I had similar surgery to what is being proposed for you except that my flap came from my chest muscle instead of my arm. I had 6 teeth and part of jaw bone removed along with all the lymph nodes. The trach was the most difficult for me. You will not be able to talk. Because my father had similar surgery I knew what to expect. I made up a one page sheet of paper with most of the words I might like to say in different colors and different sizes in boxes. I then had it laminated and took it into surgery with me when I woke up I had a way to communicate. I would just point to the word. For example if I was in pain I would point to the word pain and on scale of 1 to 10 point to the number. If I was cold point to cold, etc. It was so helpful that the ICU nurse asked for a copy of it. Pain management is very important as this surgery is no fun at all. That type of surgery takes a long time to complete so you are likely to have fluid accumulate in your lungs while on the table so long. It might be difficult for you to cough that up through the trach so they will sometimes use a suction tube to help you remove that liquid. It is also no fun but you will be able to breath better afterward. If the cancer is truely in the base of your tongue that is the part of your tongue that does not move, then there are other treatments to consider such as Brachytherapy. I have had that as well because I had a reoccurrance in the base of my tongue 19 years after the type of surgery you are having now. I agree with Cheryld it is no fun but you will get through it. This cancer is tenacious stuff so they have to take large margins to get it all. Just hope that they do in your case. Best of luck my friend.