can't decide between gastric and sleeve ..help

You also need to research the Duodenal Switch, even if the surgeon you're presently working with doesn't do it. You simply CANNOT make an informed decision unless you're fully informed. (*grin*)

I don't know if you have any co-morbs, but you do have a BMI greater than 50. The DS has the very best long-term, maintained weight-loss stats for patients of any size, but especially so for those with a BMI greater than 50. It also has the best stats for treating diabetes and high cholesterol, and like the Sleeve it still allows you to take NSAIDs. Because the DS, like the Sleeve, preserves all normal stomach function, there's far less chance of dumping or developing reactive hypoglycemia.

I chose the DS over ten years ago, and I couldn't be happier. I'm pretty effortlessly maintaining a loss of 170 pounds. I eat pretty much anything I choose, but if I make a pig of myself on carbs I may suffer some serious gas. That *might* be a negative, but I prefer to think of it as positive reinforcement. (*grin*)

It's much easier to change your surgeon now than to get a revision later. Make sure you're making the very best choice for you.

I wanted the sleeve but because I had so much scar tissue from a previous surgery they would only allow me to have the lapband and it's been 2 years and i've only losy 14 lbs.

Sorry to hear that!

Then you were poorly served. All the lapband did was increase your chance of having serious issues like slippage, scar tissue, etc.

I asked the surgeons at the initial meeting/conference which they would choose if they were getting it, universally chose sleeve, but none of this group were doing DS.

I don't think they do DS where I'm at either.. but am going to research and weigh options!

Then TRAVEL...many of us do to get the surgery we want not one they offer us close by. Many also will self pay to get the DS over having insurance pay for any other surgery.

I'm in the same boat.  It's hard to decide so when I meet with the doctor I will ask him which he thinks is the best for me and my situation.  I just wanted to let you know you are not alone sitting on the fence sort of speak. 

What is your weight-loss history like?  Do you lose when you diet, only to regain it as soon as you stop being so strict?  Does your body fight you tooth and nail from the first day, seeing very little results at all?  These are important in considering your own metabolism. 

If you can diet like a champ and still get no results (that was me), I wouldn't expect much more out of the sleeve, for it just helps you feel comfortable eating less, which is perfect for some people.  The gastric bypass and DS (what I had), change your body's metabolism.  Living with it, you simply take extra vitamins and eat more protein.  It's not a big deal to work into your life.  If you need that metabolic change - selecting a procedure that gives you that is key.

Other things to consider:

If you are prone to gastric reflux, the sleeve may make it worse.  Gastric bypass is the most recommended for those with GERD. 

If you need to take NSAIDS (advil, aspirin, aleve, etc), then the RNY is out because they are highly NOT recommended.

AND if like me you have both GERD and need NSAIDS, you chose which you prefer to live with...I prefer being able to take NSAIDS...oh, and my GERD also almost disappeared.

I was like you, Valerie...I held on to every calorie I ate and even those that just wafted around me! I could lose weight, my issue was not being able to keep it off.