UPMC’s Maroon Talks Life After Becoming an Ironman

By: Joseph C. Maroon, M.D.

For the past several months, I’ve spent 24 hours each week swimming, biking and running to prepare myself for the greatest physical challenge: the Ironman triathlon in Kona, Hawaii. Now that I’ve completed it, what now?
The Saturday morning after finishing the triathalon, I was not in a chlorinated pool swimming endless laps, I was not getting on my bike to ride 75 to 100 miles, and I did not lace up my shoes to walk and run for hours until exhaustion. The ache in my muscles had begun to abate, and my quads were no longer trembling after pedaling a bike for 7 hours in 90-degree heat. And thankfully, I no longer saw air bubbles when I closed my eyes, the bubbles I followed for the entire 2.4 miles in the ocean while drafting the swimmer in front of me to get a slight advantage.
The incredible high from the massive release of endorphins—that intense feeling of “flow” and focus—was followed, within 48 hours, by a depletion of the “feel good” brain factors and so I experienced a mild depression. But a week later, what lingered was the cheers of the crowd and the immense sense of satisfaction I felt when I heard the announcer call my name and tell me I was “an Ironman.”
Although my time was slow—16 hours, 3 minutes, when the winning male athlete did it in just over half that time—I take solace in the fact that my finish time was almost the same as the same race I completed 10 years ago. It’s great to know that physiologically, with intense effort, it’s possible to maintain the same physical endurance, quickness, and agility I had in years past. And an incidental benefit was that my body fat percentage dropped from 16.5 percent before my 7 months of training to 10.2 percent one week after the triathlon.
As my body recovers from pushing its limits, another remarkable observation is the improvement in my thinking, my ability to process information, and my reaction time (which was actually measured before and after the race with the ImPACT™ test). It’s absolute proof that brain health is directly related to physical activity. Indeed, neuroscientists have clear evidence that exercise produces large cognitive gains, helps fight dementia, and triggers the release of the protein BDNF (brain-derived neurotropic factor) that has been called the “miracle-grow” of the brain. 
Just a few of the benefits of BDNF…

  • improves and increases blood flow to the brain,
  • increases the production of new brain cells (neurons),
  • increases the connections (synapses) between neurons where memory is stored,
  • slows the development of Alzheimer’s disease by reducing plaque and beta-amyloid peptides. 
A recent study of 600 people, age 70 and over, was carried out by a team at the University of Edinboro. The individuals kept detailed information about their daily physical, mental, and social habits for three years. The data revealed that those who had engaged in the most physical exercise showed less brain shrinkage and damage to the white matter, which is considered the “wiring” of the brain’s communication system. Similarly a study by Dr. Kirk Erickson of the University of Pittsburgh reported that adults aged 60-80 who walked moderately (30-45 minutes, 3 days a week for one year) increased the volume of their hippocampus, the part of the brain that is so critical for memory. The good news, from my own personal experience and many studies now, is that you don’t have to be an Ironman triathlete to gain the benefits of enhanced brain function from exercise! 
Now, after two weeks, my body has almost fully recovered and is back to homeostasis or balance, and I feel calmness and a continued sense of satisfaction as I return to the similarly challenging, totally engaging and exciting field of neurosurgery. And as I return more focus on my work, I will continue a program of interval and aerobic strength training, teamed with core exercises and stretching, including yoga, at least an hour a day.
Each time after finishing what has been described as the most punishing of all endurance races, my first words are “this is the last time!” Then two or three years later, I find myself training again with the same self-punishing rituals of swimming, biking and running. When I ask myself “Why?” the answer is the same: as Mihaly Csikszentmihalyi so scientifically and accurately described in his book, Flow:  The Psychology of Optimal Experience, “The greatest moments of our lives are when our mind or our body is stretched to its limits in the voluntary pursuit of something both difficult and worthwhile.” This kind of perseverance—in any endeavor—provides incredibly fulfilling and sensual moments. In many ways triathlons are a metaphor for life, as well as for neurosurgery: commitment, passion, the need to practice and repeat often-boring activities, and the overcoming of physical and mental pain are all universal requisites for success. I am triply blessed to experience the same “flow” experience with my family and children, in my profession, and through triathlons.
Joseph Maroon, M.D., 73, just finished his fifth Ironman Triathlon world-championship event – considered the planet’s most grueling. In addition to seeing patients with Tri-State Neurological Associates through UPMC, Maroon is a professor and the vice chairman of the Department of Neurological Surgery at the University of Pittsburgh School of Medicine. He also is an author, an international speaker and expert, and the longtime neurosurgery team physician for the Pittsburgh Steelers.