Surgeon thinks bypass is better for me xpost

I finally got to meet the surgeon today and he seems wonderful!! I felt very at ease with him. He has been doing sleeves for a long time and thinks that  it's a better option for some. But, with my sweet tooth, he thinks that the bypass would help me change more and be more successful. I've been so against the bypass for myself, but I did tell him that I'd open my mind to it.
I have a surgery date!!! June 27th. So, I just have to make my mind up before then. I'm looking for input.
I'm a heavyweight. Highest weight 432, now 360 ish. My triggers are cake, chocolate, potatoes, nutella. Those are the big ones, but I LOVE carbs. Pizza, pasta, bread, you name the starch, I love it. I worry about the food restrictions, complications, dumping, stoma closing, etc, with the bypass.
The surgeon did let me know that the complications with bypass are usually easier to fix than the sleeve. Due to the higher pressure system in the sleeve.
He also let me know that though medicaid says they cover the sleeve, he hasn't been able to get them to cover anyone.
Any input would be so welcome.

With your BMI I would consider the DS.  It has more malabsorption then the RNY and unlike the RNY the malabsorption is permanent.  You do have to be very dilligent about supplements with malabsorption and more so with the DS because it is more malabsorptive.  But it has better stats for weight loss and maintenance.  Your surgeon may not do the DS so you may want to look for a surgeon that does do it.
But, and this is a big but, no WLS will work for you if you don't address your carb addiction.  I managed to regain almost all the weight I lost with my first WLS because I couldn't control my carb addiction.  WLS is a tool to help us make changes in the way we eat but we have to make the changes.  With the RNY you may have dumping syndrome when you eat sugar but only 30% of people do have that so you can't count on the to help you.

I'm telling you that if sweets/lots of carbs are your weekness, bypass will definitely take care of that for you. Dumping is NO FUN!!!

But....not everyone dumps!!! Don't let someone base the surgery on something that only, maybe 30% of RNY'rs have. Do your own research for what is best.

I would consider the DS or the RNY only at that high of a BMI

Do remember that not everyone dumps, so dumping CAN help but it is crucial that you do not even test the waters. You have to assume you dump, and avoid all foods that could make you dump..... like the things you love!

Dumpign is also no picnic, and is often followed by reactive hypoglycemia later on (though people with the DS also get RH)

That you have already lost so much is AWESOME..... there are some incredible statistics about people who have significant weight loss pre-op....they lose more, and maintain better in general.