low risk for another stroke.
“When young people have strokes, it’s kind of a blessing and a curse because their recovery tends to be better. Their brains are more adaptable,” Dornbos said. “He’s probably at a slightly higher risk of stroke than the general population, just because it’s happened to him before. But he’s not at tremendously higher risk.”
‘The best medicine’
Adiel performed with the UK Wind Symphony just five months after the inexplicable series of strokes thrust him into the biggest challenge of his young life. He’s on course to earn his Doctorate of Musical Arts in Trumpet Performance and determined to achieve his goal of teaching and playing trumpet professionally.
Adiel is forever grateful for all the treatment he’s received from UK HealthCare. But his favorite therapy has been with him since birth.
“Music is indescribable,” he said. “It’s something past words and something past feelings. It’s some of the best medicine in the world.”
Exploring the current use and future of alternatives to traditional informed consent in acute stroke trials