Alex Webb removes the black bandana from around his neck, revealing a red scar at the base of his throat.
The scabs from the surgery are nearly healed, but the scar will endure, forever reminding Webb of the two decades he relied on a breathing tube to live.
The tube came out April 19, eight days shy of Webb's 21st birthday.
It was a big moment for the Sandusky resident -- another milestone in a life chock full of them. After all, Webb's overcome odds longer than those found in Las Vegas.
It's his determination that's gotten him this far, and it's his determination that he'll need to make further progress.
The air tube's out. Next comes the feeding tube.
"Alex is a very courageous young man," said Laura Lloyd, speech-language pathologist with Fisher-Titus Medical Center. "He's faced more medical challenges in his 21 years than most of us will face in our entire lifetime."
Webb was born a month premature with a tied tongue and malformed jaw and mouth.
He couldn't swallow and choked on his own saliva, leading doctors to give him a tracheotomy and a feeding tube. His body was sustained by a nutrient-rich solution injected into his stomach through the tube.
Doctors diagnosed him with dysphagia, a condition affecting about 15 million Americans that impairs a person's ability to swallow.
Webb had an especially bad case, and medical staff predicted an early death.
But he proved them wrong. Not only did Webb pull through, he grew up in a loving household, attended school, made friends and learned to drive.
In short, he grew up like any normal kid.
Despite all of his progress, Webb's condition meant he couldn't eat or drink and his words were mostly unintelligible.
Webb snuck a soda here and there -- his favorite drink is Mountain Dew -- but he risked choking on the liquid. He developed pneumonia when liquid got into his lungs, because he didn't have the ability to cough it up.
For a long time, nothing could be done about this.
But then a few years ago, when he was in his late teens, Webb underwent extensive mouth and jaw surgery.
Medical staff broke his jaw, removed all of his teeth and clipped his tongue.
They then rebuilt his jaw and outfitted him with dentures.
After recovering from the procedures, Webb joined a speech and swallow therapy program at Fisher-Titus Medical Center, where he received training from speech-language pathologists Lloyd and Lindsey Soisson.
At weekly sessions, Lloyd helps Webb learn how to swallow using electrical stimulation pads that help his throat muscles handle drinking water, soda, V8, and pureed foods.
At first, Webb could only take small sips.
But the therapy has built up his muscles, and now frat boys would be impressed by Webb's chugging technique.
It was challenging, but Webb always "rises to the challenge," Soisson said.
"It was hard on me," Webb said. "It was physically and mentally hard."
As Lloyd helped him learn to swallow, Soisson helped him learn to speak.
Until doctors clipped his tongue, Webb could only produce a limited range of sounds.
"When we started, he only had vowels, so we joked he sounded like the teacher from 'Charlie Brown,'" Soisson said.
The teacher makes incomprehensible "wah wah wah" noises.
But with Soisson's help, Webb's now learned some of the more difficult sounds, like words that begin with "F." He's still working on S, K and G sounds.
To make the sessions fun, Soisson has Webb practice words from the song lyrics of his favorite band, Green Day.
A Metallica song or two might also sneak into the sessions.
As Webb's speech continues to get clearer, he's becoming more of an extrovert.
Webb has a job at Goodwill, he's working on getting a new car and he's hoping one day soon to get his own place.
Weaning Webb off liquid food will take time, but the process will be far easier than removing the breathing tube.
"I'm still getting used to it," Webb said.
Solid foods are in Webb's future. He knows this.
He knows that soon he will no longer feel the need to wear the bandana, which he's worn around his neck for so long.
He knows that with a little time, a little help from two coaches and a lot of determination, he may be able to eat cake on his next birthday.