Medical treatments often require patience, as they involve managing symptoms rather than providing immediate cures. However, when a swift and straightforward solution presents itself, it can be one of the most rewarding aspects of the profession.

Consider the case of Jo, a patient who recently visited me. She was extremely anxious after suddenly developing tinnitus, a condition marked by persistent ringing, buzzing, or hissing sounds that only the sufferer can hear, with no external source and no way to turn it off.

Jo was well aware of how tinnitus had severely impacted the lives of others, filling her with fear that she might face the same fate. This condition, which is more prevalent than many people realize, affects approximately one in ten individuals. It can be incredibly disruptive, interfering with sleep, diminishing focus, and fostering anxiety and depression.

She knew people whose lives had been turned upside down by the condition – the relentless ringing, buzzing or hissing that only you can hear, with no external source and no off switch. She was frightened it was going to happen to her too.

Tinnitus is far more common than most people realise, affecting around one in ten of us. It can be profoundly debilitating – disrupting sleep, eroding concentration, and driving anxiety and depression. 

The sounds vary: ringing, buzzing, whooshing, clicking, whistling, a constant tone. For some people it comes and goes; for others it never stops. Jo’s was a ringing in both ears. 

She had also noticed her hearing wasn’t as sharp as it used to be – her husband complained she was shouting and had the television up too loud, while she was convinced, he was mumbling.

When I looked in her ears, I found the answer almost immediately: Both ear canals were packed with dark, hard, dry wax.

Ear wax lubricates and protects the ear, but when it builds up and hardens, it causes hearing loss and irritates the eardrum. That irritation, in turn, can produce tinnitus

Wax has a purpose: it lubricates and protects the ear. 

But when it builds up and hardens, it blocks the ear canal, causes hearing loss and irritates the eardrum. That irritation, in turn, can produce tinnitus. 

I prescribed a week of daily olive oil ear drops to soften the wax. Following this routine, the wax should slowly dislodge, opening the eardrum and reducing the tinnitus. 

I explained to Jo, as I do to all my patients, that cotton ear buds are never the solution to ear wax build-ups. 

This is because the sticks can push the wax further in, further worsening hearing or tinnitus problems.

Jo also decided to pay to have her ears microsuctioned – where the wax is removed by a healthcare professional using a small suction device. 

However, for most patients, olive oil drops should do the job. 

Once the wax was removed, Jo’s recovery was miraculous. Her hearing returned to normal and the ringing stopped. Now she thinks it is her husband who is shouting.

It is such a simple fix, and yet I am constantly surprised by how many tinnitus sufferers have never been told to check their ears for wax. 

Moreover, in this situation, while I prescribed the olive oil drops, these products are available over the counter in most pharmacies. 

Unfortunately, microsuction is generally no longer offered at most GP surgeries – due to NHS cost–cutting – meaning patients will typically have to pay around £60 for it. But, for many, it can be transformative.

Of course, ear wax is not the cause of every case of tinnitus. Another is a little-known condition called temporomandibular joint syndrome – or TMJ.

The temporomandibular joint is the hinge that connects your jawbone to your skull, and when it is not working properly, this can trigger tinnitus.

The TMJ sits in very close proximity to the ear, and the two share nerve pathways. Dysfunction in this joint, whether caused by teeth grinding, jaw clenching, arthritis or poor bite alignment, can produce tinnitus alongside the more obvious symptoms of jaw pain, clicking, painful chewing, headaches and earache. 

This is why I always routinely ask tinnitus patients whether they have any of these symptoms now.

And the good news is that treating TMJ dysfunction can bring real relief for tinnitus. This usually starts with jaw exercises and a custom-fitted mouth guard worn at night to reduce grinding and clenching, combined with anti-inflammatory medication.

Presenter Zoe Ball, 55, revealed in 2024 that she suffers from temporomandibular joint syndrome – or TMJ – which can be a cause of tinnitus

Where those measures are not enough, Botox injections into the jaw muscles can reduce clenching very effectively, and steroid injections directly into the joint are another option. 

As the joint settles, tinnitus often improves alongside it.

Certain medications can also cause tinnitus as a side effect, including anti-inflammatories, aspirin and some antibiotics. 

In some cases, this is reversible when the medication is stopped or changed, but patients should never alter or stop any prescribed medicine without speaking to their doctor first.

For some patients, tinnitus can be linked to later-life hearing loss. 

Hearing degrades over time and, in some cases, this can lead to tinnitus. The same issue can occur in patients who have had their hearing damaged by long term exposure to loud noises.

For these patients, hearing aids can often help reduce tinnitus symptoms. In fact, more than half of people report meaningful improvement in their tinnitus when wearing hearing aids, though it typically returns when the aids come out. 

