Hi Trace,
I'd like to clarify because ultimately what matters here is YOU.
During my six years with the sleeve the only vitamins I needed to take were B-12 and a multi. My lab tests were once a year and there were no major differences between my pre-surgery results and post surgery ones. I attribute that to the fact that my digestive/absorptive process was not really altered except for the fact that with a reduced stomach you don't make much intrinsic factor which is why we take B12.
I also assume that's why I had no constipation, or other such issues. The surgery /recovery was a piece of cake. After the DS I felt pretty crappy for a couple of months.
Now, with the DS, I have about 30 different labs tested every three months. Hence my comment about insurance. That WILL reduce to once or twice a year after I stabilize. I take vitamins about 9 times a day in an effort to isolate my issues which, as a result of the DS, are abnormal PTH, copper, D, calcium and iron. I also expect this to get easier as time goes on and hopefully I will only have to take them a couple of times a day like many of the vets. In addition to my 15 or so supplements I have to take stool softeners and Miralax daily, as well as being conscious to eat plenty of fat (I've never been a butter guy, more of sugar dude so that has taken some getting used to). I said PT job because I have had to literally spend hundreds of hours researching. Virtually everyone at the beginning does. Again, with time and experience, this will be second nature. I should have said PT job for the first year.
While I am happy with my DS I would be lying if I didn't say that I wish the sleeve had solved my problem. The simplicity of it is soothing for me. However, as other have commented (and I can attest) you are highly unlikely to get the weight loss you will with a DS. And, you will still be on a diet. You will have some help, but you will still have to put in a hard day's work. However, like the DS, you will be able to eat a normal diet.
Everybody can give you anecdotes. But I think the best stats point to 50% EWL over several years. Would you be OK at 220? Would you be OK having to remain vigilant about your diet? If so, the sleeve may be OK for you. If not, the DS will probably leave you happier. Are you a volume eater or a grazer? I'm a grazer and I think that's one of the reasons I didn't do well with the sleeve. If you eat every hour the sleeve will not help you.
Diana's comments about getting the DS all at once are valid, although in my case I seem to be losing at a typical rate. Larra's comments about insurance are also valid. Due to my wit and charm, Kaiser has given me no issues with revisions, tests, or infusions. I'm now thinking I'd like a tummy tuck (that will be the ultimate test of whether I can work the Kaiser system to my advantage!) Anyway, Larra, Diana, Southern Lady, Munchkin, Scott and many others are some of the most knowledgeable people on the internet about the DS and they are always willing to answer questions so you have a tremendous resources on this board.
In general, DS people are the best informed about WLS. They have to be to have found the surgery and do the follow up required.
Finally, and this is what sold me on the DS, few people revise out of the DS, but many people revise into it. Also, DS people are generally happier than with other surgeries. To me, that's a very valuable piece of data. I am also happy with my DS.
You seem bright. I have every confidence you will reach the right conclusion for you.
I wish you the best. And remember: you're not alone.
Mark