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Whoosh [hwoosh, hwoosh, woosh, woosh] noun 1. a loud, rushing noise, as of air or water: a great whoosh as the door opened. verb (used without object) 2. to move swiftly with a gushing or hissing noise: gusts of wind whooshing through the trees. verb (used with object) 3. to move (an object, a person, etc.) with a whooshing motion or sound: The storm whooshed the waves over the road. Also, woosh. Origin: 1840-1850; imit.

Pulsatile tinnitus is a rhythmical noise that is synchronous with the patient's heartbeat.

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Another Possible Cause of Pulsatile Tinnitus: Anemia

Whenever I read about a "supplement" that can cure or even help pulsatile tinnitus patients, I have to admit I roll my eyes a little.  That's because I haven't read any accounts by doctors that say that these supplements work.

But when Judie, one of the whooshers in our Facebook group, recently told her story about how taking supplements helped her pulsatile tinnitus, I was intrigued.  I'm sharing excerpts of her messages below (with her permission, of course) because the underlying cause of her pulsatile tinnitus is one that we haven't explored on this site yet: ANEMIA

According to the American Society of Hemotology (ASH), anemia is the most common blood disorder, and one possible symptom of anemia is whooshing!  See the resources at the end of this post. 

Men, women and children can have anemia.  According to this medical journal abstract, Anemia is not a disease in itself; it's evidence of an underlying condition.  Anemia is diagnosed via blood tests.

ASH indicates that there are many different kinds of anemia, so symptoms and treatments may differ. 

But one whoosher, with one type of anemia, found that taking iron and B-12 helped her.  Here is Judie's message:

"I am 64 years old  I have Lupus and chronic anemia.

I have recently found out that some people that suffer from PT are anemic, but once getting their hemoglobin to a good range, the PT goes away or gets much quieter.

I have experienced PT for over 5 years.  Sadly, after I saw many doctors, neurologists, and ENT specialists, I had a head cat scan with contrast (ended up getting an allergic to the dye) brain wave test and a few other grueling ones. The absolute worst part is when the doctor said ..."Learn to live with it!"

Once I started taking iron and B-12 supplements it has helped a great deal.

I was so anemic at one point I had an infusion of iron/B-12 and I enjoyed the peace and quiet until my hemoglobin went back down a few months later...

Until I finally found the fact that I was anemic & simply needed iron and B-12 to build me up is when the whooshing got almost silent.  Funny part was when I went to bed it seemed so strange NOT to hear it. But I don't miss it!

My bottom line is that I had suffered with PT for over 5 years and went through all of the gory tests and terrible side effects from the tests and not even an ENT specialist knew what was causing it. By my own reading and experimenting I found that this works for me and I have "quiet ears" now."


Whooshers, a word of caution: As always, we don't promote self-diagnosis here; instead, talk to your doctor about the possibility of anemia causing your pulsatile tinnitus. We all know that there are so many possible causes of pulsatile tinnitus. It is not easy to isolate the cause -- but we do need to depend on doctors to help us with that.  However, we can help them help us by learning more about the possibilities.

And this goes without saying, but before taking any supplements or medications you should discuss this with your doctor and do so under medical supervision. 

Anemia may not be the cause of my whoosh or yours, but it's worth looking into. 

We'd love to hear your stories.  Thank you, Judie, for sharing yours.  Has anyone else been diagnosed with anemia?  Do supplements and/or vitamins help you, too?  Please share comments below by clicking on the "Comments" tab.  

Sources:

"Anemia," American Society of Hematology, Hemotology.org.

"Anemia,"  Marion Dugdale, M.D., Obstetrics and Gynecology Clinics of North America, Volume 28, Issue 2, Pages 363-382 (1 June 2001).

Thu, November 11, 2010 | link          Comments

Pulsatile Tinnitus Doctor-Patient Communication II

A couple months ago, I wrote about doctor-patient communication.  As a patient, I often hesitate to relay to my current doctors (whom are wonderful, by the way) how some of my former doctors treated my pulsatile tinnitus symptoms. It often feels like you can't say something bad about one doctor -- even if it's true -- without insinuating something bad about all doctors.  I wonder why that is.

