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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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My Tell-Tale Heart: Why I Think Edgar Allan Poe May Have Been a Pulsatile Tinnitus Sufferer

On this spooky weekend before Halloween, let's consider the story of one of the most famous poets and storytellers: Mr. Edgar Allan Poe.  Poe lived a short life of forty years.  His critics and fans alike wonder what he could've accomplished had he lived another forty. 

I wonder what his writings-to-be may have revealed further about him ... his inner demons, his emotional turmoil, and perhaps even his physical health. 

That's because, by most accounts, Mr. Poe was a troubled man who lived a short life filled with tragedy.  Both of his parents died before he was three years old, one of his siblings died at a young age and he lived in poverty most of his life.

But then there was his brilliance and creativity. By the age of five he was reciting poetry.  By the age of thirteen he had written enough to publish a book.  His reputation remains creepy, haunting and mysterious, in an intriguing sort of way.  I was actually surprised that he lived a life so short; my impression of him and his writings has always been that of a matured, established writer, but his legacy of great writings seems to drown the fact that he died much too soon.  

In 1848, one year before his death, he attempted suicide, and, while the exact cause of his death remains a mystery, some believe he killed himself in 1849, at the young age of forty.  Forty years of tragedy, depression and irrefutable genius.  He wrote stories with details that readers can, all these years later, hear on the page. 

Which brings me to what I've noticed (er, researched obsessively) as I've surveyed his collection: many of his works have references to sounds that sound like pulsatile tinnitus.  

My interest began after reading (again... I read it a long time ago in school) one of his most famous pieces: "A Tell-Tale Heart," a fictional story in which the narrator hears a relentless, beating HEARTBEAT sound that he initially attributes to an old man he later kills, and then, to his conscience. Watch this (it's a cartoon but it may be too scary for the kiddos):


At one point he even talks about how he fancies a ringing in the ears, but that THIS sound --the heartbeat sound-- is different from the ringing; and it was not in his ears, but in his head:

"The ringing became more distinct : I talked more freely to get rid of the feeling: but it continued and gained definitiveness until, at length, I found that the noise was not within my ears. 

No doubt I now grew VERY pale; but I talked more fluently, and with a heightened voice. Yet the sound increased and what could I do? It was A LOW, DULL, QUICK SOUND MUCH SUCH A SOUND AS A WATCH MAKES WHEN ENVELOPED IN COTTON. I gasped for breath, and yet the officers heard it not. I talked more quickly, more vehemently but the noise steadily increased. I arose and argued about trifles, in a high key and with violent gesticulations; but the noise steadily increased. Why WOULD they not be gone? I paced the floor to and fro with heavy strides, as if excited to fury by the observations of the men, but the noise steadily increased. O God! what COULD I do?"

"Villains!" I shrieked, "dissemble no more! I admit the deed! -- tear up the planks! -- here, here! -- it is the beating of his hideous heart!" 

(Click here to read the full text of  "A Tell-Tale Heart," in the public domain)

The sound got stronger the more he focused on it, the more his heart rate increased, and yet the officers who came over could not hear it. 

Sound familiar???

Two and a half years ago, when I realized I was experiencing the symptom of pulsatile tinnitus, I quickly became interested in how many famous people did as well. For validation? Ok, sure, yes, I'll admit that.   

I soon figured out that there are long lists of famous people with regular tinnitus (the ringing kind), but pulsatile tinnitus?  Nope, not one.  Forget it.

I've accepted the fact that the kind of tinnitus I experience is rare. Pulsatile tinnitus is NOT regular tinnitus.  But now that this site has been up and running for over two years and we've shared hundreds of stories about pulsatile tinnitus, we know that many of us with pulsatile tinnitus are --not always, but often-- mistakenly diagnosed as having the regular, more common form of tinnitus --a completely different symptom.  So, I'm sort of obsessed with the possibility --or likelihood-- that some of these "famous tinnitus sufferers" in fact experience(d) PULSATILE TINNITUS.

My theory is supported, I think, when the sounds that some of these famous "tinnitus" sufferers describe seem to more accurately describe *pulsatile* tinnitus sounds than regular tinnitus sounds.

WHOOSHING, BEATING, PULSING, CLANKING, CREAKING, CLICKING, AND ANY OTHER SOUND THAT IS IN SYNC WITH THE PULSE OR HEARTBEAT.  

