Complete laryngectomy

@roblem

Hello, Rob - thanks so much for your reply. So, did the higher setting of the EMST actually help with the constant coughing and phlegm? That's my goal. It's great to be able to strengthen the force of my cough, but I'd rather not need to cough at all. Thanks again!

Skip

@skip0716,

For me yes as my coughs were more productive and my voice/speech including loudness and volume also improved. With that in mind, I was age 56 and very dedicated to it in 2024 where I did it every day 5reps of 5sets no matter what and eventually getting to the 150-difficulty level. However, full transparency my speech/swallowing therapist said I was only patient that she had that ever reached the 150 level and she has been doing her job for 10yrs. and has had over 1,000 patients over her tenure.

Hello,

For several months now, my days have been filled with coughing up phlegm. It's terrible. I had 2 mandiblectomies in the past 17 months, with the most recent being October of 2025. But I wasn't coughing up phlegm until about January of this year. Is this something that will improve over time by itself, or is there something i can do to help it?

I've already done things like drink lots of water and sit in an upright position when i consume my liquid diets (i'm on liquids for about another 6 months until I get my lower prothetic teeth). I've had swallow analysis and other tests, too, and nothing shows that there's much (if anything) going down the wrong tube. I'm feeling helpless and hopeless, as my quality of life has plummeted because of this. I never good a good night's sleep, and all through the day, I need to have a box of kleenex and a trash sack nearby.

Sometimes I have trouble coughing up the mucus, regardless of the fact that I've been blowing into the EMST 75 (an "expiratory muscle strength trainer"). I've been doing everything they've told me to do, but this problem is not going away.

So, yes - I've seen a pulmonologist and my primary care physician, but they tend to make my situation sound bleak. I'm hoping it's a matter of just getting my information to the right person. I've also seen a couple of doctors at the local VA hospital, but they didn't have the answer.

I'm 68 years old, living in SoCal. I'll travel anywhere to see who I need to see. You would think there should be someone near me who could provide the answers, given the population of where I live. But that's another problem; getting appointments.

Please help!

@roblem

Good to know. So, are you still coughing as much now as you were in 2004?

@skip0716
I think you meant 2024 and yes less coughing now.

@skip0716 Hello and welcome. Two mandiblectomies! Both sides or did the initial one fail?
The phlegm issue seems to be common after a mandiblectomy, it certainly was in my case for a few years. I figured it was just part of the way the body heals, either by the perceived invasion of the throat area or the fact that we were under anesthesia for many hours.
I'm five years out and everything has finally calmed down, including issues with the gum being irritated along side the prosthetic teeth, requiring ablation three times. Being a fellow vet, I know we have both been through tough times prior. Sometimes however it just doesn't seem right that we have to power through something like this at our age. We are supposed to enjoy life now.
Churchill said that when you are going through hell, go fast. Unfortunately you can only go at the pace your body heals, which is not fast like it was when we were young and dumb. I have no advice for you on how to deal with this other than to perhaps offer you hope that it likely will get better over time, a long time unfortunately. I've got your six for what good that does, because sadly I've got no ammo. Courage.

@hrhwilliam
Hello, William - yes, both sides. My entire lower jaw is now made up of my left and right fibula bones. These surguries were done 9 months apart (last year).

I'm assuming you were on liquids until your prosthetics went in. When you started eating soldid foods, did the incidence of coughing / phlegm go down?

Hello,

For several months now, my days have been filled with coughing up phlegm. It's terrible. I had 2 mandiblectomies in the past 17 months, with the most recent being October of 2025. But I wasn't coughing up phlegm until about January of this year. Is this something that will improve over time by itself, or is there something i can do to help it?

I've already done things like drink lots of water and sit in an upright position when i consume my liquid diets (i'm on liquids for about another 6 months until I get my lower prothetic teeth). I've had swallow analysis and other tests, too, and nothing shows that there's much (if anything) going down the wrong tube. I'm feeling helpless and hopeless, as my quality of life has plummeted because of this. I never good a good night's sleep, and all through the day, I need to have a box of kleenex and a trash sack nearby.

Sometimes I have trouble coughing up the mucus, regardless of the fact that I've been blowing into the EMST 75 (an "expiratory muscle strength trainer"). I've been doing everything they've told me to do, but this problem is not going away.

So, yes - I've seen a pulmonologist and my primary care physician, but they tend to make my situation sound bleak. I'm hoping it's a matter of just getting my information to the right person. I've also seen a couple of doctors at the local VA hospital, but they didn't have the answer.

I'm 68 years old, living in SoCal. I'll travel anywhere to see who I need to see. You would think there should be someone near me who could provide the answers, given the population of where I live. But that's another problem; getting appointments.

Please help!

@skip0716 I only had one side done. Was still able to eat solid foods more or less. I think the phlegm issue held on about three years. The cough lasted maybe a few months but was always worse drinking cold fluids and it still can cause me swallowing issues, which I think is likely from my cancer treatments years before.
I'm sorry you had to go through this twice. It is an amazing surgery and one most people have never heard of. My own PC had never known someone who went though it prior to me. My dentist found it fascinating so I shared the surgery photos with him. Curious kids who notice the leg scar and ask, I just tell them to never swim with sharks. That is easier to believe than the truth.
I hope you recover well. You might get some tissue growth / infection / swelling along the outer gum line. Not sure if this is because the tissue grows or just gets irritated for a while. I had this burned off or ablated three times in four years. That feeling of numbness: it doesn't really go away but you do learn to ignore it after a couple years. The leg is never 100% but it is close. The odd aches and twinges seem to dissipate after three years but I still cannot move my big toe. Weird stuff I guess. All in all it is a much better life than prior to the surgery. Enjoying corn on the cob once again is very satisfying.
A double! You are my second one I know of. The first one drove his car into a cable across a road at night and it destroyed his entire lower jaw. He was my mentor for my surgery.
Curious why you needed this surgery. Was it due to cancer treatment, accident, or other?
I wish you good healing.

@skip0716 Some patients on this site battling mucous have had some success with using a sparkling carbonated water or club soda to cut through mucous. Even the readily available flavored sparking waters have helped more than regular water. Others have been prescribed Mucinex to thin the mucous, have you tried that? A family member undergoing radiation for tonsil cancer found sleeping in a recliner helpful when his thick mucous production was a big problem. Another patient with mucous issues suggested ordering Himalaya Salt Mint sports candy, lemon flavor. These are an interesting item as I have tried them for moisturizing my dry mouth. I ordered from Amazon.
Has your ENT or surgeon suggested scoping to see if the area is healed well? Have you requested a referral, despite the long wait to get in elsewhere?