This topic is about a person named Dee who is facing a tough decision regarding her health. After undergoing emergency surgery in 2002 due to toxic megacolon from ulcerative colitis, Dee had her entire colon removed and an ileostomy created. Later, an attempt was made to reconstruct a pelvic pouch, but it led to numerous complications, including severe weight loss, abdominal pain, and infections. Now, her surgeon suggests removing the pelvic pouch and opting for a permanent ostomy. Dee is seeking advice from others who have faced similar choices.

Here are some pieces of advice and insights shared by others:

1. Research thoroughly and trust your own instinct.
- It's important to gather information from various sources like surgeons, gastroenterologists, and online communities. Let your intuition guide your final decision.

2. Permanent ileostomy or colostomy can restore quality of life.
- Many who chose a permanent stoma report a return to normal activities, including work, travel, and sports, without pain. Counseling or therapy can help with acceptance, and feelings of failure often diminish as health improves.

3. Internal pouches have significant failure rates.
- Some people have experienced chronic diarrhea, pain, and pouch leaks. Success rates can be lower than expected, as seen in some studies and personal experiences.

4. Consider a J-Pouch performed by an experienced colorectal surgeon.
- A J-Pouch might be better tolerated than older pelvic pouches. If your current surgeon doesn't offer it, consider finding one who does.

5. Give yourself time; don’t be rushed.
- Make sure to understand every option, risk, and timeline with your medical team. Being fully informed can help with acceptance if a permanent ostomy is chosen.

6. Practical stoma-management tips.
- Finding the right system (wafer, seal ring, pouch) is crucial. Once you find the right appliance, daily life can feel normal.

7. Emotional and physical recovery pointers.
- Keeping a positive attitude and walking early post-surgery can speed up recovery. Remember, there is life after ostomy surgery, and most people won't know you have a pouch unless you tell them.

8. Information resources.
- The Mayo Clinic's ulcerative colitis page can be a helpful resource: http://www.mayoclinic.com/health/ulcerative-colitis/DS00598

These insights aim to provide support and guidance for anyone facing similar decisions.