Hi Gordon,
Sorry I didn't get back to you sooner. I'm only on this board during lunch hour weekdays so if I'm not in the office, I won't respond. Recently because of personal tradegy, I'm on the board less and less.

Medicare used to pay for the indwelling prosthesis but has decided as of 10/2010 that it will no longer pay for it unless it is ordered from a medicare approved distibutor. Unfortunately the one I wear is not carried by a medicare approved facility according to my speech therapist. I still work so still have private insurance so haven't had to go there yet. It costs around $225 and mine needs to be changed 4 times a year, which is unusual. Most people can make it 6 months or a year before they need it changed. It needs changing once it starts leaking. I think Medicare still covers the cost of changing it. Check with Emory.

Failures - if the TEP leaks, it has failed. This is leakage around the prosthesis, not through. Since you are leaking food and liquids into the lungs, you may require a PEG tube. Plan B is to close the TEP at whcih point your only options to speech are the electrolarynx and esophageal speech. Talk to your dr about failures. I don't know much thank god.

Here is the link to Dr Brooks blog:

read on my blog at:http://dribrook.blogspot.com/
Itzhak Brook MD

There is a search engine in the upper right corner of the board. If you type in Dribrook, you get all his postings.

There is also blog in the section on blogs by the caregiver of a total larygectomee you might want to read. Other than that, there are not any others currently on the board that have had this surgery, so you may not get a lot of responses.

Take care,
Eileen