I had my perm ileostomy in Aug '09, still learning what products and changing schedule works best, still feel like a novice. Luckily my anus and rectum were removed too so I don't have any of those issues to deal with. (mooping!) LOL at the word.
1. I still use Immodium and Lomotil, but *much* less than before the surgery.
2. I do get tired at times, but *nothing* like before the surgery. Before my surgery I was so ill and worn out from constant diarrhea that my teenage children and my sisters were doing my grocery shopping, laundry, house cleaning, yard work. I was able to drag myself to work 2 nights a week and spent much of my shift in the restroom. Since my surgery I have my life back!! I do all my own chores!! I work 4 nights a week and often stop in the fitness center at work before I leave! I take walks! I visit my kids at college!! My house is in the middle of woods and it's always been a chore to keep leaves off the grass this time of year. The last 2 years I was useless. This year, I am keeping my yard green! YAY!!
3. The most difficult thing...hmm..Probably my awareness of it almost all the time. Sometimes I feel so preoccupied by my stoma: Is it going to leak? Worried that I will lay on my belly in my sleep and cause a blow out. How long will this wafer last? What is that itchiness? is it a problem? What will I see when I remove the wafer for the change, some new problem? (I've had a couple of skin issues) I am a nurse so I see other stomas, and I compare how mine looks to theirs (their stomas look more healed than mine). I have a couple of great wound care nurses where I work and I often go pick their brains for ideas or suggestions.
I would like to put body image as a problem for me too. I wear baggy tops, maternity tops, flared skirts. I am far from a fashion plate, but I am comfortable. I just turned 50, got divorced 5 years ago, would like to try dating, but can't imagine any man ever wanting any thing to do with me again. I am so aware of this bag, it's hard to believe that others don't see me as just a big ostomy bag walking around. LOL
When I was first home from the hospital I was on the phone with a good friend, he heard the very busy stoma making noise and he said, "Oh you are percolating! You sound like a coffee maker!" We both had a good laugh, it was the precise desciption. I try hard to deal with things with humor. I attend meetings with an awesome ostomy support group. That helps a lot too.
Good luck with your surgery if you have it.