Susiebuddy - Sorry in advance for the long post but I kind of brain dumped in my response. I'm not Meesh but I am a former UC'er like Suebear.
I currently have an end ileostomy following surgery #1 of 3 and am having surgery #2 to create my pouch and go to a loop ileo on Jan 4. I came to the decision to have my colon removed because nothing but steroids worked for me and I couldn't keep enough blood in me to keep me from getting anemic and needing iron and blood. I missed several events over the summer that I wanted to attend because I felt so bad and wore a diaper frequently because I could never guarantee if I would make it to the bathroom. I still worked 5 days a week - just an altered schedule starting at 10 or 11. I was on Remicade every 4 weeks and it was having no effect. My GI did a scope and said that I could try to get approved for Humira (not guaranteed nor was he confident that it would work) or try to get into a trial but his recommendation was that I have surgery following my scope to determine if Remicade was helping me - just very slowly...it wasn't. I had already decided that if the remicade wasn't helping my colon and I were going to part ways.
Everything I have heard indicates that if you are in good health it is better for you so if you are going to have surgery I would recommend doing it while you're still feeling good. I was not in good health going into surgery #1. I had lost approx 20 lbs in 6 weeks and was weak, anemic, and losing blood rapidly. I'm now healthy and looking forward to surgery #2 and a faster recovery due to my better health.
I had already done the research (check out jpouch.net and jpouch.org if you haven't already) and decided that I wanted to have jpouch surgery rather than an end ileo because to me it would just be easier in the long run. Now that I have my end ileo, if I had to have it for the rest of my life I could live with it happily as it has given me my life back but I'd rather try for the jpouch and go to a kpouch or end ileo if the pouch fails. I think that a lot of my decision to get a jpouch vs a permanent ileo is based upon vanity, convenience, and finance. I have never have any indicators for Crohns so hopefully it won't show up later and affect my pouch. During the week prior to surgery I did start to feel better - but with UC better is relative. I wondered why I was having surgery and then I ended up running to the bathroom and that question was quickly answered.
I went into my workup and meeting with the surgeon hoping to have a 2 step but due to my steroid use, Remicade use, and recent weight loss the surgeon recommended 3 steps with a reduction in my chance of complications of 12% by having a 3 step. It wasn't a tough choice. I was mentally accepting of what was going to happen before I went into surgery because I just wanted relief and my life back. I have now had "Arnold" (my ileo) for 4 months. I feel better than I have in 2 years (UC diagnosis 2 yrs ago). I have energy again. My alarm clock goes off at 5am and I can get up without too much trouble (I was never a morning person). I can eat again (proven by the 25+ lbs that I've gained since surgery). I can go out and not look for the closest bathrooms or foods that I can eat. My diapers are stored away waiting for take down as I may need them again for a month or so (then again I might not). People have even commented that I'm like my old self again. My only regret as it is with many who have had the surgery, is that I didn't do it sooner even though I only lived with UC for 2 yrs (severe pancolitis). Sometimes I wonder if I would be as happy going through all of this if I hadn't tried Remicade like I did and hadn't been as accepting of surgery. When I was diagnosed with UC and didn't get into remission (ever), I knew that surgery was likely to occur - I was just hoping to keep my colon a little longer. I'm amazed at how much better a person can feel when a bad colon is removed. I knew I had made the right decision - no second thoughts - when the surgeon said it was a good thing I had it removed and didn't try anything else because my colon tissue was friable.
I hope that this helps. Feel free to ask anything you'd like and check out the ostomies board on Healing Well and also jpouch.org in addition to the stories on jpouch.net. I especially recommend that you read through Mark and Megan's accounting of Mark's surgeries there. I went through them prior to surgery and I think that it helped to prepare me for what was going to happen when I had surgery.
Good luck with your decision. I think that the most important thing is for you to be at peace with whatever decision you make. Plus, a pouch can become an ileo and an ileo can become a pouch as long as the surgeries are done with that in mind - so you can change your mind.
Summerstorm decided to go with a perm ileo when she had surgery as have others on the ostomies board and I'm sure that they can give information about
why they made their decision to get a perm ileo vs a jpouch or kpouch if you're interested.