Just a couple of months ago in this post, I mentioned The New York Times' column, "Think Like a Doctor," and guess what?  Today's mystery is about a pulsatile tinnitus patient whose underlying cause stumped even some of the best doctors around (not a big surprise to us, right?!).  As you'll read, the patient has had extensive testing and some possible causes, such as fibromuscular dysplasia (FMD) were ruled out.  Apparently, doctors now know the cause, and the question is: can any of you figure it out?

SPOILER ALERT: The diagnosis has been posted, and a link to the details is below.  

I'm thrilled that our symptom is getting this kind of exposure, and it will be great when this patient's underlying cause is published!

I think a very big hint is that her pulsatile tinnitus is accompanied by pain, since we've done a poll on the question of pain, and only 19% of those pulsatile tinnitus patients polled said they also experience pain.

There are more results for other poll questions we've had over the past few years here.  They're not scientific, but they provide some interesting insight into many of our cases.

Do your symptoms match hers? Can you solve this mystery, or suggest further testing?  Dr. Sanders, the author of the article, invites readers to post their ideas on The New York Times' site and/or leave a "comment" below or email me at whooshers@gmail.com! 

The answer will be posted tomorrow.  

*If anyone here can guess the correct diagnosis, you'll get a free Whooshers.com T-Shirt! leave your guess in the comments section, on my Facebook profile page, or email me if you prefer!  One guess per reader please.

UPDATE: The diagnosis was "Hemicrania Continua." Fascinating!  Even better: medication, not surgery, solved the underlying cause.  No, wait - even better is that her doctor diagnosed her in part because she came across a BLOG POST written BY A PATIENT who suffered the same symptoms and was diagnosed with Hemicrania Continua.

SEE, SHARING OUR STORIES REALLY DOES MAKE A DIFFERENCE!

Read more details about the diagnosis here. I'll be adding this underlying cause to our Cured Whooshers page.

For more information on Hemicrania Continua, including a list of common symptoms (which does not include pulsatile tinnitus but now we know it should!), see the Hemicrania Continua Information Page on the National Institute of Neurological Disorders and Stroke's Web site.  

Source: "Think Like a Doctor: An Ice Pick in the Head," Lisa Sanders, MD, The New York Times, January 5, 2012.

Sigmoid sinus diverticulum is a cause of pulsatile tinnitus that we have already explored here and here, but lately I have heard some very promising news from both patients and doctors about this cause and possible solutions that I want to share.  

In this recent study (the link is to the abstract/summary, so ask your doctors to access the full report), Dr. Eisenman in Baltimore, Maryland indicates that surgical intervention of pulsatile tinnitus (also called pulse-synchronous tinnitus) may be highly successful.  This report describes 13 patients, all of whom experienced pulsatile tinnitus as a result of sigmoid sinus diverticulum, and all of whom reported no more whooshing after surgery.  That's 13 Cured Whooshers, folks!

And there may be additional options for sigmoid sinus diverticulum patients to consider.  Like the one in this study, also published recently.  Doctors YH Park and HJ Kwon in Korea indicate in this study that an embolization procedure corrected this 31-year old patient's pulsatile tinnitus symptom. 

Interesting, too, is that the diagnosis of the same cause was determined via different means for different patients.  It appears that CT scans (CTA/CTV) as well as cerebral angiograms were the tools used to diagnose the same cause. From the limited details provided in the summaries, it seems that a CT scan is often done first, presumably because it is a less invasive test than a cerebral angiogram, and then the angiogram may be done to confirm the diagnosis and (if this method is chosen) complete the embolization process. Sometimes the diagnosis and treatment may be done in a single procedure (as was the case in the second study above).  It depends on the precise diagnosis, cause, the doctor's insight and the patient's educated understanding of his or her options.  That's why I think reading these reports and reviewing them with our doctors, so they may further explain their complexities, is so important. 

