Before working with Jennifer Steelman, a speech language pathologist at Missouri Delta Medical Center's ReStart, the best he could manage for several years was sucking on a piece of ice and spitting the water back out.
Underwood explained that about four years ago, he went through radiation treatment for throat cancer and had a tracheostomy.
"It caused a lot of scar damage in his throat and esophagus," Steelman said. The result was dysphagia -- difficulty in eating and swallowing -- that even surgery was unable to correct. "He was a really severe case," she said.
Steelman said the disorder is not uncommon as 60-70 percent of those who have radiation treatment to their throat or esophagus end up with some type of dysphagia. She noted providing a feeding tube costs Medicare around $31,000 per year and the total cost of dysphagia is estimated at $1 billion per year.
The last hope for Underwood to have a normal life again was relearning to swallow again using VitalStim, the first proven treatment for dysphagia.
"It uses electrical stimulation directly to the muscles of the throat to help swallowing," Steelman said.
"You can feel it pulling the muscles," Underwood said.
Despite the severity of his condition, after undergoing VitalStim therapy with Steelman for about a year, Underwood was discharged in October.
After three years, he is finally able to eat again -- and enjoy a cup of Joe at the coffee shop with his friends.
"It really affected the quality of his life," Steelman said.
While the technology deserves some of the credit, Underwood's gratitude is mostly for Steelman and the "genuine concern" she showed during their sessions together.
"She's really concerned about her work," he said.