This topic is about a 75-year-old individual who decided to remain a permanent ostomate after having an ileostomy due to a life-threatening emergency. Initially, a reversal surgery was planned, but after careful consideration, the decision was made to cancel it. Here are the reasons and insights shared:

- The individual prefers the certainty of living with a stoma over the uncertainties and risks associated with reversal surgery.
- The previous surgery was nearly fatal, and the family is concerned about the risks of undergoing another major operation.
- Concerns about quality of life include the possibility of having 7-8 liquid stools daily, potential incontinence, and the need for constant access to a toilet. There is also a higher risk of pneumonia, especially with existing emphysema.
- The individual feels physically fit, manages the ostomy bag well, and values the support from the community.

Additional considerations and advice include:

1. Insurance complications exist, as switching from the wife's employer plan to Medicare would incur lifelong penalties, leading to high deductibles for future surgeries.
2. The surgeon supports the decision, acknowledging the risks and benefits of both options.
3. It's important to understand the differences between an ileostomy and a colostomy, as they involve different parts of the digestive system. Individuals should assess their own anatomy and health needs before deciding.
4. Diet can impact bile-driven diarrhea; increasing sodium and reducing fat intake can help manage symptoms.

Advice and insights from others in similar situations:

- Many older individuals have also chosen not to undergo reversal and are content with their decision, noting that "the grass is not always greener."
- Common reasons for refusing reversal include potential complications, prolonged recovery, risk of chronic diarrhea, and the desire to avoid additional stress on family members.
- For those with a colostomy and most of their colon and rectum intact, a successful reversal is more likely. It's important to consult with a surgeon about the specifics of one's health and goals.
- New members considering reversal should seek advice and gather information on real-world outcomes to make informed decisions about their long-term quality of life.
- Dietary adjustments, such as keeping fat low and maintaining adequate salt intake, can help manage symptoms after partial colon loss.
- Medicare Part D penalties can be costly, but the plan may still offer significant savings on medications.
- Living with an ostomy can still allow for a full and active life, including long marriages, dancing, travel, and daily activities, as long as the pouching system is well-managed.
- Staying active can help prevent parastomal hernias, with the community encouraging members to "secure the pouch, stay off the couch."
- The forum community offers ongoing support, reassuring members that "we’ve got your back.