What we already know is that there are many possible cause of pulsatile tinnitus.  Each cause is different, and these many reports of patients with this particular cause indicate that indeed two people with the same underlying cause may undergo different procedures to diagnose it and to correct it, depending on factors such as medical history, individual circumstances and doctors' inclinations.  Please discuss and review all tests and options for correction, including their risks/benefits, with your doctors to determine if this is a possible cause to look into and, if so, how it may be determined and corrected.  

So we end the year and begin a new one with stories of 14 Cured Whooshers!  The second study above indicated that this cause is rare, which may very well be true, although I have heard personally from several more patients in recent months with the same cause and positive results.  Maybe instead of "rare," the condition is better described as "rarely diagnosed," as is the case with many other causes of pulsatile tinnitus.  Perhaps the research is picking up regarding this cause, and that's nice to know!

If you are a patient with sigmoid sinus diverticulum and/or dehiscence, I'd love to hear from you.  Doctors indicate that the subtleties of this cause can be -and often are- easily missed on films, so it's very important to see a doctor who is familiar with this cause and the medical research, much of which is recent.  After all, the success of a diagnostic test depends on the cause(s) it is designed to detect ALONG WITH the eyes looking at the films.  

These two new reports will be added to the Cured Whooshers page.  Hooray for more cured whooshers and the doctors who have gone to great lengths to help them!

-WhooshEr

Sources:

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.

If you're a Whoosher, here are some ideas --products and gestures-- for your holiday wish list. And if you aren't a Whoosher but you know one, take a look at the list of Whoosher-Wants!

Several Whooshers contributed ideas and feedback for this post, so thank you!   Please free free to add more to the "Comments" section at the end of this post. 

Happy Holidays!!  

10.  A Good Pair Of Earplugs

Sometimes when an earplug is placed in the ear, the sound of the whoosh subsides. This is especially helpful when trying to get to sleep or while reading.  Ear muffs may work, too!

9.  A White Noise Machine, NOT A "Sound" Machine

White noise is often the best noise to mask the pulsing sound of pulsatile tinnitus, because it provides a steady sound that masks the pulsing rhythm.  For many of us, it is the rhythm of pulsatile tinnitus that bothers us even more than the volume of the sound.  As one of our Whooshers put it, the goal is a "soft hum."

Another great option is a white noise audio file (click here to download one for free!) that can be played on an iPod, iPhone, or MP3 player.  Help your Whoosher download and play the audio file.  

Sound machines that play animal sounds (crickets, frogs, etc.) or ocean sounds are not usually helpful because those are rhythmic sounds that compete with our whooshing sound, so please don't buy us one of those! 

8.  SleepPhones

A great product that provides a method for listening to white noise (or any other sound/music of choice) while comfortably fitted around your head.  I like this product best for listening to white noise while sleeping. It's a smart alternative to a sound pillow.  Here is a link to the Whooshers.com review.

7.  A Whooshers.com T-Shirt

Increase pulsatile tinnitus awareness while wearing this comfortable shirt! (It's too late to order for Christmas 2011, but if you're willing to wait until the beginning of Jan 2012 we'll have more available then!) 

6.  A Luxurious Bubble Bath

Some Whooshers report finding relief when their heads are underwater.  Steady water flowing, in the shower or bath, also sometimes masks the whoosh.  This great suggestion is from a fellow Whoosher: Fill the bath with bubbles, sink your head in the bubbles and the popping sometimes drowns the whooshing.  

5.  Turn Up The TV When We Ask You To, And Don't Keep Asking Why

It sounds like a small thing, but it's not.

4.  Accompany Us To Doctors' Appointments

We may not ask you to, but most of us appreciate the company.  You may even be able to help organize medical bills, papers, etc. 

3.  Ask Us How We're Doing

Pulsatile tinnitus can be a very isolating symptom, especially since it is not visible.  It is easy to forget that someone suffers from it, and how much.  It's probably not a good idea for us to dwell on it too much, but asking us once in a while how we're doing and really listening to our answer helps us cope. If your Whoosher had a doctor's appointment, ask how it went.  Encourage your Whoosher to try to find an audio file that sounds like the whoosh s/he hears, so you can listen to it and understand and bit more what it sounds like (and how annoying it is!). 

