I can constantly hear music in my head. It can be when I wake up, when walking the dogs, or in the car. It’s really getting me down. What’s wrong with me?
As strange as it might sound, hearing noises that aren’t there isn’t uncommon. There are a variety of causes, but most frequently, it’s this sort of symptom is due to a condition called tinnitus.
It’s not totally clear what causes this, but we know it’s often linked to hearing loss. It can also be a side effect of medication.
Commonly, patients describe hearing a constant or intermittent high-pitched ringing, but others say it’s more like a humming or whistling. Some describe a buzzing or beeping.
Today’s reader asks DR ELLIE CANNON about the constant sound of music they can hear – which is often a symptom of tinnitus, although it could be an incredibly rare auditory hallucination
The ‘noises’ plague people, causing a huge amount of stress, and often stop them sleeping. It’s uncommon, but not unheard of, for people to hear more complex sounds such as music, simple melodies and familiar songs.
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Hearing music can also be what we’d call an auditory hallucination – although this is far less likely than tinnitus.
Usually these involve voices rather than music.
Hallucinations are a sign of the mental illness schizophrenia, but they can also happen with alcohol and drug misuse and be triggered by grief and confusion.
In any case, it’s important to see a doctor who can offer a diagnosis. It is vital to mention to a doctor if other new symptoms are present, such as changes in vision, dizziness, headaches or difficulties in movement.
They should be able to carry out an ear examination and hearing tests. Other investigations, including a brain scan, may be needed to rule out serious disease. Once a diagnosis is made, patients should expect to be referred to a specialist clinic for treatment.
Three months ago, I had a total knee replacement. Since then I’ve suffered from tightness, stiffness, intermittent numbness and some throbbing in the knee operated on. The doctor says this kind of discomfort is normal. Am I right to be worried?
Recover time after a big operation like this can vary quite a bit. Factors that dictate this include the state of a person’s general health and fitness prior to surgery, and whether there were complications. In the case of joint replacement, physiotherapy during recovery can play a big role too.
After a knee replacement, it can take up to three months for pain and swelling to settle down, but it can take as long as a year for any leg swelling to completely disappear.
You could be looking at a year or two before things are totally ‘back to normal’. Of course, when you’re in discomfort, this can feel never-ending. Swelling is often described as feeling like tightness, stiffness or throbbing.
Another reader wants to know when their knee will return to normal after replacement surgery
Follow-up appointments – with a doctor or other specialist – after a knee replacement are very important.
Patients should be offered sessions with a physiotherapist, but a great deal of rehab work has to be done by the patient in their own time. The patients who are most diligent at keeping up their exercises, and making sure they stay as healthy as possible, have the best results.
I’d also say that people know their own bodies, and if recovery after an operation does not feel right, particularly with significant pain, then it absolutely warrants a discussion.
Pain may be related to infection, or there may be some transient nerve or muscle damage. Excess scar tissue can also form, which could account for a slow recovery. Numbness is considered a recognised complication of a knee replacement.
For the past 13 years, I’ve been taking Oxycodone and Duloxetine tablets for the pain I suffer in my neck and lower back. I try to keep myself active and healthy, but I’ve put on weight every year since stating these medications. Can you offer any advice?
Unfortunately, both long-term pain condition and taking pain medicines can result in weight gain that may be very hard to shift. Part of the reason is that it’s often difficult to unpick the cause.
Do you have a question for Dr Ellie?
Email [email protected] or write to Health, The Mail on Sunday, 2 Derry Street, London, W8 5TT.
Dr Ellie can only answer in a general context and cannot respond to individual cases, or give personal replies. If you have a health concern, always consult your own GP.
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For example, chronic pain can result in low mood and loneliness, which may result in overeating, even when we think we are being healthy.
Similarly, chronic pain, by its nature, leads to limited mobility and reduced exercise which also undoubtedly affect weight.
Oxycodone is a strong, prescription-only painkiller, related to morphine – these are known as opioid drugs and they can be highly addictive.
Duloxetine is an antidepressant and anti-anxiety medication which is used in both these conditions. It is also used in chronic pain and may be prescribed in combination with standard painkillers by pain clinics.
This drug commonly causes weight changes, as well as upset in the bowels and problems with appetite.
Unexplained weight gain, or weight loss, or potential medication side effects should always be discussed with a GP or pain specialist. Gaining weight can also increase the risk of other health problems, and these need to be monitored.
Youngsters deserved some fun… and didn’t break the rules
It will probably come as no surprise to you to learn that I’ve put my nightclubbing days behind me. As a mother-of-two and a GP in her 40s, I wasn’t among the revellers dancing the night away last week, after clubs were allowed to reopen.
If I were 21 again, would I have been there?
Perhaps. Do I think it was possibly not the wisest of things to be doing right now? Maybe.
Youngsters dancing on July 19, 2021 following the reopening of The Piano Works in Farringdon, London as the kicked off ‘Freedom Day’ as soon as lockdown restrictions were lifted
But I certainly wasn’t going to join in the tutting and judging that seemed to go on endlessly on social media.
In fact I found it quite sad, and reflective of the mean-minded, net-curtain-twitching attitude that seems to have become worryingly commonplace over the past year.
Younger people have been affected disproportionately by the pandemic.
Their education has been stunted.
They’ve lost their jobs and seen their finances decimated.
They have also opted, in their millions, to be vaccinated against a virus that’s unlikely to harm them.
And once vaccine passports come into force, anyone wanting to go clubbing will need to have had a jab.
Just to be clear: they were breaking no rules last week.
They can’t be blamed for living their lives, or for the pandemic.
Baffled by a barrage of experts
We are in the midst of an epidemic – of experts.
They’re on TV and the radio, in the newspapers and online day in, day out – for the past year and half we’ve been bombarded by often conflicting scientific opinions.
Even I, as a doctor, find it baffling, sifting through it all – particularly as it often contradicts and, I’d argue, sometimes even undermines official guidance.
I’ve lost count of the times a patient has sat in my clinic and said they simply don’t know what to think or do any more, as they seem to be constantly reading differing things.
These experts are doubtless well-meaning, and I wouldn’t want to censor anyone, but scientists would do well to remember that by having these debates so publicly, they might also be creating distrust.
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