Sorry I am so delayed in responding, I haven't been on here for a while. Dr. Leyden is an excellent surgeon, one of the best. I had Dr. Dy and was very happy but I wouldn't hesitate to use any of the Mayo Endocrine surgeons. They do only check one gland, not all 4, because of scar tissue. If they get in there and there is hyperplasia or the PTH doesn't drop, then they will continue checking. That was an initial concern of mine also, that they wouldn't check all of them, but they have research behind why they do what they do. They have the team approach at Mayo, not only consulting with other surgeons but also the endo's and any other physician if they find other problems. It is nice because the best physicians in the world are under one roof. With your DEXA scores, I would get something scheduled asap. I felt better as soon as I woke up from surgery. The pain was gone, the brain fog, the constant urination. It was unreal how fast the body recovers. I only had osteopenia and I will have a bone scan in March to see if it's gone. Fingers crossed!