I started getting spasms of my tensor tympani muscle around the time I began using AirPods with noise cancellation. Could hear it clearly and had a doc visually confirm.
Correlation not causation, but weird enough that a stopped using them.
That's what we do. Rails mostly just a json api, with a React front end. Devise handles auth. Useful gems in models and services, sidekiq doing its thing... Happy with the setup.