Do get to Memorial Sloan for a 2nd opinion.
I'm kind of surprised that you hadn't heard about cystectomy already since you were first diagnosed 20 months ago, but it is what it is.
Now that you've seen the info from Cleveland Clinic about diversions you have a sense for the mechanics of the options.
People on this site have had cystectomies and we're doing just fine. There are folks here who have had each of the different options so we can answer questions.
I have a neobladder and have had it since October 2008. You don't always get a choice on the diversion because it depends on what they find when they are in there but you still want to give the surgeon your preference on which you would rather have.
It's pretty scary when you first hear about it, but it is not nearly as scary once you recover from surgery. WAY better than dead! I'm actually better off without mine because I had prostate issues that I no longer have.
You may or may not need a cystectomy. Get to MSK for that 2nd opinion to find out. If they think you do, ask them questions. Some people may not be ready to even hear about it right away so they may not have said anything because when they mentioned cystectomy you may have looked like a deer in the headlights. In any case, make a list of questions you want answered and write down the answers when you discuss it with them.
Also, ask questions here. We are happy to help you.
Mike
PS: Nothing I can't do now that I could do before getting my bladder out. Golf, skiing, scuba diving, etc. I get to do more without breaks to pee because I don't have to go so often.
