I kind of agree with exhausting all other alternative options. Although surgery was highly recommended for me (I was hospitalized with a severe flare and I am steroid resistant), I always wonder what if. I'm actually doing very well post takedown but it's still overall a pretty traumatic journey. I was just so sick of being sick and felt like UC had robbed me of so much of my life. I hated living in fear of another flare and the hospital stays were so emotionally taxing.
A major factor in my decision was being absolutely terrified of the risk factors for the harder drugs. My best friend is a nurse practitioner at Sloan Kettering. While it is indeed rare, she has cared for several patients with immunosuppressant drug induced cancers. I have small kids, lost my mom to cancer and it was a risk I was just not willing to take. But these are my own fears and TONS of people do well on these drugs. As I see it though, when you are that small percentage, what difference does it really make.
My advice is to take your time making this decision. Yes, meet with the surgeon but also try everything out there that you possibly can so that if you do decide to go the j-pouch route, you are very confident in your decision.