Since I started writing about my experience on this site, it's no secret that many of the doctors I first visited did not take my symptoms seriously.  Not at all.  And on top of that, I was treated like I was wasting their time.  One rolled his eyes at me when I said I heard a pulsing sound.  Another told me to "live with it" and actually said I might be crazy.  And yet another -- one of the "top" doctors in the country, mind you -- spent only 3.5 minutes in the room with me before sending me on my way with what he called "nothing to worry about."  That's just the beginning... I could go on and on. 

If I were in a restaurant and the waiter rolled his eyes at me or called me crazy or refused to serve me, I wouldn't tolerate it.  So why should I tolerate that kind of treatment just because someone has "M.D." after his or her name?

But instead of reacting as I normally would when someone says something unnecessarily rude or mean to me, I would just freeze. I was caught off guard because I'd really never had this experience before with doctors -- or with anyone, frankly.  The "live with it" mantra followed me out the door after each of these visits, as did the notion that maybe I was crazy.  They hovered over me.  I couldn't shake it off; I almost began to believe them. 

There is no way to describe this without sounding melodramatic, and I'm not a melodramatic person.  But there I was: an otherwise healthy woman with a debilitating pulsing sound in my head, desperate for help, yet paying money (big money!) to be treated like I was a crazy person that was wasting doctors' time. Over and over and OVER again.

Very soon after launching Whooshers.com, I learned that, unfortunately, I was not the only pulsatile tinnitus sufferer who experienced this kind of treatment.  Lucky for me, by the time I launched this site, I had found some good doctors, but the veil of (okay, I'll say it) -- SHAME -- wasn't finally lifted until I realized that so many of YOU had experienced the same.  It was sad to me that so many of us had endured the same lack of care, but there really is comfort in numbers.  I'm not crazy and it wasn't me.  It's not you.  

So I was beyond thrilled when I read an article published recently by Dr. Martin Young, an otolaryngologist, titled, "Tinnitus Highlights Poor Doctor Patient Communication."  If you haven't yet read it, do.  Not only does Dr. Young acknowledge the significance of tinnitus patient-doctor communication, but he also specifically distinguishes pulsatile tinnitus sufferers and non-pulsatile tinnitus sufferers by noting that ignoring pulsatile tinnitus symptoms may equate to ignoring signs of a significant health issue.

To tinnitus patients --all tinnitus patients-- the doctor-patient relationship means everything. 

Even if a tinnitus patient suffers the incurable form, it is a conversation that may begin to make us feel better, cope better and live better.  Not only is it not unusual to expect to have this conversation with our doctors, but it is terribly distressing when what we thought would be a conversation turns out to be --well-- something else. It certainly doesn't make us feel any better. 

Now, almost two years into my experience with pulsatile tinnitus, I've found doctors who hear me and listen to me.  They probably hear and listen to every patient who walks into their offices, and they most likely always have.  I regret that it took me so long to find them.  One doctor put his hand on my shoulder and said he didn't think I was crazy.  As funny as it may sound, that was a turning point in my care.  I hadn't even told him about the other doctors, but I'm sure he could tell from the look on my face -- and the long list of films of tests I'd had and my list of doctors I'd already seen -- that I was desperate for that validation. 

Aren't we all?

That's why I encourage other Whooshers to keep looking for advocates when they feel like giving up.  There were times when I thought I was in the Twilight Zone because "good" and even "great" doctors with wonderful credentials and accolades gave me practically zero face time and a level of courtesy that made a trip to the DMV seem pleasurable.  But eventually, I found doctors who believed me when I told them I heard this pulsing noise, and they recognized that my symptoms were important to investigate. They listened to me and several of them heard my whoosh (I have objective pulsatile tinnitus), and they made themselves available to answer my questions.  They treated me like a human being. 

Tinnitus patients seek validation.  This is not a melodramatic need; this is a reasonable need.  And those of us with pulsatile tinnitus seek specialized care, not because we're high maintenance people who want to waste doctors' time, but because medical journal article after medical journal article written by doctors conclude that pulsatile tinnitus can be a symptom caused by something that is more than trivial. You can find links to many of these articles and studies under the "Resources" section on our homepage or on the "Cured Whooshers" page. 

Sure, we'd also like quick explanations, but we know that pulsatile tinnitus is rare.  Once we realize what we're dealing with, I think I can speak for most of us that we can have patience for answers as long as we feel like someone is looking into the underlying causes with care and not blowing us off.