2.  Relieve Us Of One Stressful Chore A Day

For many of us, an increase in stress can increase the intensity of the whoosh.  By taking something off your Whoosher's plate you could really help him/her cope. 

1.  Listen And Learn

The best thing a Whoosher can receive is comfort that those around us try to understand this unusual symptom we deal with and how it affects us.  Listen and learn more about pulsatile tinnitus on Whooshers.com.  Understand that pulsatile tinnitus is NOT regular tinnitus.  It is a rare symptom.  Participate with us on Whoosher Wednesdays and help our community get more attention and support!  

Another whoosher's underlying cause has been diagnosed and treated. Yep, another Cured Whoosher!  Her name is Karen, and her story of challenges and hope was highlighted recently in an extraordinary article in The Washington Post.  Karen reached out to me recently, and I'm so glad she did.  She provided Whooshers.com with more whooshing details at the bottom of this post, so be sure to read all the way to the end!

The cause of Karen's pulsatile tinnitus is Fibromuscular Dysplasia (FMD).

According to the Fibromuscular Dysplasia Society of America (FMDSA), FMD is a "disease [that] causes one or more arteries in the body to have abnormal cell development in the artery wall." Most of those affected with FMD are women.  There is no cure for FMD, but there is treatment.  Also, "Many people with FMD do not have any symptoms or signs on physical examination and are diagnosed by accident during a radiology scan for another problem."

For FMDSA's thorough information page, including symptoms, causes and treatments, click here.  FMDSA is a non-profit organization of wonderful people that work tirelessly to increase awareness of the disease.  They have an impressive and growing network of doctors and patients that band together to help people who would otherwise feel isolated. 

Before I tell you more about Karen's story, I have to share a little side story:

I learned about FMD a few years ago upon receiving an email from Tom Burton, a writer at The Wall Street Journal about an article he had just published.  Mr. Burton's article, "The 'Rare' Disease That Isn't," and the accompanying video presented what I thought was an exceptional insight into FMD.

The thing was, Mr. Burton contacted me only a few hours after I launched Whooshers.com, before the word had gotten out yet that Whooshers.com was up and running.  How did he find it, and so quickly?  I hadn't even told my family I'd launched the site yet. I wasn't sure if anyone would ever find it, much less a reporter.  What I didn't know then was that the email from Mr. Burton about FMD began what would be a steady stream of emails about possible and "rare" or "rarely diagnosed" causes of pulsatile tinnitus.

Throughout Mr. Burton's piece are references to the "whooshing" and "swishing" and "swooshing" sound experienced by many FMD patients.  In the video, you can even HEAR one patient's whoosh!  Mr. Burton recognized that the symptom that was the topic of Whooshers.com could be a symptom of FMD, and I'm very glad he gave me the heads up so I could put up links to his piece and the FMDSA resources to share with you all.

I still don't know how Mr. Burton found me, but I was very intrigued by his message and the link to his article.  Also?  I must add that I was a bit freaked out because the story indicated that FMD can be fatal if not properly identified and treated. So, I thought, why wasn't the possibility of FMD even mentioned to me before by my doctors? 

By the time I read Mr. Burton's story, I had several diagnostic tests done, but I hadn't yet been checked out for FMD, which, according to the article and FMDSA, may affect far more people than once thought.  Sometimes pulsatile tinnitus is the only symptom of FMD, and, even in cases of FMD, pulsatile tinnitus is a symptom that is often disregarded. 

I made an appointment with a cardiologist and had some fairly straightforward tests to rule out FMD.  The thing is, your doctor needs to be familiar with characteristics and details of FMD to detect FMD, and few are.  If you experience some of the symptoms of FMD check out the resources at the end of this post and discuss them with your doctors. Also, FMDSA has many links to medical reports that your doctor can read if s/he is not familiar with the disease, and they have information about doctors who are familiar with FMD.

