It would seem I have found the issue, sound quality. Under Sound, select your speaker device, go to properties, then Advanced tab, and make sure the Default Format is, for example, 48000 Hz. As I do music work on my machine a fair amount and my hardware supported it... I use 192,000 Hz...which FFXIV seems to have an issue with. Not an ideal fix, but it, after a day of testing seems resolved. The issue comes back instantly if I put the audio back at 190000Hz, so it is reasonable to say that is the issue at this point.