DougK
I don’t want to sound callous, but I want to approach this as a decision making problem as we do in my profession, to hopefully give you an objective perspective.
You have two options with two different outcomes, under some simplifying assumptions, therefore 4 different scenarios. Each scenario has different costs (sorry for the terminology, but that is what we use) and rewards associated with it.
1) You try the j-pouch, and the results are satisfactory. Then your reward is a life without an ostomy. It is a big reward! The reversal surgery at this point is a very minor procedure, so cost associated with is is very small.
2) You try the j-pouch, and the results are not satisfactory. Your cost will be the suffering and the emotional turmoil of the process, the length of which depends on how long it would take you to accept that it is failing, or how bad it gets and how fast. The takedown surgery is also a cost, although small. One reward is that you will know that you at least tried, and will not wonder forever what would have happened if you had tried. One more cost is that you might have to remove the pouch one day, however this is a possible outcome of all but the first scenario. The end ileostomy surgery is also a cost, again in all but the first scenario.
3) You get an end ileostomy, and the results are satisfactory. One cost is always wondering what would have happened if you tried the pouch. Having the surgery to create the end ileostomy is another cost. Finally, you might need to remove the pouch one day. The reward is that you might have avoided a possible difficult experience with the pouch. That bag is an inconvenience and also a convenience at the same time, because we assume the results are satisfactory in this scenario. So, I think the reward and the cost of living with the bag cancel each other out.
4) You get the end ileostomy, and the results are not satisfactory. I don’t want to discuss this scenario.
To make a decision, we sum the total rewards and costs of all scenarios for each option (pouch vs ileostomy), and compare them. The total sum of rewards on the two j-pouch scenarios (satisfactory and unsatisfactory) are much higher than the sum of rewards in the end ilesotomy scenarios. The costs are, in my opinion, comparable. The methods suggests: take the j-pouch path.
Of course, this an ultra simplified view of the outcomes. If trying the pouch will cause you to lose your job, or lose your mental health due to the turmoil it will cause, then it is not as good a scenario. I am not trying to cover every possible outcome that could happen. I am trying to show you that your thinking here “But I don’t want to destroy my life to prove the J Pouch will fail.” is not strongly justified.