Yes, you can go without a shirt on. I swim, surf, snow ski, and live life like a “normal” person. I empty my bag about 6 times a day, and I change my entire appliance every three to four days. Some people go longer. The entire change takes about 10 minutes. I usually get up once or twice a night to empty my bag. I have no discomfort whatsoever. I’d recommend doing some research on YouTube about living with an ileostomy. One other suggestion: if you have an ostomy support group in your area I’d recommend attending to get other people’s experiences. Please let me know if you have any other questions.