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2018-01-10 / South Texas Living

Non-stop music only he can hear

DEAR DR. ROACH: I hear music playing in my head at all times. I can’t stop it, even if I’m reading, having a conversation or being active. It’s there when I wake up in the night or in the morning. Even if I consciously stop it and try to hear only the ambient sounds around me, the music always comes back. Is this indicative of any major problems? I am a very healthy 64-year-old male, and this is annoying. It has been going on for most of my life. I wonder if a psychiatrist could help. The only prescription I take is zolpidem for sleep, but I would consider any meds that would help stop this. -- S.H.

ANSWER: There are several medical reasons to have music in your head. One is called “musical ear syndrome,” which is a type of hallucination most commonly associated with hearing loss. Another is associated with psychiatric disease, especially obsessive-compulsive disorder, but also with schizophrenia or mood disorders.

However, my experience is that there are many, many normal people with no psychiatric illness who have music playing in their head almost all the time or all the time. Many people have had a song stuck in their head (often called an “earworm”), but a few people have this continuously. I had one patient in whom this was a major source of distress, and in that case, it appeared to be related to the use of an antidepressant.

Solving anagrams and reading are supposed to help, but in your case I am almost sure that would be temporary. Sometimes playing the music that is in your head can stop it. There are a few case reports of treatment with medication (such as carbamazepine) being effective, but sometimes reassurance that this is almost normal makes it easier to deal with.

DEAR DR. ROACH: I was diagnosed with pancreatic cysts. A recent MRI scan showed that they are less than 2 cm and have been stable for a year. My doctor tells me these are benign and don’t need any more follow-up. Could these cysts become cancerous later on? -- K.

ANSWER: The medical term “cyst” means any fluid-filled, walled structure. They can occur in practically any anatomic location you can think of. In the pancreas, there are several types of cysts, as well as pseudocysts (fluid collections, usually as a result of pancreatitis, that develop a wall after some weeks), and cystic neoplasms, which have the potential to become cancerous.

You didn’t tell me how you were diagnosed. Very often, these are found incidentally when a CT scan is obtained for some other reason. In this case, when there are no symptoms present, the only concern is whether they can grow and cause symptoms later on, or worse yet, could become cancerous. Since pancreatic cancer is justifiably feared, I understand your reasons for asking the question.

Fortunately, I agree with your doctor completely. The likelihood of a small cyst (your largest cyst is 1.4 cm) being cancer is less than 5 percent. Since it hasn’t changed in a year of follow-up, your risk for cancer is very, very low.

Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to ToYourGoodHealth@med.cornell.edu. To view and order health pamphlets, visit www.rbmamall.com, or write to Good Health, 628 Virginia Drive, Orlando, FL 32803. © 2017 North America Synd., Inc. All Rights Reserved

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