No damage/tear upgrades is agonizing. Only worse thing, outside of The Lost, is when you play as Maggie and get no speed upgrades. I'll quit a run over that. Thankfully I never have to play her again...until Afterbirth anyway...
Yeah Maggie's speed is terrible. Speed is really underrated in the game outside of damage.
Thankfully (or not thankfully) I only do Eden runs.
Just had a reroll of a run with rubber cement, ipecac, mom's contact (tears always shoot from behind), and shielded tears. Barely survived.