Need some help finding help with four year old sleeve.

I received my sleeve from Dr. Aceves in Mexicali in March of 2011. I was feeling great for about three years but last year in November I got a terrible stomach bug and haven't felt well since. I got an emergency gall bladder surgery two weeks ago that went fine but I am still worried something is going wrong with my sleeve. I've had a lot of shakes, sweats and neurological issues ( trembling, muscle weakness). I don't know if the sleeve is the reason for this but I sure would like to get it checked out.

Problem is, back here in the states it seems impossible to ask for, forexample, a CT scan to make sure everything is ok. I talked to the guy who did my gallbladder surgery and described my symptoms and he said they had *nothing* to do with my gallbladder -- which I actually don't believe because I feel a lot better afterwards -- there are just certain symptoms that have been the same for a year that haven't improved as well. 

I am wondering if anyone else has been in this situation. Did you end up going back to Mexico for followup? Because I would certainly do that but it just seems weird I can't get a CT scan or any kind of check on my stomach. Obviously I've been operated on and if I am having health problems it seems the stomach should be looked at. I'm on the verge of going to the ER and telling them 'my stomach hurts' and trying to get them to do an MRI. 

Any advice for this problem? 

I haven't had my surgery yet, but I had my gallbladder out in 2003 and I remember how HORRIBLE that was.... Worst pain in my life.  I had the sweats, trembling, shaking, inability to hold still, and to top it off, I waited too long to go to the ER and ended up with Pancreatitis.  I think your doctor is wrong about some of the symptoms being unrelated with your gall bladder.  I think our bodies react differently to trauma and illness so the "effects" can never be cut and dry.  Have you talked to your primary care doctor?  He/she didn't do the surgery, but they can prob. refer you for some tests if you express concern.  That would be the first thing I would do before going to the ER and paying 10-20 times the copay and getting "the look" from people who don't think you need to be there because you aren't bleeding or unconscious.  I hope you can get it all figured out and it's nothing too terribly wrong!!    

Really???

It was actually the surgeon I saw this morning and I swear -- a couple weeks before I had it out I was waking up VIBRATING all across my chest. When he took it out he said it was black and full of pus. You'd think if you had something like that in you it would cause ALL KINDS of symptoms incl. diarrhea since the duct that makes bile would be blocked. 

I am so frustrated with medical people lately. 

I would agree with the doc that the stomach probably has not causing the shakes and neurological issue. Rather unlikly.  May be vitamin- minerals deficiency, hormonal issues (adrenals, insulin, etc) . 

When last time you had detailed blood work done? Vitamins, minerals, hormons, etc. A PCP can over that. Shaking muscle weakness can be a symbol of neurological issue - so checking vitamins like B1 B12 may be a good idea. If that is ok - and you need someone to check your insides - a good gastro doc can do that. 

I took me a while - but I found locally great gastro who can take care of things like end, colonoscopy, etc etc... 

I do have a great local WLS surgeon, but the other doc can deal with any issues related to guts.  

Shapes - sweats - can be blood sugar issue - or hormonal - and a doc who deals with hormonal issue is endocrinologist.  

Does this happen at a certain times of day? Also it sounds like hypoglycemia and other ailments as well.....you can go to your local drug store and purchase a glucometer meter with strips and meter for around $30-40. This would be the cheapest way of narrowing down things before an er visit. An er visit won't buy you that ct/mri your looking for. You may need lab work done, possible xray or ultrasound. Ct/mri are not just given right off the back. Also have you checked your blood pressure? That and checking your blood sugar are 2 important things you can do at home and report to the doc. If your experience neuro problems i don't think its related to your gallbladder, but i can be wrong. Neuro problems can be related to low and high sodium levels.....hence you need lab work done. Keep us informed and i hope all goes well.

I have had a lot of work done. Both Vitamin D and B12 are actually high given the amount I was supplementing. I paid for a test from an outfit called Spectracell that tests a full panel of micronutrients -- all the others such as b6, copper and folate were ok too. They were baseline, but adequate. Even the rest of the fat soluble vitamins were fine because I was taking my vitamins even if there was fat malabsorption.  I have REALLY low iron though and they also found low carnitine, which is a pretty weird finding. 

I was checking my blood sugars for a while and got a test for diabetes -- pretty much normal although I do get hypoglycemic on occasion and sometimes wonder if I'm dumping. My neurological exams have all been normal. Liver function, kidneys, all normal -- just iron deficiency anemia. 

The reason I think this be might be connected to my sleeve is because in the hospital I had nothing by mouth for four days and IV antibiotics. When I got home it was a rough recovery; I had low grade fevers in the afternoon and some continuing neuro problems but nothing like what I had experienced before that. I was thinking there might be a slight perforation or infection somewhere in the sleeve junctions that improved with bowel rest and antibiotics since the surgeon said the gallbladder was not connected. 

Up to several months ago I had no health problems whatsoever. This was 3.5 years sleeved. The likelihood at that point of having a surgical problem was nearly zero. I was at a good weight and had great energy, just motoring along with my sleeve, sleeping well, traveling, no food intolerances, nothing. Then one day I started to get hot flashes and stomach pain and sort of got sicker and sicker after that. I doubled up on vitamins for a month and added more D and B12 and also copper and folate, since sometimes those deficiencies can cause neurological issues. But it was none of those things. I agree it's got to be either an endocrine problem -- OR...the sleeve. 

I know this advice is like closing the barn door after the horse escapes, but you should have chosen a follow-up surgeon back in the States as soon as you came back after your surgery in Mexico. Having the sleeve goes hand-in-hand with regular checkups by a sleeve surgeon for the rest of your life. Please find a good bariatric sleeve surgeon and make an appointment with him/her as soon as possible. Only a bariatric surgeon can determine whether your sleeve is causing your problems. Good luck.

psychoticparrot

That's not really how it works for out-of-country sleevers or at least not very well. In order to get follow-up from a bariatric surgeon in the states you have to join the same "bariatric program" you would have had to join if you were sleeved by them. Several places wanted me to take classes, attend seminars and check-in appointments, plus fill out an "application" that cost between 50 to 100 dollars to "process", even before any bloodwork was done, most of it redundant ;such as iron status which I have already been tested for ten times.  In fact many of these programs don't even offer the kind of in-depth micronutrient screening I mentioned above even though there are several long term nutrient deficiencies such as copper and b1 that are found in sleeve people later down the road. 

I can see the value of doing this in beginning if you are really worried that you were at risk for complications say in the first year. But it makes more sense after four years to find a gastroenterologist who would call in the advice of a bariatric surgeon if necessary. I had absolutely no reason to follow up anything or even worry about my sleeve until four years later. 

Have you had any lab work done since being discharged from the hospital? If no, then you have no idea were your labs stand at after the organ was taken out. If you have a PCP, i would call them monday and let them know what is going on. Hopefully they can just shoot you over to a lab and schedule you an appointment to come in (probably in a perfect world does this happen). Of course, let them know you've already spoken to the surgeon and that has gone nowhere. If you go to the ER, the first thing they will do is basic lab tests, but the ER is such an expensive way to go. If you can bare it till monday, then try your PCP first and let them know how  URGENT this is.

Good point. I have not had bloodwork since I left the hospital but the symptoms I was complaining of preceded the gallbladder surgery. 

What I am really looking for is the easiest way to get someone in the states to look at/image my sleeve. There has to be a way that does not involve paying dieticians and filling out workbooks.