Sleeve vs RNY
I was all set for the RNY, malabsorption, dumping syndrome, tools that would aid in my weight loss. I found out these tools would only last approx 18 months. As well as the sleeve was developed as 1st step for super morbidly obese (which I am, bmi >60) and the RNY is 2nd step once enough weight is lost. Confused to say the least. I've waited so long, only want to do it once. Help!!!! Going to Mexico.
Our deepest fear is not that we are inadequate.
Our deepest fear is that we are powerful beyond measure.
It is our Light, not our darkness that most frightens us.
We ask ourselves -- Who am I to be brilliant, gorgeous, talented, fabulous?Actually, who are we not to be?
You are a child of God. Your playing small does not serve the world. There is nothing enlightened about shrinking so that other people do not feel insecure around you. We were born to manifest the Glory of God that is within us. It is not just in some of us, it is in everyone.
And as we let our light shine, we unconsciously give other people permission to do the same. As we are liberated from our own fears, our presence automatically liberates others.
M Williamson
At your BMI, I would consider nothing less than a DS!
For information, dumping syndrome - if you have it (30%?), does not stop at 18 months - I still very much have it at 9 years!!!! For me, there is also some degree of fat malabsorption at this point too ...
A restriction only surgery is most likely not going to be enough for you to lose enough to get to a healthy weight, although of course, there will always be exceptions 
Proud Feminist, Atheist, LGBT friend, and Democratic Socialist
It sounds like you are confused.
VSG, or the sleeve, was developed as the first step of a two-part procedure, but that procedure was not RNY. It was the DS, or duodenal switch. With such a high BMI, the DS might well be the most effective WLS for you.
Malabsorption of calories after RNY does go away after a couple years. Dumping syndrome may or may not go away, but only about 30% of RNY patients experience dumping syndrome anyway, so you should not count on that as tool to aid in your weight loss.
I would talk with a surgeon that performs VSG, RNY, and DS about which might be best for you. Since you plan on having surgery in Mexico, you'll also need to think about your follow up care. Who will you be seeing for follow up? Since the DS is a less common procedure than RNY, you may have more trouble finding a doctor to do your follow up if you have that surgery.
Kelly
Please note: I AM NOT A DOCTOR. If you want medical advice, talk to your doctor. Whatever I post, there is probably some surgeon or other health care provider somewhere that disagrees with me. If you want to know what your surgeon thinks, then ask him or her. Check out my blog.
What I like about the sleeve is it is the 1st stage for the DS, which is the most effective for high bmi patients. My surgeon does not perform DS on lower bmi patients - unless that has changed since my surgery. Also with the sleeve you can continue taking NSAIDs.
I do not dump - wish I did because I love sweets too much. However by not dumping I must be more disciplined, which is a good thing.
I do love my RNY, though.