Some devices now include built-in white noise generators for additional tinnitus relief. 

White noise is a constant sound that doesn’t change in pitch or volume – typically, something that sounds a bit like static coming from the un-tuned radio, or a fan. 

For tinnitus relief, it works as sound therapy to provide a steady, neutral background noise, which helps reduce the contrast between the internal ‘ringing’ and the quiet environment.

GP, author and broadcaster Dr Philippa Kaye

However, the truth is that, for many patients, the underlying cause of the tinnitus will never be identified. For many, it can occur out of nowhere. But that does not mean, for these patients, it can’t be resolved. 

Cognitive behavioural therapy – a form of talking therapy – has strong evidence behind it for tinnitus: it does not silence the sound, but it changes your relationship with it, helping you identify unhelpful thought patterns, improve sleep and reduce the spike of anxiety that the ringing can trigger.

Sound therapy includes standalone white noise machines, tinnitus apps, or simply a radio tuned to static at night – all make it easier for the brain to ‘tune out’ the tinnitus.

Fascinatingly, there is also a new treatment that could revolutionise treatment. It’s called the Lenire device and it uses a combination of sound therapy and mild electrical stimulation of the tongue. 

The science behind it is complex, but a recent study of over 200 patients reported more than a 90 per cent improvement rate at 12 weeks. It’s currently only available privately, often at prohibitive costs of around £4,000. However, it is possible that it may be adopted on the NHS in the future.

Tinnitus is more than just a sound in your ear, it can really have an impact on your life. But, at the same time, it is invisible to doctors who are often too quick to dismiss it as a minor issue. 

That’s why it’s so important that patients ask to be checked for the most common causes, including ear wax build-up, TMJ syndrome and hearing loss. 

Finding the cause could be the way to find a life-changing solution.

An individual closely associated with the deposed Venezuelan leader Nicolás Maduro has been extradited to the United States, as confirmed by Venezuelan authorities. This individual faces serious federal charges, including orchestrating an extensive money laundering and bribery operation linked to Venezuela’s government-run food distribution and oil sectors.

Alex Nain Saab Moran, a 55-year-old Colombian national who previously served as the minister of industry and national production under Maduro’s administration, made his appearance in a Miami federal court on Monday, announced the U.S. Attorney’s Office for the Southern District of Florida. The Department of Justice emphasized that Saab is considered innocent until proven guilty beyond a reasonable doubt.

The prosecution alleges that starting around 2015, Saab spearheaded a prolonged scheme to embezzle funds from a humanitarian initiative designed to supply food to Venezuela’s impoverished citizens.

It is further claimed that Saab and his accomplices illicitly sold Venezuelan state-owned oil worth billions of dollars, bypassing U.S. sanctions in the process, according to the Justice Department. The authorities allege that the profits were funneled through U.S. bank accounts to obscure the transactions and perpetuate the fraudulent activities.

Venezuelan President Nicolás Maduro (L) addresses supporters alongside the Colombian businessman Alex Saab during a rally in Caracas on January 23, 2024. (GABRIELA ORAA/AFP via Getty Images)

“Alex Saab allegedly used American banks to launder hundreds of millions of dollars stolen from a Venezuelan food program meant for the poor and proceeds from the illegal sale of Venezuelan oil,” Assistant Attorney General A. Tysen Duva said in a statement. “This is unacceptable. The Criminal Division will not allow foreign actors to exploit the American financial system and use it as a safe haven for the proceeds of their corruption.” 

Beginning around 2015, Saab and his associates allegedly paid bribes to Venezuelan government officials to secure contracts tied to the country’s CLAP welfare program, which was intended to purchase and distribute food to vulnerable and impoverished Venezuelans. 

Instead of delivering the promised food supplies, prosecutors allege the group used shell companies, fraudulent invoices and falsified shipping records to embezzle hundreds of millions of dollars from the program for their own personal gain.

Businessman Alex Saab walks through Miraflores Palace in Caracas, Venezuela, on Tuesday, Feb. 20, 2024. (Carlos Becerra/Bloomberg via Getty Images)

Around 2019, as sweeping U.S. sanctions crippled Venezuela’s oil exports and placed severe strain on the country’s finances, including its ability to pay Saab and his associates under the CLAP program, Saab and his partners allegedly exploited their corrupt ties to government officials to gain access to billions of dollars’ worth of oil owned by Venezuela’s state-run oil company. 

Officials allege the group sold the oil under false pretenses and used the profits to sustain and expand the original food fraud scheme.

Saab and his associates reportedly laundered the allegedly stolen funds through U.S. bank accounts in an effort to conceal the money trail, giving American authorities jurisdiction to prosecute the case.

