Hi Alan --

We went to see Barry's ENT surgeon yesterday -- she had HNC over 15 years ago and had radiation treatment, so knows where it's at! She did an endoscopic exam and positioned the monitor so Barry could see what his epiglottis (the flap that closes off your trachea from your pharynx when you swallow) was doing when he spoke, coughed, and swallowed. Right now it doesn't look as much inflamed as somewhat unresponsive to little bits of saliva starting to work their way down past it into his larynx -- at that point his voice would get a bit gravelly or bubbly -- she taught him the little "cough" needed to clear the saliva out and prevent it from being aspirated. (Nelie--I'll bet it's the same "cough" that your therapist showed you). He tried it several times and could see that the saliva was expelled back into the pharynx; very interesting!

What this showed us was that he has a ways to go before it all starts working "naturally" again. Our ENT emphasized that it would -- that he had to be patient and most importantly, practice swallowing and be aware of what was happening in the back of his mouth -- do the "cough" when he felt that he might be aspirating stuff. Be careful eating.

She also said, from personal experience so it meant a lot -- it can take a while for all this to heal, but it will --

Gail