Ever wonder when you can get your first unique in TTWL? Level 11. That's right, you play through quite a bit of the game before you get a usable weapon, making this run significantly different from other runs.
Once I got my first few uniques, the run was practically normal from then on, but the beginning was a gear-less and ability-only struggle. You'd have to be crazy to try this, as just when you thought something was difficult, the next threat is way worse.
Overall, the run was not too horrible, it just highlights the lack of choice in the early game, forcing you to do the story before you can get any unique gear. The reason I didn't do all the Mount Craw missions is because it would have taken way too long to justify the rewards.