Let's demand better care and treatment and acknowledge the good doctors out there who are helping pulsatile tinnitus patients.  They're out there and they don't receive enough appreciation. 

And by the way, reading Dr. Young's article encouraged me to tell my current doctors about the bad experiences I've had with some (not all!) of my previous doctors.  Change has to manifest from the inside out, so doctors should probably encourage other doctors to treat their patients better.  Dr. Young seems to think along these lines and I agree with him.  And one of these days, I'm going to write to those first doctors I saw, with the sincere hope that they'll consider the next pulsatile tinnitus patient who walks in their offices a little more seriously than they considered me.  After all, how will they know unless we tell them?

Article: "Tinnitus Highlights Poor Doctor Patient Communication," Martin Young, MBChB, FCS(SA), Diagnosis and Treatment, KevinMd.Com, November 2010.

Sat, November 6, 2010 | link          Comments


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RESOURCES

NEW: Click Here to Download the PDF, "Top Ten Pulsatile Tinnitus Tips for Doctors." Review it with your GPs and ENTs!

Radiation Dose Chart - American Nuclear Society (ANS) Public Information Resources Page: Click here for an interactive dose chart for various medical diagnostic tests. A downloadable and printable version is also available on this page. Discuss with your doctors.

Find a Neurotologist: American Neurotological Society (ANS) Membership Roster 2015-2016, by state (US) - International contacts at the bottom of the page. NEW! (This PDF file will download when you click here)

Find a Neurointervention Specialist: Society of Neurointerventional Surgery (SNIS)- Click on "Physician Locator"

Find a Neuro-Ophthalmologist: The North American Neuro-Ophthalmology Society (NANOS)

Site: Neuroangio.org - Your neurovascular education and information resource. Patient Information.

UCSF Pulsatile Tinnitus Clinic

Blog: Tales From Clark Street

Presentation: "Algorithm for Evaluation of Rhythmic Tinnitus," Douglas E Mattox, MD, Patricia Hudgins, MD, Jahrsdoerfer Lecture, University of Virginia, March 25, 2010. (This link is to the abstract/summary)

Presentation: "Imaging of the Patient with Tinnitus," Mary Beth Cunnane MD, Massachusetts Eye and Ear Infirmary, Dec 2013. (NEW! Mentions Pulsatile Tinnitus and Whooshers.com. Republished with Permission.)

Article: "Imaging in Pulsatile Tinnitus: Diagnostic Pearls and Potential Pitfalls," B. S. Purohit, R. Hermans, K. Op de beeck; 1SINGAPORE/SG, 2Leuven/BE, European Society of Radiology, 2014.

Article: "Imaging In Pulsatile Tinnitus : When Should It Ring A Bell?" G. Bathla1, V. Chong; 1singapore/SG, 2Singapore/SG, European Society of Radiology, 2012."

Article: "Emma's Story," A Personal Account of Pulsatile Tinnitus, The British Tinnitus Association (BTA).

Article: "Pulsatile Tinnitus: Contemporary Assessment and Management," Aristides Sismanis, Current Opinion in Otolaryngology & Head & Neck Surgery: October 2011 - Volume 19 - Issue 5 - p 348357 doi: 10.1097/MOO.0b013e3283493fd8, Otology and neuro-otology: Edited by Myles L. Pensak.

Article: "Temporal Bone: Vascular Tinnitus," William W.M. Lo and M. Marcel Maya, Vascular, pp.1361-1374, 2003.

Article: "Diagnostic Clues in Pulsatile Tinnitus (Somatosounds)," Carlos Herraiza and José Miguel Aparicioa, Unidad de Acúfenos; Instituto ORL Antolí-Candela, Madrid, Spain; Unidad de Otorrinolaringología, Fundación Hospital Alcorcón, Madrid, Spain; Otorrinolaringología, Hospital Quirón, Madrid, Spain, Acta Otorrinolaringol Esp. 2007;58(9):426-33. This is a link to the article abstract.

Article: "How I Struggled with (PULSATILE) Tinnitus," The Story of Actor Graham Cole, Daily Mail Online, January 10, 2007.

