Just came back after a few years and saw perks changed. Bloody Commando still a thing?

Was just wondering what changed about the build or if it's even viable anymore. I wouldn't mind playing a new build but coming but after so longs a little overwhelming and it would be nice to just slip back in to things. Also, what's changed in the world?

Thanks for any answers, I remember this community being pretty dope back in the day. I'm excited to jump back in with yall on some events.