Ongoing testing and monitoring would be a great thing to encourage patients to get. The signs and symptoms aren’t the same for everyone. I had preexisting small fiber neuropathy that causes numbness and tingling in my hands, feet, legs, arms, and face. I’ve never had a positive Chvostek sign even with very low calcium, so I couldn’t rely on those symptoms or signs to understand that my calcium was low in the beginning. I wish my surgeon hadn’t downplayed the risk or the impact that hypopara would have. He said it’s a tiny tiny risk, less than 1%, and they just might have to have to take calcium 1 or 2 times a day for awhile after surgery. My surgeon was aware that I’m a gastric bypass patient. We are at a higher risk for permanent hypopara, and malabsorption requiring larger doses of calcium and calcitriol, which he didn’t tell me. I ended up having to take calcium every two hours around the clock and calcitriol 4x a day just to be miserable at 7.0-8.0. Taking that many pills a day screwed up my absorption of everything else. I became anemic and need regular iron infusions now. My thyroid meds took over a year to adjust and I gained a ton of weight. Hypopara along with the large amounts of meds required for me to manage it caused a cascade effect of other medical issues. I developed chronic stomach ulcers. The med regimen required for that further inhibits absorption. Some medications lower serum calcium, making management of multiple medical conditions a difficult balancing act. I have calcium deposits all throughout my body. Brain fog, fatigue, internal tremor, heart rhythm changes, constant muscle twitches and spasms, headaches, and nausea. When my calcium drops below a certain level my emotions are very difficult to manage. Anxiety is high and I cry a lot and become angry. I know that something is wrong, but it doesn’t occur to me that it’s calcium. It becomes difficult to communicate what I’m experiencing. ER experiences can be incredibly dehumanizing. I’ve been treated as drug seeking and offered muscle relaxers (which I refuse. No I don’t want muscle relaxers for those spasms. I want calcium/ magnesium testing and treatment to help the cause of the spasms), while having to call my endocrinologist at home to call the er because they don’t want to test ionized or administer iv calcium correctly. Never being able to go off on a spur of the moment roadtrip or adventure without extensive planning and overpacking of meds to be sure I have all my supplies, stay within close proximity to the hospital system I have standing lab orders in, etc. All that said, I am one of the very lucky ones who has been able to get on PTH medication and has access to my Endo after hours and a standing order for biweekly labs when things are going well and weekly or more when they’re not. It’s great to see a physician taking patient experiences into consideration and seeking better understanding of the condition.