My husband has had tongue and larnyx removed and is unable to use a TEP. He can use electro larnyx with the straw on the roof of his mouth but he prefers to use the "Speak It" app on his iPad and iPod. This is a low cost alternative to other devices offered after his surgery. Texting is another frequent method of communication--thank goodness we live in the age that many people also use this.

All this takes some adjustment but it works and he is here.