Hi gpk,

I am a total laryngectomee and I speak just fine. I have a TEP, transesophageal puncture, in my throat, which a small slit between the trach and the esophagus where they insert a voice prosthesis. To speak, you cover the hole in your neck with a finger which forces the air through the hole in the prosthesis into your esophagus and up your throat. You speak as you do now. If you have the same surgery I had which totally removed the larynx, you will have two separate pathways. Your esophagus to your stomach and the trach hole in your neck to your lungs. Since your mouth and nose are no longer connected to your breathing apparatus, the reason for the hole in the neck, you will not be able to smell most things, although I can smell a little if I'm directly over it. I am surprised your doctor didn't explain any of this to you and was remiss in not doinng so.

Not everyone is a candidate for a TEP. Your esophagus must be able to vibrate for that to work. The doctor and speech therapist checked this out on me before deciding I was a candidate. Ask you surgeon about this. There is also a high percentage of TEPs that fail so it is a risky surgery.

Also make certain your surgeon is very experienced in this surgery. Ask how many he has done and how many TEPs failed. They often have to take an artery from your arm or some other part of your body to form a flap. I did not need this so can't comment on it other than it apparently takes a long time to heal and his very sore.

I was lucky and had the TEP placed at the time of the surgery which allowed me to speak about 8 days later but sometimes it is a few months before they do the TEP and insert the voice prosthesis leaving you until to speak unless you can use the electro larynx.

If you can't have a TEP you should be able to use the electro larynx although I was totally unable to speak with one. I don't remember why. Something to do with the shape of my mouth and rear dentures.

Find out more about what you are having done and if you are a candidate for a TEP, then ask me any questions you would like. There is also a Dr Dribrook on this board that had the same surgery. You could read his blog and/or PM him.

Good luck and keep us posted.

Take care,
Eileen