My surgeon once told me he thought there should be an IQ test for having this surgery and I admire your thoughtful approach. I had a child at age 43 pre-DS (at 280 lbs on a hi-protein diet when I got pregnant). I think living longer for your son, and giving him a sibling are powerful reasons to do it, and overcoming disability with DS weight loss made me a better parent and helped me get a better job. You will find taking vitamins to be second nature. As for carbs, your appetite will change. You will see food as contributing to your health and not just pleasure. I buy clothes when I want to, not because I have to. You will need good health insurance throughout the DS journey, though. My DS needs come above all else. A surgery mate lost her job and husband in one year and went on welfare, and suffered significant complications because she stopped paying for vitamins and went back to high carb meals. This is a lifetime commitment, no matter what life throws at you. Malabsorption of vitamins and the need for protein is forever. I am confident you will make the right decision, because you are so thoughtful about it.