@br97 I also am having some long term effects of muscle atrophy and fibrosis/stiffness from neck radiation 13 years ago. I have been researching and find that people have benefit from red light therapy, which is a kind of low powered laser. Some are using a device at home. Swallowing therapy by a specialist in speech therapy is helpful to some people. These long term consequences of radiation are not really more than touched on when we initially had this therapy, but at that point surviving is the primary issue. I thing nowadays there is a more proactive approach but the larger medical institutions. I am seeing my medical team at Mayo in Rochester MN next week and we will discuss this. I am certain that they will have more treatments available than we have locally in NW Ohio. I think your second opinion is the best choice because tracheostomy is a huge step. Traveling to a teaching hospital or large cancer center may be worth it for what they can offer.