VO: Welcome to Extraordinary People, a podcast series from UK HealthCare. The stories you'll hear are from patients who've overcome the most challenging moments of their lives, and our providers who've helped thousands of patients navigate those moments.

Adiel Nájera: My couch to my front door was like not even five steps. Physically, I could not get up and go. But I mustered the strength, I guess, to open the door because my dad was on the phone with me to tell me to get up and just go open the door, you know? And he was about to call 911 to just break in. He was like, "I want those people to just break in. Like, I don't care." But I got enough strength to open the door. I guess, I fell a little bit when I opened the door. And at that moment, my band director was there and some of my friends. And they were with me for a little bit, they want to see how I was and how I was functioning. And that's whenever my band director said, "Okay, we need to go to the hospital again. We want to go to Good Samaritan."

Host: Adiel Nájera is a 25-year-old PhD student in the University of Kentucky's Music Program. Like his father, Paul, Adiel is a distinguished trumpet player. He one day hopes to be a music professor. In April 2022, Adiel suffered a series of strokes. He was seen initially at UK Good Samaritan Hospital before he was rushed to UK Albert B. Chandler Hospital.

Adiel Nájera: The last thing I remember was, I think, my trumpet professor, he got a priest, a local priest, to come give me a blessing. I remember him giving me a blessing and then waking up-- or not waking up, but just the next thing I remember was tossing a little ball with the nurse, like for PT or whatever, and that was like April 14th.

Host: Adiel's parents, Paul and Johjania, and his brother, Johniel, flew from Texas to Lexington and were just able to see him before he went into surgery.

Adiel Nájera: My dad looked at the CT scan, and he's like, "Yeah, it looked like fireworks in your brain," what he saw. I had to have brain surgery. Originally, the doctors didn't want me to have brain surgery because they're like, "If he goes, he's most likely going to pass away based off the complications." But they felt good enough at the moment to make that happen.

Host: Dr. David Dornbos, a vascular neurosurgeon with the Kentucky Neuroscience Institute, led the team that quickly worked to save Adiel. They first removed a portion of his skull at the base, near his cerebellum, to alleviate swelling and remove dead tissue. Here's Dr. Dornbos explaining Adiel's second procedure.

Dr. David Dornbos: The second procedure we did for him was to prevent any secondary strokes. His artery was injured and was actually completely blocked from the injury, so there's not really a way to open it or like to stent it open just based on that particular artery. There is a risk, since it's injured kind of down in the neck, just because there's no blood flow, you'll get a little blood clot that'll form above that. Just because there's no blood flow, so the blood just sits there in pools and clots. So, there is a risk that, if the injury starts to open back up, which can happen as it heals, you could send that clot north and cause a bigger stroke.

So, we actually took him for a procedure. That was a catheter procedure the second time around. Actually, I put a plug into the artery down below to completely kill it off so there's no chance it could ever open back up. He had what's called a dissection. So, the artery develops a little tear in it. And then, when you have a tear inside an artery, the flow will start to pool behind the tear and it'll cause the tear to kind of flip up and block the artery. But we don't really know what caused his. It's most commonly seen after a trauma, usually like a car accident or something like that. It was pretty unusual. But like whenever a younger person comes in with a stroke, especially from like an occluded major artery like what he had, it's almost always actually a dissection, or it very commonly is due to like a secondary tear of the artery. Once the thing is torn though, like having multiple strokes in succession is pretty common. But anytime you have an injury anywhere, you form a little kind of clot on that, it's the body's process of starting to heal it. But the problem is, obviously, it's on the inside of the artery. If that clot starts moving, it causes other secondary problems.

Paul Nájera: Well, at some point, he and I are going to go have a few drinks. He'll be able to tell us when to stop because he knows what the brain is doing. And then, we're going to go pause that.

Host: Paul Nájera, Adiel's father, was impressed by the bedside manner demonstrated by Dr. Dornbos and other UK HealthCare providers.

Paul Nájera: But Dr. Dornbos is my new hero. I mean, he tolerated me and was very-- I mean, to say gracious is an insult. Initially, the last phone call we got before we left Texas was, if he has to go into surgery, he's not going to make it. You know, we got to see him. We got to get there before the surgery. And the trumpet teacher had got us a priest, which is important to us. Adiel goes to mass every day there at the Catholic chapel on campus, so he knew him-- I mean, not knew him, but I mean, you know, he'd seen him and stuff. And so, that was nice.

The first thing, it was a three-hour surgery, the longest three hours of my life, because they were pretty blunt with us about it. But we were happy to see him before, not happy to let go. But, you know, the first thing I asked him was before we go into this room, because he came down, you know, all the screen, all it says is complete. It doesn't say anything else and that, I understand, you don't want to just publicize anything out there. But before I went in that room, I said, "Before we go in there... You all go in there..." And I said, "Is my son alive?" Because I'm not ready to deal with that, but at least I got to get mom ready for that. And he said, "Yes." Okay, now we can go in there.

Host: Johjania Nájera, Adiel's mother, was equally impressed with Dr. Dornbos.

Johjania Nájera: He was so caring, yet so professional, yet so approachable and kind. And it made the world of difference to us, the confidence that we knew that he truly cared. It wasn't just a job. It wasn't something that he had just trained for, but he cared for us, and that he was going to do everything he could, you know, to get him where he needed to be. And he truly saved our son's life. I mean, his hands, his knowledge, his caring just saved him and we're forever grateful.

Host: Adiel, his father and brother, attended a music competition in Delaware less than a week before he was hospitalized. Adiel recalled not feeling well upon returning home and stayed in touch with his family in the days that followed. Johjania encouraged him to visit an internal medicine physician at UK and he made an appointment.

