Block. For most of us, it's 99.99% mental. Unfortunately, i'm one of those people and it's irritating since I have to take a total of 7 pills daily at 3 different times of the day. To get me through, I sometimes hide the pills in gelatin dessert or applesauce. For folks who've had radiation of surgery in the neck, however, it can me more serious and they should check in with their primary care doctor.