Article: "I Got Lifesaving OP for Whooshing Thanks to US Help," David Powell, Daily Post UK, DPW West, Feb 19, 2013.

Article: "Vital Signs: An Unwelcome Ringing," by Dr. Christopher Linstrom, Discover Magazine, April 2010. (About a cured patient with pulsatile tinnitus symptoms!)

Article: "Tinnitus Highlights Poor Doctor Patient Communication," Martin Young, MBChB, FCS(SA), Diagnosis and Treatment, KevinMd.Com, November 2010.

Article: "Pulsatile Tinnitus: Recent Advances in Diagnosis," Aristides Sismanis MD, Wendy R. K. Smoker, MD, The Laryngoscope, Volume 104, Issue 6, pages 681-688, June 1994. ABSTRACT (Summary)

Article: "Neuroradiologic Assessment of Pulsatile Tinnitus," Department of Otolaryngology Head and Neck Surgery Loyola University Medical Center, Maywood, IL: Dr Kircher and Dr Leonetti; Department of Otolaryngology-Head and Neck Surgery Henry Ford Health System, Detroit, MI: Dr Standring; Presented at the Annual Meeting of the American Academy of Otolaryngology-Head Neck Surgery, Chicago, IL. Sept. 22-24, 2008. (CLICKING THIS LINK WILL DOWNLOAD THE PDF FILE)

Article: "Imaging of Tinnitus: A Review," Jane L. Weissman, MD and Barry E. Hirsch, MD, Radiology, August 2000.

Article: "Imaging in Pulsatile Tinnitus," G. Madania and S.E.J. Connor, Clinical Radiology, Volume 64, Issue 3, Pages 319-328 (March 2009).

Article: "Imaging of the Patient With Tinnitus," Mary Beth Cunnane MD, Massachusetts Eye and Ear Infirmary, December 31, 2013. (NEW! Mentions Whooshers.com and PULSATILE tinnitus as well.)

Article: "Imaging of Pulsatile Tinnitus: A Review of 74 Patients," Guner Sonmez, C Cinar Basekim, Ersin Ozturk, Atilla Gungor, Esref Kizilkaya, Clinical Imaging, Volume 31, Issue 2, Pages 102-108 (March 2007). (This is an abstract/summary-you have to pay to see the article in its entirety)

Article: "Pulsatile Tinnitus: A Review of 84 Patients," Daniel Waldvogel, Heinrich P. Mattle, Matthias Sturzenegger and Gerhard Schroth, Journal of Neurology, Volume 245, Number 3, 137-142, DOI: 10.1007/s004150050193, November 12, 1997.

Article: "Role of Angiography in the Evaluation of Patients With Pulsatile Tinnitus," Edward J. Shin, MD; Anil K. Lalwani, MD; Christopher F. Dowd, MD, Laryngoscope 110: November 2000. (PDF FILE)

Article: "Angioplasty and Stenting for Intractable Pulsatile Tinnitus Caused by Dural Venous Sinus Stenosis: A Case Series Report," Li Baomin, Shi Yongbing, and Cao Xiangyu, Dept of Neurosurgery, Chinese PLA General Hospital, Beijing, Otol Neurotol. 35.366-370. Dec 2014.

Article: "CT Angiography as a Screening Tool for Dural Arteriovenous Fistula in Patients with Pulsatile Tinnitus: Feasibility and Test Characteristics," J. Narvid, H.M. Do, N.H. Blevins and N.J. Fishbein, American Journal of Neuroradiology 32:446-453, March 2011.

Article: "Brain Dural Arteriovenous Fistula (BDAVF)," Patient Information, www.NeuroAngio.org

Article: "Usefulness of C-Arm Cone-Beam Computed Tomography in Endovascular Treatment of Traumatic Carotid Cavernous Fistulas: A Technical Case Report," Sato, Kenichi MD, PhD; Matsumoto, Yasushi MD; Kondo, Ryushi MD, PhD; Tominaga, Teiji MD, PhD, Neurosurgery: August 2010 - Volume 67 - Issue 2 - p 467470.

