I feel for you also. I only have my teeth issues, trismus, and people ask what did I say, even worse, is asking a co-worker next to them, what did he say? Makes me mad. I have nothing else to offer with this, except when I go to the hospital I see quote a few people who have communication issues, and use sign language. Apparently quite a few, more than I thought who are not communicative challenged, take up this skill. I only say this with sincerity if it can help. I wish to pick up the skill myself to communicate with or for others in need.