The miracles of the body adaptability are amazing. I originally used an electronic device that gave me a Darth Vader voice, then I learned to talk again by swallowing air then belching it back up to vibrate the muscles in my esophagus. This created the sound wave that the vocal cords create. The result is a raspy hoarse sounding voice but is a means of communication. Due to the tight constriction of the valve at the top of the esophagus, I had a prosthetic place in my trachea that allows me to talk much easier. The voice is still (different) and I cannot pronounce any word that starts with an "H" but most people will not notice it when I'm saying 'hello or how are you' They're expecting those words and it doesn't register that the 'h; is not pronounced.