Article (Abstract): "A Convenient Sonographic Technique for Diagnosis of Pulsatile Tinnitus Induced by a High Jugular Bulb," The American Institute of Ultrasound in Medicine, Minoru Nakagawa, MD, Norimitsu Miyachi, MLT and Kenjiro Fujiwara, MD, Department of Neurosurgery (M.N., K.F.) and Clinical Laboratory (N.M.), Kosei General Hospital, Hiroshima, Japan, J Ultrasound Med 27:139-140 0278-4297, 2008.

Article: "Surgical Treatment of the High Jugular Bulb in Patients with Ménières Disease and Pulsatile Tinnitus," V. Couloigner, A. Bozorg Grayeli, D. Bouccara, N. Julien and O. Sterkers, European Archives of Oto-Rhino-Laryngology Volume 256, Number 5, 224-229, DOI: 10.1007/s004050050146 (ABSTRACT)

Article: "Brain AVM," (arteriovenous malformation), MayoClinic.com

Article: "Chiari Malformation," MayoClinic.com

Article: "Ménière's Disease," National Institute on Deafness and Other Communication Disorders (NIDCD)

Article: "TMJ Disorders," MayoClinic.com

Article: "Anemia," American Society of Hematology, Hemotology.org

Article: "Pseudotumor Cerebri," (also called Benign Intracranial Hypertension) MayoClinic.com

Article: "Pulse-Synchronous Tinnitus," The Intracranial Hypertension Research Foundation

Article: "Coarctation of the Aorta," MayoClinic.com

Article: "Man Cured of Hearing His Eyeballs Move," www.bbc.co.uk, July 27, 2011. Superior Canal Dehiscence Syndrome (SCDS)

Article: "Diagnosis and Cure of Venous Hum Tinnitus," Laryngoscope, Chandler JR, 93(7):892-5, July 1983.

Article: (Abstract) "Sinus Wall Reconstruction for Sigmoid Sinus Diverticulum and Dehiscence: A Standardized Surgical Procedure for a Range of Radiographic Findings," Dr. DJ Eisenman, Department of Otorhinolaryngology - Head & Neck Surgery, University of Maryland School of Medicine, Baltimore, Maryland; Otology Neurotology, 32(7):1116-9; September 2011.

Article: (Abstract) "Awake Embolization of Sigmoid Sinus Diverticulum Causing Pulsatile Tinnitus: Simultaneous Confirmative Diagnosis and Treatment," Park YH, Kwon HJ, Department of Otolaryngology-Head and Neck Surgery, Chungnam National University School of Medicine, Daejeon, Republic of Korea, Interv Neuroradiol. 2011 Sep;17(3):376-9. Epub 2011 Oct 17. (NEW!)

Article: "A New Therapeutic Procedure for Treatment of Objective Venous Pulsatile Tinnitus," Sanchez TG, Murao M, Medeiros HRT, Kii M, Bento RF, Caldas JG, et al. Int Tinnitus J. 2002;8(1):54-57.

Article: "Glomus Tympanicum," The New England Journal of Medicine, Volume 362:e66, Number 22, June 3, 2010.

Article: "Resolution of Pulsatile Tinnitus Following an Upper Mediastinal Lymph Node Resection," Wang YZ, Boudreaux JP, Campeau RJ, Woltering EA, South Med J. 2010 Apr;103(4):374-7.

Article: (Abstract) "Dissection of the Internal Carotid Artery After SCUBA-Diving: A Case Report and Review of the Literature," Franz Hafner, MD,* Thomas Gary, MD,* Froehlich Harald, MD,* Ernst Pilger,* Reinhard Groell, PD,w and Marianne, Brodmann* "Neurologist. 17(2):79-82, March 2011. (NEW!)

Article: "Carotid-Cavernous Sinus Fistula," Bobby S. Korn, M.D., Ph.D., and Kang Zhang, M.D., Ph.D., N Engl J Med 2011; 364:e15, February, 24, 2011. (WARNING: GRAPHIC IMAGES)

Article: "Pulsatile Tinnitus Cured by Mastoidectomy," Duvillard C, Ballester M, Redon E, Romanet P., Department of Otolaryngology-Head and Neck Surgery, Hôpital Général, Dijon, France, Ann Otol Rhinol Laryngol, September 2004.

Article: "Pulsatile Tinnitus: A Symptom of Chronic Subclavian Artery Occlusion," Marcio Francisco Lehmann, Charbel Mounayer, Goetz Benndorf, Michel Piotin, and Jacques Moret, AJNR Am J Neuroradiol 26:19601963, September 2005 (PDF).

