Thanks to everyone who has given suggestions for how to fix this. Unfortunately most of them require me standing up for longer than I can manage, so I've mainly just fiddled with settings (since I can do that from my bed).
but when I can, I'll be:
* calibrating the extruder
* trying to clear clogs in the hot-end
* calibrating the z-axis offset (which is a multistep nightmare in this setup)
and keep in mind that's me saying it as someone who has made it their livelong profession and hobby of touching computers as much as they can. I love a bunch of little places to change things. I love being able to fiddle with settings.
3d printing has too many settings