The District of Columbia is a special case. It is not an actual state, and hence does not have senators or congressional representation. It is located between Virginia and Maryland on the Potomac River. It is on the Potomac River between Virginia and Maryland and coextensive with the District of Columbia.
Alcohol, caffeine, antibiotics, aspirin, or other drugs can also cause ear noises. Tinnitus may occur with hearing loss. Sometimes, it is a sign of high blood pressure, an allergy, or anemia. Rarely, tinnitus is a sign of a serious problem like a tumor or aneurysm.
Middle ear problems that cause hearing problems can also cause tinnitus. These include common entities such as middle ear infection and uncommon ones such as otosclerosis, which hardens the tiny ear bones or ossicles. Another, rare, cause of tinnitus from the middle ear that does not result in hearing loss is muscle spasms of one of the two tiny muscles in the ear. In this case, the tinnitus can be intermittent and at times, the examiner can also hear the sounds.