“When illicit proceeds are moved through the United States financial system, our courts have jurisdiction and our prosecutors will act,” U.S. Attorney Jason A. Reding Quiñones said in a statement.

Venezuelan President Nicolas Maduro (R) shakes hands with Colombian-born businessman Alex Saab in Caracas on January 15, 2024. (FEDERICO PARRA/AFP)

Saab was previously indicted in the U.S. in 2019 and extradited from Cabo Verde in 2021. He was pardoned by President Biden in 2023 as part of a prisoner swap, though prosecutors say the new case involves alleged conduct not covered by that pardon.

A Miami-based attorney for Saab declined to comment to The Associated Press.

If convicted, Saab faces up to 20 years in federal prison. The government is also seeking forfeiture of any property or proceeds allegedly obtained through the alleged criminal activity.

The case was investigated by a U.S. Homeland Security Task Force (HSTF), which includes the Drug Enforcement Administration (DEA), the Federal Bureau of Investigation (FBI) and Homeland Security Investigations (HSI).

Imagine a job where getting paid to like videos and photos on social media is part of the daily routine. For many, this might seem like an idyllic work-from-home opportunity. However, for some individuals, this seemingly perfect job turned out to be a costly lesson.

Several people have reached out to the ABC7 I-Team with stories of financial loss stemming from a “work-from-home” scheme that required them to “invest” in order to earn more money. Initially, participants were enticed by the prospect of earning cash simply by engaging with social media posts. Yet, the venture soon revealed its pitfalls, leaving many with empty pockets.

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Erica Tyler, a resident of Chicago’s Westhaven Park neighborhood, was among those who took the leap. She dedicated herself to CloudBoost Technology Advertising, an Australian company, after hearing about the opportunity through a friend. Enthusiastic about the potential, she not only participated herself but also began making presentations and recruiting others to join the program online.

While some individuals reported initial success and earnings, the facade quickly crumbled. Erica and others now warn of the risks associated with such pay-to-work models, highlighting the importance of thorough research and skepticism when it comes to too-good-to-be-true job offers.

Erica heard about the work-from-home program from a friend. Then, she started making presentations and even recruited others online.

The job? To like social media posts from the comfort of her own home. Her husband, Willie Tyler Jr., and friend, Chris Kimbrough, of Bolingbrook, also signed up.

Erica says she started with a $500 cryptocurrency “work” deposit to join the team.

“I’m upset, number one, because they got us to trust them. OK. And we trusted that they were a growing company,” Erica said.

Erica says she later deposited another $15,000 into the crypto platform over the course of a year. She and others say deposits helped them move up in “tiers” to hopefully make more money by “liking” more posts.

But last August, consumers say, the company shut down, and they were unable to cash out. Erica estimates her losses at nearly $37,000. Willie says he lost $3,000 in crypto deposits.

“Put me in a hole,” Willie said. “Because not just on my account, you know, I trusted them, but I also brought people in, family members, some close friends, you know, that they lost money also.”

Kimbrough also says she lost thousands.

“I’m very upset about that,” Kimbrough said. “And, you know, I had one of my friends to put up money for me, and then, family members helped put up money for me.”

Gwendoline Ashford of Georgia was a top recruiter.

“I had a team of over 120 people,” Ashford said.

She says some of those people think she has their money, but she, too, lost money, $27,000, after the company collapsed, she says.

“They had offices in Atlanta, Alabama. They had huge parties, and they would give people money to open up these offices and take videos,” Ashford said.

Ashford started an online petition bringing other former workers together. Many, like the people in ABC7’s story, reported claims to the FBI Internet Crime Complaint Center and the U.S. Secret Service.

Assistant Special Agent in Charge Peter Vogl at the U.S. Secret Service Chicago Field Office told the I-Team about the warning signs.

“Because if you have to pay to participate, if they’re requiring you to get more people involved, too, in order to progress and make more money, then, one might take a little step back and think about what you’re doing,” Vogl said.

If a company is asking workers to pay more to reach the next level, Vogl said, “That’s definitely, in my mind, a red flag, because if you’re an employee of a company, why should you have to pay in order to progress? You should be able to, through your work, gain progress within the company.”

The I-Team called CloudBoost Technology Advertising. The Australian Securities and Investments Commission lists the company as registered business in Sydney, Australia, but the number ABC7 called was disconnected.

ABC7 also called several contact numbers for managers. Most were disconnected. I-Team Consumer Investigator Jason Knowles left voicemails with other contact numbers but never heard back.

When asked if he thought it was too good to be true, Kimbrough said, “Absolutely, and I feel embarrassed.”

“You shouldn’t pay money to work,” Erica said.

The Better Business Bureau told the I-Team that it warns consumers about task-based income offers like this one.

The BBB says research indicates this company carried out tactics commonly associated with work-from-home scams.