The topic at hand is about deciding between living with a long-term ileostomy or opting for a J-pouch reversal after dealing with severe ulcerative colitis. The person considering this decision is concerned about potential complications with a J-pouch, such as pouchitis and frequent bathroom visits, but also acknowledges that life with their current ileostomy has been quite positive. They are seeking insights from those who have lived with an ostomy for over a decade to understand how it affects daily life and aging, and whether anyone regrets not attempting a reversal.

Here are some shared experiences and advice from others:

1. Long-term ileostomy experiences:
- Many have lived with a permanent ileostomy for 10 to 45 years, often saying it saved or greatly improved their lives without limiting work, travel, sports, or family activities.
- Typical wear-time for an ostomy appliance is 3 to 7 days, though some need more frequent changes as they age, which remains manageable.
- Changes in weight, menopause, and aging skin generally cause little to no additional issues.
- Some are concerned about future arthritis affecting their ability to change the pouch.

2. Complications with a J-pouch:
- Some experienced pouch failure, leading to issues like fistulas, blockages, short-bowel syndrome, chronic pouchitis, and multiple surgeries, eventually returning to a permanent ileostomy.
- Common problems include malnutrition, dehydration, urgency, frequent bowel movements, and the need for ongoing antibiotics or biologics.

3. Positive J-pouch experiences:
- One person reported four excellent years with predictable bowel movements and no urgency before unrelated health issues arose. They note that successful outcomes might be underrepresented in forums.

4. Factors to consider when deciding:
- Ensure the diagnosis is ulcerative colitis, not Crohn’s, as Crohn’s can recur in a pouch.
- Choose a surgeon with significant experience (40-50+ procedures) and a specialist center.
- Be prepared for a challenging initial recovery and ensure strong pelvic-floor muscles.
- Fewer surgeries can mean fewer adhesions, which can complicate future operations.
- If content with an ileostomy, many suggest sticking with it to avoid potential J-pouch complications.

5. Practical living tips:
- Common appliance change routine is every 3 to 4 days, with some extending to 5 to 7 days.
- Monitor skin health, as issues typically arise from leaving appliances on too long.
- Support belts for hernia prevention or exercise are optional, with varied experiences.
- Naming the stoma or viewing it positively can help mentally.
- Adjusting diet and learning output patterns can simplify life over time.

6. Resources and communities:
- YouTube channels and websites like "Permanent Stoma or J Pouch Surgery?" by Hannah Witton, Let’s Talk IBD (Maggie), The Ostomy Diaries (Amber), and Vegan Ostomy (Eric) with veganostomy.ca offer additional insights and support.