This ended up being a practice run for my main completion of Mania + mode. I ended up using the lowest assist item which gives you 1 life to start with, instead of 0. I gave in but unsatisfied I went back and re-beat this stage without any assists. That unassisted version will be the gameplay shown in the full game tutorial for this mode. I wanted to complete this mode without any assists. When I completed regular Mania mode I abused the assists and it felt cheap, a while back. This level gets super dense and rediculous at times. Its hard to even plan movement or grab healing items at times. This was the only stage on Mania + that gave me any real issues with Shiva.