Lisa, My husband has a trach and he uses it as a backup. It was an emergency thing because at one point he could not breath because his right tonsil was so badly swollen and blocked his breathing. With treatment the swelling has went down and he can breath now on his own. He breathes through his nose and mouth. He eats as normal. Depending on the design of the trach he speaks with no problem. If the cannula which is inserted in the trach has holes in it I was told the person could not speak.