Consider another of Poe's works: his poem, "The Bells." When I hear the word "bell" I think of ringing, but if you read the poem, Mr. Poe doesn't describe the sound as ringing at all… the sounds are more like swooping, rhythmic bangs of sound. Here is an excerpt:

"… Yet the ear it fully knows,

By the twanging

And the clanging,

How the danger ebbs and flows;

Yet the ear distinctly tells,

In the jangling

And the wrangling,

How the danger sinks and swells,

By the sinking or the swelling in the anger of the bells -

Of the bells,

Of the bells, bells, bells, bells,

Bells, bells, bells -

In the clamor and the clangor of the bells! ..."

So what if Mr. Poe really did experience pulsatile tinnitus?  Well if he did, no one knew it, and it's likely Mr. Poe suffered from a symptom that no one understood back then (they hardly understand it now!).  That would explain his feelings of isolation, no?  Some historians believe Mr. Poe committed suicide, while others believe he suffered from tuberculosis or rabies ... even "brain congestion" has been suggested as a cause of death.  Syphilis was another suspected cause of death, one which interestingly includes pulsatile tinnitus as a possible symptom. 

When Mr. Poe died, pages from what some believe was the last piece of his work were found.  There was no title, and it wasn't complete, but the pages seem to be a short journal describing a man's experience during a storm on New Year's Day in 1796, titled, "The Light-House."

The narrator briefly comments that he hears some echo in the walls, but then he quickly ignores this and says, as if he is trying to convince himself, that his worries are "all nonsense."

"It is strange that I never observed, until this moment, how dreary a sound that word has — “alone”! I could half fancy there was some peculiarity in the echo of these cylindrical walls — but oh, no! — this is all nonsense."

Maybe Mr. Poe wasn't crazy or mad.  Maybe he heard some of the same heartbeat-like sounds we hear. It's such a complex sound and sensation to describe, yet he does it so well, doesn't he?  So well that, I believe, he may very well have experienced the sounds himself.  But since the outside world couldn't hear them, he lived a life of denial and shame.  It's a possible theory, no?

Like when he wondered if the walls were creaking in his home? This same home where he isolated himself to, perhaps, cope with an often debilitating symptom.  How many times did you wonder if the sound you hear was in your home?  After all, it's much more difficult to explain or accept that the noise is internal. 

In just a few days, a cottage that Mr. Poe called home in New York over 160 years ago will be open to visitors.  I am eager to visit, and I can't help but wonder if, within those walls, Mr. Poe considered the same things we pulsatile tinnitus sufferers do: Am I hearing things?  What is this sound I hear?  Am I going mad?  Does anyone really believe me?

The only difference is now, with the help of the Internet, we have this site and a growing network of whooshers and doctors around the world who understand the symptom: pulsatile tinnitus sufferers no longer have to feel alone.  

Since historians agree that Edgar Allan Poe invented the modern detective story, perhaps it's time to reconsider Mr. Poe's intriguing life and work, his legacy as an artist and how the mystery behind his health and eventual death fit in to it all.

Were the noises really there or were they imagined?  Might others have heard them if only they tried?

Could Edgar Allan Poe be the first on our list of Famous People With Pulsatile Tinnitus? 

Happy Halloween!!

Sat, October 29, 2011 | link          Comments

Poll Results: Are You A Whoosher Who Experiences Hyperacusis?

Hyperacusis is an over-sensitivity to or lower tolerance for certain frequencies of sound.  These interesting results from our (albeit non-scientific) poll show that over half of whooshers who responded do experience hyperacusis in addition to pulsatile tinnitus.

Yes, I also experience hyperacusis. 58%  (58 votes)

No, I do not experience hyperacusis. 27%  (27 votes)

I'm not sure if I experience hyperacusis. 13%  (13 votes)

Other. 2%  (2 votes)

Poll questions are like little pockets of insight into our cases, and our doctors may find them helpful as well as interesting, so thank you for participating!  We have a brand new poll up on the righthand side of this page... please vote and let your whoosh be heard!  

And be sure to see our Poll Results page, where we compile all previous Whooshers.com polls and results. 

-WhooshEr

Sat, October 1, 2011 | 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.