Having been through this, I agree that there is no right answer for everyone because our situations are so different (disease stage, attitudes, etc). I believe this decision is often made for us. In my case I was admitted to hospital, severely anemic and weak and was absolutely tied to the toilet. I had been in a worsening flare for a year and had my share of accidents, etc and had gotten to the point of being in severe pain and in a weight loss sprial.
When I was admitted they arranged for a surgical consult "just in case" and I was in total denial - there was no need for surgery..... Well, after a week in hospital it was obvious that I had run out of medical options - IV steroids didn't work, I couldn't tolerate the immunosuppressants and that left only Remicaide, which because of the severity of my UC, the chances of success were slim. At this point, things became much clearer - I wanted to get on with my life. My GI was very forthright about the Jpouch and what life would be like and also the risks of surgery. Three days later I had a total colectomy and I'll never forget laying in bed the next day and realizing that I no longer had to worry about running to the bathroom - it was an amazing feeling. I didn't really have any time to contemplate what life after surgery would be like, so I didn't really have a baseline. But the most difficult part was regaining my strength because I had lost so much weight. Had I gone into it a bit healthier I think the recovery would have been even easier. The ostomy bag for me was actually a life saver. I could now go out and about without worrying about where bathrooms were, I was able to eat things that I had been on my taboo list for so long - it truly was like starting life over - not to sound to over dramatic, but that's really what it felt like. Seven months later I had the jpouch surgery and am still adjusting to that new anatomy. I am five months into my jpouch and life is pretty good. There was definitely an adjustment period - don't let anyone tell you otherwise - there were some days early on that I felt like I was back in my UC life, but that too passes.
Bottom line, it is a very personal decision and one that you have to be comfortable with.
UC Flare: Feb 2006
Pancolitis: Diagnosed Oct 2006
Colectomy Mar 17, 2007, J-pouch surgery fall 07
40mg, (last dose was May 15!!)
Salofalk 500 mg: 10 tabs daily, Salofalk 4 g enema: nightly 1/2 nightly
6MP 75 mg daily (started Jan 19. 2006) stopped due to severe reaction
Fish Oil, Probiotics, Multivitamin