ROCHESTER, Minn. -- Playing video games is a serious business for Randy Fitzgerald.

The Rochester man is a professional gamer, who livestreams for Facebook and plays under the name of Nomad written as “N0m4d.”

Playing video games for a living is not the only thing that sets the 41-year-old Fitzgerald apart.

He was born with a medical condition called arthrogryposis, which left him unable to use his legs or arms. Despite that seemingly overwhelming obstacle, he plays games with a modified controller using his chin, lips and other facial muscles.

After going to school for video game design, Fitzgerald was an intern at Activision. In 1999, he became a well-known figure at the annual E3 electronics and video game expo. He became a member of an E-sports team and competed in public championships.

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That notoriety evolved into being a celebrity when he became the first paraplegic professional video gamer in 2007. Fitzgerald went from big competitions to game streaming.

Born in Iowa, Fitzgerald came to Rochester for medical treatment at Mayo Clinic. After spending a year in his teens recovering from surgeries at Saint Marys Hospital, he decided to live here. In October, he moved into his own house in southwest Rochester with his best friend/caretaker, “Smiley” Gutzman and his teenage niece, Alana Mullen.

Q. How did you get into video gaming?

“I was born in ‘79. So my dad had an Atari. And so I started by playing those games.

“But the earliest memories are … him taking me to the local bowling alley, when I was really young. I remember he would pull a pinball machine up next to the Pac Man machine. He’d put me on my stomach on the pinball machine, so I could reach the Pac Man joystick with my chin.”

“In 1985, the original Nintendo game system came out… I remember looking at the controller and I thought, ‘How am I going to play this?’ Because, you know, we went from just a joystick and one button (on the Atari) to a D (directional) pad, and two buttons. ... It took me about five minutes of staring at the controller. I realized when I turned it sideways… I could put my chin on the D-pad and my top lip on the A and B buttons. And I’ve been playing that way ever since.”

Q. What’s your go-to game for work and what do you play for fun?

“It's different these days. It is a job. I have to play most days versus playing when I want to. I am hardcore gamer, so it’s hard to pick just one game. Pac Man is my most beloved, because I played it with Dad. As far as modern games, I’m best known for “Call of Duty: Rainbow Six.” That’s what most people expect to see me play. The developers even named a setting configuration after me.”

Q. How did that situation with “Call of Duty” come about?

“I had a hard time holding the left trigger and the right trigger at the same time to raise my gun, aim and shoot. I could do it, but it was very hard. And it hurt. On a message board, I wrote about the problem.”

“Soon I was surprised to see 25,000 people signed a petition to make a setting for me. So they made the left trigger a toggle. That way I could tap to lift the gun and tap again to lower it.”

“Since then, almost all of the versions of Call of Duty have included the Nomad setting as an option to configure your controls.”

Q. What is a day of work like for you?

“It starts by making graphics for the upcoming evening. Setting up the recording software. Making sure the camera is set up right.

“You have to be in the right mindset. This is not just playing games. It’s a lot more than that.

"You are teaching people who are watching how to play and what to do. You have to be entertaining, smart, funny and witty … for seven hours, almost every day. When I’m done, I’m just wasted. I don’t talk to anyone. I put headphones on, shut down and watch TV.”

Q. You are an online celebrity, but are you ever recognized on the streets of Rochester as Nomad the gamer?

“Not usually. I was recognized in town a while back, when I went out to eat sushi with my friend, Igor (Vovkovinskiy, the tallest man in the world).

"Of course, both of us kind of stick out like sore thumbs. People saw us and said, ‘Holy crap, you’re Igor. And then they looked at me and said, ‘Aren’t you the guy who plays games with his face?’ I told them that us world record holders have to stick together."

Q. Where did the name Nomad come from?

“I think of a nomad as someone who searches the world for a purpose in life. Along the way, they learn all of these things and wisdom. Then they share that wisdom in every place they go and with every person they encounter.

Q. How do you keep such a positive outlook?

"It's how I was raised. My parents didn't treat me differently. They taught me that I could do what I want, but the world didn't owe me anything.

"But life would be a lot tougher without my best friend, Smiley. He has basically dedicated his life to helping me. I'm a lucky man. I have someone to help me to reach my goals."