Need some help finding help with four year old sleeve.

Go to a gastroenterologist for a consult.  He can order and read a scope if he believes it's needed.  You don't need a bariatric surgeon.  Partial gastrectomies, which is what your sleeve is, are fairly common.  They're used to treat ulcers and stomach cancer.  A good GI doc will know what he's looking at.  But your symptoms don't really sound connected to a problem with your stomach!

My advice is from a totally different vantage point. I am a cancer patient, and found that I persistently "thought" some symptoms were attributed to either low blood pressure, low blood sugar, etc. I was wrong. I eventually realized that I needed to stop diagnosing myself, and this in turn led to me describing ONLY my symptoms to the doctors and dropping the preceeding self-diagnosis. 

Consequently, I would try seeking medical care based soley on your symptoms. If it happens to be related to the sleeve then they should figure it out. By not prefacing you think it is from the sleeve it will then kick in your insurance and the docters should take it more seriously.

For example, prior to being officially diagnosed at my physical for a couple of consecutive years I would point out a spot on my face and ask if it was normal, then describe what was happening. I was dismissed. Eventually, it turned out it was indeed skin cancer that had gone unchecked for a couple of years. No bueno. Once, however, I was diagnosed initially with that cancer the doctors took my symptoms and family history far, far more seriously. All of a sudden I was getting screened when symptoms popped up. Time and time again it came back as cancer. I shudder to think of what might have happend had I not caught that first skin  cancer, as those later seemingly benign and common symptoms could have just as easily been dismissed.

Keep going to doctors until they figure it out or perhaps your symptoms relinquish. I learned the hard way.

Thanks for the advice happy teacher. I understand what you're saying, it makes sense. 

Shakes and neurological issues sounds more like malnutrition to me.  The only thing that has to do with your sleeve is you not taking care of yourself.  Your PCP can do a full nutritional panel for you.