After suffering chest pains while driving a couple days later, he went to the ER, but was released after his tests came back clear. Additional tests were ordered during a followup appointment with internal medicine and indicated no signs of a stroke or any other life-threatening condition.

Johjania Nájera: And everybody keeps asking me in my flying back and forth to work, you know, "How are you holding up?" And I'm telling you it is because of the care that he has received since day one. We have not had to worry about anything, information... I have never, not that we've experienced this before, but I have never even heard of people that have experienced things like this, that they have, honestly, received the medical care that Adiel has received. And I'm talking from communication, how the appointments have been taken care of for him seamlessly. I have watched, you know, the doctors truly work together in true collaboration. It's been mind-blowing. And nobody ever wants this to happen, but we believe that God had him in the right place at the right time. And if it happened, it happened at UK, and we're so grateful.

Host: What you are hearing are excerpts from when Adiel's brother, Johniel, helped him relearn to play the trumpet in June. Faith, family and music are the pillars of Adiel's life. While he was rehabbing at Cardinal Hill, a music therapist came to visit once. It was his most memorable day in the hospital.

Adiel Nájera: When it comes to music, when I was in the rehab hospital, that was the one thing I wished I had more of, music therapy. But when I did have that one session, there are no words that could explain how just great it was to listen again. Because my parents and my family thought that whenever this happened, I might never play again. And so just for myself, just listening, having a session to listen to music, it shows the true impact of musicianship in general. It doesn't have to be an instrument. It can be a physical instrument. It can be someone singing in a band or whatever it is. So, that was great.

When it comes to my playing, when my doctors cleared me to play because they wanted to make sure everything was okay, I'll do the walking again, I'll do this, whatever. I don't mind learning that over and again. But because of my skill and my age, I was definitely not the best in the whole world, but I was very talented. And so when I first got back on and even now, it's difficult to know that, at least right now, I'm not at the same place or stage as I was before. I can't tell the future. I know it's going to take time to get back to that place.

Paul Nájera: They both drank the Kool Aid, they both fell in love with it and, you know, doing it at a higher level and quicker than what I did. And a lot of that was intentionally planned, because of course you always want better for your kids. You know, growing up, we were poor. It was nine of us, and so I didn't have a proper lesson in my life. It was proper lesson or eat. So, you know, I wanted better for my kids, and I was able to provide that, we were able to provide that, and we did. And so, they got a lot of advancement pretty quickly. And then, you know, I had them playing in church when they were in 7th grade with me every week. So, they have that performance experience, and I rewrote a lot of the music for them to make it easier, but just for them to be successful at it initially. But then, they started taking off.

Johjania Nájera: His spirits are good, but, you know, he gets sad. He said, you know, "Well, I had to, because my right hand on those fast pieces, it's just not what used to be." But immediately, "But mama," he said, "It's not that I'm giving up on that hand." And just to keep up and not to let everyone else down, he said, "I used the left hand."

So, when you ask, "Is Adiel still the same Adiel I remember?" You know, yes, because always putting everybody else first and worrying about-- like, I said, first thing he says, "Well, I didn't want to let everybody down," that's who he has always been. And when all of this happened, being away and not knowing the faculty or his friends like we did, like for his undergrad, even got to know some of his friends when he was doing his masters. But here, we had not had that opportunity to see that that is the Adiel that they had always known since day one, how he helped everybody all the time and always was thinking of others. Knowing that we still have that son is a blessing.

Dr. David Dornbos: Every time he plays trumpet, he's kind of doing his own occupational therapy. I mean, he is teaching his fingers those fine motor skills again. He's teaching himself as he's kind of working through it. And that's something that, at his level, no occupational therapist is going to actually be able to teach him how to do. That's just something that he's going to have to kind of work back through, and is working back through. But yeah, having those fine motor skills beforehand and being so healthy beforehand, both of those things are going to help him in his recovery process because two of the bigger indicators in a stroke in terms of how you do, a lot of it is your pre-stroke abilities and your pre-stroke health, and then also, he's a little bit different, but usually like the better and quicker that you can get the artery back open is the second big thing.

Adiel Nájera: I get 0.000001% better one day. I'm good knowing the next day, if I grow the same amount, I'm good. I'm 25, it might take me 20 years to fully come back. Whether or not I like that timeline, it's not my choice, but music has definitely been something I can always go back on. It's definitely helped me with the process of just everything, just from learning the instrument to music in general. I mean, like I said, there was a point where my family didn't think I was going to be able to play again. But now, I can play again and I'm blessed just to have the opportunity again, because I know there's a lot of people out there that don't even have the opportunity again. So even though I'm not fully back and whether or not I like it or not, I have to understand I'm able to do something still, and still make an impact hopefully. And what I try to focus on when I'm playing, if I don't focus on if it's one person in the audience or it's a thousand people in the audience, all I care about is if I move someone to enjoy the music, to improve their lives, just one person, even out of a thousand, I've done my job correctly.

Host: Adiel is on pace to graduate with a Doctorate of Musical Arts and Trumpet Performance in Spring 2024. In September 2022, less than six months after his surgery, Adiel completed the last of his therapy programs and performed in a recital for the first time since he was hospitalized.

Adiel Nájera: My father said, "If you only have to take just like one or two pills for the rest of your life, I, I think you came out pretty good."

Paul Nájera: I think he came out pretty. Good.

VO: This episode of Extraordinary People was brought to you by the UK HealthCare brand strategy team. If you were a patient at UK HealthCare and would like to share your story, please visit ukhealthcare.com/stories. We would love to help you tell it. Thank you for listening.