While there is no cure for FMD, it may in many cases be treatable with medication and/or medical procedures. Sometimes, if the FMD patient experiences pulsatile tinnitus, the treatment may even make the whooshing go away.  

Which brings me to Karen, an FMD patient and Cured Whoosher. Among other harrowing symptoms, page two of the article in The Washington Post reveals that she experienced pulsatile tinnitus.  

UNFORTUNATELY (this drives me bonkers) for us, the writer of the piece does not use the term "pulsatile tinnitus," however Karen described the symptom as well as she could have: loud pounding in her ear, which sounded like a heartbeat; whooshing sound.  An ear, nose and throat (ENT) specialist's response to this symptom was, "Everyone can hear their heartbeat." 

I know a LOT of you have heard that same response.  Karen says she was also told to lose weight to stop the whooshing, which is another recommendation that many whooshers receive, often without a clear and convincing reason that doing so may remedy the problem. In fact, many people with FMD are in tip-top physical shape and exercise regularly.  Weight is sometimes a factor, but it depends on the cause.

But Karen didn't hear a sound that "everyone can hear," nor did she need to lose weight to stop her symptom.  She had FMD, which was misdiagnosed for too long and required treatment.  She kept searching and eventually found answers. Her treatment continues and her whooshing is GONE. 

I'm grateful for The Washington Post article and The Wall Street Journal article, but *why oh why* isn't the "whooshing" called by its name:  PULSATILE TINNITUS?  There have been so many missed opportunities to expose our symptom, in articles published worldwide, like this one that was highlighted recently on Whooshers.com and papers worldwide.  They don't mention the term pulsatile tinnitus!?! While the symptom is described very well - we even hear it in the video I referenced above - not referring to it by its (bad, but we'll take it) name is a BIG problem when it comes to diagnosis and treatment.  NOT everyone experiences pulsatile tinnitus; it is a rare symptom that warrants medical evaluation. FMD is just one of many, many possible causes of pulsatile tinnitus, and the word MUST start getting out that it's a real symptom with a real name. 

But I guess, for now, we'll take whatever exposure we can get.  Today I'm glad to report that we have yet another Cured Whoosher! Karen's story will be added to the growing list of others.  It gives us all hope.  Hope!

And below, in her own words, Karen shares her story in more detail as it pertains to the whooshing.  

Karen, thanks for sharing your story with us and with The Washington Post!  Your effort to increase awareness about FMD and pulsatile tinnitus will no doubt help many people!  I'm sure it already has.

Here is Karen's story for Whooshers.com:

I have had pulsatile tinnitus (PT) probably forever.  I did not know what is was called until it finally went away!  Here is my story.  
 
I first became aware of my PT (and concerned about it) some time in my 30's.   I had always heard my heart beat in my ear so I thought every one must hear it.   I called it "pounding" and I would tell people and physicians that I would have a pounding headache and the pounding would sound like my heart beat in my ears.  I recall feeling dizzy with the pounding.  It was whooshing - and perhaps that would have been a better description, but I called it "pounding."  I was becoming more and more dizzy with terrible migraine headaches. 

The whooshing (pounding) would come and go but I would be aware of it when lying down, or turning my head to the side.  During those years I was taking many medicines that would either increase heart rate, or increase blood pressure - but I was unaware that the medicines I was taking were excessive and combined dangerously.  I actually thought every one had whooshing in their head and was told on one occasion by a Neuro ENT that every one could hear their heartbeat in their ear.  I went to see him but he ended up ruling out vertigo and bad visual ocular reflexes, as I felt the dizziness and pounding in my ears when I moved my eyes as well.
 
