(adv.) With extreme anguish or desperate struggles.

abominably awfully baldly balefully bitterly blatantly brashly confoundedly cruelly damnably deadly deathly deplorably deucedly distressfully distressingly dolorously dreadfully egregiously excessively excruciatingly exorbitantly extravagantly flagrantly frightfully grievously harrowingly heartbreakingly hellishly horribly improperly inexcusably infernally inordinately intolerably lamentably miserably nakedly openly painfully pathetically piteously pitiably ruefully sadly shatteringly shockingly something awful something fierce sorely staggeringly terribly torturously unashamedly unbearably unconscionably unduly unpardonably woefully