Question: Good morning Dr. , I'm scheduled for a 3rd cervical reconstruction due to an accident during the 1st surgery (had only 1 herniated disc @ C5/6) wherein a ligament that assists in keeping your head up was severed. After a reconstruction 1 yr later that fused me from C3-T3 w/rods, plates, etc., left me in chronic pain and my head began to fall fwd again as well as an autofusion at the OA (sp?). After years of PT', stretching my head back only exacerbated the thoracic pain. So, here I am despite trying every modality known including OMT, scheduled for a corpectomy to remove osteophytes at OA and something at C3/4 to counter balance the 2 small triangular plates above. It's not an option because in addition to severe pain, I can't speak well, barely open my mouth, chew, swallow, just to name a few. I am most concerned although I have a very competent pain mgmt Dr., how to handle the 1st 48-72 hrs of post operative pain. I've been put on Fentanyl patches w/ Dilaudid for breakthrough despite my protests, it's better than anything beginning w/oxy!! Do you have any suggestions for those 1st few unbearable hours since Morphine & Dilaudid IV gave me only 15 minutes of relief? With fentanyl, I do feel nauseated, loopy, and it seems to go straight to the pain. Breakthrough? We already have a wiening plan in place reducing the medications every 2-4 weeks depending on my progress when I get home. Thank you so much for your assistance. I've never had an addictive behavior nor drug seeking issues. I simply want quality of life until this 3rd & final surgery works. XXXX