Years passed and I became used to the pounding. It negatively impacted my sleep, my attention and ability to focus.  When I became pregnant with my first child at age 42 the whooshing increased.  I thought it was just the increased cardiac demand that the increased weight had on me.  And by the way, I gained too much weight and did so very fast.  I was retaining fluid; everyone around me, including doctors, told me I should be swollen and bloated - little did I know that I was more bloated than I should be.  I finally developed pregnancy-induced hypertension with fear of developing pre-eclampsia.  I was sent immediately from the OB/GYN to the ER thinking I'd have to deliver prematurely, but luckily I was put on hospital bed rest until the baby was big enough to come out safely.  My blood pressure was dangerously high but maintained below 150/90 with no medicine.  I ended up losing 20 pounds of fluid in those last few weeks. The whooshing persisted - even louder than before - but was the last thing on my mind - I had long since stopped telling doctors about it.
 
When I delivered I thought my blood pressure would resume to normal but it did not.  I was determined to figure it out and had researched in PubMed about hemangiomas which I had developed on my finger.  I learned about a case in which the woman had hemangiomas during pregnancy on her hand and her kidney causing hypertension. I requested a scan of my kidneys and the dopplers detected stenosis in one or more vessels.  My primary doctor said it could be due to fibromuscular dysplasia (FMD).  I instantly read up on the condition and sought support through a patient group called FMDSA.  When I got the diagnosis it was determined to be in my kidneys and in my internal carotid arteries.  My FMD specialist, Dr. Jeffrey Olin, said the tortuosity in the internal carotids as it passed by my ears was causing the whooshing. He could hear it through his stethoscope. And the increased velocity of blood flow through the twists in the vessels caused the sound (bruit).
 
I had an angioplasty of my renal arteries, and since then I have been treated by an angiotensin II receptor blocker medicine for my renovascular hypertension.  My blood pressure is now well below 120/70 all the time, and I no longer get the whooshing.  I am not sure if that is due to the lower blood pressure or the fact that the medicine relaxes smooth muscle found in arteries. But I only get the whooshing now on a rare occasion if I turn my head far extreme to the side and hold it.
 
I guess my advice for patients who hear the whooshing is: get your doctor to listen with the stethoscope for the bruit, see a vascular medicine specialist and consider getting a doppler all the way up along the carotids to where they divide to form the internal carotids, and check your blood pressure during the day in various conditions or positions.  Second and third opinions never hurt either.

Sources:

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

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

"The 'Rare' Disease That Isn't," Thomas M. Burton, The Wall Street Journal, June 27, 2009. (Video)

Fibromuscular Dysplasia Society of America

FMD is just one of many possible underlying causes of pulsatile tinnitus.  See this and other Cured Whoosher stories on our Cured Whooshers page.  

About six months ago, I heard from Brad, a (now former) whoosher who told me he first visited this site just over two years ago - probably not long after I launched it.  Like most of us, he had searched for years for a diagnosis and a possible fix. He told me that his doctor had discovered the underlying cause of his pulsatile tinnitus: transverse sinus stenosis, which is a narrowing of a vein near the brain.  His doctors had suggested a procedure to correct it, he had it, and it seemed to have worked. 

Brad followed up with me recently with the great news that he was still living in silence - no more whooshing!  He wanted to share his story here to reach other whooshers, and I'm so glad he did.  

Transverse sinus stenosis is a relatively rare cause of pulsatile tinnitus that evades most of the normal diagnostic tests, probably because we're talking about a tiny vein that is simply too small for a lot of tests to detect.  I happen to be familiar with this cause because transverse sinus stenosis is the cause of my pulsatile tinnitus, too.  Like Brad's, mine was discovered via a cererbal angiogram, after many, many other tests that did not detect it.  I have met only a few other whooshers around the world with the same cause since I launched this site in 2009, and I haven't found a whole lot of information about this cause and its treatment as it pertains to the symptom of pulsatile tinnitus (and not something else).

