Yeah I included a couple macros to make sure my e4ae or virus and such fire normally. I still feel limited though. In WoW it was easy thanks to Healbot. shift/ctrl/alt was accompanied by a click, not another button

very interesting the mouse, but a bit pricey.
The mouse is an investment. It won't make you a better gamer in general but it certainly doesn't hurt and gives you some options.

I never really used Healbot before (didnt' heal much in WoW), but I can guess at some functionality. Are you aware of mouseover macros and what they do? You can hover the cursor over a party-member name or player name in the field and press the macro, casting whatever spell you set it to cast on whoever the mouse is hovering over - no clicking necessary. Is that something you're looking for?