Article: "Carotid Endarterectomy Relieves Pulsatile Tinnitus Associated with Severe Ipsilateral Carotid Stenosis," J Kirkby-Bott, H.H Gibbs, European Journal of Vascular & Endovascular Surgery, Volume 27, Issue 6, Pages 651-653, June 2004.

Article: "MR Angiography Imaging of Absence Vertebral Artery Causing of Pulsatile Tinnitus: A Case Report," *Mehmet Cudi Tuncer; **Yekta Helbest Akgül & *Özlen Karabulut,* Department of Anatomy, Faculty of Dicle University, 21280, Diyarbak¹r, Turkey.** Department of Otorhinolaryngology, Özel Diyarbakr Hospital, 21100, Diyarbakr, Turkey, International Journal of Morphology, v.28 n.2 Temuco Jun. 2010."

Article: "Endovascular Treatment of Sigmoid Sinus Aneurysm Presenting as Devastating Pulsatile Tinnitus. A Case Report and Review of Literature." Mehanna R, Shaltoni H. Morsi H, Mawad M., Interv Neuroradiol. 2010 Dec;16(4):451-4. Epub 2010 Dec 17.

"Pulsatile Tinnitus Caused by an Aneurysm of the Transverse-Sigmoid Sinus: A New Case Report and Review of Literature," Lenck S, Mosimann PJ, Labeyrie MA, Houdart E., Department of Neuroradiology, hôpital Lariboisière, 2, rue Ambroise-Paré, 75010 Paris, France, J Neuroradiol. 2012 Oct;39(4):276-9. doi: 10.1016/j.neurad.2012.02.001. Epub 2012 Sep 29. (NEW!)

Article: "Intractable Tinnitus and Sensorineural Deafness Cured by Surgical Correction of Coarctation of Aorta," S. Rathinam, A.M. Pettigrew, J.C.S. Pollack, Interactive Cardiovascular and Thoracic Surgery 3:431-433 (2004).

Article: "Pulsatile Tinnitus," Don McFerran FRCS Consultant Otolaryngologist Essex County Hospital, Colchester, British Tinnitus Association, October 2007.

Article: "Pulsatile Tinnitus and Dural Arteriovenous Malformation (Dural AVM)," G. A. J. Morrison, The Journal of Laryngology & Otology (1989), 103:1073-1075 Cambridge University Press (ABSTRACT).

Article: "Medical Mystery: Giving Birth Didn't Ease a Woman's Dangerous Hypertenstion," Sandra G. Boodman, The Washington Post, October 17, 2011.

Article: "That Noise Wasn't Just Tinnitus," Sandra G. Boodman, Special to The Washington Post, July 7, 2009

Article: "What's That Noise In Her?" H. Lee Kagan, Discovery Magazine, January 2006. (About a patient with arteriovenous malformation (AVM) and her doctor whose patience and persistence paid off).

Article: "The 'Rare' Disease That Isn't," Thomas M. Burton, The Wall Street Journal, June 27, 2009

Article: "Diseases and Conditions/ Fibromuscular Dysplasia (FMD)," Cleveland Clinic. Lists symptoms, details, treatments, and resources including Whooshers.com.

Article: Unraveling Pulsatile Tinnitus in FMD: A Report of the United States Registry For Fibromuscular Dysplasia."

Video: "A Rare Disease That May Be Underdiagnosed," Thomas M. Burton, June 26, 2009 (Hear an example of a whooshing sound in this short video)

Whooshers.com Pulsatile Tinnitus Sounds (Real Ones Recorded by Real Whooshers!)

Audio: Having trouble describing the sound you hear to others? Listen to this collection of sounds that whoosh and see if you can find a match to yours! Demonstrations: Heart Sounds & Murmurs, from the University of Washington Department of Medicine

Audio: FREE White Noise from White Noise MP3s.com

Audio: SimplyNoise.com

Whooshers.com Review: SleepPhones- Soft, comfortable headphones to help mask the whoosh for a good night's sleep.

Click Here for the International Association for Suicide Prevention (IASP)

Replace "ringing" with "whooshing," and here it is: our theme song.