There are quite a few medical reports about possible connections between transverse sinus stenosis and idiopathic intracranial hypertension (IIH), but not all patients with transverse sinus stenosis are also diagnosed with IIH, and vice versa. And it's important to note that not all IIH patients experience pulsatile tinnitus, although we have many whooshers in our network who are IIH'ers.  I've looked but have not found many medical reports regarding a case of transverse sinus stenosis in the absence of an IIH diagnosis, and remedy of the pulsatile tinnitus upon a procedure to fix the stenosis (as opposed to a procedure to remedy other symptoms of IIH). This may explain why I have not heard of many whooshers with this diagnosed cause and remedy, but I'm still looking! 

In the meantime, here is a link to the search results for "transverse sinus stenosis," for any of you who may be more curious about the diagnosis and procedures reported to have corrected it, so you may share and discuss some of those search results with your doctors.   

So back to the exciting news:

After some much needed recovery time and some gradual confidence that the whoosh really may be gone for good (which is a common stage I recently wrote about here on the site), Brad was kind enough to share his story, which I'm posting below. 

Thanks, Brad, for sharing your wonderful news and details that I know will help other Whooshers out there! I'm thrilled to share your story here and on our Cured Whooshers page, where there is a growing list of underlying causes of pulsatile tinnitus as well as medical reports and stories like this one about real people who find real silence. 

It's wonderful to hear more and more cases of ours being solved.  Like I always say, sharing our stories is the first step towards recovery! If you are a cured whoosher and would like to share your story (anonymously, if you prefer!), I'd love to hear from you. 

There are many possible underlying causes of pulsatile tinnitus; this story is about just one.  I encourage every pulsatile tinnitus patient to share the links to medical reports and abstracts (summaries) on this site with your doctors so that they may read and review them with you.

Here is Brad's story:

My first experience with PT came when I was 28 years old.  I noticed that when I was laying down to sleep I could hear an odd whooshing sound in my right ear.  It was different from the pulsing or pounding sound I could hear whenever I worked out or had an increase in blood pressure from exertion.  This was a whoosh; it reminded me of the sound you hear when placing a doppler over a blood vessel.  It didn't last long, and I was able to fall asleep without difficulty.  However, it seemed to happen every night, even when I laid on my right side when the pillow was covering that ear.  After a little time had a passed I also noticed that it happened when I bent over.  I wasn't sure what to make of it so I went to my general physician who referred me to an audiologist. 

I went in and had my hearing checked, but I had no hearing loss.  The audiologist told me there was nothing they could see that would cause the PT and that if it didn't disrupt my hearing I should be fine.  So I figured it wasn't anything to worry about and since it wasn't debilitating I decided to just try to ignore it. 

So two years went by and it was still just an annoying sound that I heard when I was in a quiet room trying to sleep.  It wasn't too distracting at that point so I just kept trying to ignore it.  At this point in my life I started graduate school, which increased the stress in my life.  I started to notice that the whooshing could be heard during the day when my stress level was elevated.  I asked a few physicians if they could think of anything that causes this and none really had much advice for me. 

After a few months the PT started to increase in frequency and volume, so I went to my new GP.  She noticed my blood pressure was high/normal.  She put me on a couple of anti-hypertensive medications and I noticed a decrease in the volume of my PT.  At that point I was pretty excited because the sound was again only audible in a quiet room and was totally manageable, in my opinion.  During this time I also noticed that I could make the sound completely go away when I pressed on my carotid artery, but this bit of information didn't seem to impress anyone else so I didn't think much else about it either.

Another year went by.  I graduated from grad school, moved back home and got good health insurance again.  I went to a new GP who referred me to a neuro-otologist (or neurotologist).  I thought to myself that this guy is an expert so he will figure out what is going on for sure.  I saw him once - he had me get an MRI and see another audiologist. When I went back to him to review the MRI he told me there was nothing visible on the MRI and the audiology exam was normal, so my PT is just something I am going to have to "live with."  I wasn't too excited about hearing this but since the sound was controlled with blood pressure medications I just accepted it and went home.

