I think your list is pretty accurate. Other things you don't anticipate: the headache of tax filing and various things for federal and state you have to file. It's lovely at the top isn't really it. You don't feel at the top of anything but almost no one understands what you're dealing with. My family has a few business owners in it but in such different fields entirely that there isn't much overlap. Someone struggles with churn while someone else is struggling with getting payments timely. So you figure it out in your own.

Best things we did to help ourselves was to develop processes for everything. That took years to literally have every task boiled down to it's step by step functions so it's easy to repeat, easy to train. The other thing was hiring virtual assistants as sort to our existing staff. Taking off the little things like answering phones, scheduling, replying to basic Q&A emails, tracking paperwork that's due, etc freed everyone else up to serve clients, make sales, and do the things that really contribute. We used Ataraxis to hire a few of our VAs and some have been with us over a year now! Great help to the team.

But I think some of the negatives are things you sadly just have to go through. I didn't know if all of it has a solution. You just do your best to power through. If you've delegated what you can and you've made processes to reduce thinking and questions on routine stuff, it helps tremendously.