Hi tired2,
I empty my pouch around 4 times a day, once when I wake up, once later in the morning, in the afternoon and before going to bed. Because the motions are emptied straight into the bag now and not from behind, I do not have any feelings of urgency.
I've noticed that the foods that I eat can affect how often I need to empty my bag, but it is not nearly as much as before I had the operation.
I am sure your doctors will give you painkillers. I'm pretty useless when it comes to pain threshold, so believe me, if I can handle it - anyone can. Personally, I'd recommend the op, it has really improved my lifestyle.
I hope you'll learn to love your pouch and accept it as part of you, once you've done that, everything else should be a whole lot easier. I dress it up so that it can't be noticed, and those that I've told about it often comment on the fact that it seems invisible.
Hope this helps.
Smiles