I suffered from daily headaches for about a year, around the time that I had to go on BP meds.  It wasn't debilitating but was annoying.  I had it when I woke up in the morning and it normally would go away with ibuprofen or tylenol.  It would come back again when the meds wore off and I would have to take some again.  I was under a tremendous amount of stress, so I related it to stress and my PT.  These headaches lasted for about a year and then eventually just went away.  I went headache-free for almost 4 years before my stent placement. 

Another year went by. My medications weren't working as great as they used to, and the volume of my PT was increasing.  I started to get stressed out and worried, so I asked my GP to refer me to someone else.  She sent me to a neurologist who specializes in tinnitus but not PT.  He ran a few tests in his office and sent me for another MRI but added a MRA and CTA.  He also sent me to another audiologist.  Well of course nothing showed up on any of these tests.  But he didn't give up -- instead, he sent me to a neurosurgeon who specializes in micro-vascular abnormalities.  That doctor decided to order a cerebral angiogram to look at the smaller vessels in my head.  I was positive at this point that he was going to have to see something. 

I had the angiogram and while I was waking up in recovery the neurosurgeon came in to provide me the results.  I was still groggy from the sedation but my wife was sitting next to me, so I figured one of us would remember the conversation.  Basically he told me that he saw a small stenosis (narrowing) in my venous sinus.  This is a vein that drains from the head into the jugular vein.  Even though he saw the stenosis he didn't try and open it up because he didn't know if it would be helpful.  He tells me that if my PT increases to come back and see him.  I missed that part of the conversation which ends up being important later. 

I went home thinking there wasn't anything he can do and my PT is here for life.  I was unhappy and I became a little depressed. 

The next year that went by was hell.  My PT became louder and I kept upping my blood pressure medications.  I was constantly occluding my carotid artery with my finger just so I could hear out of that ear.  As the year went by I sank deeper into a depression and I started to wonder if I could continue to do my job because I was constantly occluding my artery just to hear and I was so stressed out all the time.  I decided to go to an ENT to ask him about ablating the auditory nerve in my right ear, rendering me deaf in that ear, just so I don't have to hear it anymore.  I set a date to meet with him and waited.  During the waiting for that appointment I decided to go to the neurosurgeon again just to see if he had any other advise.  I'm so glad I went back. 

When I went to see the neurosurgeon he advised me that the angiogram the year before did show a stenosis and he could try and stent it open.  At this point I thought to myself, why didn't we do this last year?  If he had offered that then I would have said yes but I guess he didn't think my PT was very debilitating and didn't offer it. He could tell now that I was at the end of my rope and offered to do the procedure. 

The procedure required another cerebral angiogram followed by stent placement.  It was scheduled ASAP. I can't tell you how excited I was to have hope that it may work.  They were able to place a 4 cm stent in my right cerebral venous sinus and when I woke up there was finally silence.  No need to occlude my carotid, no need for fans to sleep.  It was awesome. 

After the stent was placed I had a daily headache for about 3 months.  My body had to adjust to having a foreign body.  It wasn't a bad headache and I was willing to just ignore it because the PT was gone.  Eventually my head got used to the stent and the headaches went away. 

It's now been 9 months. I'm off of blood thinners and had a repeat angiogram to make sure everything looked good and it did. 

I was lucky.  It took persistence on my part but I finally found someone who could diagnose my problem and fix it.  I feel blessed everyday now that my PT is gone.

My only advice for other whooshers is to keep searching for answers and for someone who wants to help you.  There are so many physicians who are ready to write you off but there *are* a few who really want to help.  The key is to find someone interested in helping.

I found Whooshers.com about 2 years before my procedure.  It was a great find.  I was so happy to actually put a name to what I was hearing.  No one had diagnosed it as PT; I did that on my own and then tailored my search based on that for doctors.  I had no one to talk to who had similar symptoms as me.  It was exciting for me to know I wasn't alone and that it had a name.