Hi everyone, I am new to this forum and already overwhelmed with so much great information. My 67 year old husband had SCC of mandible and soft palate with surgery and reconstruction with scapular flap in Aug 2020 and then radiation completed in early Nov. On top of that, an incidental finding of large Unrelated Kidney tumor resulted in a radical nephrectomy in Dec.
He is recovering well but has poor swallowing ability at this point. He can drink milk and OJ in the morning and sips on water and carbonated drinks during the day to help with mucus. As the day goes on, swallowing gets more difficult. Majority of calories are provided by GT feeds with Osmolite. While we keep hoping for return of more swallowing ability, I am trying to look ahead at nutrition concerns on a more long term basis.
Thank you for this opportunity to share and join.

It is the scarring from the radiation that causes the swallowing difficulties. What is most important is for your husband to do his swallowing exercises religiously every day. It happened to my husband and the oncologist said he was surprised by how much scarring there was taking place. It is internal. Doing the exercises makes it less likely he will suffer from atrophy of the swallowing muscles. My husband was fed with a feeding tube. Eventually we found an interventional radiologist who used magnets to open up his esophagus which was totally closed. But then he developed silent aspiration and that led to pneumonia. Do find out if you can access the services of a speech and language pathologist at your hospital. She can do a swallowing test and show you how the liquids go down into the esophagus. She will also be able to give your husband more exercises that can help with his swallowing. She can recommend the types of food your husband should be eating and the thickness (e.g. honey grade, nectar grade and spoon grade). It’s important, please get help ASAP.

As gmcraft said, swallowing exercises are the most effective way to maintain and strengthen a swallow. A good exercise is the effortful swallow. He needs to swallow (no liquid) but squeeze very hard with your tongue and throat muscles throughout the swallow.

Another exercise is to hold his breath, take a sip of water, swallow, and then cough hard. Do that 3 times in a row, 3 times a day. If he's not confident drinking, then he can do it without taking a sip, but he must do the rest (hold breath, swallow, cough)