This game was a lot of fun! I felt like I was able to keep ahead of the enemies for a pretty long time but eventually all the negative side effects caught up with me and I died :(
When the game started, I initially thought the health bar was part of the level, and I couldn’t really tell I was moving until some enemies came on the screen. Maybe having some static obstacles would have helped show me where the background was relative to my player block.
The side effect choices were all tough to make, even though there was some positive I usually felt like the downsides all outweighed the good things. It might have felt more like making forward progress if some of the negative side effects made enemies harder (faster, more of them, etc.) instead of just debuffing the player.